The consequences of the COVID-19 pandemic on the refugee population: a rapid review.

AIMS: This is a rapid review examining the available evidence about the repercussions of the COVID-19 pandemic on the refugee population. METHODS: A search in the databases such as PubMed, Scopus, CINAHL, PsycINFO, and Web of Science was conducted and all relevant original articles, letters, and editorial and policy papers were included. RESULTS: From 208 publications matching the search criteria, 36 were included. These publications were categorized into three distinct domains: Public Health, Policies and Financing, and Technology. Our findings revealed that the situation of the refugee population has worsened during the pandemic. Difficulty accessing healthcare, violation of human rights, lack of access to technology devices, unfavorable government policies, and economic crisis were the most important aspects impacted by COVID-19. CONCLUSION: Governments, health managers, health professionals, and policy makers should be aware of refugees' problems during the pandemic to provide immediate solutions.

Adverse events in meditation practices and meditation-based therapies: a systematic review.

OBJECTIVE: Meditation techniques are widely used as therapy and wellbeing practices, but there are growing concerns about its potential for harm. The aim of the present study is to systematically review meditation adverse events (MAEs), investigating its major clinical categories and its prevalence. METHOD: We searched PubMed, PsycINFO, Scopus, Embase and AMED up to October 2019. Eligible studies included original reports of meditation practices (excluding related physical practices such as Yoga postures) with adult samples across experimental, observational and case studies. We identified a total of 6742 citations, 83 of which met the inclusion criteria for MAEs with a total of 6703 participants who undertook meditation practice. RESULTS: Of the 83 studies analysed, 55 (65%) included reports of at least one type of MAE. The total prevalence of adverse events was 8.3% (95% CI 0.05-0.12), though this varied considerably across types of studies - 3.7% (95% CI 0.02-0.05) for experimental and 33.2% (95% CI 0.25-0.41) for observational studies. The most common AEs were anxiety (33%, 18), depression (27%, 15) and cognitive anomalies (25%, 14); gastrointestinal problems and suicidal behaviours (both 11%, 6) were the least frequent. CONCLUSION: We found that the occurrence of AEs during or after meditation practices is not uncommon, and may occur in individuals with no previous history of mental health problems. These results are relevant both for practitioners and clinicians, and contribute to a balanced perspective of meditation as a practice that may lead to both positive and negative outcomes.

Clinical impact and prevalence of MRSA CC398 and differences between MRSA-TetR and MRSA-TetS in an area of Spain with a high density of pig farming: a prospective cohort study.

OBJECTIVES: Tetracycline resistance (TetR) is a phenotypic marker of the livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) CC398 clone. The aim of this study was to analyse the prevalence of MRSA CC398 in patients in contact with healthcare facilities and differences between patients with MRSA-TetR and MRSA tetracycline-susceptible (TetS) strains. METHODS: Patients diagnosed with MRSA from January 2012 to December 2015 were divided into two groups, MRSA-TetR and MRSA-TetS. Epidemiologic and clinical data were evaluated. Molecular analysis was performed (multilocus sequence typing, spa typing) on MRSA-TetR strains. RESULTS: Data from 288 MRSA patients were obtained, and 106 (36.8%) carried MRSA-TetR (93 typed as CC398 (87.7%); the remaining 13 isolates were ascribed to CC9, CC1, CC121, CC30, CC97, CC146 and CC152). The most frequent spa type was t011 (56.6%, 61/106). Detection of MRSA-TetR increased over the years (21.9%, 16/73, in 2012; 50.7%, 36/71, in 2015; p <0.001). Hospital acquisition was found in 16.7% (19/114) of MRSA-TetR patients vs. 83.3% (95/114) in MRSA-TetS patients (p <0.001). Frequency of MRSA-TetR patients in nursing homes was lower than in MRSA-TetS patients (4.7%, 5/106, vs. 27.5%, 50/182, p <0.001). MRSA-TetR as distinct from MRSA-TetS was associated with workers on pig farms (49.0%, 52/106, vs. 1.0%, 2/182; p <0.001), fewer admissions to hospital (46.2%, 49/106, vs. 68.1%, 124/182; p <0.001) and fewer comorbidities (81.1%, 86/106, vs. 59.9%, 109/182; p <0.001). Sixty cases of MRSA-CC398 infection were diagnosed, including, among others, endocarditis, septic arthritis, prosthetic joint infection, pneumonia and bacteraemia. CONCLUSIONS: Prevalence of MRSA-TetR (especially CC398) at the hospital level in a Spanish region with intensive pig farming activity is high and is responsible for severe infections. Significant differences were detected in clinical and epidemiologic characteristics among MRSA-TetR and MRSA-TetS patients.

Effect of temperature on the release and remobilization of ecotoxic elements in AMD colloidal precipitates: the example of the Libiola copper mine, Liguria, (Italy).

Due to their characteristics, colloidal particles are able to control the dispersion of many organic and inorganic pollutants in soils and streams. Colloidal precipitates generated by acid mine drainage (AMD) process are usually amorphous or nanocrystalline materials, and their stability plays a crucial role in controlling the fate of metals released by sulphide oxydation. This paper describes a study of elements release (Fe, Al, Mn, Cd, Co, Cr, Cu, Ni, S, Zn) due to desorption or destabilization of three different colloidal precipitates, two ochreous and a greenish-blue precipitate, sampled at the Libiola mine site (northwest Italy). The samples were heated at high temperature in order to verify this treatment as inertization process. At room temperature, the most easily extracted element was S (with released percentages from 8.39 to 29.17 %), but considerable amounts of Cu, Zn and Mn (up to 16.6, 610.6 and 595.6 mg/kg, respectively) were also observed in the leachates for greenish-blue precipitates. The highest release of elements (S > Cu, Zn, Mn, Cd > Co, Ni > Al, Fe, Cr), with minor differences depending on the mineralogical composition of the samples, was observed for heat-treated samples obtained through moderate heating and mainly formed by anhydrous phases. Samples treated at high temperature had the lowest release, with only Cu showing a significant concentration in the leachate of greenish-blue precipitates. The results showed that dissolution/desorption is limited from ochreous natural colloidal precipitates occurring at the Libiola mine site but also that high amounts of some metals can be remobilized from greenish-blue precipitates. The destabilization of all percipitates through dehydratation-dehydroxylation can further remobilize important amounts of ecotoxic elements. Heat treatment at high temperature could be a definitive, although expensive, way to fix heavy metals in the solid fraction, preventing their dispersion in the surrounding environment.

Religious and spiritual interventions in mental health care: a systematic review and meta-analysis of randomized controlled clinical trials.

BACKGROUND: Despite the extensive literature assessing associations between religiosity/spirituality and health, few studies have investigated the clinical applicability of this evidence. The purpose of this paper was to assess the impact of religious/spiritual interventions (RSI) through randomized clinical trials (RCTs). METHOD: A systematic review was performed in the following databases: PubMed, Scopus, Web of Science, PsycINFO, Cochrane Collaboration, Embase and SciELO. Through the use of a Boolean expression, articles were included if they: (i) investigated mental health outcomes; (ii) had a design consistent with RCTs. We excluded protocols involving intercessory prayer or distance healing. The study was conducted in two phases by reading: (1) title and abstracts; (2) full papers and assessing their methodological quality. Then, a meta-analysis was carried out. RESULTS: Through this method, 4751 papers were obtained, of which 23 remained included. The meta-analysis showed significant effects of RSI on anxiety general symptoms (p < 0.001) and in subgroups: meditation (p < 0.001); psychotherapy (p = 0.02); 1 month of follow-up (p < 0.001); and comparison groups with interventions (p < 0.001). Two significant differences were found in depressive symptoms: between 1 and 6 months and comparison groups with interventions (p = 0.05). In general, studies have shown that RSI decreased stress, alcoholism and depression. CONCLUSIONS: RCTs on RSI showed additional benefits including reduction of clinical symptoms (mainly anxiety). The diversity of protocols and outcomes associated with a lack of standardization of interventions point to the need for further studies evaluating the use of religiosity/spirituality as a complementary treatment in health care.

Nursing home care: exploring the role of religiousness in the mental health, quality of life and stress of formal caregivers.

Despite the high number of studies on family caregivers, there is little research on the impact of religiosity on formal caregiving (paid providers). We examine the role of religiousness in the mental health, quality of life and stress of nurse aides (NA) who provide care for patients in a nursing home. NA in a Brazilian nursing home were invited to participate. Because of its coping function, we hypothesized that religiousness was related to better mental health and quality of life. Linear regression was used to test this hypothesis and control for confounders. Compared with the Brazilian general population, NA scored higher on measures of religious involvement. Intrinsic religiosity was associated with better mental health and quality of life. Organizational religiosity was associated with better social functioning, better general mental health and fewer anxiety symptoms. Non-organizational religiosity (prayer), however, was associated with negative outcomes, such as higher stress, poorer general health perceptions and more anxiety symptoms. Most NA indicated that they had prayed for and with their patients. In conclusion, paid caregivers (NA) have a strong sense of religiousness, which plays an important role in many ways, including the type of care they provide, their mental health and their quality of life.

Internal carotid artery dissection in a patient with Behçet's syndrome.

The authors report a case of internal carotid artery dissection in a young woman with Behçet's syndrome. The authors postulate that a vasculitis of the vasa vasorum already suspected as the basis of aneurysm formation in course of Behçet's syndrome can account for occurrence of arterial dissection in this inflammatory condition.

A sentinel network of general practitioners for epidemiologic surveillance in Italy.

A Computer Network of General Practitioners (GP's) has been established connecting 110 general practitioners representing a statistically selected national sample, homogeneously distributed all over Italy. The purpose of the network is to increase the epidemiologic surveillance on the health status of the Italian community, to collect useful data on the routine activity of the GP's, to promote computer use among them, and to organize some "ad hoc" investigations on specific subjects (case-control studies). To this purpose, a specific software was developed both to meet the requirements of epidemiological research and to manage general practitioners' clinical files. A working prototype of health card using micro-computer technology is also being experimented on a subset of the GP's.

An experimental network of general practitioners for purposes of epidemiological surveillance in Italy.

A Computer Network of General Practitioners (GPs) has been established, connecting 150 general practitioners representing a statistically selected national sample, homogeneously distributed all over Italy. The purpose of the network is to increase the epidemiological surveillance on the health status of the Italian community, to collect useful data on the routine activity of the GPs, to promote computer use among them, and to organize some "ad hoc" investigations on specific subjects (case-control studies). To this purpose, a specific software was developed, both to meet the requirements of epidemiological research and to manage general practitioners' clinical files. A working prototype of a health card using micro-computer technology will also be experimented with a subset of the GPs.

[The general practitioner and clinical records: a survey of the knowledge of users of a software package]. / Medico di base e cartelle cliniche: indagine conoscitiva su utenti in possesso di un pacchetto software.

The FATMA project--subproject 6, Line of Research 2--aims at implementing a new computerized information network for general practitioners using the same kind of software and homogeneously located throughout Italy. Thus, patients' case form data can be collected for public health purposes. After a study of literature in order to check whether other countries had implemented similar projects and what they consisted of, a survey based on a computerized questionnaire was carried out on a group of g.p.s. who had already received a software for the management of their clinical and professional activities from Janssen Informedica. This survey aimed at judging some aspects of users in order to select potential monitors of the information network who would test a new software. The analysis regards both g.p.s' social and professional data and the use of a computer package with reference to the quality and quantity of the clinical data they input. 2,010 questionnaires were filled in all their parts and mailed back to Informedica. It came out that g.p.s. believe more and more they can improve the organization and management of their work by using a software equipped with routines and easy access procedures so that clinical data, diagnostic reports and treatment can be collected, placed on files and updated. Thus, a new software should be developed. While meeting g.p.s' needs, it must overcome the limits of packages now available concerning the possibility of carrying out epidemiological studies. The software can become a tool to collect clinical data of patients, diseases and diagnostic procedures through standard protocols directly from g.p.s records.

Acute respiratory and cardiovascular effects of inhaled ketanserin in chronic obstructive pulmonary disease. A comparative study with intravenously administered ketanserin.

In a double-blind, crossover study, nebulized ketanserin, a 5-HT2 receptor antagonist, and a placebo were given to eight patients with moderate to severe nonasthmatic COPD. Intravenous ketanserin had rapid onset of action and induced a longer lasting bronchial response than inhaled ketanserin. These results confirm that ketanserin acts as a mild bronchodilator in patients with COPD and demonstrate that the inhaled route has no advantage over the intravenous route in terms of effectiveness. Thus, 5-HT may play a role in bronchomotor tone, at least in patients with chronic airway obstruction.

Effect of ketanserin, a new blocking agent of the 5-HT2 receptor, on airway responsiveness in asthma.

Most of the antihypertensive drugs have a liability for adverse effects in asthma. Since there are few available data on the effect of ketanserin, a new antihypertensive drug which is a type-2 serotonin receptor antagonist, on human respiratory function, we have tested whether this drug can modify bronchial hyperresponsiveness to methacholine in asthmatic patients. The protective effect of intravenous ketanserin (0.14 mg/kg) was small, but significant.

Itraconazole: increased activity by chlorhexidine.

Chlorhexidine increases the activity of itraconazole against Candida isolates; itraconazole-chlorhexidine combinations show synergistic activity in culture media. The activity of itraconazole is discussed.

Itraconazole activity against fungal germination.

Itraconazole was found to be superior to ketoconazole in its antifungal activity in vitro against Hyphomycetes and Candida. In particular, complete inhibition of germination of Candida albicans and Aspergillus spp. by a lower dose of itraconazole can explain the better activity in vivo of this drug.

Microbiological perspective of ketoconazole.

The analysis of the results obtained in our trials, which took into account different experimental conditions, suggests that ketoconazole is a very effective anti-Candida drug. In particular, ketoconazole inhibits the development of the hyphal form of C. albicans which is highly invasive. In our trials, we were also able to demonstrate that it is possible to extend ketoconazole's range of action to gram-negative bacteria, if the drug is used in appropriate pharmaceutical forms. Moreover, its in vivo efficacy against dermatophytes and ifomycetes can also be explained by its ability to concentrate in keratinized tissues. From the investigations carried out on leukocyte populations, it has also been demonstrated that ketoconazole does not negatively interfere with the cell defense mechanisms of the host. In fact, the opsonic index and intraphagocytic killing do not significantly change in the presence of ketoconazole in therapeutic doses.