Impact of the healthcare reorganization of the Local Health Authority services in Rieti (Italy) during the SARS-CoV-2 pandemic

Background

The need to contain the spread of the SARS-CoV-2 pandemic has forced national and local organizations to define and implement targeted emergency response and management measures. As the knowledge about the infection grew, a wider range of organizational measures were deployed.

Methods

This study involves the SARS-CoV-2 infected people managed by the Local Health Authority of Rieti (Italy). Diagnostic test waiting times and hospital admission rates in the Province of Rieti are investigated as the pandemic evolved. Trends were analyzed in relation to the tempora spreading of SARS-CoV-2, to the organizational actions taken by the Local Health Authority of Rieti, and to the deployment of actions across the territory. A municipalities classification of the province of Rieti was conducted after a cluster analysis based on the diagnostic test waiting times and the hospital admission rates.

Results

Our findings show a declining trend, thus indicating a possible positive effect of the measures taken to contain the pandemic. The cluster analysis of the municipalities of the Province of Rieti makes evident an inhomogeneous geographical distribution of examined parameters (diagnostic test waiting times and the hospital admission rates), demonstrating the capability of Local Health Authority of Rieti to reach even the most disadvantaged areas and implying that the differences are due to the demographical variabilities.

Conclusion

Despite some limitations, this study outlines the importance of management measures in response of the pandemic. These measures should adapt to social, cultural and geographical nature of the territory involved. The findings of the present study will contribute to the update of further pandemic preparedness plans of the Local Health Authorities.

Soft tissue augmentation by means of silicon expanders prior to bone volume increase: a case series

In guided bone regeneration (GBR) interventions, the incorrect manipulation of the soft tissues may lead to exposure of graft due to insufficient amount of tissue needed for a free-tension flap closure. The aim of this investigation was to evaluate the clinical and radiographical effectiveness of soft tissue augmentation in aesthetic areas. A total of 6 patients were treated in the Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, with a radiographical follow-up at 1 year from the loading. At the follow up, no soft tissue dehiscence was observed This study presented an innovative approach for soft tissue augmentation prior to bone regeneration in aesthetic areas. Augmentation of soft tissue with a silicon expander device before bone regeneration is a simple technique and also allows to obtain greater bone tissue in selective cases.

Preliminary analysis of the Respiratory Disease, based on Hospital Discharge Records, in the Province of L'Aquila, Abruzzo, Italy

BACKGROUND

The hospital discharge records (HDRs), integrated by other electronic health archives, besides some contra, can be a valuable and low-cost tool for monitoring public health.

METHODS

Throughout a retrospective cohort study, we analyzed all hospitalizations in ordinary regime from the HDRs database of the residents in the province of L'Aquila, with the exception of day hospital, rehabilitation and long-hospital stay between 2008 and 2013, with a principal diagnosis of respiratory disease of 460 to 519, according to the ICD-9-CM. We calculated number and standard hospitalization rate (SHR) for respiratory diseases in groups of diagnoses: Pneumonia, Asthma, COPD and Respiratory Insufficiency, Other diseases in the general population in the pediatric population and the over 65s, in the Province of L'Aquila and in the three areas of L'Aquila, Marsica and Peligno-Sangrina.

RESULTS

We observed different trends in SHRs in the different areas and for some of the different groups.

CONCLUSIONS

Diverse possible causes of the different trends are discussed, with a specific focus on a possible relation with the earthquake of the 6th April 2009, since coherent with the related scientific literature.

[Post-mastectomy breast reconstruction: esthetic-psychological rebalance]

Patient motivation and desire are the main indications for restoring the breast. Breast reconstruction can alleviate the sense of deformity that may develop after mastectomy or conservative treatment.

The expanded polytetrafluoroethylene (ePTFE) in the surgical treatment of Parry-Romberg syndrome: case report

Expanded polytetrafluoroethylene (ePTFE) was used in conjunction with autologous fat and silicone prosthesis to reshape the facial contour in a patient with mild Parry-Romberg syndrome (PRS). Patches of ePTFE were implanted in the temporo-malar and parotidean areas, fat was injected into the genian area and lower lip, and a middle-density solid silicone device was implanted in the chin. No complications were observed. The correction remained stable at follow-up 24 months post-op, permitting facial movements without alterations in contour. As far as we know, there has been no previous experience of ePTFE use in the treatment of PRS reported.