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Background It is still unknown whether COVID-19 vaccines induce a prothrombotic state or increase the hypercoagulable condition in subjects with a predisposition to thrombosis. Objectives We evaluated the coagulation profile in a series of healthy subjects who received the first dose of the BNT162b2 or the ChAdOx1 vaccines and assessed whether hypercoagulability developed. Patients/methods Volunteers among the staff of the University of Padua or health care professionals in the Padua University Hospital who had received either the ChAdOx1 or BNT162b2 vaccine in the previous 10 ± 2 days were eligible. A cohort of unvaccinated volunteers among family members of the University staff acted as control group. Global coagulation monitoring was assessed by whole blood rotational thromboelastometry, whole blood impedance aggregometry and thrombin generation. Platelet count was also obtained. Results One hundred and ninety subjects were enrolled: 101 (53.2%) received the ChAdOx1 vaccine and 89 (46.8%) the BNT162b2 vaccine. Twenty-eight non-vaccinated subjects acted as controls. Thromboelastometry parameters were all comparable among groups. Thrombin receptor activating peptide (TRAP)-, ADP- and ASPI-induced platelet aggregation were similar among groups, as well as platelet count. Endogenous thrombin potential (ETP) was comparable among groups. The results were confirmed after controlling for age, gender and hormonal. Considering women taking combined oral contraceptives or thrombophilia carriers, no differences were detected in thromboelastometry or thrombin generation parameters between subjects who received ChAdOx1 vs. BNT162b2 vaccines. Conclusions No significant activation of fibrinogen-driven coagulation, plasma thrombin generation or clinically meaningful platelet aggregation after ChAdOx1 or BNT162b2 vaccination was observed.

This article explores blending equipment and reveals advantages and disadvantages of blenders for production of dry building mixes. This analysis results in highlighting a pneumatic blender as one of the most challenging and poorly explored blenders to blend dry mixes. Such blenders fully comply with ecological and production regulations, do not deal any harm to employee’s health, and its technical characteristics are in no way worse than those of mechanical blenders. After examining challenging directions of their improvement we offer a new design of such a pneumatic blender, which aims to enhance the quality of final product through increasing product uniformity by intensifying the blending process. Its main concept is based on blending dry building mixes in air turbulence flow. Additionally, this article deals with the method of calculation design and technological parameters of such a pneumatic blender. A graphical comparison of experimental and theoretical dependences of the coefficient of inhomogeneity on time is presented. Main parameters, that define blender’s geometric and utility features, are pressure, gas consumption, material lifting range. The results of this article can be used in the design of pneumatic mixers for mixing dry building mixtures, as well as in the educational process of bachelors and masters.

The production of building materials is a complex technological process involving the processing of raw materials with various physical and mechanical properties, as well as using a variety of degrees of complexity of technological equipment and auxiliary mechanisms. High-pressure pneumatic transport has found application in construction, refractory, chemical and other industries. It is widely used for transportation of fine-grained bulk materials such as cement, alumina, soda, apatite, ash, clay, synthetic products, mineral fertilizers. The process of pneumatic transportation occurs due to the action of compressed air on the material being moved. However, at the same time, as a rule, there are through channels in the material layer, which leads to an increased consumption of compressed air, part of the unloaded material remains at the bottom of the pump chamber, which reduces productivity. Due to the fact that some fluidizing devices can form through channels in the material layer and given the large volumes of material being transported, it is necessary to solve issues to improve the efficiency of pneumatic chamber pumps and reduce the consumption of compressed air required for transporting bulk materials. This can be achieved by organizing effective fluidization of the material, that is, uniform mixing of the transported material with air.

The paper reviewed the application of the discrete element method for researching the motion of the ball load in vibration mills with circular vibrations of the grinding chamber at different amplitude-frequency characteristics. Vibration mills are actively used in various industries, in particular for road construction in the production of bitumen or mineral components. The paper presents the model of the vibration mill used in numerical calculation, the main indicators of the load’s kinematics providing the efficiency of the vibration mill, presents and analyzes the results of numerical experiments, determines the rational mode of operation of the machine.

Portal vein thrombosis (PVT) is a common complication in cirrhosis, and when complete, it increases morbidity and mortality in liver transplant candidates. The aim of the study was to assess the hemostatic status, as well as clinical characteristics of thrombus and patients, as predictors of therapeutic efficacy of anticoagulation for the treatment of PVT in cirrhotics.Patients with cirrhosis consecutively treated for PVT with enoxaparin were enrolled. All patients underwent evaluation of coagulation status and thrombophilia screening. Thrombus characteristics and extension were evaluated at baseline and during follow-up. Anticoagulation was continued until recanalization or up to 12 months. Variables correlated with the response to anticoagulation were used to create a predictive score that was validated in an external multicenter cohort.A total of 65 patients were included and had partial PVT in most cases (72%). Treatment with enoxaparin resulted in an overall response rate of 66% (43/65) after a median time of 4.4 months and 76% (33/43) within the first 6 months. At multivariate analysis, efficacy of anticoagulation correlated with the severity of liver disease, complete verus partial PVT, age of the thrombus, and time interval from treatment start (6 months). The areas under the curve of the statistical model for predicting the response to anticoagulation were 0.84 and 0.76 for the training (n=65) and validation (n=60) cohorts, respectively.Early diagnosis and early treatment are key factors for the successful management of PVT in cirrhosis, so that screening of PVT and prompt start of anticoagulant treatment should be mandatory.

Thrombotic events in congenital hypo-afibrinogenemia have been rarely reported, either in association or not with replacement therapy or thrombotic risk factors. We describe clinical findings and management of thrombosis of abdominal aorta with peripheral embolism in a patient with congenital afibrinogenemia. A review of arterial thrombosis in inherited hypo-afibrinogenemia was also performed. The patient with a severe bleeding history requiring prophylaxis with fibrinogen concentrates (FC) was admitted for ischaemia of the 4th right toe. An angio-CT of abdominal aorta showed a thrombosis from the origin of renal arteries to the carrefour with a distal floating part. No thrombotic risk factors were found; a previous traumatic lesion of aortic wall might have triggered the thrombus formation, whereas the role of FC prophylaxis remains uncertain. The patient was successfully treated with FC, enoxaparin followed by fondaparinux, and low-dose aspirin without bleeding or thrombosis recurrence. After 2 years, aortic thrombus was almost completely recovered. Sixteen hypo/afibrinogenemia patients with arterial thrombosis were found in Literature, showing that thrombosis often occurs at a young age, involves large vessels, its recurrence is not unusual, and therapeutic strategy is not defined yet. Our therapeutic approach was effective and also safe, but further studies are needed to improve the knowledge of pathogenesis and the anti-thrombotic management in this peculiar setting.

The article analyzes virtual experiments of the lining of a ball-type drum mill depending on a number of factors: the diameter of a mill, the diameter of grinding bodies, the number and height of liner lifters. The numerical experiment was performed using the EDEM software; a parametric model of the mill housing with variable liner lifters was created and imported, studies were performed using the virtual simulation method. A virtual experiment made it possible to study the grinding process without interacting the equipment which eliminates the risk of injury during and allows for more accurate research data. As a result of simulation of virtual experiments, values of the average kinetic energy of grinding bodies and the number of their collisions were determined.

CF3COOAg-Qr-P systems, where Qr is quercetin and P is an organic solvent, have been studied by spectroscopic methods. The reaction between silver trifluoroacetate and quercetin has been shown to produce colloid solutions, whose destruction terminates with the precipitation of a silver phase. The kinetic characteristics of the reaction between silver trifluoroacetate and quercetin in ethyl acetate have been determined.

The article presents data of experimental results of two-stage centrifugal dust concentrator, describes its design, and shows the development of a method of engineering calculation and laboratory investigations. For the experiments, the authors used quartz, ceramic dust and slag. Experimental dispersion analysis of dust particles was obtained by sedimentation method. To build a mathematical model of the process, dust collection was built using central composite rotatable design of the four factorial experiment. A sequence of experiments was conducted in accordance with the table of random numbers. Conclusion were made.

SummaryWe investigated a family with prekallikrein deficiency, using both standard coagulation tests and molecular biology techniques. The propositus was found to be a compound heterozygote for a Trp383 stop codon and a Cys529Tyr point mutation. The former mutation was located in exon 11, the latter in exon 14. The propositus inherited the first defect from his father and the second from his mother. Both parents had slightly low prekallikrein levels, but the combination of the two genetic defects produced a phenotype characterized by an extremely low prekallikrein activity and antigen. The propositus’ plasma showed a progressive reduction in APTT when incubated for a long time. Conversely, plasma deficient in factor XII, factor XI or high molecular weight kininogen (HMWK) failed to show shortening of the APTT. No circulating anticoagulant was found because the patient’s APTT was fully corrected by pooled normal and factor XII-, factor XI- or HMWK deficient plasma. No associated abnormality was apparent in the propositus or his parents. As expected, no tendency for bleeding was noted even after tonsillectomy.

SummaryThe role of circulating microparticles (MP) of different origin and tissue factor (TF)-bearing in overweight and obese patients with and without metabolic syndrome is still a matter of debate. In a case-control study, the presence of hypercoagulability was evaluated in overweight and obese patients by measuring MP, thrombin generation (TG) and FVIIa-AT complexes. Twenty overweight patients (body mass index [BMI] range 25–29.9 kg/m2), 20 with I degree (30–34.9 kg/m2), 20 with II degree (35–39.9 kg/m2) and 20 with III degree obesity (≥ 40 kg/m2) were enrolled and compared to 40 age and gender-matched normal weight individuals. A significant increase in median levels of all MP subtypes was observed in the three degrees of obese patients compared to controls. Overweight patients had higher levels of annexin V-MP (AMP), endothelial-derived, leukocyte-derived and TF-bearing MP than controls. Obese patients had a significantly shorter median lag time (p< 0.05), higher median peak thrombin (p< 0.01) and increased median endogenous thrombin potential [ETP] (p< 0.001) compared to controls. Overweight subjects had significantly increased ETP compared to controls (p< 0.05). Both AMP levels and ETP were found to positively correlate with BMI, waist circumference, and inflammatory parameters. No significant increase in FVIIa-AT complex was seen in cases compared to controls. We conclude that obesity is associated with overproduction of procoagulant MP and increase TG. Interestingly, hypercoagulability is found in overweight patients free of metabolic syndrome and increases with the severity of obesity. Assessment of MP and TG may be helpful in the early characterisation of the prothrombotic state in obese patients.

The prevalence of lupus anticoagulant (LA) and antiphospholipid antibodies (APA) in young patients ( 0.5). An inherited coagulation defect was found in seven (7.5%) patients. Our data suggest that the presence of LA or APA is associated with an increased incidence of thrombotic manifestation in young patients. Moreover LA is more frequent in patients with idiopathic DVT. Because the incidence of recurrent thrombotic manifestations in patients with LA or APA is estimated to be ∼50% within 2 years from the first thrombotic episode, the tests should be performed in all patients with juvenile thrombosis.

We evaluated the efficacy of cabergoline, a new ergoline derivative, in blocking puerperal lactation in a group of women delivered by cesarean section. In a single-blind controlled trial 36 women were randomly allocated to treatment with cabergoline 1 mg in a single dose p.o. (n = 18) or bromocriptine 5 mg/day p.o. for 14 days (n = 18). Treatment was started about 50 h after delivery. Clinical assessment of breast signs and determination of serum prolactin were performed just before treatment and at 3, 5, 7 and 14 days. In the cabergoline-treated group milk secretion was inhibited in 17 women (94.4%). Maximum decrease of serum prolactin was -89.7% at 5 days, and the prolactin-lowering effect of cabergoline was still present at 14 days. In the bromocriptine group milk secretion was inhibited in 16 women (88.9%). Maximum prolactin decrease (-86.9%) was reached at 3 days. Persistent side effects were comparable in the two groups. This study demonstrates that a single oral dose of 1 mg cabergoline is as effective in suppressing puerperal lactation as a full treatment with bromocriptine, even in women delivered by cesarean section.

A patient with combined factor V and factor VII deficiency is described together with a family study. The pro positus appeared to be double heterozygous for factor V and factor VII deficiency. Since the patient showed a parallel de crease of activity and antigen, he appeared to be double het erozygous for a true deficiency. The patient had inherited the factor V defect from the mother and the factor VII defect from the father. The parents of the propositus were not consanguin eous. Other family members were found to have isolated factor V or factor VII deficiency. This is the third family so far described with this peculiar combined defect but the first to be investigated by clotting and immunologic assays.

A 78-year-old woman was admitted to our hospital because of syncope associated with hematomas in both legs. Acquired hemophilia A (AHA) with a low antifactor VIII antibodies activity was diagnosed. Whole blood (WB) thrombelastographic profile depicted a hypocoagulable state. During hospitalization, the patient experienced life-threatening bleedings in the neck and in the right thigh. FVIII concentrates and rFVIIa was safe and effective in controlling acute hemorrhagic symptoms. Immunosuppressive therapy was used successfully to eradicate the inhibitor. At discharge, FVIII inhibitor was absent and thrombelastogram showed a normal profile. Our report confirms that AHA is a heterogeneous condition in terms of risk of bleeding. Even though the criteria for the diagnosis of AHA is quite well defined, a laboratory test useful to predict the bleeding risk and monitor the response to treatment is lacking. ROTEM profile appears to be correlated with the response to treatment and with the eradication of the inhibitor.

The effect of pre-eclampsia on coagulation and fibrinolysis in newborns is still under investigation. We have evaluated several coagulation and fibrinolysis parameters in umbilical cord blood of 20 newborns from pre-eclamptic women and of 40 newborns from normotensive women with similar gestational age. Additionally, the presence of factor V Leiden and prothrombin G20210A mutation in cord blood has been assessed. Neonates from pre-eclamptic women exhibited significantly lower birth weight (2.48 +/- 0.92 versus 2.88 +/- 0.68 kg, P < 0.05) and were more frequently admitted to the neonatal intensive care unit (45 versus 20%, P < 0.01) as compared with neonates from normotensive women. Cord blood protein C antigen and activated protein C resistance mean levels were slightly higher in the group of neonates from pre-eclamptic mothers. Fibrinogen levels were lower in this group as compared with control newborns (132.17 +/- 46.97 versus 156.08 +/- 49.58 mg%, P < 0.02), and unrelated to birth weight. No significant differences between cases and controls were found in plasminogen activator inhibitor-1 or tissue plasminogen activator cord blood levels. Heterozygous prothrombin 20210A was found in three newborns from normotensive mothers, whereas no factor V Leiden mutation was found in either group. In conclusion, pre-eclampsia seems to have only mild effects on coagulation and fibrinolytic factors in the cord blood of newborns. Since no excess of common polymorphisms predisposing to thrombosis was found in newborns from pre-eclamptic mothers, it is unlikely that the carriership status of these genetic defects of newborns influences the adverse pregnancy/neonatal outcomes.

Five monkey recipients of a porcine renal xenograft were studied to determine the relationship between fibrin formation in acute humoral xenograft rejection (AHXR) and procoagulant and anticoagulant factor levels to establish whether changes in coagulation parameters could be used to predict AHXR and determine whether AHXR is associated with overt disseminated intravascular coagulopathy (DIC) in this model. Variable degrees of compensated consumptive coagulopathy were observed in each primate. Elevated thrombin-antithrombin (TAT), F1+2 and D-dimer levels consistent with thrombin generation and fibrin formation were recorded. There was no consumption of the main clotting inhibitors (including antithrombin) or a progressive, severe drop in fibrinogen levels and platelet counts, although grafts were left in situ. After transplantation, D-dimer levels remained persistently high, so they were of limited value in defining this coagulopathy. At post mortem, no cases of multiorgan involvement typical of overt DIC were observed. The lack of a rapid postoperative recovery of clotting inhibitor levels after transplantation was invariably associated with early poor outcome. This study shows that AHXR is associated with various degrees of compensated consumptive coagulopathy in our pig-to-primate model. No clear relationship was found between coagulation parameter levels and graft outcome.

A. Zanetto1 , A. Ferrarese1, K. Rodriguez1, M. Fadin2, S. Gavasso2, C. Radu2, P. Zerbinati2, A. Vitale3, U. Cillo3, F. Farinati4, F.P. Russo1, G. Germani1, P. Simioni2, P. Burra1, M. Senzolo1 1 Multivisceral Transplant Unit, Department of Surgical, Oncological and Gastroenterological Sciences, Padua University Hospital, Padua, Italy 2 Department of Cardiologic, Thoracic, and Vascular Sciences, Padua University Hospital, Padua, Italy 3 Hepatobiliary Surgery and Liver Transplantation Unit, Padua University Hospital, Padua, Italy 4 Gastroenterology, Department of Surgical, Oncological and Gastroenterological Sciences, Padua University Hospital, Padua, Italy

s / Digestive and Liver Disease 46S (2014) e129–e135 e133 management mean costs =16,440$ for patient). HCV etiology had a strong impact on post-LT survival (Hazard Ratio =1.59, 95% CI =1.22–2.09, p=0.0007). Using recent data on SOF efficacy and costs in the base-case scenario, 12-week pre-LT SOF therapy showed a median survival benefit of 3.1 QALYs, an ICER of 35,168$/QALY, and a NHB of 0.9 QALYs, whereas the ICER and NHB of a 24-week therapy were 52,527$/QALY and −0.2 QALY respectively. Conclusions: SOF used as pre-transplant therapy in HCV patients proved to be a cost-effective treatment strategy compared with post-LT SOC therapy. Conflict of interest: None declared. Disclosures: S. Fagiuoli acted as either Advisory Board Member or Speaker’s Bureau for: BMS, MSD, Gilead Sciences, Abvie, Roche, Janssen, Novartis, Grifols, Biotest, Kedrion, Bayer. Liver Transplantation NITp Working Group Luciano De Carlis (Surgery and Transplantation, Ospedale Niguarda Ca’ Granda, Milan, Italy), Michele Colledan (Gastroenterology and Transplantation Hepatology, Ospedali Riuniti, Bergamo, Italy), Giorgio Rossi (Liver Transplantation Unit, Fond, IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy), Enzo Andorno (IRCCS San Martino, Genoa, Italy), Andrea Risaliti (Liver Transplant Unit, University of Udine, Udine, Italy), Vincenzo Mazzaferro (Liver Transplantation, IRCCS INT, Milan, Italy), Marco Vivarelli (Liver Transplantation Unit, Ancona Hospital, Ancona, Italy), Umberto Tedeschi (Liver Transplantation Unit, Verona Hospital, Verona, Italy), Davide Bitetto (Gastroenterology and Transplant Hepatology, Ospedale Papa Giovanni XXIII, Bergamo, Italy), Angelo Sangiovanni (Gastroenterology Unit, Maggiore Hospital Policlinico, Milan, Italy), Lucio Caccamo (Liver Transplantation Unit, Fond. IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy), Daniele Neri (University of Padova, Padua, Italy), Giuseppe Piccolo (Fond, IRCCS Ca’ Granda OMP, Milan, Italy), Francesco Paolo Russo (University of Padova, Padua, Italy), Luciano Biti (Liver Transplantation Unit, Verona Hospital, Italy), Paolo Angeli (University of Padova, Padua, Italy), Vittorio Corno (Gastroenterology and Transplantation Hepatology, Ospedali Riuniti, Bergamo, Italy) http://dx.doi.org/10.1016/j.dld.2014.08.012 OC-09 TUMORIGENIC POTENTIAL OF CANCER STEM CELLS (CSCS) ISOLATED FROM HUMAN CHOLANGIOCARCINOMA (CCA) SUBTYPES IN CIRRHOTIC LIVER A. Torrice1 , G. Carpino2, A. Fraveto1, A. Renzi3, M.C. Bragazzi1, F. Giuliante4, A.M. Derose4, V. Cardinale1, R. Gentile1, P. Onori3, C. Napoletano5, A. Franchitto3, A. Cantafora1, G. D’Argenio6, N. Caporaso6, G. Grazi7, E. Gaudio3, D. Alvaro1 1 Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy 2 Health Science, University of Rome “Foro Italico”, Rome, Italy 3 SAIMLAL, Sapienza, University of Rome, Rome, Italy 4 Surgery, Hepatobiliary Unit, Catholic University of the Sacred Heart School of Medicine, Rome, Italy 5 Experimental Medicine, Sapienza University of Rome, Rome, Italy 6 Gastroenterology Unit, Department of Clinical and Experimental Medicine, Federico II University of Naples, Naples, Italy 7 Hepato-Biliary Surgery, Regina Elena National Cancer Institute, Rome, Italy Introduction: Two different forms of CCA has been considered. A pure mucin-secreting form (Mucin-CCA) located either intra or extra-hepatically and a Mixed-CCA form with a peripheral location. We previously identified different subpopulations of CCA CSCs, including epithelial (CD133+, LGR5+, EpCAM+),mesenchymal (CD90+) and quiescent (CD13+) CSCs. Aim: To evaluate the tumorigenic potential of different subpopulation of CSCs isolated from human Mucinand Mixed-CCAs. Methods: CSC subpopulations were immunoselected from human CCA samples (n=18 surgically resected patients) or from primary cultures. The tumorigenic potential of CSC subpopulations was tested either in vitro (spheroid formation), or in xenografts obtained by subcutaneous or intrahepatic injection in normal or cirrhotic (CCL4-induced) livers in SCID mice. In vitro, epithelial CSCs (CD133+, EpCAM+, LGR5+) formed a higher (p 80% (p

The aim of this study was to determine the role of the ST segment elevation resolution50% between the ECG before and 2 hours after thrombolytic therapy as a predictor of acute myocardial infarction (AMI)-related artery patency, assessed by a coronary angiography performed 1 month after AMI.This study enrolled 95 patients, 75 men and 20 women, 58 years mean aged, admitted to the coronary care unit with diagnosis of AMI. Patients were treated with thrombolysis within 6 hours from the onset of chest pain, according to the GUSTO trial.The findings showed a significant prevalence of ST segment elevation resolution50% in inferior AMI (p0.01). It has been observed that the ST segment resolution is correlated with lower (p0.01) and earlier (p0.05) peak in serum creatinekinase (CK) and CK MB release and with less damage of left ventricular ejection fraction assessed by ventriculography (p0.01). All these findings indicated a lower extensive myocardial damage. Patients with ST segment resolution presented a prevalence of one or two-coronary vessel disease, with an infarct-related vessel narrowing like that observed in the other patients without ST resolution. Nevertheless a TIMI grade 2 or 3 flow was observed more frequently, but not significantly, in the subjects with ST resolution; a significant prevalence was limited to TIMI 3 grade flow (p0.05). In the present study ST segment elevation resolution50% represented a highly sensitive and a poor specific predictor of vessel patency in inferior AMI, but with a poor sensitivity and specificity in anterior AMI.Personal experience suggested that the thrombolytic therapy has a less favourable effect on the artery patency assessed 1 month after AMI, rather than in the acute phase as reported in previous studies. Dynamic changes of flow or a following worsening in atherosclerotic plaque could be probably responsible of reocclusion of an initially reperfused coronary artery.

Two hundred forty women were studied, who underwent symptomatological anamnesis, clinical examination and urodynamic investigations for female urinary incontinence. Our aim was to distinguish among the three main forms of incontinence (stress, urge and mixed incontinence). When only symptomatological anamnesis is considered, there is an incidence of error in nearly a third of the cases and, when further factors like menopause, prolapse and parity are considered, the incidence of error does not reduce. A correct diagnosis can be determined only by a combined use of clinical assessment and urodynamic investigations. (As regards clinical examination, a positive stress test leads to a diagnosis of stress incontinence. As regards urodynamic investigations a cystometry positive for instability of the detrusor muscle leads to a diagnosis of urge incontinence. If both clinical examination and urodynamic investigations are positive, the diagnosis is of mixed incontinence.) Our findings suggest that routinely it is sufficient to execute only cystometry among urodynamic investigations.

Since the initial observation of an association between low maternal serum aFP and trisomies noninvasive for chromosomal abnormalities is an obvious goal of genetics and obstetricians. Here are reported the results of a biochemical screening for fetal trisomies study based on the dosages of maternal serum aFP, bHCG and uE3 at 16 week gestational age on 1166 pregnant women without risk factors for genetical abnormalities. Sensitivity, positive predictivity and negative predictivity of the screening were 50%, 42.86% and 99.74% respectively.

The primary purpose of this study is to examine the influence of the female gender on the early and 1-year post-discharge prognosis after acute myocardial infarction (AMI). Moreover, the therapeutic approaches are compared between the two sexes during the early phase of AMI. We performed a retrospective cohort study of 341 patients, 219 men and 122 women, consecutively admitted to the coronary care unit with AMI. Among the baseline characteristics, the age greater than 70 years, the systemic hypertension and the diabetes mellitus are more represented in women; on the contrary cigarette smoking is prevalent in the male gender. The analysis of laboratory and clinical parameters does not show any statistic differences between the two sexes, except the ejection fraction and the coronary reperfusion. The first turns out to be lower in the females and the second one is more often observed in the males. As for the intra-hospital complications, the cardiogenic shock is prevalent in the female gender, the early mortality gets to 26% in women and 11% in men (p0.01). The late mortality during the follow-up does not present any difference between the two sexes. From our data, we conclude that transmural AMI, cardiogenic shock, ventricular fibrillation and 2-3 degree atrio-ventricular blocks are significantly bound to a higher early mortality in women. In them the atrial fibrillation is the only predictor of 1-year mortality. Finally, thrombolysis, beta-blockers and significantly aspirin and heparin (p0.05), are less used in the female patients, while diuretics and digoxin are more employed.(ABSTRACT TRUNCATED AT 250 WORDS)

The purpose of this study is to define the importance of age as predictor of early and late mortality following acute myocardial infarction (AMI). At the same time, effects coming from the use of various therapeutic approaches are considered. We have studied 341 patients, 188 aged70 years and 153or = 70 years, consecutively admitted to the coronary care unit with diagnosis of AMI. Our findings show that ageor = 70 years, female gender, cardiogenic shock, ventricular fibrillation and early post-infarction angina are significantly connected to higher intra-hospital mortality. As for predictors of 1-year mortality, they turned out to be the ageor = 70 years, indirect signs of more extensive infarction as previous necrosis, acute heart failure, cardiogenic shock, new bundle branch blocks and pre-discharging lower ventricular ejection fraction. In patients agedor = 70 years, especially in ultra eighty-year old men, thrombolysis, heparin, beta-blockers and aspirin are significantly less employed. All drugs used in the early hours of AMI turned out to be bound to beneficial effects with reduced mortality, except diuretics and antiarrhythmics. The only drugs correlated with an improved 1 year survival are betablockers, aspirin and thrombolysis. On the contrary, the use of diuretics and digoxin is limited to patients with a greater clinical dysfunction. These drugs are associated to a higher late mortality. The present study confirms the finding that elderly patients with AMI who are submitted to less aggressive therapeutic approaches and are more frequently represented by women, have a higher mortality.

In pediatric gynecology, inflammatory vulvo-vaginitis are very common. Their diagnosis cannot be based either on the symptoms (itching or pain) or on the signs (leucoxanthorrhea) for these classifications are "non-specific". At the Consulting Room of pediatric gynecology of the Vittore Buzzi Hospital, 215 "non-specific" vulvo-vaginitis cases have been analyzed through bacteriological and microscopical examinations of vaginal secretions. The vaginal tampon resulted negative in 53% of the cases and positive in the remaining 47%. Comparing these results with microscopical examinations we obtain: 81.8% of sensibility, 77.4% of specificity, 87.8% of negative predictive value and 62.2% of positive predictive value. In particular, this last figure is influenced by the high number of false positives of the vaginal tampons, due to the growth "in vitro" of opportunist germs momentarily quiescent "in vivo". Thus it is useful to associated the microscopical examination (that will indicate all the cases in need of treatment) and the bacteriological examination (that will indicate the right cure).