SUMMARY BackgroundEndoscopic dilatation for Crohn's disease has been evaluated only in some small and heterogeneous studies.

Leishmaniasis is one of the most neglected tropical diseases and epidemic outbreaks often occur worldwide. This paper reports some epidemiological features of the disease in Tigray, northern Ethiopia, with the aim of studying the disease distribution and the environmental factors that may have influenced it. Medical records from patients with Leishmania attending the Italian Dermatological Centre of Mekele in the period 2005-2008 were retrospectively reviewed. Age and gender distribution, clinical types, occupation, co-morbidity, urban/rural origin, altitude and rainfall were investigated. The result was 471 patients affected and the prevalent clinical form was cutaneous leishmaniasis (86%). Five main risk areas were identified in the Tigray highlands and only isolated cases were reported at altitudes below 1700m. The variables related to a higher risk of catching leishmaniasis were male gender, age over-14, poor education, outdoor activities and living at high altitudes. Climatic and environmental changes occurring in this region and land degradation are discussed as factors influencing leishmaniasis distribution. Further research including field missions and geomapping is needed to quantify the actual disease burden in the region.

Objective:Systematic bibliography analysis of about the last 17 years on multiple chemical sensitivity (MCS) was carried out in order to detect new diagnostic and epidemiological evidence. The MCS is a complex syndrome that manifests as a result of exposure to a low level of various common contaminants. The etiology, diagnosis, and treatment are still debated among researchers.Method:Querying PubMed, Web of Science, Scopus, Cochrane library, both using some specific MESH terms combined with MESH subheadings and through free search, even by Google.Results:The studies were analyzed by verifying 1) the typology of study design; 2) criteria for case definition; 3) presence of attendances in the emergency departments and hospital admissions, and 4) analysis of the risk factors.Outlook:With this review, we give some general considerations and hypothesis for possible future research.

Preventable trauma deaths are defined as deaths which could be avoided if optimal care has been delivered. Studies on preventable trauma deaths have been accomplished initially with panel reviews of pre-hospital and hospital charts. However, several investigators questioned the reliability and validity of this method because of low reproducibility of implicit judgments when they are made by different experts. Nevertheless, number of studies were published all around the world and ultimately gained some credibility, particularly in regions where comparisons were made before and after trauma system implementation with a resultant fall in mortality. During the last decade of century the method of comparing observed survival with probability of survival calculated from large trauma registries has obtained popularity. Preventable trauma deaths were identified as deaths occurred notwithstanding a high calculated probability of survival. In recent years, preventable trauma deaths studies have been replaced by population-based studies, which use databases representative of overall population, therefore with high epidemiologic value. These databases contain readily available information which carry out the advantage of objectivity and large numbers. Nowadays, population-based researches provide the strongest evidence regarding the effectiveness of trauma systems and trauma centers on patient outcomes.

The observed prevalence of sideropenia and sideropenic anaemia is much greater than what the scientific literature reports for Western populations. Pathologies inducing bleeding and the country of origin (i.e. genetic factors, pre-existing conditions) appear to be associated with anaemia. Nutritional factors are less important because of an adequate nutritional income. Prevention programmes should then aim at screening larger samples for improving the access of migrants to health-care services.