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Between the 4th and 10th of November 2011 a cut-off low developed in the western Mediterranean, parted from the Atlantic flow and evolved into a Tropical-Like Cyclone (TLC) around the Balearic Islands, where it persisted for three days. Between 12:00 UTC on 06 Nov and 12:00 UTC on 09 Nov, the TLC generated intense winds, heavy rainfall and waves up to 8 meters. To investigate the drivers of this event we ran a set of numerical simulations over the entire Mediterranean basin and extending to the "European" Atlantic ocean in order to account for the effects of the Atlantic circulation on the Mediterranean region. Different initial conditions, nesting and model coupling strategies have been tested with the COAWST system, which includes an atmospheric (WRF), an ocean circulation (ROMS), and a wave (SWAN) model, and pushing the horizontal grid spacing down to 5x5 km. Since the cyclone developed southern of the Iberian Peninsula and the Pyrenees, the sensitivity to topography was also explored. The results of the numerical experiments demonstrate how this event is strongly influenced by the initialization strategy and the balance of the initial fields with respect to the marine conditions and topography. In particular, two-way coupling the atmospheric model with ocean and wave models showed that the interaction with waves in the presence of a detailed SST fields can modify the distribution of heat fluxes, rainfall and horizontal pressure gradient. Also the 10 meters wind is conditioned by the coupling and by the wave-induced roughness patterns, especially in the southern part of the basin where the larger fetch produces more developed sea for the study of the case. The effect of atmosphere-ocean-waves interactions associated to the TLC is also pronounced in the marine variables, resulting in a decrease of SST and Mixed Layer thickness along the trajectory of the cyclone.

In November 6-8, 2011, in the Balearic islands an extra-tropical depression developed into a Tropical-Like Cyclone (TLC) characterized by a deep-warm core, leading to a mean sea level pressure minimum of about 991 hPa, 10 m wind speeds higher than 28 m/s around the eye, and very intense rainfall, especially in the Gulf of Lion. To explore in detail the effect of the sea surface temperature on the Medicane evolution, we employed the coupled modeling system COAWST, which consists of the ROMS model for the hydrodynamic part, the WRF model for the meteorological part, and the SWAN for the surface wave modeling. All model run over 5 km domain (same domain for ROMS and SWAN). COAWST was used with different configurations: in Stand Alone (SA) mode (that is, with only the atmospheric part), in atmosphere-ocean coupled mode (AO), and in a fully coupled version including also surface waves (AOW). Several sensitivity simulations performed with the SA approach were undertaken to simulate the TLC evolution. Especially in the later stage of the lifetime, when the cyclone was weaker, the predictability appears limited. Sensitivity simulations have considered the effect of the cumulus scheme (using an explicit scheme the Medicane does not develop and remains an extra-tropical depression) and the PBL scheme (using MYJ or MYNN resulting "Medicane" are extremely similar, although the roughness appears rather different among the two experiments). Comparing the three runs, the effects of different simulations on the Medicane tracks are significant only in the later stage of the cyclone lifetime. In the overall modeled basin, wind intensity is higher in the SA case w.r.t. both coupled runs. When compared to case AO, winds are about 1 m/s larger, even though the spatial distribution is very similar (possibly because of the lower SST produced by case AO). Case AOW produces less intense winds then SA and AO case in the areas where the wave is most developed (differences are about 2-4 m/s), while they are more intense in the neighborhood of the eye of the cyclone. Moreover, the inclusion of the wave model (AOW) has implications in the water column, by changing the depth of the ocean mixed layer along the track of the Medicane, so that eventually the SST in AOW run is colder than in AO. The date chosen for the run initialization appears important: an earlier initial condition allows to properly simulate the evolution of the cyclone from the cyclogenesis and to include the effect of the air-sea interaction through the coupled models.

The paper presents a preliminary implementation of a 3-D integrated, wave-current-sediment numerical model in a shallow water area of the NW Adriatic Sea, with the aim of assessing the erosion patterns and bottom morphology modifications that may be induced by severe marine conditions. The numerical modeling results show how complex, integrated numerical tools are becoming suitable both for preliminary investigations and for effective littoral management activities as well.

During winter 2012 an extreme meteorological event stroke the whole Europe and particularly its central-southern sector. A strong and persistent spit of cold air coming from Siberian region (a Cold Air Outbreak, CAO) insisted on northern Italy and the Adriatic sea basin, leading to decreases in the sea temperatures up to 6 oC in less than two weeks, ice formation on the Venice lagoon and an exceptional snow fall in the Apennine region. In the sea the CAO was associated to a significant episode of dense water formation (DWF), a crucial phenomenon that heavily impacts the whole Adriatic Sea (from the sinking of water masses and associated ventilation of the northernmost shelf, to the flow along the western coast, until the flushing of southern Adriatic open slope and submarine canyons, with associated sediment transport and bottom reshaping). The extent of the DWF event in the Northern Adriatic sub-basin was estimated by means of coastal observatories, ad hoc measurements and, until now, results from existing one-way coupled atmosphere-ocean models. These are characterized by no SST feedback from the ocean to the atmosphere, and therefore by turbulent heat fluxes that may heavily reflect a non-consistent ocean state. The study proposes an investigation of the 2012 CAO using a fully coupled, three components, ocean-atmosphere- wave system (COAWST). Results highlight that, although the energy interplays between air and sea do not seem to significantly impact the wind forecasts, when providing heat fluxes that are consistent with the ocean temperature we find modified heat fluxes and air sea temperatures figures. Moreover, the consistent description of thermal exchanges adopted in the fully coupled model can affect the basin circulation, the quantification of dense water produced mass, and the description of its migration pathways and rates of off-shelf descent.

Shelf types of dense-water formation (DWF) processes occur frequently in the Northern Adriatic Sea (NA), due to specific synoptic conditions and wind patterns, mostly related to the blowing of cold and severe Bora winds, advecting cold and dry air from north-eastern Europe, down the Dinaric Alps. The use of low-resolution modelled winds is not able to properly reproduce the fine scale features typical of this basin, particularly in the case of the cross-basin Bora patterns, being the complex Adriatic orography ioften poorly reproduced in atmospheric models.Therefore, in order to understand and model the processes of DWF in the NA, it is mandatory to use high-resolution meteorological and circulation models. Within the framework of activities of the Italian flagship Project "RITMARE" and of the FIRB "DECAL- OGO", several numerical meteorological models at high resolution are made available to describe events of exceptionally dense water formation, such as that registered during the winter 2012 in the NA region, when large energy losses were registered due to cold and extremely strong Bora winds. Available measurements in the NA (temperature, salinity, density, wind speed, direction and inferred heat fluxes) are used to carry out a first semi-quantitative comparison among existing meteorological models implemented over the region. Specifically, two uncoupled meteorological modelling systems (BOLAM/MOLOCH and WRF) and one one-way coupled (COSMO/ROMS) have been implemented for the simulation of this cold air outbreak. The uncoupled models are able to capture well the low level cold air intrusion, modulated by the narrow orographic gaps, and the evolution in the sensible heat fluxes intensity. However, the intensity of the fluxes results over- estimated when compared to those derived from observations. Preliminary one-way coupled model results seem to partially correct this overestimation, most likely due to the exceptional cold SST not captured by the ocean climatological values adopted by the uncoupled models. A full bi-directional coupling with ocean circu- lation models, as planned within RITMARE project, will allow to better investigate the reasons of this discrepancy.

A dipyridamole-echocardiographic test (DET) was carried out to find out how safe and useful it was in predicting clinical outcome and in identifying patients at risk. The test was performed in 107 asymptomatic patients early (5 to 8 days) after a first acute uncomplicated myocardial infarction managed with thrombolytic therapy. All patients were followed up for a mean of 15 months and 94 underwent coronary angiography. The test was considered positive if transient asynergy of contraction was newly detected either in the infarct and adjacent areas or in the remote zones; two subsets were studied, according to the dose of dipyridamole (0.56 or 0.84 mg.kg-1) needed to induce ischaemia. The test was accomplished satisfactorily in 96% of patients. Intra-inter-observer agreements were 88% and 91% respectively. The test also proved safe at the high infusion dose. During the follow-up period, two patients died, one experienced re-infarction and 12 (12%) developed recurrence of angina. DET was abnormal in 32 patients (adjacent and remote asynergy in 28 and four patients respectively): 18 had a critical and two a non-critical stenosis in the infarct-related vessel, and nine had an occluded artery with collateral distal flow. Multivessel disease was present in 11 patients considered positive, four in the remote and seven in the adjacent zones. However, 20 patients with negative DET results had multivessel disease. Of the positive DET patients, seven had angina. There were eight total events in the 71 negative DET patients, five of whom had multivessel disease. Abnormality was more pronounced in positive DET patients, but did not influence the outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

The aim of this study was to assess the incremental value of tissue harmonic imaging vs conventional echocardiography for evaluating left ventricular ejection fraction by manual and automated quantitation as well as visual estimation in patients with distorted left ventricles.In 25 patients unselected for image quality and with distorted left ventricles who underwent a nuclear study, digital cineloops of standard apical views were acquired by both tissue harmonic imaging and conventional echocardiography and sent to six observers for analysis of visual and quantitative left ventricular ejection fraction. Tissue harmonic imaging improved both the correlation and agreement of all echo techniques with nuclear measures, compared with conventional echocardiography echo, reducing standard errors (SE) to below 10%: for the visual estimate SE=7.5%, for manual tracing SE=6.3% and for automated tracing SE=8%. Tissue harmonic imaging decreased inter-observer variability compared with conventional echocardiography echo for both visual assessment (12.4% vs 18.4%, P0.05) and quantitative measures (for manual tracing, 8.2% vs 11.8%, P0.05; for automated tracing, 7.8% vs 16.8%, P0.05).In patients with distorted left ventricles unselected for image quality, tissue harmonic imaging improves accuracy and reproducibility of both visual and quantitative echocardiographic assessment of left ventricular ejection fraction. In particular, it promotes automated quantitation by reducing its high standard error into a clinically reasonable range.

Epidemiological evidence shows that among women, the incidence of all, including less severe, coronary events is still increasing. However, owing both to diminished lethality as well as the reduction in the rate of acute myocardial infarction, mortality has globally decreased. The strong association observed between mortality and major cardiovascular risk factors as well as between their temporal changes and the occurrence of coronary disease makes the undertaking of multifactorial prevention strategies, including the formulation of risk charts for asymptomatic women and men, necessary. The different "penetrance" of risk factors in women, together with their interaction with female hormones, plays an important role in the development of cardiovascular disease. The excess risk of cigarette smoking is 2-4 times higher in women than in men and the correlation with the number of cigarettes smoked daily is distinct. However, the risk starts to decrease immediately after stopping and after 3-5 years is similar to that of non-smokers. In women, the association between hypertension, coronary artery disease and early mortality is stronger than in men: there is no threshold below which the risk disappears. Diet and lifestyle strongly influence the development of hypertension. For this reason, the American Heart Association/American College of Cardiology guidelines recommend adherence to a set of dietary and lifestyle habits including body weight control and physical activity. In particular, diet may modify the "penetrance" of risk factors in women: hence excess intake of saturated fatty acids associated with decreased cereals, fruit and vegetables does not only alter the lipid profile but also increases the risk of coronary disease. An elevated total/HDL cholesterol ratio and the presence of lipoprotein(a) constitute significant risk factors for coronary events. On the other hand, high HDL cholesterol levels (45 mg/dl) are considered to be protective in women. However, data on the efficacy of strategies aimed at reducing blood LDL levels in hypercholesterolemic women are limited and controversial. Pharmacological therapy is recommended in women with primary familial hypercholesterolemia and during menopause when the patient presents with two or more risk factors. Besides, pharmacological therapy is also indicated for women with a history of coronary artery disease in whom benefits exceed those observed in male patients with a similar clinical picture. In diabetic women, the risk of coronary mortality is increased 3 to 7-fold compared to the 2 to 3-fold increase observed in diabetic men. Diabetes definitely increases the effects of the other risk factors and modifies the protective effect by estrogens. However, to date, there is no evidence that keeping glucose levels within normal limits reduces the risk of coronary artery disease nor has a glycemic threshold capable of predicting mortality risk in diabetic women been established. For this reason, guidelines for such patients are aimed at keeping the other risk factors under strict control in order to significantly reduce their effect. Obesity results in a series of metabolic alterations that increase the risk of cardiovascular disease in both sexes. Although most, if not all, data confirm that obesity alone is not of predictive value, central obesity constitutes a risk factor for cardiovascular disease. A body mass index24.9 kg/m2 and a waist circumference80 cm are recommended so as to decrease the likelihood of developing a menopausal insulin-resistance syndrome. It has been demonstrated that in men, a sedentary lifestyle is correlated with a higher cardiovascular and all-cause mortality; some recent observational studies suggest a 25-30% decrease in the mortality risk for women who perform physical exercise. Current guidelines recommend at least 30 min daily of dynamic moderately vigorous activity, including brisk walking. Rather than to the reduction in the serum levels of endogenous estrogens, the increase in the incidence of disease and of mortality following menopause should be attributed to the age-related modifications in risk factors which result in an increased risk of coronary artery disease. In spite of the proved detrimental effect of estrogen deficiency on LDL- and HDL-cholesterol, on arterial smooth muscle cell proliferation and on insulin secretion and in spite of the data of numerous observational studies and of the HERS trial (all, however, with methodological limitations), clinical evidence does not justify widespread estrogen prescription, not even for purposes of secondary prevention. Besides, the dosages and the route of administration are still subject of debate. (ABSTRACT TRUNCATED)

Echocardiographically recognized resting function, myocardial viability (by low-dose dobutamine) and stress-induced ischemia (by high-dose dipyridamole) are potent predictors of subsequent events, but their relative value in patients evaluated very early after acute myocardial infarction remains to be established.To assess the feasibility and usefulness of an integrated approach with resting and pharmacological stress echo for risk stratification in patients evaluated very early after myocardial infarction.Sixty acute myocardial infarction patients without contraindications to stress testing, and who were being given thrombolytic therapy, underwent resting echo (16-segment model of left ventricle, each segment scored from 1 = normo-hyperkinetic to 4 = dyskinetic), high-dose dipyridamole (up to 0.84 mg/kg over 10') and low-dose dobutamine (up to 10 mcg/kg/min) echo on the third-fourth day after drug withdrawal. The response was "ischemic" with a dipyridamole-induced increase in the regional score1 in segments with a resting score3, and "viable" with a dobutamine-induced decrease in the regional score1 in segments with resting score1. All patients underwent coronary angiography on the tenth-twelfth day after the acute event, and all of them were followed up for 15 +/- 10.04 months.Ischemia elicited by dipyridamole appeared in 29 patients (48%) and dobutamine-induced viability was observed in 28 (47%). Ischemic events occurred in 26 patients (43.4%), five of which during the early in-hospital period. There were three deaths (5%), one re-AMI (1.7%), 7 Canadian Class III-IV angina (12%) and 15 (25%) early revascularization procedures undertaken independently of stress echo results. Events occurred in 21 patients (72%) with dipyridamole-induced ischemia and in 5 (16%) without it (p0.001). Likewise, events occurred in 13 patients (46.4%) with dobutamine-induced inotropic recovery and in 13 (40.6%) without it (p = ns). Event-free survival occurred in 64% of dipyridamole-positive patients, as opposed to 90% of dipyridamole-negative patients (p = 0.025). Dipyridamole echocardiographic test sensitivity and specificity for events were 81 and 74%, respectively. Sensitivity and specificity for events of dobutamine viability were 46 and 55%, respectively. In a multivariate logistic analysis, dipyridamole-induced myocardial ischemia was the strongest predictor of subsequent events (p = 0.01). According to Cox analysis, dipyridamole positivity had a relative risk estimate of 4.Pharmacological stress echo is feasible even very early after acute myocardial infarction via a useful approach based on low-dose dobutamine to assess myocardial viability, and high-dose dipyridamole to assess ischemia. For risk stratification purposes, stress-induced myocardial ischemia outperforms resting function and myocardial viability, and it is independent of angiographic data. Revascularization procedures do not seem to be effective when only viability is present.

Several weeks of prophylactic anticoagulation are routinely prescribed before and after electrical cardioversion of atrial fibrillation. Recent studies have supported the use of transesophageal echocardiography to guide early cardioversion: patients in whom no thrombus is observed are treated with heparin followed by one month of warfarin therapy after the procedure. This kind of treatment requires hospital admission during heparin infusion, because of the need for monitoring partial thromboplastin time.To evaluate if a short at-home treatment (three days) with warfarin is sufficient to reach a good level of anticoagulation, in order to permit safe electrical cardioversion in day-hospital for patients who show no thrombi on transesophageal echocardiography.One hundred twenty-four patients with atrial fibrillation, who were candidates for cardioversion, were treated with warfarin: 10 mg the first and second day, 5 mg the third day in group A patients (n = 79); 15 mg the first day, 10 mg the second and third day in group B patients (n = 45). On the fourth day, INR value was measured and if it was2, warfarin therapy was prolonged until patients reached a good level of anticoagulation. Transesophageal echocardiography was performed when the INR wasor = 2, and patients were cardioverted with DC shock if there were no thrombi. The patients were discharged on the same day of the procedure, and warfarin therapy was continued for 4 weeks there-after. If a thrombus was detected, patients repeated transesophageal echocardiography after 6 weeks of warfarin therapy, and were cardioverted if the thrombus disappeared. Otherwise, cardioversion was deferred and they received prolonged warfarin treatment. If there was poor visualization of the left atrial appendage, patients received conventional warfarin therapy for 3 weeks before and 4 weeks after electrical cardioversion.Mean INR value after three days of warfarin treatment was 2.41 in group A patients and 3.02 in group B patients. Twenty-one patients from group A and 3 patients from group B required anticoagulant therapy for a mean of 3.3 and 5.1 days, respectively, before reaching a good level of anticoagulation (INR valueor = 2). Eight patients reverted spontaneously to sinus rhythm before transesophageal echocardiography. Eighteen thrombi (15.5%) were identified on the transesophageal echocardiography, all of which were in the left atrial appendage. In 11 cases, thrombus disappeared after 6 weeks of warfarin therapy. In 7 patients (6%), the atrial appendage was not sufficiently visualized. Electrical cardioversion was performed on 109 patients and was successful in 88 (80.7%). None of them experienced a clinical thromboembolic event.In the majority of patients in atrial fibrillation, a short at-home warfarin treatment is sufficient to reach a good level of anticoagulation in order to permit safe electrical cardioversion in a day-hospital situation. Larger initial doses can achieve even better results. This treatment algorithm minimizes the anticoagulation period, hospital stay, overall duration of atrial fibrillation and the time required for the mechanical function of the left atrium to return.

We outline here the logical flow of papers that attack the problem of estimating the wave conditions in front of and at the Venetian littoral. We start from the determination of the wind fields, followed by that of the wave fields. The wave data are then transferred to the coast. We end by analysing the wave conditions inside the main inlet to the Venice lagoon. This paper gives a brief account of the logical flow of arguments from paper to paper, indicating the main results and outlining the robust structure of the overall research. We end with a discussion on the accuracy of the results, and with an indication of the possible lines for further research.

Thromboembolic complications after electrical cardioversion (CV) of atrial fibrillation (AF) have been attributed to the dislodgment of preexistent left atrial thrombus during the resumption of atrial contraction. Transesophageal echocardiography (TEE) has been used to identify patients without thrombus, who potentially could undergo CV without anticoagulation. However, embolic events after CV in patients without evidence of thrombus on TEE have recently been reported.To evaluate if absence of thrombi or prethrombotic conditions such as spontaneous echo contrast or left atrial appendage disfunction can justify electrical CV without anticoagulant therapy.Seventy-four patients with AF and candidates for CV underwent monoplane TEE. Patients were cardioverted without anticoagulation in case of: 1) absence of thrombus and/or spontaneous echocardiographic contrast and 2) good visualization of left atrial appendage, with a well defined peak blood flow velocity greater than 20 cm/sec. In all other cases, patients underwent anticoagulant therapy which started 3 weeks before CV and continued for 4 weeks afterwards.Forty-six patients, without thrombus or "prethrombotic" conditions, did not receive anticoagulation, while 28 followed traditional therapy with warfarin. Four patients with a thrombus in the left atrial appendage were identified: 1 died of cerebral embolism 3 days after the beginning of anticoagulation, in another one CV was definitely deferred because of the persistence of thrombus after 1 month of warfarin therapy. One patient, with left atrial appendage disfunction, died suddenly after 5 days of anticoagulation. Two patients reverted spontaneously in sinus rhythm. Two patients refused electrical CV. The remaining 67 patients underwent electrical CV which was successful in 56 of them. Cerebral embolism occurred 24 hours after CV in one patient who did not receive anticoagulation. Repeat TEE soon after embolism showed absence of thrombus or spontaneous echo contrast, but the presence of low flow velocity in the left atrial appendage.In patients in AF candidates for CV, exclusion of thrombi or prethrombotic conditions by TEE does not exclude the risk of thromboembolic events and the need for anticoagulant therapy. Left atrial appendage function can be stunned or impaired immediately after CV, favouring a thrombogenic milieu and subsequent embolic events. Therapeutic anticoagulation at the time of as well as after cardioversion is actually recommended.

We studied 142 patients (121 males, 21 females) survivors of a first non complicated acute myocardial infarction (AMI) treated with thrombolytic therapy between March 1988 and December 1989. Dipyridamole echocardiography test (DET, 67 patients) and exercise electrocardiography test (EET, 104 patients) were performed to assess sensitivity and specificity in identifying patients at risk for an unfavorable clinical outcome and subsequent cardiac events: 67 patients underwent coronary arteriography within 4 weeks after AMI. DET positivity was related to the detection of a new transient asynergy of contraction either in infarct area or in remote zones. The mean follow-up period was 12 months (range 4-20). Clinical follow-up end-points of the study included death, re-AMI, angina. Sensitivity and specificity of EET and DET were 75 and 68%, 53 and 71% respectively. If EET plus DET were considered, sensitivity was 81% and specificity 60%. The fairly good DET sensitivity and specificity could be partially explained by some stunned myocardium exhibiting prolonged contractile dysfunction despite myocardial reperfusion. EET sensitivity and specificity is comparable to previous observations in AMI not treated with thrombolytic therapy. DET seems to be a useful and safe test in prognostic evaluation of asymptomatic patients after thrombolysed AMI, but its value is improved in association with EET.

Static lung volumes, flow volume curve in air and in a helium-oxygen mixture, PaO2 and pulmonary vascular pressures were measured in 16 patients 2 weeks after uncomplicated acute myocardial infarction and repeated 2 h after furosemide 40 mg i.v. administration. The patients with wedge pressure (WP) greater than 18 mm Hg had significantly lower values of FEV1, FEV1/VC%, MEF40 and MEF 25 in comparison with the patients with WE less than 18 mm Hg. A negative correlation was found between both PAP and WP and MEF25 values (p less than 0.001). After furosemide respiratory function tests improved only in patients with a good hemodynamic response to the drug. PaO2 did not change significantly. Airflow response to helium seemed to be a useful test for determining the site of major bronchial compression.

The extent to which patients with low peak serum creatine kinase (CK) at their first myocardial infarction differ from patients with high CK levels in terms of risk for subsequent ischaemic events was investigated in 266 patients who survived the first 48 h from the onset of infarction. All patients were followed up for one year. Four groups were formed based on peak CK less than or equal to 200, 201-400, 401-800 and greater than 800 IU l-1. During follow-up the incidence of mortality was 15% (N = 39), non-fatal re-infarction 9% (N = 23), and angina 53% (N = 140). Hospital mortality was significantly higher (P less than 0.02) in the highest CK-group (16%), but the incidence of non-fatal re-infarction, angina pectoris and late mortality was similar in the four groups. In hospital survivors, ischaemic ST-changes during pre-discharge symptom limited bicycle stress test and multiple vessel disease were equally distributed in all four groups. We conclude that while hospital mortality is directly related to peak CK, there is no relationship between peak CK and late mortality, non-fatal re-infarctions, or recurrent angina. Accordingly, diagnostic and therapeutic procedures in the individual patients are not influenced by the amount of serum CK released during acute infarction.

This paper presents the first steps in the implementation of a morphological numerical model to be applied in the Bevano River region, a shallow water area in the Adriatic Sea, with the aim of helping the identification and assessment of erosional patterns and bottom morphological modifications induced by severe marine storms. The numerical modeling, performed using a fully 3D coupled wave-current-sediment version of the ROMS model, has been complemented with in situ data analysis and observations: a first qualitative validation of the results was given by the analysis of images acquired via an ARGUS video station. Hydrodynamic modeling highlighted how shear bottom stresses and bottom currents fields were heavily influenced by severe storm situations, and had large effects on the morphology of shallow regions. The correlation between the wave-current induced bottom stresses and the resulting topography was investigated. Nearshore hydrodynamics modeling results demonstrated the dominant role played by alongshore sediment transport, with the magnitude of both cross- and along-shore wave-induced currents strongly depending on wave height and direction. We found a good qualitative conformity between the results of the numerical models applied during a “Bora” storm and the corresponding video observations; both techniques indicated the migration of the existing sandbar within the range of about 40 m seaward. Results show how integrated numerical open source tools, often used in oceanography, are becoming suitable for both preliminary investigations and for planning the effective littoral management, and how their calibration can be supported by the use of new low cost techniques, such as video measurements.