Role of emergency thoracic ultrasonography in spontaneous pneumomediastinum. Two case report

Early identification of spontaneous pneumomediastinum in an Emergency Department is possible with thoracic ultrasound. We report two cases of spontaneous pneumomediastinum, diagnosed in a 26-year old man with chronic asthma and a 19-year old athlete, and discuss the role of thoracic US alongside conventional X-ray and thoracic CT in emergency medicine. The patients were transferred to an Emergency Department, where conservative treatment produced a good outcome. The greater sensitivity and specificity of thoracic US over conventional supine X-ray in the detection of occult pneumothorax is ever more appreciated. However, training in the diagnosis of pneumomediastinum is required.

Volatile Blood Pressure Due To Baroreflex and Autonomic Failure

An 85-year-old male was hospitalized because of deterioration of his general condition and infection of the tracheostoma. He had had laryngectomy, bilateral neck dissection and radiation therapy for a laryngeal carcinoma 5 years earlier. Despite a good recovery, he could not get up because of a new onset of postural symptoms (dizziness, lightheadedness, collapse). Late onset of baroreflex failure and autonomic nervous system failure were diagnosed. Volatility of blood pressure (supine hypertension, upright hypotension) was treated with NaCl supplement during the day and a short-acting antihypertensive (clonidine) at night. With this regimen, the patient could walk without support.

Il «Castellazzo» di Monte Iato in Sicilia occidentale (PA) Quinta e sesta campagna di scavo. Aggiornamenti dal territorio

From May 15th to 30th and 15th to 30th September 2015 took place the fifth and sixth excavation campaign at the Castellazzo of Monte Iato. The presence of 15 participants made it possible to deepen the research significantly and ex-pand the surface area of investigation. It is completely emptied a room already identified in previous campaigns and provided new information about the relationship with the existing cemetery. Part of a burial in a supine position was destroyed by the installation of wall 20. Traces of another turret projecting from the walls have been discovered in the east and another section of the inner walls (15) was fully exposed. A gate, between two towers, is the first entry traced so far, on the north-eastern side of the plateau. The archaeological materials found confirm the characteristics and type of construction. Being a military camp of ephemeral nature, although active at least 30 years, objects such as arrowheads and crossbow quarrels, knives, buckles and harnesses for horses have been found. One of the environments has been interpreted as an area where gaming took place because of the presence of four dice in ivory, glasses and different coins, in addition to the greater extent than the other environments found. Among the findings are reported a glass weight with a cufic inscription dated to the mid-twelfth century and two bronze coins dated in 15th centu-ry.