[Major emergency management in ship collusion].

Aim Of The Study: To prove that a correct management of a major emergency allowed a quick triage, trauma team, appropriate treatment, discharge and treatment of many patients injured patients when, in January 2007, a crush between a merchant ship and an hydrofoil happened in the Messina strait, that separate Sicily and Calabria.

Materials And Method: Four deaths and 105 injuries were observed. Our experience in the emergency care refers to 25 patients of them.

Revelation of an asymptomatic ventricular septal defect in elderly patient before a surgical intervention.

Certain congenital cardiac defects may go undetected for several years due to lack of symptoms and signs. The natural history of ventricular septal defects depends on the size of the defect and on the pulmonary resistance. In adults congenital heart disease, ventricular septal defects represent about 10% of the cases.

Revelation of Brugada electrocardiographic pattern during a febrile state.

The prevalence of the Brugada-type ECG and its natural history are still unclear. The Brugada syndrome is usually identified by a characteristic Brugada-type ECG that consists of ST elevation of a coved type in the precordial leads V1 to V3 and ventricular fibrillation that can lead to sudden cardiac death, although affected individuals may have a normal ECG. Mutations in the cardiac sodium channel gene SCN5A, which encodes the alpha-subunit of the human cardiac voltage-dependent Na+ channel (Na(v)1.

Paroxysmal atrial fibrillation, pre-bundle branches and right bundle branch conduction disturbances without acute myocardial infarction in a patient admitted for an intestinal subocclusion.

Dissimilar electrocardiographic patterns associated with right bundle branch block have been described. The morphological diversity in right bundle branch block patterns is likely to be related to multiple factors-site of block, nature of defect (functional, necrosis, fibrosis), degree of conduction delay, and associated pathologies with their own ECG patterns. The prognosis of right bundle branch block in the absence of underlying cardiac disease is good but it may be poor in other cases, particularly coronary artery disease.

Abnormal troponin I levels in acute pulmonary embolism without abnormal concentrations of D-dimer at admission.

Serum troponin I is a sensitive indicator of myocardial damage but abnormal troponin I levels have been reported without acute coronary syndrome and without cardiac damage. It has been reported that right ventricular overload and hypoxia in acute pulmonary embolism may lead to right ventricular myocardium injury reflected by elevated cardiac troponin levels and that in patients with acute central sub-massive or non-massive pulmonary embolism, even mild increase in troponin I >0.03 mug/L may provide relevant short-term prognostic information independent to clinical, laboratory and echocardiographic data.

[Breast abnormalities: a retrospective study of 208 patients].

Ectopic breast tissue occurs in 0.4-6% of the general population. Usually, these tissues develop along the embryonic milk line but other sites are reported in the literature.