[Mortality in Muggia in the upper Adriatic, from 1886 to 1918.].

Muggia is a town situated between Trieste and Koper in the upper Adriatic. It belonged to the Venetian Republic of San Marco and then, after the Napoleonic Wars, it came under the rule of the Austro-Hungarian Empire. Originally a small fishing village, it experienced industrial and demographic growth with the development of its shipyards, and in this it followed, albeit on a smaller scale, the fate of the nearby city of Trieste. Imperial regulations mandated that parish priests were to serve as civil registrars and that all death records (liber mortuorum) were to report the cause of each death, as communicated by the physician. This article examines the causes of death in the town of Muggia over a fairly homogenous period of time, up to the end of World War I. The main causes of death during this time include infectious diseases, both acute (see the town's contribution to the last cholera epidemic in 1886) and chronic (bronchopulmonary diseases and tuberculosis appear as a constant cause of death over the years). There was the usual high rate of child mortality, as well as workplace accidents or at any rate violent deaths, and a broad range of poorly delineated chronic conditions of diverse origin (neoplastic, malnutritional), which accounted for all those deaths whose definition was no longer of medical concern.

Drug-induced acute cholestatic liver damage in a patient with mutation of UGT1A1.

BACKGROUND: A 54-year-old woman presented with a 3-week history of fatigue and with jaundice that began 2 days before admission. She had been undergoing treatment with flavoxate for urinary incontinence (for 2 months before admission) and with tibolone for climacteric syndrome (for 6 months before admission). Laboratory tests revealed elevated concentrations of aminotransferases, bilirubin, gamma-glutamyltransferase and alkaline phosphatase. Liver biopsy revealed histological evidence of subacute, drug-induced liver damage. INVESTIGATIONS: Physical examination, liver function tests, serology tests, autoantibody tests, genetic analysis of the TATA box of the UGT1A1 gene, ultrasonography and CT scan; MRI cholangiography; liver biopsy. DIAGNOSIS: Drug-related hepatitis in a patient with Gilbert's syndrome. MANAGEMENT: Flavoxate and tibolone were discontinued. Liver function test results improved progressively and normalized after almost 2 months.