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The objective of this study was to investigate the long term trend of pediatric injuries in Veneto Region (North-East of Italy) over 10 years, evaluating if seasonality in injury hospitalisations exists. Regional data on hospital admissions during the period 2000-2009 were analysed. Injury was defined as any condition identified by the International Classification of Diseases, 9th edition, Clinical Modification (ICD-9-CM) codes 800-999, excluding late effects from injury (ICD-9-CM codes 905-909), and complications of surgical and medical care, not classified elsewhere (ICD-9-CM code 995-999) in the first diagnostic field. Cyclic trends in seasonality of injuries were tested with Nam test. Thirty-five thousand seven hundred and fifty-one hospitalisations due to an injury have been recorded. Significant seasonal variation in hospitalisations for injuries was observed, with a summer to winter ratio ranging from 1.8 for minor injuries to 2.0 for severe injuries (p <0.001). The observed pattern of increased admission in the summer months should guide resource planning and implementation of preventive strategies.

Background: Whether immigrant children receive unnecessary treatments and surgical procedures to a greater extent than non-immigrants remains controversial., Objective: To investigate whether hospitalisation rates differ between immigrant and non-immigrant preschool children and the extent to which such differences relate to specific pathological conditions., Methods: All discharges occurring to children aged 1-5 years between 2005 and 2007 in the Italian Region of Veneto (4.8 million inhabitants) were analysed by diagnosis related groups (DRGs). Crude and age-standardised hospitalisation RRs of immigrant versus Italian children were computed. Results Hospitalisation rates for medical conditions were similar between immigrant and Italian children. However, hospitalisation rates among immigrant children were significantly lower than those among Italians for all the most frequent surgical DRGs. RRs (95% CI) of immigrant versus Italian children were 0.46 (0.41 to 0.51) for tonsillectomy/adenoidectomy and 0.46 (0.38 to 0.57) for testes procedures in boys; 0.44 (0.38 to 0.49) for tonsillectomy/adenoidectomy and 0.47 (0.34 to 0.65) for extraocular procedures in girls. Only circumcision procedures were more frequent (fourfold excess) among immigrants., Conclusion: Hospitalisation rates for the most frequent surgical procedures are significantly lower among immigrants compared to non-immigrant preschool children. Reduced surgery rates among immigrants might result from a complex interplay between parental attitudes and knowledge of paediatric conditions, language barriers and access to primary care.

Background: This study investigates the degree to which a previous hospitalisation for injury of any intent is a risk of subsequent youth suicide and whether this association is influenced by family socioeconomic status or economic stress., Methods: A nationwide register-based cohort study was conducted covering all Swedish subjects born between January 1977 and December 1991 (N=1,616,342, male/female ratio=1.05). The cohort subjects were followed-up from January 1998 to December 2003, when aged 7-26 years. Poisson regression and the likelihood ratio test (95% CI) were used to assess the age-adjusted effect of hospitalisation for injuries of various intent on youth suicide and its effect once adjusted for family sociodemographic and social circumstances., Results: Each set of exposures was associated independently and significantly with suicide mortality. Being hospitalised for self-inflicted injuries or injuries of undetermined intent was associated with a risk of suicide 36 to 47 times, respectively, that of subjects never hospitalised in the period under study (95% CI 28.36 to 45.58 and 26.67 to 83.87 for self-inflicted injuries and for events of undetermined intent, respectively; overall p<0.01). Similarly, previous events of unintentional injury markedly increased the risk of suicide (RR 3.08; 95% CI 2.26 to 4.19). These effects were solid and not substantially altered after adjustment for family demographic and socioeconomic circumstances., Conclusion: A strong association exists between previous hospitalisation for injury of any intent and youth suicide. The association is robust and unaltered by family socioeconomic circumstances.

Objective: Italy has become an important host country for economic immigrants. The study is aimed at providing a descriptive analysis of obstetric hospitalizations among Italian and immigrant women in North-Eastern Italy., Design: Population-based registry descriptive study., Setting: Veneto Region, Italy., Methods: All obstetric hospitalizations in 2006-2007 were extracted from the regional archive of hospital discharge records (n = 144,698). Discharges for vaginal delivery, cesarean section, threatened abortion and other antepartum diagnoses, miscarriages, and induced abortions were identified among residents with Italian or foreign citizenship, and irregular immigrants. Hospitalization rates for the above diagnostic categories were computed for Italian and foreign Veneto residents., Main Outcome Measures: Delivery rates, proportion of cesarean sections, hospitalization rates for antepartum hospitalizations, miscarriage, induced abortion, and hospitalization rate ratios of immigrants versus Italian women., Results: Among Italian women, regular and irregular immigrants, the percentages of teenage deliveries were 0.7, 2.9, and 8.4%; the ratios of miscarriages to deliveries were 0.16, 0.15 and 0.35; the ratios of induced abortions to deliveries were 0.13, 0.24 and 0.81, respectively. Regular immigrants accounted for 10% of population aged 15-49 and for 20% of deliveries. The age-related increase in miscarriage risk was steeper among regular immigrants. The induced abortions to deliveries ratio peaked among Italians aged <25 and regular immigrants aged ≥35 years. 40% of Italians and 30% of regular immigrants sought care outside nearest hospitals., Conclusions: Wide differences in reproductive behavior, health status, and patterns in the access to health services exist between Italians, regular and irregular immigrants even though they represent three connected populations.

Background: Numerous studies have investigated mortality during a heatwave, while few have quantified heat associated morbidity. Our aim was to investigate the relationship between hospital admissions and intensity, duration and timing of heatwave across the summer months., Methods: The study area (Veneto Region, Italy) holds 4577408 inhabitants (on January 1st, 2003), and is subdivided in seven provinces with 60 hospitals and about 20000 beds for acute care. Five consecutive heatwaves (three or more consecutive days with Humidex above 40 degrees C) occurred during summer 2002 and 2003 in the region. From the regional computerized archive of hospital discharge records, we extracted the daily count of hospital admissions for people aged >or=75, from June 1 through August 31 in 2002 and 2003. Among people aged over 74 years, daily hospital admissions for disorders of fluid and electrolyte balance, acute renal failure, and heat stroke (grouped in a single nosologic entity, heat diseases, HD), respiratory diseases (RD), circulatory diseases (CD), and a reference category chosen a priori (fractures of the femur, FF) were independently analyzed by Generalized Estimating Equations., Results: Heatwave duration, not intensity, increased the risk of hospital admissions for HD and RD by, respectively, 16% (p < .0001) and 5% (p < .0001) with each additional day of heatwave duration. At least four consecutive hot humid days were required to observe a major increase in hospital admissions, the excesses being more than twofold for HD (p < .0001) and about 50% for RD (p < .0001). Hospital admissions for HD peaked equally at the first heatwave (early June) and last heatwave (August) in 2004 as did RD. No correlation was found for FF or CD admissions., Conclusion: The first four days of an heatwave had only minor effects, thus supporting heat health systems where alerts are based on duration of hot humid days. Although the finding is based on a single late summer heatwave, adaptations to extreme temperature in late summer seem to be unlikely.

Objective: To assess the burden of hospitalization for acute coronary syndrome (ACS) and the impact of the new diagnostic criteria for acute myocardial infarction on epidemiology of ACSs., Methods: We analysed the hospital discharge record archives of the Veneto Region in the period 2000-2003, including admissions of regional residents outside the study area. We defined a list of ICD-9-CM codes for the identification of different types of ACS. We examined trends in standardized hospitalization rates as well as patient characteristics (age, sex) and pattern of care (setting, invasive revascularization, length of hospital stay, in-hospital mortality)., Results: The hospitalization rate for non-ST-elevation myocardial infarction increased by about 70%, with a parallel decrease in hospitalizations for unstable angina, whereas the hospitalization rate for ST-elevation myocardial infarction remained unchanged. These trends are likely influenced by the new diagnostic criteria for acute myocardial infarction. At the end of the study period, although the main patient characteristics did not vary substantially, the pattern of care turned out to be more aggressive., Conclusions: Despite some limitations, our results indicate that the new diagnostic criteria for acute myocardial infarction have a major impact on epidemiological evaluation. These data may be relevant when comparing epidemiological data of different periods and planning healthcare policies. Further studies are needed in order to evaluate the accuracy of ICD-9-CM codes in the diagnosis of ACSs.