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In this paper is described the story of acupuncture in China and in Europe. Besides storical points of view, are discussed the social-political reasons that raised acupuncture to a high level in people Republic of China, and the practical reasons of this therapy. Besides are discussed summarily the indications and scientific bases of this methodology.

The Authors report their experience about the problem concerning sanitary transport programmed and of urgency either in Italy either abroad. They list the problem concerning this type of activity: transport's criteria, choice of the means of transport, medical assistance and technical suitable apparatus. In this paper the Authors refer the casuistry in the years 1978-1979: 111 sanitary transports, half by sanitary aeroplane in patients with high risk pathology, both in Italy and abroad. Authors' conclusions are that never they had a worsening in the clinical conditions of the patient during the transport; on the contrary, an earlier transport always allowed an anticipation of qualified and suitable treatment.

"The questions asked in many population censuses on place-of-residence at one or several fixed past dates allow the number of migrants during a specific period of time to be calculated. However, the questions asked in the censuses are retrospective, so that the migrants who died or emigrated abroad during the period considered are not included. There is no way of estimating the number of migrants who emigrated abroad; on the other hand, a simple method is available to estimate the number of migrants who died. In this paper this method of estimation is applied to data from the Italian censuses of 1971 and 1981." (SUMMARY IN ENG AND FRE), (excerpt)

This paper considers the descriptive capacity of Italian census data on spatial mobility. A systematic comparison is carried out between the Italian census and traditional sources--particularly the population register. The discussion concerns the items collected and published as well as the measurements obtained, their meaning, and their comparability. Many examples are presented, especially on migration flows during the 1976-1981 period, as recorded by the 1981 Italian population census, applied to the whole country as well as the regions, with particular reference to the Veneto region.

"The paper is concerned with the problem of discriminating two ancient populations with respect to the presence of the 'Istituto delle Partecipanze', a sort of collective property of the land, beginning in 1253 in some areas of the Emilia region. A time series analysis on the marriages registered in the last four centuries has been performed and different classes of the ARIMA models have been fitted to the data. The results give evidence to the heterogeneous development that characterizes the two populations in some aspects of the their bio-demographic history." (SUMMARY IN ENG AND FRE), (excerpt)

The surveillance of occupationally related disease is a research topic in many countries. A working group on the information system within the Italian Association for Occupational Health has recently proposed to reorganize the national surveillance system. In Epidemiologia e Prevenzione a series of contributions relevant to this issue will be published. This paper reviews the on-going research in our country and abroad (United States, United Kingdom, Scandinavian Countries and Canada).

"The author examines the history of the wealthy Italian colony of Nicaragua, compared with the other ethnic groups which had migrated there from Europe, and Northern and Southern America. The paper highlights the peculiar aspects of this settlement, the characteristics of the integration and what still remains of the Italian identity. The main sources for this research in Nicaragua come both from local documents and publications and the interviews [of] relatives of Italian immigrants...." (SUMMARY IN ENG AND FRE), (excerpt)

This study estimates the incidence and prevalence of larynx and lung cancers using a mathematical model based on available data on specific mortality and survival. In Italy, larynx and lung cancers account for more than 95% of respiratory cancers. In this paper, estimates of age/sex-specific and age-standardized incidence rates and prevalence are presented for the years 1970 and 1987. Age and birth-cohort effects on incidence are also presented by sex and broad geographical area. The procedure was firstly validated using data from four cancer registries: Varese (Northern Italy), Parma (North-Central Italy), Florence (Central Italy), and Ragusa (Southern Italy). Estimates were then carried out at the national level and for each major geographical area (i.e. North, Center and South). Larynx cancer age-standardized incidence rates increased for men by about 25% from 1970 to 1987. Age-specific rates increased for ages greater than 44 years, but decreased for younger ages. Cohort effects are low for older cohorts; they steeply increase and plateau for the 1900-1905 cohorts, and then peak for the 1930 cohort. The risk for cohorts born after 1930 systematically decreases. We estimated that the 1930 birth cohort has a risk five times higher than the 1890 cohort. For women, the incidence rates increased by about 30% from 1970 to 1987, for all age classes. Cohort effects steadily increase from the 1886 birth cohort to the 1960 cohort. The estimated prevalence between ages 30 and 84 increased from about 24,400 cases in 1970 (23,000 males and 1,400 females) to about 51,400 cases in 1987 (48,600 males and 2,800 females). For men, 42% of the increase can be attributed to an increase in the incidence of the disease; 45% can be attributed to population aging, and only 13% to an increase in the survival probability. Corresponding figures for women are 42%, 48%, and 10%. For lung cancer, we estimated 32,000 incident cases for 1987 (28,000 men and 4,000 women), two times the corresponding figures for 1970 (14,000 men and 2,000 women). Looking at age-adjusted rates, the overall risk of lung cancer increased by about 60% for men and 52% for women during a period of 17 years. Age-specific incidence rates increased proportionally with age for ages greater than 50 years. By contrast, there was a slight but systematic risk reduction in younger age classes.(ABSTRACT TRUNCATED AT 400 WORDS)

The authors briefly reviewed the literature concerning the risk factors for primary pleural tumors in humans. The results from the most relevant studies emphasize the fact that the large majority of mesotheliomas are associated with exposure to asbestos or asbestiform fibers. Exposure to asbestos is mainly through industrial use, and mesotheliomas result from occupational, para-occupational, or environmental exposure. Fibers of crocidolite, amosite, and chrysotile appear to be, in descending order, more carcinogenic for pleural tissues. The authors summarize the available data on consumption of asbestos and asbestos-based products in Italy. The chrysotile-asbestos mine in Balangero (Piedmont) stimulated the industrial production of asbestos-cement; asbestos has been largely sprayed among shipyards and user for insulating railroad coaches and carriages. Italy had the greatest consumption of crocidolite in Europe, which was not banned until 1986. The authors discuss the major findings derived from descriptive epidemiological data presented in previous papers dealing with this issue. In addition, standardized mortality rates of primary pleural tumors for European countries are shown. A clearly increasing trend for mortality is observed in Italy, which has also the provinces with the highest mortality rates in Europe. Among Italian provinces, the mortality rates are consistent with the number of asbestosis cases receiving workman's compensation. The authors present the results of both cohort and case-control analytical studies performed in Italy, and provide suggestions for further research.

"Status of women is generally recognised as a key variable in the analysis of demographic and social behaviour. Women's status is a multidimensional concept that arises from the complex interactions of different factors. In this paper, the links between women's individual characteristics and roles that women played are analysed by the means of a sequence of multivariate techniques. Data are taken from the Italian Multipurpose Survey and the roles of worker, wife and mother are considered." (SUMMARY IN ENG), (excerpt)

"In the paper the hypothesis of differences in household incomes depending on the sex of the householder is investigated. The data come from the 1991 Bank of Italy Survey on Household Income....A multiple regression model has been formulated in order to appreciate the contribution of the householder's sex to the family and per-capita income differentials." (SUMMARY IN ENG), (excerpt)

This paper condenses legal thought elaborated during the late Middle Ages by law doctors regarding rules to be observed during the plague. What they thought about this problem was scattered through wide commentaries on Roman and Canon law. Those hints were gathered by three Italian jurists working at the beginning of the XVI century, at the time of a strong, new epidemic wave (1522-1523). Italy showed again its primacy in the growth of the peculiar Continental common law. In the first part of this work we present the legal rules dealing with prevention, i.e. what lawyers could learn concerning good government of a city from old texts. This is interesting because this teaching gave a model referred to public powers all over Europe. In this way old teachings were transferred to modern governors, who had the opportunity to select the alternatives offered by ancient wisdom and its recent interpretations. The three 'tractatus' we refer to were written at the same time independently of each other. However, we shall see that they have many common conclusions, because they derive from the same cultural environment. The three authors worked in Bologna, Avignon and Pisa, but with the same legal sources which were at that time the same all over Continental Europe. From these works it is possible to understand how wise the different provisions issued by the local government were. In the second and final part of this work regulations during the plague for private business will be illustrated.

"In this paper we examine some biometric aspects of women's fertility cycle and we statistically test a hypothesis concerning the effects of hormone interactions on cycle temporal dynamics. The data base has been provided by the Catholic Marriage Advisory Council Centre...and concerns 31,290 cycles (belonging to 1,781 women), classified according to their length, the length of pre and post ovular phases and woman's age. The distributional model of cycle and phase lengths has been estimated by a kernel procedure and interesting statistical cause-effect relationships have been highlighted showing a sort of hormonal balancing action on the physiological process." (SUMMARY IN ENG), (excerpt)

Several measures were adopted by European countries in the aftermath of the Chernobyl accident. In this paper these measures are reviewed and the European Communities initiatives for food marketing and exports are analyzed, together with the reference levels for radioactive concentration in the main food matrices chosen in different European countries in the very few days after the accident. A particular attention has been devoted to the emergency management in Italy, outlining exhaustively the laws enforced at the time of the accident and explaining how the reference levels for food contamination were chosen. Finally, a tentative balance about emergency management in Italy is struck and some questions are raised about the commitments undertaken or to be undertaken by international institutions.

Prevalence of hepatitis C virus (HCV) varies in the dialytic population according to the geographic area (5-85%); the European average is 19%, with marked differences between dialysis units. The means of virus transmission is still not clear and represents one of the major management problems faced by dialysis units. US authors and European study groups have recently demonstrated a high level od HCV infection in patients with essential mixed cryoglobulinemia (EMC), suggesting that the virus plays an etiological role. The authors examined the correlation between mixed cryoglobulinemia and HCV and the possible etiological role of the virus in the pool of patients undergoing dialysis at the Centre. In September 1994 28/63 (44.4%) patients were found to be Ab anti-HCV positive (second and third generation ELISA); circulating cryoglobulins identified as Type II following immunofixation were found in 2/28 patients (7%) using centrifugation and cold incubation techniques. In the absence of the pathologies classically associated with cryoglobulinemia, the patients were diagnoses as suffering EMC. The HCV/EMC correlation in the dialysed population has been analysed in a limited number of studies, with discrepant results (0-47%). This paper highlights the association between HCV and EMC in 7% of chronic dialysed patients and given that the finding of anti-HCV Ab in serum solely documents previous exposure to the virus, we can only indirectly attribute an etiological role to HCV. The search for viral RNA in the serum, cryocrit and surnatant of patients found affected by EMC may provide additional etiopathogenetic information.

The European Organization for Research and Treatment of Cancer (EORTC) was founded in 1962. The first urological group was French-speaking and concentrated particularly on testicular tumours. Shortly after, an English-speaking group started its activities in Yorkshire, with main emphasis on prostate cancer, and a "bladder cancer group" attracted many urologists from Belgium and other European countries. In 1976 all these groups were fused into a one new urological group of which M. Pavone-Macaluso from Palermo, Italy, secretary of the French-speaking group, was chosen as secretary and then chairman of the unified group, whereas Ph. Smith from Leeds, UK, chairman of the English-speaking group, was elected as chairman and later as secretary of the new group. The two "founding fathers" celebrated the 10th and 20th anniversaries of the foundation of the group respectively in Leeds in 1986 and in Palermo in 1996. Later chairman were L. Denis, Belgium; F. Schröder, The Netherlands; D. Newling, UK; F. Debruyne, The Netherlands and R. Hall, UK. A. van der Meijden, The Netherlands, will take over in 1997. The present secretary is A.V. Bono from Varese, Italy. The present structure of the group consists of a variety of working parties (disease-orientated groups), with special interest in a given pathology (such as prostate cancer, superficial or advanced bladder cancer, etc.) and of other committees (chemotherapy, quality of life, quality control). All the activities are coordinated by a Data Centre in Brussels, that is responsible for the statistical support. In its 20 years of activity the group has made many contributions of significance which have coincided with a number of changes in the urological oncology and have obtained international recognition. The paper analyses in detail the most significant of the group's achievements in the various fields of urological oncology.

Outcome research measures the clinical, economic and humanistic outcomes of pharmacological therapies on patients suffering from different diseases. Outcome research can be applied either to phase II and III clinical trials to assess new drugs for registration or to already marketed drugs to assess their real value when used in clinical practice in a large population of patients. Oncology can be a major field of application because there is a large amount of new treatments put on the market, often without demonstration of significant improvement in survival or Quality of Life but with higher prices than the old molecules. Patients and disease specific outcomes have been identified for cancer by a Working Group set up by the American Society of Clinical Oncology, with the former being defined as more critical to establish the value of new treatments. Survival, drug toxicity and impact on Quality of Life are the most important patient's outcomes to consider before recommending anti-cancer therapies for use in clinical practice. The present paper will describe the outcomes in oncology and will deal with the transferability to clinical practice of the results of clinical trials.

The generally accepted classification of hemorrhoids presents some rather wide gaps which may either be due to expressions of intrinsic limits or recent moves of the Colonproctology field. The authors of this paper would like to present their proposal for a new classification that considers the results of the National Multicentric Study that was performed in collaboration with nineteen centres and a total of 1,494 patients. In addition, a comparative study was conducted on the two forms of classification. Nineteen patients (1.28%) were considered unclassifiable with the new classification system while 49 were (3.29%) with the presently used one. These results were found significant with the MacNemar Chi-Square test. The description of type 2 and 3 in the new classification system was found useful in 69% of 2nd degree, 77% of 3rd degree and 28% of 4th degree using the present system. Acute events (type 5,6 and 7) proposed with the new classification were found in the present system with several different rates. We have also included the data taken from a national and international survey we conducted on the usefulness of the new classification that provoked intense debate within two of the most important national institutes. The result was the elaboration of a design on the new classification.

During the '80s, evidence was collected that air pollutants concentrations close to, or lower than, air quality standards could negatively influence public health at short term, i.e. within a few days. The European Union financed, between 1993 and 1995, the study "Short term effects of Air Pollution on Health: a European Approach using epidemiological time-series data" (APHEA-1 project), involving more than 25 millions inhabitants in 15 cities, investigated between 1977 and 1991. In this paper, the main results, already published in various scientific journals, are reported. The health effects were studied as mortality for natural causes, cardiovascular and respiratory diseases, and as emergency hospital admissions for all respiratory diseases, bronchial asthma, and chronic obstructive pulmonary disease (COPD). The pollutants whose measures were available for the analysis are sulphur dioxide (SO2), nitrogen dioxide (NO2), particulate matter (PM) measured either as black smoke or total suspended particulate, and ozone (O3). The analysis was carried out by each participating group following a detailed protocol, defined during various workshops, through the construction of Poisson regression models, adjusted for autocorrelation and overdispersion, accounting for variables influencing the daily count of deaths, such as long time trends, season, temperature, day of the week. This paper reports the results of the meta-analysis, performed using the values of each city, as relative risk of dying or being admitted to hospital associated with increases of 50 micrograms/m3 in the 24 hours average concentrations of each pollutant. The daily number of natural deaths was associated with increases in the levels of PM, SO2, O3, and NO2. Cardiovascular and respiratory deaths were associated with increases of the levels of PM, SO2, and O3; cardiovascular deaths were associated also with increases of NO2 concentrations. Emergency hospital admissions for the whole group of respiratory disorders are less consistently associated with PM, SO2, and NO2, whereas there is evidence of association with O3. COPD admissions are related to the air pollutant levels, especially those of O3. Lastly, NO2 levels may play a role in exhacerbating asthma, and SO2 levels can have an effect on asthma in children. A second study is currently going on, involving over 40 millions residents in 34 cities. The aims of this project are: to evaluate the dose-response relationship, to investigate on synergy among pollutants, on the "harvesting" phenomenon, on the geographical differences inside Europe and with the U.S. through the collaboration with a similar American study now in progress. The existence of an association between daily variations in the levels of urban air pollution and adverse health effects was confirmed in Europe. This association is weak, but it involves the whole resident population, so it is a major cause of concern from the public health point of view.

This paper is an up-to-date review of the scientific evidence on mechanisms of pollutant generation and health effects for a number of urban air pollutants. The review focuses on main sources and health effect of ozone and photochemical smog, benzene, polycyclic aromatic hydrocarbons, and particulate matter. These agents are "priority pollutants", generated by vehicle traffic, and their regulation is currently being examined by the European Council and the European Commission. The aim is to reach, by the year 2010, values lower than 180 micrograms/m3 for ozone as maximum hourly concentration, 2.5 micrograms/m3 for benzene as an annual average, 93 micrograms/m3 for nitrogen dioxide as 98 degrees percentile of hourly concentrations, 50 micrograms/m3 for particulate as a daily average. The goal can be achieved only by means of immediate interventions on emissions.

Legislation for the control of sexually transmitted diseases (STD) in Europe dates back several centuries, with laws specifying criteria for STD notification, diagnosis, and therapy, as well as guaranteeing treatment and medical visits at no cost. However, there still exist gross differences among European countries in terms of the geographical distribution of facilities and resources and in patients' access to services. This paper describes the STD legislation of the past 10 years for 14 European countries and compares this legislation with that in Italy.

Moving from the most recent progresses in some address international acts on bioethics of the research, the Convention of human rights and biomedicine and La declaration universelle sur le génome humain e les droits de l'homme, this paper describes the legislative acts which regard many aspects of theoretical and practical scientific research, both in the Italian national and supra-national fields. This legislation concerns mainly the following topics: rights of the human subjects of research, informed consent, privacy on the personal data, activity on organ transplantation, research in genetics, activity in the field of treatment of human gametes and embrios. The author here quotes these legislative acts referring briefly to national and international laws.

The data related to abuse and seizures of the main classes of controlled drugs in Europe and Italy are presented. The system of keeping up-to-date the tables of controlled drugs in Italy is briefly discussed. In the end, a list of the main new drugs in the clandestine market of synthetic drugs in Italy is presented, by taking into account the street names, doses and pharmacological effects. The paper ends with a brief description of the new trend of purchasing controlled drugs on internet sites.

The present paper focuses on the Italian registries: their actual achievements, future developments and the possible critical states. The present setting is analysed in perspective with the international and European framework of cancer registries. Given the recent development of new cancer registries in Italy, and their participation to traditional and new international publication of their data, there is an increasing delay in publication time, both in Italy and abroad International and national institutions played an important role in helping and supporting registries' development, but delays in publications and some uncertainty in coordinating incidence and survival analyses in a unique framework is posing an unavoidable challenge.

The security of electronic medical information is very important for health care organisations, which have to ensure confidentiality, integrity and availability of the information provided. This paper will briefly outline the legal measures adopted by the European Community, Italy and the United States to regulate the use and disclosure of medical records. It will then go on to highlight how information technology can help to address these issues with special reference to the management of organisation policies. To this end, we will present a modelling example for the security policy of a radiological department.

This paper provides comments on the European Directive 2002/44/CE of 25 June 2002 on the minimum health and safety requirements regarding the exposure of workers to the risks arising from physical agents (vibration) (sixteenth individual Directive according to Article 16(1) of Directive 89/291/EEC). The European Directive on mechanical vibration was published in the Official Journal of the European Communities L 177/13 on 6 July 2002. The Directive includes the definitions of hand-arm vibration and whole-body vibration, establishes the daily exposure limit values and action values for mechanical vibration, and gives provisions related to (i) determination and assessment of risks, (ii) measures aimed at avoiding or reducing exposure, (iii) information, training, consultation and participation of workers, (iv) health surveillance of the exposed workers, and (v) derogations and transitional periods for the implementation of the obligations of employers when the daily exposure limit values are exceeded. The author discusses the strong link which exists between the assessment of risk due to vibration exposure at the workplace and the health surveillance of the exposed workers. The occupational health physician, as a specialist with expertise in human factors and in the early detection of vibration-related adverse health effects, will have an important role in the assessment of risks arising from mechanical vibration in order to implement an effective health surveillance of the exposed workers. The Member States must bring into force the requirements of the Directive no later than 6 July 2005.

According to an Anglo-Saxon pun, "gout is the king of diseases and the disease of Kings". In fact, it is well-known that in past times a quantity of famous persons, including Kings and Popes, were affected with this rheumatic disorder. In this paper biographical anecdotes on several Popes (Pius III, Julius II, Julius III, Clement VIII, Innocent XI, Clement XII and Pius VIII), King George IV and Queen Anne of England, as well as on some members of the Lorraine lineage, all suffering from gout, are sketched out. These historical data are briefly discussed in relation to the celebrated Hippocrates's aphorisms on gout.

This paper presents a computerised system for the monitoring of integrated cervical screening, i.e. the integration of spontaneous Pap smear practice into organised screening. The general characteristics of the system are described, including background and rationale (integrated cervical screening in European countries, impact of integration on monitoring, decentralised organization of screening and levels of monitoring), general methods (definitions, sections, software description, and setting of application), and indicators of participation (distribution by time interval since previous Pap smear, distribution by screening sector--organised screening centres vs public and private clinical settings--, distribution by time interval between the last two Pap smears, and movement of women between the two screening sectors). Also, the paper reports the results of the application of these indicators in the general database of the Pathology Department of Imola Health District in northern Italy.

Over recent years the possibility that adverse effects on health could result from exposure to electromagnetic fields has become one of considerable scientific, political and economic importance. In response to this, there has been intense activity, both at the international and national level, on the evaluation of biological effects literature and assessment of health hazards of human exposure to non-ionizing electromagnetic radiation. The health authorities of an increasing number of countries, including Italy, become involved in the development of recommendations, regulations or technical advice to limit the exposure of the workers and the general public and they are looking to the international organizations, particularly to the International Commission on Non-Ionizing Radiation Protection (ICNIRP), for some guidance in this respect. In this paper an attempt will be made to present a comparative analysis of the existing or recently proposed standards.

Today's approach to the treatment of patients with arterial hypertension is no longer based solely on reducing high pressure values but forms part of a broader context designed to reduce the overall cardiovascular risk. The very decision of whether to begin anti-hypertensive treatment or not depends both on the degree of hypertension and on the presence or otherwis of other risk factors, organ damage or associated pathological conditions. The present paper summarises recent indications provided by the guidelines issued in 2003 by the European Society of Hypertension and the European Society of Cardiology. The criteria for planning anti-hypertensive treatment in patients with a different level of cardiovascular risk are the subject of particularly concentrated discussion and the approach to the hypertens patient in special clinical conditions such as ageing, diabetes mellitus, the presence of renal, cerebrovascular or coronary pathology and pregnancy will be treated separately.

The diffusion of acupuncture in Europe begun in the 50ies, following 2 main trends: traditional (or energetic) acupuncture and reflexotherapeutic acupuncture. In 1973, in Turin, Italy, the Italian Society of Reflexotherapy, Acupuncture and Auricolotherapy (SIRAA) was founded. This Society over the years tried to integrate the 2 different trends, whose main characteristics are analysed in this paper. The first aim of SIRAA, since its foundation, has been to study acupuncture and auricolotherapy by means of research and by scientific trials, in order to promote the understanding of its mechanisms of action and to clearly show all its therapeutic applications. The development of acupuncture in Italy, the activities of SIRAA from the origins up to now and the future aims of this Association are described. Among the aims, particularly important is to propose scientific research models compatible with evidence based medicine, but also able to warrant the adequacy of the acupunctural method. In conclusion, it is pointed out the necessity to address the future research on acupuncture not only towards the study of the mechanisms of action and the evaluation of therapeutic results, but also towards some new branches now considered with increasing attention, such as preventive medicine, rehabilitation and palliative cares.

This paper is an attempt to individuate some principles and guidelines apt to regulate the relationship between orthodontists and financing third parties, applicable to most western European Countries. The concepts of orthodontic treatment need, orthodontic treatment request and orthodontic screening are discussed, alongside with a short overview of some of the most common indexes to assess the severity of the malocclusion and/or the treatment priority. The screening method introduced by the Danish Ministry of Health is presented; its importance lies in the fact that for the first time a direct correlation between health risk and individual malocclusions is recognized and assessed. In the discussion, it is stressed how the screening system tightly depends on the chosen general model for orthodontic care. Different models of orthodontic care organization as presently used in many European countries are presented and shortly discussed; among these, the Norwegian model is described more in details, because of its simplicity. Eventually, some guidelines considered necessary in order to achieve satisfactory standards of quality and efficiency are presented and discussed.

An accurate Leishmania classification was defined since 1980s by the use of isoenzyme analysis. To date, this procedure still represents the reference identification technique, despite the increasing use of molecular approaches. Studies and surveillance methods on leishmaniases are strongly conditioned by the knowledge and mapping of all the parameters characterizing each nosogeographical entity. On this respect, the identification of parasites from all the actors of the natural life cycle plays a key role. With the increasing population movements and climate changes, novel risk factors could be identified associated to Leishmania geographical distribution and spreading: a) the introduction into Italy of new populations of L. infantum from other countries; b) the introduction of new Leishmania species that may find a suitable milieau to support their life cycle in our country. The objective of this report is to present the surveillance activity on imported leishmaniases by the Leishmania Identification Reference Centre, ISS. Two different methodologies were routinely applied: a) isoenzyme electrophoretic analysis, which requires parasite culture, and b) a number of molecular techniques, used for both diagnosis and parasite identification, differently applied according to the geographical origin of the suspected leishmaniasis case. When possible, both types of methodologies were applied. From 1986 to June 2002, 38 imported cases of leishmaniases were identified: 9 visceral (VL) and 29 cutaneous (CL) cases, of which 22 from the Old and 7 from the New World. Pathology, Leishmania species/zymodeme and geographical origin features are reported in the paper. Seven out of 9 VL patients were HIV positive, of whom 5 detected in the period 1993-1995. This high importation rate can be associated to the general increase in Mediterranean Leishmania/HIV coinfections in that period. Following HAART treatment, VL imported cases became occasional; no introduction of new L. infantum populations has been detected. On the other hand, our findings show an increase of CL imported cases from different areas of the Old and New Worlds. This phenomenon, however, is so far limited to new Leishmania species that could hardly be introduced in our country, because of their strict biological requirements (i.e. vectors and/or natural reservoir hosts). Since June 2002, 10 further suspected imported cases were recorded. For these patients--whose Leishmania identification is still in course--the origin/visited geographical areas were only slight different from the previous. However, the characteristics of the patients are changing: there are more immigrants that occasionally visited their place of origin, and Italian military staff.

Aim: The aim of this paper was to evaluate how many patients with syncope should be hospitalized according to the 2001 European Society of Cardiology (ESC) Guidelines on the management of syncope., Methods: Starting from August 2002 we prompted a Syncope Unit (SU), as a multi-disciplinary functional structure including the Emergency Department. One of the main objectives of the SU was the implementation of the 2001 ESC Guidelines on Syncope and of the relevant criteria for hospitalization. All the clinical data concerning the patients presenting with syncope were prospectively collected and stored in a dedicated database., Results: Between September 1, 2002 and April 30, 2003, 402 patients were observed for a syncope. Out of these, 19 had a cardiogenic syncope, 3 focal neurologic disorders, 25 a severe trauma, 4 severe orthostatic hypotension and 5 carotid syncope. Therefore, 56 patients out of 402 were found to have indication to therapeutical hospitalization. Among the remaining 346 patients, 83 patients were found to have a structural heart disease and/or an abnormal ECG, 1 had syncope during exercise, 3 presented a familial history of sudden death. Thirty-three were found to have severe comorbidities and further 14 had occasional indication to hospitalization. Thus, 190 out of the 402 patients with syncope (47.3%) presented at least 1 criterion for hospitalization according to the ESC Guidelines., Conclusion: The implementation of the ESC Guidelines on Syncope is technically feasible. Nevertheless, even when the Guidelines are strictly observed, a high percentage of patients with syncope has still to be hospitalized. Our data suggest that new criteria should be established for a safe Emergency Department discharge of the patients with syncope, particularly of those with structural heart disease or abnormal ECG.

Target of this paper is to draw the relationship between environmental factors and some impacts due to human activity, in order to outline environmental quality restoring strategies for water bodies, which include among result indicators also biological parameters expected for Italian regulation and European directives. Morphologic equilibrium and correct knowledge of processes regulating fluvial dynamic, as basic factor of ecosystem functionality condition, are highlighted. Statistic evaluation processes of water quality data and implementation and validation of mathematical models are described.

When Europe-wide protest arose against agbiotech in the late 1990s, opponents linked its risks with "globalisation", which symbolised the neoliberal policy framework. "Sustainable agriculture" was invoked in divergent ways by proponents and critics of agbiotech. By the late 1990s a legitimacy crisis led to a regulatory impasse. Some analyses diagnosed deficits in regulatory procedures and stakeholder relations, thus needing a remedy in "risk governance". Eventually policymakers defined a common problem: how to restore public and market confidence. Regulatory changes began to accommodate criticisms from mainstream consumer groups and environmental conservation agencies. By contrast, environmentalist groups still sought to undermine public confidence in safety claims. In mediating the conflicts, various governance roles operate as sources of further tension. Risk regulation will continue to bear the burden of legitimacy problems unless R&D agendas are opened up for debate and change. [ABSTRACT FROM AUTHOR]

In this paper the author analyses the presence of Islam in the European public space, and the debates it produces among the populations of Europe. The case of hijab constitutes a significant example of these discussions, and is analyzed extensively. Some conclusions will refer on the process of establishing of forms of reactive identities, and on the role of conflict on symbolic and religious issues in the process of change of European societies. [ABSTRACT FROM AUTHOR]

Several clinical trials show that cardiac resynchronization therapy (CRT) in patients with moderate-severe heart failure increases survival, improves quality of life and reduces hospital admissions. The high cost of this new technology, incurred by health organizations at the moment of the implant, requires to assess whether its use is economically rational for the Italian Health Service. The paper summarizes evidences of the impact of CRT on the use of hospital resources and on quality of life, and presents a model to calculate incremental costs per quality adjusted life years (QALYs) gained in patients with moderate-severe heart failure treated with optimal medical therapy. The model is based on efficacy data drawn from clinical trials and on other information concerning the Italian context collected and validated by a team of experts from Assobiomedica and the Italian Federation of Cardiology. The model estimates that the incremental cost per QALY gained attributable to CRT is Euro 63,225 if all effects (years of life gained, increased quality of life and reduction of hospital costs) are censored at the end of the first year after the implant and Euro 21,720 if all effects are censored at the end of the third year. Cost-effectiveness of CRT is thus strongly dependent upon the duration of its effects: longer benefits of the therapy compensate initial costs and thus make the technology more cost-effective. In order to get better estimates of the economic profile of CRT it is required to collect more precise data from routine practice on survival, quality of life and hospital resources. The model presented can be easily adapted to take into account new evidence and to calculate cost per QALY gained in regional and local contexts.

The paper underlines above all how the analysis and interpretation of school-to-work transition and, more generally, of the relationship between young people and labour, need a complex theoretical and methodological framework, involving structural, institutional and individual variables. Secondly, it focuses on the not satisfying condition of young Italians for what regards their participation to the labour market: they often find work opportunities characterized by precarity and/or low professional skills. Thirdly, it suggests how young generations show some innovative behaviours and moods aimed to find good and new opportunities inside ongoing transformations. [ABSTRACT FROM AUTHOR]

Created in 1996, the Foederatio Europea Orthodontica or European Federation of Orthodontics represents, today, 15 associations counting almost ten thousands European colleagues. Committed to establish and develop good relationships between the national scientific orthodontic societies of the European Continent and to pursue a common goal to communicate and share an up-to-date orthodontic information, it has undertaken, with a minimal budget (one Euro/orthodontist as annual fee), several actions including a valuable and user friendly internet site (www.Feoonline.com) - an annual award for the best scientific paper published in Europe - a list of excellent speakers ready to communicate, an objective support for the national association which is selected for hosting the general assembly and a newsletter on the web that will be soon published in national journals of the FEO members. Thanks to devoted professionals that have actively contribute in the founding and the management of the federation, FEO is now grown up and ready to plan and finalize, with the specially created think tank, new common actions and some exciting steps for the future. It is time for those that have been reluctant in the past, to join the group and be part of its further development.

There has been a proliferation of Orthodontic Boards across the world but there is no uniformity in standards, purposes or in the type of examination. In order to promote discussion at the International Orthodontic Congress in Paris in September 2005 a questionnaire was sent out to 80 Orthodontic Societies on the World Federation of Orthodontists list. There was a limited response to the questionnaire but the results are described in this paper. It illustrated that there were mainly two types of Board, mandatory ones that acted to license the Orthodontist in that country on the Specialist register and voluntary ones where the orthodontist demonstrates his excellence. The paper describes the answers to the various questions asked on the purpose, eligibility and type of examination of the Boards. They were also asked about the feasibility of an International Board. This was rejected as an option but an affiliation of Boards was recommended.