Search

Since December 2019, the world has been facing the life-threatening disease, named Coronavirus disease-19 (COVID-19), recognized as a pandemic by the World Health Organization. The response of the Emergency Medicine network, integrating "out-of-hospital" and "hospital" activation, is crucial whenever the health system has to face a medical emergency, being caused by natural or human-derived disasters as well as by a rapidly spreading epidemic outbreak. We here report the Pavia Emergency Medicine network response to the COVID-19 outbreak. The "out-of-hospital" response was analysed in terms of calls, rescues and missions, whereas the "hospital" response was detailed as number of admitted patients and subsequent hospitalisation or discharge. The data in the first 5 weeks of the Covid-19 outbreak (February 21-March 26, 2020) were compared with a reference time window referring to the previous 5 weeks (January 17-February 20, 2020) and with the corresponding historical average data from the previous 5 years (February 21-March 26). Since February 21, 2020, a sudden and sustained increase in the calls to the AREU 112 system was noted (+ 440%). After 5 weeks, the number of calls and missions was still higher as compared to both the reference pre-Covid-19 period (+ 48% and + 10%, respectively) and the historical control (+ 53% and + 22%, respectively). Owing to the overflow from the neighbouring hospitals, which rapidly became overwhelmed and had to temporarily close patient access, the population served by the Pavia system more than doubled (from 547.251 to 1.135.977 inhabitants, + 108%). To minimize the possibility of intra-hospital spreading of the infection, a separate "Emergency Department-Infective Disease" was created, which evaluated 1241 patients with suspected infection (38% of total ED admissions). Out of these 1241 patients, 58.0% (n = 720) were admitted in general wards (n = 629) or intensive care unit (n = 91). To allow this massive number of admissions, the hospital reshaped many general ward Units, which became Covid-19 Units (up to 270 beds) and increased the intensive care unit beds from 32 to 60. In the setting of a long-standing continuing emergency like the present Covid-19 outbreak, the integration, interaction and team work of the "out-of-hospital" and "in-hospital" systems have a pivotal role. The present study reports how the rapid and coordinated reorganization of both might help in facing such a disaster. AREU-112 and the Emergency Department should be ready to finely tune their usual cooperation to respond to a sudden and overwhelming increase in the healthcare needs brought about by a pandemia like the current one. This lesson should shape and reinforce the future.

Objectives To detect possible severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA contamination of inanimate surfaces in areas at high risk of aerosol formation by patients with coronavirus disease 2019 (COVID-19). Methods Sampling was performed in the emergency unit and the sub-intensive care ward. SARS-CoV-2 RNA was extracted from swabbed surfaces and objects and subjected to real-time RT-PCR targeting RNA-dependent RNA polymerase and E genes. Virus isolation from positive samples was attempted in vitro on Vero E6 cells. Results Twenty-six samples were collected and only two were positive for low-level SARS-CoV-2 RNA, both collected on the external surface of continuous positive airway pressure helmets. All transport media were inoculated onto susceptible cells, but none induced a cytopathic effect on day 7 of culture. Conclusions Even though daily contact with inanimate surfaces and patient fomites in contaminated areas may be a medium of infection, our data obtained in real-life conditions suggest that it might be less extensive than hitherto recognized.

We describe clinical characteristics, treatments and outcomes of 44 Caucasian patients with coronavirus disease (COVID-19) at a single hospital in Pavia, Italy, from 21–28 February 2020, at the beginning of the outbreak in Europe. Seventeen patients developed severe disease, two died. After a median of 6 days, 14 patients were discharged from hospital. Predictors of lower odds of discharge were age > 65 years, antiviral treatment and for severe disease, lactate dehydrogenase > 300 mg/dL.

Objective: This study aimed to assess the role of Tocilizumab therapy (TCZ) in terms of ICU admission and mortality rate of critically ill patients with severe COVID-19 pneumonia. Design: Patients with COVID-19 pneumonia were prospectively enrolled in SMAtteo COvid19 REgistry (SMACORE). A retrospective analysis of patients treated with TCZ matched using propensity score to patients treated with Standard Of Care (SOC) was conducted. Setting: The study was conducted at IRCCS Policlinico San Matteo Hospital, Pavia, Italy, from March 14, 2020 to March 27, 2020. Participants: Patients with a confirmed diagnosis of COVID-19 hospitalized in our institution at the time of TCZ availability. Interventions: TCZ was administered to 21 patients. The first administration was 8 mg/kg (up to a maximum 800 mg per dose) of Tocilizumab intravenously, repeated after 12 h if no side effects were reported after the first dose. Main Outcomes and Measures: ICU admission and 7-day mortality rate. Secondary outcomes included clinical and laboratory data. Results: There were 112 patients evaluated (82 were male and 30 were female, with a median age of 63.55 years). Using propensity scores, the 21 patients who received TCZ were matched to 21 patients who received SOC (a combination of hydroxychloroquine, azithromycin and prophylactic dose of low weight heparin). No adverse event was detected following TCZ administration. This study found that treatment with TCZ did not significantly affect ICU admission (OR 0.11; 95% CI between 0.00 and 3.38; p = 0.22) or 7-day mortality rate (OR 0.78; 95% CI between 0.06 and 9.34; p = 0.84) when compared with SOC. Analysis of laboratory measures showed significant interactions between time and treatment regarding C-Reactive Protein (CRP), alanine aminotransferase (ALT), platelets and international normalized ratio (INR) levels. Variation in lymphocytes count was observed over time, irrespective of treatment. Conclusions: TCZ administration did not reduce ICU admission or mortality rate in a cohort of 21 patients. Additional data are needed to understand the effect(s) of TCZ in treating patients diagnosed with COVID-19.

Coronavirus disease 2019 (COVID‐19) diagnosis is based on molecular detection of SARS‐CoV‐2 in respiratory samples such as nasal swab (NS) However, the evidence that NS in patients with pneumonia was sometimes negative raises the attention to collect other clinical specimens SARS‐CoV‐2 was shown in 10 3% rectal swabs (RS), 7 7% plasma, 1% urine, and 0% feces from 143 NS‐positive patients Potential infection by fluids different from respiratory secretion is possible but unlikely [ABSTRACT FROM AUTHOR] Copyright of Pediatric Allergy & Immunology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

International audience

International audience

L'itinerario del Miage e della Val Veny si sviluppa al cospetto del Monte Bianco ed è composto da tre percorsi collegati tra loro, i quali offrono nelle Soste alcune visioni panoramiche d'insieme e numerosi approfondimenti locali di dettaglio sui ghiacciai del Miage, della Brenva, della Lex Blanche e sugli altri apparati minori. In particolare è possibile fare alcune osservazioni in merito alIe pulsazioni tardoglaciali, oloceniche e storiche, all'instabilità delle pareti rocciose e delle morene, alla copertura detritica del Miage e alla sua articolata morfologia, alla presenza della vegetazione arborea sulla sua superficie, e all'evoluzione del Lago del Miage.

The analysis of glacial and periglacial morphodynamics and the study of past climate changes are important tasks for scientific and management purposes within recently deglaciated areas. Climate changes and related effects occurring in the last decades cause uncertainties on the survival of glaciers and affect stability of mountains. A systematic study of natural hazards related to glacial and periglacial morphodynamics of the Western Alps in Italy and the Coast Mountain and the Cordillera in Canada started only in the early 1990s. Since then, several instability phenomena of these glacial and periglacial environments have been analyzed, as well as their relationship with the climatic and environmental changes taking place since the end of the Little Ice Age. From the beginning of the 2000s, it became clear that environmental changes related to global warming were accelerating so quickly in high elevation and glaciated mountains. Within this perspective, we started an international effort to collect data and compare geomorphic processes occurring in the high mountains of two distant geographic areas, but with similar physiographic characteristics. Aims was to provide scientists and local administrations with the most advanced knowledge and tools to deal with climate-related instability events occurred in glacial and periglacial areas of the Italian Alps and of Western Canada, such as landslides, debris flows, glacial lake outburst floods, ice avalanches. We identified the types of instability mainly conditioned by climate change and discussed hazard scenarios. Methodological approaches used in Italy and Canada for studying the impacts of degrading permafrost and glacier ice loss on mountain environments were compared, and strategies for communication and dissemination of results were addressed. Studies have shown differences and similarities among the two areas, which highlight the effects of regional/local physiography and climate and, at the same time, confirm the global scale of the changes underway.

A systematic study of glacier-related hazards in the Western Alps started in Italy only in the early 1990s, and greatly benefited from the pioneering studies of John Clague. He analyzed natural instability processes in the glaciated environment and their relationship with the climatic and environmental changes taking place since the end of the Little Ice Age. From the beginning of the 2000s, it became clear that environmental changes related to global warming were accelerating so quickly in high elevation and glaciated mountains. An international effort to collect and exchange data was thus required, in order to provide scientists and local administrations with the most advanced knowledge and tools to deal with the impacts of climate change. This was the premise behind the start of a fruitful scientific collaboration developed over nearly 10 years between the authors and John Clague and other Canadian scientists, with the aim to compare geomorphic processes occurring in the high mountains of two distant geographic areas, but with similar physiographic characteristics. In this framework, we analyzed and compared instability events occurred in glacial and periglacial areas of the Italian Alps and of Western Canada, such as landslides, debris flows, glacial lake outburst floods, ice avalanches. We identified the types of instability mainly conditioned by climate change and discussed hazard scenarios. Methodological approaches used in Italy and Canada for studying the impacts of degrading permafrost and glacier ice loss on mountain environments were compared, and strategies for communication and dissemination of results were addressed. Studies have shown differences and similarities among the two areas, which highlight the effects of regional/local physiography and climate and, at the same time, confirm the global scale of the changes underway. These fruitful research results fed educational activities and research training within international academic exchange programs such as GeoNatHaz.

In this study, we present a snapshot of Italian glaciers that outlines the hydrological years of 2006 and 2007 and was derived from the interpretation of high-resolution orthophotographs. The results are freely available and downloadable on the website of the Italian Glaciological Committee (http://www.glaciologia.it/). Considering that glacial resources are suffering the effects of an extreme degree of ongoing climate warming, glacier monitoring requires homogeneous and accurate contemporary surveying approaches to realize the effective management of multi-temporal glacier inventories in GIS environments. Furthermore, the diffuse and rapid withdrawal of glaciers requires the use of multi-temporal, repeatedly updated data acquired with the same instruments during the same time interval. In this work, the data collected were organized and processed using the orographic setting of the Alps (International Standardized Mountain Subdivision of the Alps, ISMSA-SOIUSA) rather than local and regional administrative boundaries within which glaciers are placed (regions and provinces). The conducted survey allowed us to evaluate the distribution of Italian glaciers (969 including the two small Apennine glacierets of Calderone in the Gran Sasso Massif), which covered an area of 387.4 km2 ± 2%. The most glaciated mountain group is the Ortles, with 134 glaciers covering an area of 76.5 km2 , whereas the Alpi Marittime hosts only one small glacier (0,041 km2 ). New data, which until now have never been published in Italian inventories, refer to the extension of the glacial debris cover (> 46 km2 , equivalent to 12% of the whole glaciated surface in 2006-2007). Debris cover was outlined on 614 glaciers, corresponding to 63% of all surveyed glacial units. The comparison of our data with those recorded in the first systematic glacier inventory of the Italian Alps (CGI 1959-1962) shows that in 2006- 2007, 181 glaciers were completely extinct, 470 glaciers remained unitary, and 171 bodies were fractionated to generate 243 new glaciers. As a consequence of recent glacial retreat and the induced fractionation of glacial bodies, the total number of glaciers increased (+ 147 glaciers), whereas the surface decreased by ca. 140 km2 (-27%). This work represents a breakthrough in the availability of glaciological data from the Italian Alps collected over a very short time period. This study will also satisfy the rising demand of open source availability of environmental data pertaining to mountainous regions.

I ghiacciai sono tra i migliori indicatori terrestri del cambiamento climatico. La conoscenza dell'evoluzione nel tempo delle loro dimensioni e della loro morfologia costituisce un elemento indispensabile per lo studio degli ambienti di alta quota e per la comprensione delle modificazioni indotte dal cambiamento climatico in atto. A tale scopo, gli archivi di dati glaciologici stanno riscontrando un interesse in continua crescita a livello internazionale. Nell'ambito del Progetto Alcotra "GlaRiskAlp" è sorta l'esigenza di disporre di un data base relativo ai ghiacciai piemontesi, il quale consenta un accesso rapido ed efficiente all'informazione disponibile per le finalità del progetto. Il presente lavoro descrive la struttura e le funzioni di questo database relazionale, strumento semplice nell'utilizzo, basato su tecnologie web e realizzato mediante software open source.

High elevation environments proved to be particularly sensitive to climate changes, in relation to an increase in instability especially in areas where the cryosphere is present. The purpose of this work is to present the geomatic methodologies that have been applied to study dynamical areas, such as glacial and periglacial ones, in order to detect morphological changes that can be ascribed to climatic changes. The working group has been composed by members of the University of Torino (GeoSitLab laboratory) and of the CNR-IRPI Torino, in the framework of the Alcotra 2007-2013 project n.56 GlaRiskAlp (Glacial Risks in the Western Alps). Remote sensing techniques, necessary for large or remote areas, have been integrated, for the purposes of this study, by GNSS campaigns in the field, using a fixed GPS station, and a kinematical one. In order to identify landscape changes over the tens of years, it is particularly useful the digital aerial photogrammetry which exploits historical aerial photos that are orthorectified, to extract themes for a topographical and geomorphological characterization of landscape at regional scale. For the specific purposes of our work, the DEM extraction, at a local scale, from flights of different years, is useful to make comparisons of glacier surface. All data have been implemented in a GIS.

Climate changes are more and more attracting the attention of the scientific community because of their direct impacts on geomorphic systems and human activities. A number of studies are currently under way to investigate the evolution of high elevation environments, which proved to be particularly sensitive to climate changes and point to increased in instability in areas of cryosphere occurrence. The here presented research has been developed in the framework of the Alcotra project n.56 "GlaRiskAlp", by CNR-IRPI Torino in collaboration with the DST Torino - GeoSitLab laboratory and is aimed to the validation of an integrated geomatic approach for the evaluation of geomorphologic changes, and related hazards, in glacial and periglacial areas, in the contest of present climatic trends. The proposed approach is based on the coupling of remote sensing techniques and field surveys, in particular digital aerial photogrammetry and satellite imagery, terrestrial scanning LiDAR, and GNSS survey. High-resolution terrestrial LiDAR acquisition, processing and interpretation are used to map periglacial areas in the three dimensions. Laser-generated models offer a visualization tool that, through the comparison of DEMs of different years, allow to detect and to interpret even small geomorphologic changes in time. GNSS-networks are suitable tools for detecting changes over larger surfaces, or horizontal ones. Digital aerial photogrammetry and satellite images can be used to create ortophotos and DTMs of different years, allowing the reconstruction of main geomorphologic changes over the last 50 years. The proposed approach has been applied to case studies of the Piemonte region (Western Italian Alps).

In questo lavoro si presenta un'analisi dell'applicabilità di alcune tecniche geomatiche per il monitoraggio di settori a marcata dinamicità geomorfologica. La finalità ultima è quella di riconoscere in modo tempestivo i segnali dell'insorgere di un'eventuale instabilità che possano evolvere in situazioni di rischio. Il contributo specifico del gruppo di lavoro, composto da Università di Torino (GeoSITLab) e CNR-IRPI Torino, è stato finalizzato all'integrazione di una gamma di tecniche geomatiche ad alcuni settori dell'ambiente glacializzato piemontese, nell'ambito del progetto interreg alcotra n.56 GlaRiskAlp (Rischi Glaciali nelle Alpi Occidentali). In questo articolo si intende approfondire una parte dei risultati relativi al progetto in riferimento allo studio volto alla verifica dell'impiego di le tecniche di fotogrammetria aerea digitale e di posizionamento satellitare (GNSS).