Search

On October 29, 2019, the Vaia storm hits the North-Eastern regions of Italy by wind gusts exceeding 200 km h-1. The forests in these regions have been seriously damaged. This contribution illustrates the methodology adopted in the emergency phase to estimate forest damages caused by Vaia storm, both in terms of damaged forest areas and growing stock volume of fallen trees. 494 Municipalities registered forest damages caused by Vaia, destroyed or intensely damaged forest stands amounted to about 42.500 ha, spread in Trentino Alto Adige, Veneto, Friuli Venezia Giulia, Lombardy and, only marginally, Piedmont and Valle d’Aosta. The growing stock volume of fallen trees was about 8.5 millions m3.

Objectives To evaluate the influence of the SARS-CoV-2 pandemic on the adherence of patients with inflammatory rheumatic diseases (IRD) to their immunomodulatory medication during the three-month lockdown in Germany. Methods From 16th March until 15th June 2020, IRD patients from private practices and rheumatology departments were asked to answer a questionnaire addressing their behaviour with respect to their immunomodulating therapy. Eight private practices and nine rheumatology departments that included rheumatology primary care centres and university hospitals participated. A total of 4252 questionnaires were collected and evaluated. Results The majority of patients (54%) were diagnosed with RA, followed by psoriatic arthritis (14%), ankylosing spondylitis (10%), connective tissue diseases (12%) and vasculitides (6%). Most of the patients (84%) reported to continue their immunomodulatory therapy. Termination of therapy was reported by only 3% of the patients. The results were independent from the type of IRD, the respective immunomodulatory therapy and by whom the patients were treated (private practices vs rheumatology departments). Younger patients (<60 years) reported just as often as older patients to discontinue their therapy. Conclusion The data show that most of the patients continued their therapy in spite of the pandemic. A significant change in behaviour with regard to their immunomodulatory therapy was not observed during the three months of observation. The results support the idea that the immediate release of recommendations of the German Society of Rheumatology were well received, supporting the well-established physician–patient relationship in times of a crisis. [ABSTRACT FROM AUTHOR]

On October 29, 2018, the Vaia storm hits the North-Eastern regions of Italy by wind gusts exceeding 200 km h-1. The forests in these regions have been seriously damaged. This contribution illustrates the methodology adopted in the emergency phase to estimate forest damages caused by Vaia storm, both in terms of damaged forest areas and growing stock volume of fallen trees. 494 Municipalities registered forest damages caused by Vaia, destroyed or intensely damaged forest stands amounted to about 42,500 ha, spread in Trentino Alto Adige, Veneto, Friuli Venezia Giulia, Lombardy and, only marginally, Piedmont and Valle d'Aosta. The growing stock volume of fallen trees was about 8.5 millions m³. [ABSTRACT FROM AUTHOR]

Hypernatremia is a common electrolyte disorder in daily clinical practice. In many cases hypernatremia is caused by a lack of free water or an increased salt load. Out-of-hospital acquired hypernatremia is often caused by an increased loss of water or a decreased water intake. By contrast, hospital-acquired, nosocomial hypernatremia is often induced by an inadequate fluid balance with saline infusions, saline overload, or due to osmotic diuresis. The consequences are structural changes in the cell morphology such as cell shrinkage. Chronic hypernatremia affects all cell functions predominantly with cerebral symptoms and coma; the main complication is a too-rapid compensation of an adapted electrolyte imbalance with development of cerebral edema. The overall osmolality should always be considered. Overall changes in osmolality correspond to the effect on the cellular stress situation and have to be taken into account and balanced slowly. In cases of unknown duration, a chronic disorder should be assumed.

Purpose: Anthracosis often results in mediastinal nodal enlargement. The aim of this comparative study was to evaluate if it is possible to differentiate endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) proven anthracotic lymph nodes from malignant lymph node enlargement by means of multislice computed tomography (MSCT)., Methods: We compared the MSCT findings of 89 enlarged lymph nodes due to anthracosis with 54 malignant lymph nodes (non-small cell lung cancer 75.9%, small cell lung cancer 18.5%, and non-Hodgkin lymphoma 5.6%). The lymph nodes were assessed for density (calcification, fat, and necrosis), shape (oval, round), contrast enhancement, and contour (sharp, ill-defined)., Results: Malignant lymph nodes showed significantly greater axis diameters (P < 0.001). Both anthracotic and malignant nodes were most often oval (86.5% of all malignant nodes vs. 81.5% of all anthracotic nodes, P = 0.420) and showed confluence in a remarkable percentage (28.1% vs. 42.6%, P = 0.075). Anthracotic nodes showed calcifications more often (18% vs. 0%, P < 0.001). Malignant lymph nodes showed a significantly greater short and long axis diameter (P < 0.001), and they had a higher frequency of ill-defined contours (27.8% vs. 2.2%, P < 0.001) and contrast enhancement (27.8% vs. 5.6%, P < 0.001). Nodal necrosis, which appeared in one third of the malignant nodes, was not observed in anthracosis (35.2% vs. 0%, P < 0.001). Confluence of enlarged lymph nodes was seen in malignant lymph nodes (42.6%), as well as in lymph node enlargement due to anthracosis (28.1%, P = 0.075)., Conclusion: Our results show that there are significant differences in MSCT findings of malignant enlarged lymph nodes and benign lymph node enlargement due to anthracosis.