Magnetic Theory and Applications in the Naples Bay (Southern Tyrrhenian Sea, Italy): Magnetic Anomaly Fields and Relationships with Morpho-Structural Lineaments

Magnetic theory and application to a complex volcanic area located in Southern Italy are here discussed showing the example of the Gulf of Naples, located at Southern Italy Tyrrhenian margin. A magnetic anomaly map of the Gulf of Naples has been constructed aimed at highlighting new knowledge on geophysics and volcanology of this area of the Eastern Tyrrhenian margin, characterized by a complex geophysical setting, strongly depending on sea bottom topography. The theoretical aspects of marine magnetometry and multibeam bathymetry have been discussed. Magnetic data processing included the correction of the data for the diurnal variation, the correction of the data for the offset and the leveling of the data as a function of the correction at the cross-points of the navigation lines. Multibeam and single-beam bathymetric data processing has been considered. Magnetic anomaly fields in the Naples Bay have been discussed through a detailed geological interpretation and correlated with main morpho-structural features recognized through morphobathymetric interpretation. Details of magnetic anomalies have been selected, represented and correlated with significant seismic profiles, recorded on the same navigation lines of magnetometry. They include the continental shelf offshore the Somma-Vesuvius volcanic complex, the outer shelf of the Gulf of Pozzuoli offshore the Phlegrean Fields volcanic complex, the relict volcanic banks of Pentapalummo, Nisida and Miseno, the Gaia volcanic bank on the Naples slope, the western slope of the Dohrn canyon, the Magnaghi canyon’s head and the magnetic anomalies among the Ischia and Procida islands.

Fever, Hemiparesis and Hyponatraemia in a 63-year-old. HIV, another Great Masquerader?

The authors describe the unusual case of a 63-year-old patient who was referred with fever and lethargy, and was found to be hyponatraemic. The patient subsequently developed hemiparesis, and neuroradiology showed several space-occupying brain lesions. The cause was later identified as cerebral toxoplasmosis in undiagnosed Acquired Immunodeficiency Syndrome (AIDS).

Prioritization of Multimedication in Multimorbidity: Where Are We Now?

Multimorbidity, the co-occurrence of multiple chronic conditions in an individual, and the frequently associated multimedication is a health issue mostly dealt with in primary care consultations.

Nutraceutics, Frailty and Polypharmacy in the Oldest Old

Malnutrition and nutritional problems are common in older adults. Multiple chronic disease, inflammation, cognitive and functional impairment, geriatric syndromes (including delirium, falls or chronic pain) and drug use (i.e. polypharmacy, adverse drug reactions) may play a role in the onset of malnutrition and nutritional problems.

Addressing Inpatient Admissions and Readmissions Due to Adverse Drug Reactions in the Oldest Old

Adverse drugs reactions (ADRs) in the older population are a major healthcare problem resulting in significant morbidity, healthcare consumption and high costs.

STOPP/START Criteria and Their Role as a Clinical Tool in Routine Practice

Screening Tool of Older Persons’ Prescriptions (STOPP)/Screening Tool to Alert to Right Treatment (START) criteria was first published in 2008, primarily as an alternative set of explicit criteria for potentially inappropriate medications (PIMs) to Beers criteria.

A Comprehensive Protocol to Mitigate Inappropriate Medication in the Elderly

The percentage of elderly population is increasing and it is estimated that by 2050 30% of the population in developed countries will be over 65. Elderly often have multiple chronic diseases that require multiple medications.

Improving Drug Prescription in Elderly Diabetic Patients

Nowadays, there is no doubt that there is a good epidemic of ageing with the inversion of the population pyramid. There is no doubt either about the current epidemic of obesity and bad nutritional habits that have resulted in an increase of diabetic patients in the world. And the union of these epidemics has led to an increase of diabetes (DM) in the elderly.

The STRIPassistant: a Digital Tool to Optimize Polypharmacy

The Structured Tool to Reduce Inappropriate Prescribing (STRIP) is a method to perform a medication review. Part of this method is the pharmaceutical analysis that is digitalized into the STRIPassistant (demo: www.ephor.eu). The effectiveness and time-efficiency of the STRIPassistant will be presented.

Inappropriate Drug Prescribing in Older Adults: How to Reduce It?

Because older patients are more vulnerable to adverse drug-related events, there is a need to ensure appropriate pharmacotherapy in these patients. Screening to identify older patients at risk of drug-related problems (DRP) and adverse drug reactions (ADR) is the first critical step within a multistep approach to geriatric pharmacotherapy.

Embolisation of Vertebral Artery Damaged Following Cervical Disc Removal

Introduction: The incidence of vertebral artery (VA) injury during cervical spine surgery is rare. Even though tamponade is effective in many cases, early consultation of an endovascular team is recommended if bleeding cannot be controlled. We report a case of emergent endovascular embolisation of left VA due to iatrogenic injury during anterior cervical disc removal and fusion. Case: A 47-year-old woman was admitted to our emergency department with serious arterial bleeding from the neck only hours after undergoing anterior cervical disc removal and fusion surgery. She was intubated and mechanically ventilated, however hemorrhage could not be successfully controlled by packing with surgical hemostatic agents. Cranial computed tomography, computed tomography of the cervical spine and CT angiography confirmed the suspected diagnosis of injury to the VA. Emergent endovascular embolisation successfully stopped the bleeding. Occlusion of the vessel was achieved by vascular plugging. The patient was discharged from our hospital 14 days after the intervention, receiving a revision surgery of the cervical spine on the day of embolisation. At the date of discharge she presented without any focal neurological deficit. Conclusion: Pre-operative radiographic imaging of the cervical spine should be used routinely to identify anatomic abnormalities of the vertebral arteries. Endovascular embolisation appears to be effective in treating acute iatrogenic dissection of the vertebral arteries.

Hepcidin and Ferritin Levels in Fever of Unknown Origin: Is There a New Biomarker?

Background and objectives: Significantly elevated serum ferritin levels are associated with both iron overload and some inflammatory conditions. Hepcidin is a protein that interferes with iron absorption in inflammatory states and acts as an acute-phase reactant. Materials and methods: Here we report the case a 33-year-old patient who presented with high fever, skin lesions and arthralgia lasting for 2 weeks. His ferritin level was 13,800 µg/l and his hepcidin level was 61 ng/dl. Results: The final diagnosis was adult onset Still's disease. The condition evolved satisfactorily with steroid treatment, but after several weeks the patient presented with an unexpected recurrence. Conclusions: Hepcidin is a good inflammatory marker that could be useful in the differential diagnosis of hyperferritinaemia.

Left Ventricular Thrombosis in a Young Ulcerative Colitis Patient: Review with a Case Report

Inflammatory bowel disease (IBD) patients are at increased risk of developing thromboembolic complications. We report here a rare case of left ventricle thrombus in a young woman with ulcerative colitis. We discuss the pathophysiology of hypercoagulable state in IBD, and briefly address current prophylactic anticoagulation recommendations.

Anti-Signal Recognition Particle Myopathy in a Geriatric Patient

Anti-signal recognition particle (SRP) myopathy is a rare idiopathic inflammatory myositis that usually affects middle-age women, and is characterized by rapidly progressive proximal and symmetrical muscle weakness, elevated creatine kinase levels, severe necrotizing immune-mediated myopathy, presence of anti-SRP autoantibodies and poor response to steroid therapy. We report a geriatric case of a previously independent patient, presenting with slow onset of proximal paraparesis, myalgia and severe gait impairment. The patient was treated with steroid and azathioprine, with laboratory and pain response but modest muscle strength improvement. The clinical presentation of this unusual patient was atypical, which hampered the correct diagnosis.

Strongyloides stercoralis - a Legacy from the Past

The authors present the case of a 65-year-old Caucasian man who had previously lived in Guinea-Bissau. The patient was diagnosed in Portugal with an anti-neutrophil cytoplasmic antibody-associated vasculitis and started on corticosteroids plus cyclophosphamide, with clinical improvement. Some months later, his general status deteriorated, iatrogenic bicytopenia developed and immunosuppressive drugs were tapered. Microbiological tests identified numerous larvae and eggs of Strongyloides stercoralis in various biological samples, and a diagnosis of hyperinfection syndrome was established. The patient was started on antihelminthic drugs but developed septic shock and died. This case highlights a rare and severe complication of immunosuppression in developed countries.