Role of meteorological factors in the spread of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic in Italy.

OBJECTIVE: Understanding the evolutionary dynamics of the Coronavirus disease 2019 (COVID-19) pandemic in the coming months is a matter of great importance and urgency for governments worldwide, making fundamental decisions based on what is known about the transmission mechanisms of the virus and its survival in the environment. The present study aimed to evaluate the impact of demographic variables, solar radiation and relative humidity on the spread of the COVID-19 pandemic of the various regions in Italy. MATERIALS AND METHODS: The retrospective longitudinal study was conducted, and data used in this study was obtained from the Italian Health Ministry. Descriptive statistics included mean, frequency, and percentage, and results presented by graphs were calculated. RESULTS: The infection trend was investigated by comparing it with the demographic situation and the irradiation indices of solar ultraviolet light that are detected with the changing seasons. The present study reported that the geographic areas with higher population density and lower solar radiation during the autumn and winter months were most affected by SARS-CoV-2. CONCLUSIONS: The analysis carried out can provide a predictive model for the future phases of the COVID-19 pandemic in Italy, regardless of the adoption of lockdown measures and behavioral factors.

Observational study of hypertension in Matelica, Italy (Matelica hypertension study).

This study summarizes the results of an epidemiological investigation carried out on the occasion of the Second World Hypertension Day (May 13, 2006) in the city of Matelica in the Region of the Marches, Central Italy. In all, 518 subjects (298 males, average age 52.3 years; 220 females, average age 55 years) with either diagnosed hypertension or who were thought to be normotensive had arterial blood pressure measured. Other cardiovascular risk factors and the costs of pharmacological treatment for hypertension were assessed as well. In 72.46% of examined subjects, arterial blood pressure levels averaged > or =140-90 mmHg if non-diabetic and > or =130-80 mmHg if diabetics. A total of 48.14% of individuals assumed in anamnesis to be normotensive had arterial blood pressure levels higher than the above values and were therefore found to have hypertensive values. The cost of anti-hypertensive treatment in the area of Matelica averages Euro 543.7/patient/year. The present data, which are in line with those of other epidemiological studies performed in Italy, confirm the view that arterial hypertension control in Italy is still largely unsatisfactory. This observation should stimulate both health and specific medical measures to counter the risk of complications of arterial hypertension in aged populations, such as those present in the territory examined.

Influence of human ascitic fluid on the in vitro antibacterial activity of moxifloxacin.

We investigated the in vitro influence of HAF on the antibacterial activity of moxifloxacin against Escherichia coli ATCC 10798, Escherichia coli K-12, Proteus rettgeri (Sanelli), Staphylococcus aureus ATCC 25923, Staphylococcus aureus NCTC 1808 and Staphylococcus epidermidis ATCC 12228. Human ascitic fluid was obtained from 6 cirrhotic patients by paracentesis. The interaction effect was evaluated by the checkerboard technique. Our results indicate the ability of human ascitic fluid to reduce minimum inhibitory concentrations of moxifloxacin against Gram-negative bacteria, but not against Gram-positives.

Can a drug-induced pulmonary hypersensitivity reaction be dose-dependent? A case with mesalamine.

Mesalamine-induced pulmonary adverse drug reactions (ADRs) in the course of therapy for inflammatory bowel diseases are rare events, having been reported in only 21 cases. This response, resembling hypersensitivity pneumonitis, is considered to be immunologically mediated and thus dose-independent. We report the case of a 70-year-old woman with ulcerative colitis (UC) who developed biopsy-proven interstitial pulmonary disease (lymphocytic alveolitis and mild interstitial pulmonary fibrosis) three months after starting mesalamine therapy. The usual treatment in cases of ADR is cessation of the drug and initiation of corticosteroids. In this case, we continued the mesalamine therapy but halved the dose, and did not add corticosteroids. This approach led to a remission of the pulmonary manifestations without a resurgence of UC symptoms. Based on a review of the literature and our own observation, we challenge the concept that mesalamine-induced pulmonary injury is always due to a hypersensitivity reaction. The evidence suggests that in some cases pulmonary ADR is dose-related; in such instances the most accepted therapy is not necessarily the most appropriate one.

Lipomas of the esophagus: a new case.

We present a new case of esophageal lipoma. The rarity of this tumor and its submucosal origin can create problems for the correct diagnosis. Symptoms, when present, are of mechanical origin (obstruction) with dysphagia. Treatment is endoscopic or surgical removal.

Circadian acidity pattern in gastric ulcers at different sites.

OBJECTIVE: Continuous intragastric pH monitoring was used in a large group of gastric ulcer patients to assess whether the 24-h acidity pattern varies in relation to the ulcer location within the stomach and to assess whether there is a circadian rhythm of pH fluctuations in this disease. METHODS: One hundred and thirty-three consecutive patients (79 male and 54 female, mean age 53 yr) with endoscopically and histologically proven benign gastric ulcer and 131 healthy subjects (70 male and 61 female, mean age 48 yr) were studied with a pH minielectrode positioned in the gastric corpus. Ulcer patients were divided into four subgroups in relation to the crater site: 1) above the angulus (n = 23); 2) angularis (n = 42); 3) antral (n = 26); and 4) prepyloric (n = 42). RESULTS: Subgroups 1 and 2 are characterized by significantly lower acidity (p < 0.0001) than healthy subjects for every time segment examined (24-h, day and night). Antral ulcers are less acidic than normal for both the total 24-h period (p < 0.01) and the night period (p < 0.0001), whereas prepyloric ulcers are less acidic for the night only (p < 0.01). In all subgroups of gastric ulcer, the acidity is higher during the evening than the night. CONCLUSIONS: The circadian acidity of gastric ulcer patients is significantly lower than normal, and this is particularly true during the nocturnal period. There is a gradient of gastric acidity that increases progressively as the lesion approximates to the pylorus. The well known circadian rhythm of gastric acidity with relatively higher acid levels during the evening than the night was maintained in all of the gastric ulcer subgroups we created.

New method for improving accuracy of 24-hour continuous intragastric pH-metry. Reflections on physiological and pharmacological studies.

Continuous 24-hr intragastric pH-metry was prospectively performed in 801 subjects with different clinical conditions using two pH electrodes placed closely adjacent. The aim was to assess the in situ repeatability of the test and to verify whether the removal of artifacts, interference, and noise usually superimposed onto the fundamental signal recorded by the measuring apparatus improves the clinical usefulness of experimental data. The following debugging/filtering procedure was used: first, pH recordings of each channel were amended separately from artifacts, then they underwent 7 min windowed median interference debugging, and finally Wiener noise filtering was applied. Afterwards, the 24-hr mean pH profile was obtained in each subject by averaging the pH tracings of the two channels every minute (1440 data points/24 hr). The efficiency of this procedure was assessed at each step by evaluating the difference among groups using the O'Brien test, a distribution-free nonparametric method well-suited for evaluating differences among groups allocated onto a two-way layout. The differences among groups calculated from raw pH data of the single channels can be very misleading, in that it is possible to find that they are significant on one channel and not significant on the other channel. Conversely, the significance of the differences among groups increases progressively at each step of the above debugging/filtering procedure applied to raw pH profiles of each channel. Seven minutes was shown to be the most suitable time lag for windowed median removal of interference.(ABSTRACT TRUNCATED AT 250 WORDS)

Circadian acidity pattern in prepyloric ulcers: a comparison with normal subjects and duodenal ulcer patients.

We used continuous 24-h pH monitoring to compare the circadian intragastric acidity of 36 patients with prepyloric ulcers (PPU) with that of 101 normal subjects (NS) and that of 206 patients with duodenal ulcer (DU). The ulcer crater was endoscopically ascertained in all cases, and PPU were located within an area up to 2 cm proximal to the pylorus. The pH curve pertaining to DU patients ran below that of NS during most of the circadian period, whereas the pH profile of PPU patients was higher than that of NS, and this was particularly true during the evening and the night. The acidity of PPU patients was significantly lower (p < 0.01) than that of NS during the night only, whereas it was lower (p < 0.05-0.001) than that of DU patients during each time interval analysed (24 h, nighttime, and daytime). Our findings show that the gastric acidity of PPU patients differs greatly from that of DU patients, since it is lower throughout the whole 24-h period, and particularly during the night. Thus these two entities are pathophysiologically different with regard to the acidity pattern and should be considered two distinct subgroups of peptic ulcer disease instead of being incorporated, as usually happens, in the clinical group 'duodenal ulcer disease'.

Intestinal metaplasia and dysplasia in gastric ulcer and its tissue repair.

The aim of this work was to study the relationship between intestinal metaplasia and dysplasia in gastric ulcers and their tissue repair in 223 patients with 236 gastric ulcers found endoscopically and treated with H2 blockers. The average duration of follow-up for the men was 32.4 months (range, 12-87 months) and for the women 42.5 months (range, 12-88 months). In 112 patients (50.2%) with 118 gastric ulcers, intestinal metaplasia in the different types was observed. The data obtained allow us to state that severe dysplasia and gastric cancer can occur only in a restricted number of patients with intestinal metaplasia in gastric ulcers and/or gastric ulcer tissue repair (two in our study, more than 60 yr old), and only in the forms with sulphomucins, more precisely type III. In relation to the fact that gastric ulcers rarely become carcinoma, the intestinal metaplasia frequently observed should not be considered "precancerous", as such, but could become so in the presence of several factors which, excluding age, did not emerge from our study.