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Background: Few studies have addressed predictors of long-term mortality after first-ever ischaemic stroke. Methods: We prospectively collected data on 361 consecutive patients admitted to 18 neurology departments in Italy for a first-ever ischaemic stroke in 1999, categorized according to the Oxfordshire Community Stroke Project (OCSP) classification. Age, gender, risk factors, previous vascular disease, in-hospital complications, stroke severity, functional status, therapy and living place at admission, discharge and after 6 months were recorded. Follow-up was available for 97% patients at 5 years. Results: Survival probability was 91% (95% CI = 88–94) at 1 month, 84% (80–88) at 6 months and 64% (58–69) at 5 years. Mortality was higher for the TACI (total anterior circulation infarct) group compared to the other categories (p < 0.0001). Hazard ratios for 5-year mortality in the final model were: 5.4 for age ≥65 years (p < 0.0001), 2.8 for TACI (p < 0.0001), 2.7 for previous vascular disease (p < 0.01) and 1.9 for cardio-embolic risk according to the TOAST risk stratification (p < 0.05). Conclusions: Our study extends the prognostic value of the OCSP classification to 5-year survival.

Awake surgery can be highly stressful for patients. In fact, being awake, patients could perceive that the environmental demands are taxing or exceed their adaptive abilities. We proposed the use of Virtual Reality as a functional and effective tool for a new class of clinical applications aimed at helping patients to cope with these specific stressful situations. Using coping skills that have been learnt during the virtual experience, patients can reduce their psychological stress and improve their collaboration and - in general - the outcome of the intervention.

Background: To determine the health needs non-nationals, information on disease occurrence is fundamental. Goals: The goal of this study was to assess the clinical and behavioral characteristics of non-Italians with a new sexually transmitted infection (STI). Methods: Data were taken from Italy’s National STI Surveillance System (1991–1999). Results: Of the 61,798 STI cases reported from January 1991 to December 1999, 6847 (11.2%) were diagnosed among non-Italians, 47.1% of whom were Africans. Being a non-Italian patient with an STI was associated with male gender (adjusted odds ratio [AOR], 1.19; 95% confidence interval [CI], 1.11–1.27), youngest age (AOR, 1.71; 95% CI, 1.43–2.04), no formal education (AOR, 20.25; 95% CI, 17.51– 23.42), and having contracted the STI abroad (AOR, 13.98; 95% CI, 12.59 –15.54). The HIV-1 prevalence among non-Italian patients with STIs was 5.5% (95% CI, 4.9 – 6.2), with large differences by continent of origin. The highest prevalence was found among European injecting drug users (54.1%; 95% CI, 37.1–70.1), South American homosexual men (41.6%; 95% CI, 32.0 –51.8), and heterosexuals from Sub-Saharan Africa (8.9%; 95% CI, 7.2–10.8). Conclusions: Non-Italian patients with STIs seem to consist mainly of migrants, and STI transmission patterns differ from those among Italians; this information is important for developing targeted STI prevention efforts. THE MASSIVE MOVEMENT ALONG the modern migration routes represents one of the most important determinants of human health and of modifications in social status worldwide. In addition to the health implications for the migrants themselves, migration has an impact on the healthcare systems of the countries that host these persons. 1 So that these countries can better assess and satisfy the health needs of migrants, and of non-nationals in general, it is necessary to have adequate information on disease occurrence among these populations. Although such data should ideally be provided by national health surveillance systems or large multisite studies, this is rarely the case, and few national health statistics anywhere distinguish between disease cases among non-nationals and those found in the native population. 2

Awake surgery can be highly stressful for patients. In fact, being awake, patients could perceive that the environmental demands are taxing or exceed their adaptive abilities. We proposed the use of Virtual Reality as a functional and effective tool for a new class of clinical applications aimed at helping patients to cope with these specific stressful situations. Using coping skills that have been learnt during the virtual experience, patients can reduce their psychological stress and improve their collaboration and - in general - the outcome of the intervention.

In the early-middle stages of Parkinson's disease (PD), polysomnographic studies show early alterations of the structure of the sleep, which may explain frequent symptoms reported by patients, such as daytime drowsiness, loss of attention and concentration, feeling of tiredness. The aim of this study was to verify if there is a correlation between the sleep dysfunction and decision making ability. We used a Virtual Reality version of the Multiple Errand Test (VMET), developed using the NeuroVR free software (http://www.neurovr2.org), to evaluate decision-making ability in 12 PD not-demented patients and 14 controls. Five of our not-demented 12 PD patients showed abnormalities in the polysomnographic recordings associated to significant differences in the VMET performance.