[A method to estimate one's own blood alcohol concentration when the ministerial tables are not avaible]. / Un metodo per stimare la propria alcolemia quando non si disponga delle tabelle ministeriali.

To reduce the prevalence of driving under the influence, tables allowing to estimate one's own blood alcohol concentration (BAC) by type and quantity of alcoholic drinks intake have been enacted by decree in Italy. Such tables, based on a modified Widmark's formula, are now put up in all public concerns serving alcoholic beverages. Aim of this initiative is to try to get subjects which consume alcoholics and then will drive a vehicle take in account their own estimated BAC and, on this base, put into effect, if needed, suitable actions (to avoid or to limit a further consumption, to wait more time before driving, to leave driving a sober subject). Nevertheless, many occasions exist in which these tables are not available. To allow anybody to rough estimate his own BAC in these cases too, a proper method has been developed. Briefly, the weight (in grams) of consumed alcohol has to be divided by half her own weight, if female drunk on an empty stomach (by the 90% of her own weight, if she drunk on a full stomach); by 70% of his own weight, if male drunk on an empty stomach (by 120% of his own weight, if he drunk in a full stomach). Consistency between BAC values estimated by the proposed method and those shown in the ministerial tables is very narrow: they differ in a few hundredth of grams/liter. Unlike the ministerial tables, the proposed method needs to compute the grams of ingested alcohol. This maybe involves some difficulties that, nevertheless, can be overcome easily. In our opinion, the skillfulness in computing the grams of assumed alcohol is of great significance since it provides the subject with a strong signal not only in road safety terms, but also in health terms. The ministerial tables and the proposed method should be part of teaching to issue the driving licence and to recovery of driving licence taken away points. In broad terms, the school should teach youngs to calculate alcohol quantities assumed by drink to acquaint them with the risks paving the way for a more aware drinking when they will come age.

Road safety and the tsunami of cell phones.

In the last years an extremely rapid massive diffusion of the cell phones is occurred. Currently in Italy, as in many other countries, almost all the youngsters and a lot of adults possess a cell phones. This device is enormously useful, but its use can determine negative effects on the user's attention, i.e. during vehicle driving. Numerous epidemiological studies show that cell phone use in driving determines a relative risk of causing a road accident around 4 (equivalent to driving with 0.8 g/l blood alcohol concentration), for both hands-held and hands-free devices. This risk doesn't seem well perceived from the Italian drivers: as our surveys show, the 2.5% of them use a cellular hands-held while driving. This situation appears to evolve toward more critical conditions, given the quick diffusion of ever more technologically advanced instruments, such as video-cell phones, mostly capable of capturing the attention, or TV-cell phones, with which the distracting occasions could be more frequent and prolonged. The use of the cell phone seems to imply an important risk for pedestrians: the first results of the monitoring results that we are producing on this matter in Rome show that the 5.5% of the pedestrians cross the road while talking with a hands-held cell phones, in the most of cases ignoring the traffic conditions at all. All this facts show the urgency to promote specific actions of prevention, in absence of which it is reasonable to foresee a consistent growth in the number of road traffic accidents. In our opinion it is necessary to capillarily inform the public of the signalled risks, possibly also in the advertising spaces of the producers and managers of the cellular telephony, apart obvious repressive actions on the use of the cell phones during the guide of a vehicle.

Reliability and inter-observer agreement of dermoscopic diagnosis of melanoma and melanocytic naevi. Dermoscopy Panel.

The aim of this study was to analyse the reliability and the inter-observer agreement of dermoscopy in the diagnosis of melanocytic skin lesions. Nine dermatologists, with a different training experience and who routinely used dermoscopy in different hospitals in Italy, evaluated clinical and dermoscopy photographs of 15 melanocytic lesions (four invasive melanomas, four histologically common naevi, and seven naevi with histological atypia). A further series of dermoscopic photographs of 40 melanocytic lesions was evaluated to quantify inter-observer concordance in recognizing dermoscopic criteria. Compared to the true (histological) diagnosis, clinical diagnosis (categories: melanoma, common naevus, atypical naevus) was correct in 40% of cases (range, 27-53%). The percentage raised to 55% (40-73%) by the use of dermoscopy, with an average improvement of 15.6%. Concerning melanoma, clinical diagnosis resulted in a sensitivity of 41.9%, specificity of 77.8%, positive predictive value (PPV) of 36.1%, negative predictive value (NPV) of 81.8%. By using dermoscopy, an improvement of diagnostic performance was found (sensitivity 75%, specificity 88.8%, VPP 71.0%, VPN 90.7%). The inter-observer agreement in melanoma diagnosis, by using dermoscopy, was similar to that obtained by clinical examination (k statistics = 0.54 and 0.52, respectively). Concerning dermoscopic criteria, the best agreement among observers was found for pseudopods, a dermoscopic parameter related to the radial growth phase of melanoma. We conclude that dermoscopy is an useful tool for a non-invasive diagnosis of melanocytic skin lesions, improving the diagnostic performance compared to clinical examination.