Incidence, clinical features and management of acute allergic reactions: the experience of a single, Italian Emergency Department.

OBJECTIVES: Few data on the incidence, aetiology, clinical features and management of patients with acute allergic reactions presenting to the Emergency Department are currently available. The aim of the study was to report the annual experience of a single Italian adult Emergency Department about anaphylaxis. PATIENTS AND METHODS: This is a retrospective, case-based study of adult patients attending the Emergency Department in Alessandria, Italy, during the years 2009-2010. We evaluated the medical records of patients satisfying diagnostic codes involving acute allergic reactions. Incidence, demographic data, causative agents, clinical features, management and outcome were reported. RESULTS: 390 patients with acute allergic reactions were evaluated during the year, corresponding to 0.7% of all Emergency Department visits. Causative agents were recognized in 55.1% of patients and more commonly included drugs (26.9%), insects (14.8%) and foods (8.9%). Cutaneous features were the single most common clinical presentation although two or more clinical features were frequently reported (17.7%). Anaphylaxis was diagnosed in 4.6% of patients. After therapy and a period of monitoring, 92.8% of patients were discharged directly from the Emergency Department, 7.0% were admitted and one patient died, corresponding to a fatality rate of 0.2%. CONCLUSIONS: Acute allergic reactions are common diseases referring to our Emergency Department. In the half of cases a precipitant agent was identified and cutaneous and/or mucosal changes were often the first feature. Most patients were definitely treated and discharged but about 7.0% of patients required hospitalisation. Observation Unit and Intermediate Care Unit were essential for clinical management of these patients.

Determining the probability of locating peaks using computerized peak-location methods in gamma-ray spectra as a function of the relative peak-area uncertainty.

The probabilities of locating peaks with a high relative peak-area uncertainty were determined empirically with nine types of peak-location software used in laboratories engaged in gamma-ray spectrometry measurements. It was found that it is not possible to locate peaks with a probability of 0.95, when they have a relative peak-area uncertainty in excess of 50%. Locating peaks at these relatively high peak-area uncertainties with a probability greater than 0.95 is only possible in the library-driven mode, where the peak positions are supposed a-priori. The deficiencies of the library-driven mode and the possibilities to improve the probabilities of locating peaks are briefly discussed.

Catholic university experience with molecular adsorbent recycling system in patients with severe liver failure.

BACKGROUND AND AIM: Molecular adsorbent recycling system (MARS) treatment is able to remove both hydrosoluble and small- and medium-sized lipophilic toxins. MARS plays an important role in modifying liver failure complications, such as hepatorenal syndrome and hepatic encephalopathy. We sought to evaluate the clinical efficacy and safety of a MARS device in a consecutive series of hepatic failure patients. MATERIALS: Twenty patients with acute liver failure, transplantation failure, or acute on chronic liver failure fulfilled the inclusion criteria of total bilirubin > or =10 mg/dL and at least one of the following: hepatic encephalopathy (HE) > or =II grade, hepatorenal syndrome (HRS) for chronic patients or total bilirubin > or =5 mg/dL and HE > or =I grade for acute patients. RESULTS: MARS was able to reduce cholestatic parameters and improve neurologic status and renal function parameters in all treated patients. We also observed an improvement in the 3-month survival rate compared to the expected outcome in patients with MELD scores between 20 and 29, as well as 30 and 39. CONCLUSIONS: Based on these results, we confirm the safety and clinical efficacy of MARS treatment, with the best results in patients with MELD score of 20 to 29. Further studies are necessary to confirm whether this treatment is able to modify patient outcomes and prognosis.

[Intestinal helminthiasis. III. A program of education and health in helminthiasis]. / Helmintoses intestinais. III--Programa de educação e saúde em verminose.

From August 1985 to June 1986 an Education Program for school-children and their parents or guardians was undertaken in Santa Eudóxia (S. Paulo, Brazil) with a view to the practice of knowledge concerning intervention with regard to parasitic helminths, with the aim of stimulating collective action. A manual of technical orientation for the coordinators had had been prepared. Three groups composed of school-children's parents or guardians was formed and these discussed four basic themes during the Course of Education and Health in Helminthiasis: 1. What the disease is like; 2. The worms which occur in man; 3. The significance of the disease; 4. Prophylactic measures. Each group prepared a manual about the content of the course. The results of the children's work were presented at the Health Education Fair, an event open to the whole community. The way this Program developed made it clear that the population had become aware of the magnitude of the problem. Furthermore, they feel the need of effective measures regarding the control of helminth infestation.

The consistency of the data for neutron fission averaged cross-sections of threshold reactions: a study on the cross-section of 46Ti(n,p)46Sc, 47Ti(n,p)47Sc, 48Ti(n,p)48Sc and 64Zn(n,p)64Cu reactions.

The consistency of the published values for fission averaged cross-sections of threshold reactions induced in a nuclear reactor is analyzed. The influence of the literature data involved in the determination of these cross-sections is discussed. Renormalizations based on cross-sections value for the standard reactions, isotopic abundances of the precursors and radiation emission probabilities of the radionuclide under study and the monitor, are applied to the evaluation of the cross-sections for the reactions: (46)Ti(n,p)(46)Sc; (47)Ti(n,p)(47)Sc; (48)Ti(n,p)(48)Sc; and (64)Zn(n,p)(64)Cu.