The effects of containment measures in the Italian outbreak of COVID-19.

The COVID-19 pandemic is spreading worldwide. Italy emerged early on as the country with the largest outbreak outside Asia. The outbreak in Northern Italy demonstrates that it is fundamental to contain the virus' spread at a very early stage of diffusion. At later stages, no containment measure, even if strict, can prevent the saturation of the hospitals and of the intensive care units in any country. Here we show that it is possible to predict when the intensive care units will saturate, within a few days from the beginning of the exponential growth of COVID-19 intensive care patients. Using early counts of intensive care patients, we predict the saturation for Lombardy, Italy. We also assess short-term and long-term lockdown effects on intensive care units and number of deaths. Governments should use the Italian outbreak as a precedent and implement appropriate containment measures to prevent the saturation of their intensive care units and protect their population, also, and above all, in anticipation of a possible second exponential spread of infections.

Self-similarity of low-frequency earthquakes.

Low-frequency earthquakes are a particular class of slow earthquakes that provide a unique source of information on the physical processes along a subduction zone during the preparation of large earthquakes. Despite increasing detection of these events in recent years, their source mechanisms are still poorly characterised, and the relation between their magnitude and size remains controversial. Here, we present the source characterisation of more than 10,000 low-frequency earthquakes that occurred during tremor sequences in 2012-2016 along the Nankai subduction zone in western Shikoku, Japan. We show that the scaling of seismic moment versus corner frequency for these events is compatible with an inverse of the cube law, as widely observed for regular earthquakes. Their radiation, however, appears depleted in high-frequency content when compared to regular earthquakes. The displacement spectrum decays beyond the corner frequency with an omega-cube power law. Our result is consistent with shear rupture as the source mechanism for low-frequency earthquakes, and suggests a self-similar rupture process and constant stress drop. When investigating the dependence of the stress drop value on the rupture speed, we found that low-frequency earthquakes might propagate at lower rupture velocity than regular earthquakes, releasing smaller stress drop.

Púrpura de Schõnlein-Henoch, presentación en el adulto / Schõnlein-Henoch purpura, presentation in the adult

Los síndromes plurigandulares autoinmunes se definen por la coexistencia de al menos dos insuficiencias glandulares a consecuencia de una pérdida de la inmunotolerancia. Existen 4 tipos, siendo el tipo 2 el más frecuente. Es condición indispensable la presencia de insuficiencia suprarrenal primaria para hacer el diagnóstico de éste último, pudiendo muchas veces ésta preceder a las otras endocrinopatías que lo conforman: enfermedad tiroidea autoinmune y/o diabetes mellitus tipo 1. La insuficiencia suprarrenal primaria se caracteriza por la producción adrenal deficiente de cortisol, mineralocorticoides y andrógenos. Es una enfermedad poco frecuente que se presenta habitualmente en mujeres en edad media, siendo su etiología más prevalente la adrenalitis autoinmune. Se discute el caso de una paciente de 35 años que consulta por híperpigmentación de piel y episodios presincopales como presentación de una Enfermedad de Addison. La paciente presentó además amenorrea de 8 años de evolución y un bocio grado II lo cual nos llevó a plantear que era portadora de un sindrome plurigandular autoinmune tipo 2.