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1.
Sci Total Environ ; 751: 141666, 2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-33181991

RESUMEN

Floating treatment wetlands (FTWs) represent a recent system within the family of surface flow wetlands, able to directly treat various types of wastewaters in natural or artificial water bodies. In these conditions, traditional non-floating macrophytes, installed in self-buoyant mats, hydroponically expand their root systems in the wastewater, interacting with a rich microbial biodiversity and thereby removing different pollutants. This study aimed to evaluate the growth performances of 5 plant species installed in different FTWs after ten years of research conducted in North Italy: Phragmites australis, Iris pseudacorus, Typha latifolia, Carex spp. and Lythrum salicaria. During the entire experimental period, above-mat biomass production varied from 46.7 g m-2 (L. salicaria) to 1466.0 g m-2 (T. latifolia), whereas below-mat biomass production ranged between 205.7 g m-2 (L. salicaria) and 4331.1 g m-2 (P. australis). Both shoot height and root length assumed the highest values for T. latifolia (189.0 cm and 59.3 cm, respectively), the lowest for L. salicaria (42.3 cm and 35.1 cm, respectively). All plant species increased both above- and below-mat biomass productions over consecutive growing seasons through horizontal colonization of the floating mats, although not always significantly. Moreover, the growth of I. pseudacorus, P. australis and T. latifolia was significantly influenced by wastewater physico-chemical composition, exhibiting species-specific behavior. In general, all species showed a good aptitude to survive in hydroponic conditions both during the growing season and the winter, even though in a few cases the survival of I. pseudacorus and P. australis was strongly reduced by alien predators (Myocastor coypus) that badly damaged plant aerial tissues.


Asunto(s)
Typhaceae , Humedales , Biomasa , Italia , Poaceae
2.
J Infect Chemother ; 27(1): 99-102, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33023821

RESUMEN

We present three patients affected by pulmonary squamous cell carcinoma, metastatic esophageal cancer and advanced non-Hodgkin lymphoma, who incurred in coronavirus 2019 (COVID-19) infection during the early phase of epidemic wave in Italy. All patients presented with fever. Social contact with subject positive for COVID-19 was declared in only one of the three cases. In all cases, laboratory findings showed lymphopenia and elevated C-reactive protein (CRP). Chest x-ray and computed tomography showed bilateral ground-glass opacities, shadowing, interstitial abnormalities, and "crazy paving" pattern which evolved with superimposition of consolidations in one patient. All patients received antiviral therapy based on ritonavir and lopinavir, associated with hydroxychloroquine. Despite treatment, two patients with advanced cancers died after 39 and 17 days of hospitalization, while the patient with lung cancer was dismissed at home, in good conditions.


Asunto(s)
Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina/uso terapéutico , Lopinavir/uso terapéutico , Neoplasias/complicaciones , Neumonía Viral/tratamiento farmacológico , Ritonavir/uso terapéutico , Anciano , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Betacoronavirus , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/tratamiento farmacológico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Brotes de Enfermedades , Quimioterapia Combinada , Neoplasias Esofágicas/complicaciones , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamiento farmacológico , Resultado Fatal , Humanos , Italia , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamiento farmacológico , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/tratamiento farmacológico , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
3.
Sci Total Environ ; 750: 141711, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32835962

RESUMEN

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease COVID-19, a public health emergency worldwide, and Italy is among the most severely affected countries. The first autochthonous Italian case of COVID-19 was documented on February 21, 2020. We investigated the possibility that SARS-CoV-2 emerged in Italy earlier than that date, by analysing 40 composite influent wastewater samples collected - in the framework of other wastewater-based epidemiology projects - between October 2019 and February 2020 from five wastewater treatment plants (WWTPs) in three cities and regions in northern Italy (Milan/Lombardy, Turin/Piedmont and Bologna/Emilia Romagna). Twenty-four additional samples collected in the same WWTPs between September 2018 and June 2019 (i.e. long before the onset of the epidemic) were included as 'blank' samples. Viral concentration was performed according to the standard World Health Organization procedure for poliovirus sewage surveillance, with modifications. Molecular analysis was undertaken with both nested RT-PCR and real-rime RT-PCR assays. A total of 15 positive samples were confirmed by both methods. The earliest dates back to 18 December 2019 in Milan and Turin and 29 January 2020 in Bologna. Virus concentration in the samples ranged from below the limit of detection (LOD) to 5.6 × 104 genome copies (g.c.)/L, and most of the samples (23 out of 26) were below the limit of quantification of PCR. Our results demonstrate that SARS-CoV-2 was already circulating in northern Italy at the end of 2019. Moreover, it was circulating in different geographic regions simultaneously, which changes our previous understanding of the geographical circulation of the virus in Italy. Our study highlights the importance of environmental surveillance as an early warning system, to monitor the levels of virus circulating in the population and identify outbreaks even before cases are notified to the healthcare system.


Asunto(s)
Infecciones por Coronavirus , Monitoreo del Ambiente , Pandemias , Neumonía Viral , Betacoronavirus , Humanos , Italia/epidemiología
4.
Sci Total Environ ; 752: 141814, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-32890831

RESUMEN

Xylella fastidiosa is one of the most destructive plant pathogenic bacteria worldwide, affecting more than 500 plant species. In Apulia region (southeastern Italy), X. fastidiosa subsp. pauca (Xfp) is responsible for a severe disease, the olive quick decline syndrome (OQDS), spreading epidemically and with dramatic impact on the agriculture, the landscape, the tourism, and the cultural heritage of this region. An early detection of the infected plants would hinder the rapid spread of the disease. The main objective of this paper was to define a geostatistical approach of data fusion, which combines remote (radiometric), and proximal (geophysical) sensor data and visual inspections with plant diagnostic tests, to provide probabilistic maps of Xfp infection risk. The study site was an olive grove located at Oria (province of Brindisi, Italy), where at the time of monitoring (September 2017) only few plants showed initial symptoms of the disease. The measurements included: 1) acquisitions of reflected electromagnetic radiation with UAV (Unmanned Aerial Vehicle) equipped with a multi-spectral camera; 2) geophysical surveys on the trunks of 49 plants with Ground Penetrating Radar (GPR); 3) disease severity rating, by visual inspection of the proportion of canopy with symptoms; 4) qPCR (real time-quantitative Polymerase Chain Reaction) data from tests on 61 plants. The data were submitted to a set of processing techniques to define a "data fusion" procedure, based on non-parametric multivariate geostatistics. The approach allowed marking those areas where the risk of infection was higher, and identifying the possible infection entry routes into the field. The probability map of infection risk could be used as an effective tool for a preventive action and for a better organization of the monitoring plans.


Asunto(s)
Olea , Xylella , Italia/epidemiología , Enfermedades de las Plantas
5.
Sci Total Environ ; 752: 141894, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-32896791

RESUMEN

The objective of this experiment was to valuate, after 14 years, the impact of annual compost applications on micronutrient and potentially toxic trace elements on nectarine tree uptake and soil fertility. The study was performed in the Po valley, Italy, on the variety Stark RedGold (grafted on GF677). Since orchard planting, the following treatments were applied, in a randomized complete block design, with four replicates: 1. unfertilized control; 2. mineral fertilization (N was supplied as NO3NH4 at 70-130 kg ha-1 year-1); 3. compost at 5 t DW ha-1 year-1; 4. compost at 10 t DW ha-1 year-1. The actual rate of application was 12.5 (LOW) and 25 (HIGH) t ha-1, since compost was concentrated in the tree row. Compost was made from domestic organic wastes mixed with pruning material from urban ornamental trees and garden management and stabilized for 3 months. The supply of compost HIGH induced an enrichment of soil total Cu, Zn and Cd, and a decrease of Fe and Co concentration; with values always below the European threshold limits for heavy metals in the soil. In addition, compost (at both rates) increased availability (DTPA-extractable) of Fe, Mn and Zn, Cd, Ni, and Pb in the top soil (0-0.15 m). Total micronutrient and trace element tree content was not affected by fertilization treatments; however, the recycled fraction returned to the soil at the end of the season through abscised leaves and pruned wood of Cu, Fe, Mn and Zn was increased by mineral fertilization; Fe and Zn also by compost HIGH. Our data show that the introduction of compost at both 12.5 and 25 t ha-1 year-1 in the row did not increase the risk of pollution related to potentially toxic trace elements and at the same time increased the bioavailability of Fe, Mn and Zn.


Asunto(s)
Compostaje , Metales Pesados , Contaminantes del Suelo , Oligoelementos , Italia , Suelo , Contaminantes del Suelo/análisis , Oligoelementos/análisis
6.
Chemosphere ; 262: 128415, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33182128

RESUMEN

The occurrence, fate and removal of microplastics (MPs) in a wastewater treatment plant (WWTP) in Central Italy were investigated together with their potential adverse effects on anaerobic processes. In the influent of the WWTP, 3.6 MPs.L-1 were detected that mostly comprised polyester fibers and particles in the shape of films, ranging 0.1-0.5 mm and made of polyethylene and polypropylene (PP). The full-scale conventional activated sludge scheme removed 86% of MPs, with the main reduction in the primary and secondary settling. MPs particles bigger than 1 mm were not detected in the final effluent and some loss of polymers types were observed. In comparison, the pilot-scale upflow granular anaerobic sludge blanket (UASB) + anaerobic membrane bioreactor (AnMBR) configuration achieved 94% MPs removal with the abatement of 87% of fibers and 100% of particles. The results highlighted an accumulation phenomenon of MPs in the sludge and suggested the need to further investigate the effects of MPs on anaerobic processes. Accordingly, PP-MPs at concentrations from 5 PP-MPs.gTS-1 to 50 PP-MPs.gTS-1 were spiked in the pilot-scale UASB reactor that was fed with real municipal wastewater, where up to 58% decrease in methanogenic activity was observed at the exposure of 50 PP-MPs.gTS-1. To the best of our knowledge, the presented results are the first to report of PP-MPs inhibition on anaerobic processes.


Asunto(s)
Eliminación de Residuos Líquidos/métodos , Anaerobiosis , Reactores Biológicos , Italia , Microplásticos , Plásticos , Polietileno , Aguas del Alcantarillado , Aguas Residuales
7.
Sci Total Environ ; 750: 141411, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32841806

RESUMEN

This paper presents a new dataset of Polychlorinated Biphenyls (PCBs) half-lives in soil. Data were obtained from a greenhouse experiment performed with an aged contaminated soil under semi-field conditions, collected from a National Relevance Site (SIN) located in Northern Italy (SIN Brescia-Caffaro). Ten different treatments (combination of seven plant species and different soil conditions) were considered together with the respective controls (soil without plants). PCB concentration reduction in soil was measured over a period of 18 months to evaluate the ability of plants to stimulate the biodegradation of these compounds. Tall fescue, tall fescue cultivated together with pumpkin and tall fescue amended with compost reduced more than the 50% of the 79 measured PCB congeners, including the most chlorinated ones (octa to deca-PCBs). However, the data obtained showed that no plant species was uniquely responsible for the effective degradation of all isomeric classes and congeners. The obtained half-lives ranged from 1.3 to 5.6 years and were up to a factor of 8 lower compared to generic HL values reported in literature. This highlighted the importance of cultivation and plant-microbe interactions in speeding up the PCB biodegradation. This new dataset could contribute to substantially improve the predictions of soil remediation time, multimedia fate and the long-range transport of PCBs. Additionally, the half-lives obtained here can also be used in the evaluation of the food chain transfer of these chemicals, and finally the exposure and potential for effects on ecosystems.


Asunto(s)
Bifenilos Policlorados , Contaminantes del Suelo , Biodegradación Ambiental , Carbono , Ecosistema , Italia , Bifenilos Policlorados/análisis , Suelo , Contaminantes del Suelo/análisis
8.
Sci Total Environ ; 750: 141700, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32861077

RESUMEN

Despite adverse health effects, ultrafine particulate matter (UFP), i.e., PM less than 0.1 µm in diameter, is an emerging pollutant not subject to regulation. UFP may cause both lung inflammation and cardiopulmonary disease and may enter the brain directly via the olfactory bulb, affecting the nervous system. In highly urbanized environments, diesel and gasoline vehicles are among the major sources of UFP including combustion-generated solid particle pollutant and metal-based particles. Metal-based UFP are of much concern, as they may promote inflammation and DNA damage via oxidative stress with generation of free radicals and reactive oxygen species (ROS). We used the honeybee as an alternative sampling system of UFP in an area of the Po Valley (Northern Italy), which is subject to intense traffic. Worker bees are widely recognised as efficient samplers of air pollutants, including airborne PM. During flight and foraging activity, pubescence of the bees promotes the accumulation of electrical charge on the body's surface, enhancing attraction to air pollutants. Bees living near the main Italian highway, the Autostrada A1, displayed a contamination of nanosized Fe-oxides/hydroxides and baryte. Sources of Fe-bearing and baryte ultrafine particles are primarily the vehicles speeding on the motorway. Pollen collected by forager bees and honey produced by the bee colony displayed contamination by nanosized Fe-oxides/hydroxides and baryte. Such a contamination exposes pollinators and humans to UFP ingestion, endangering the safety of food produced at traffic-influenced sites. Given the global spread of traffic, our findings suggest that exposure and environmental impact of ultrafine Fe-oxides/hydroxides and baryte are potentially ubiquitous, although usually overlooked in environmental policy discussions.


Asunto(s)
Contaminantes Atmosféricos , Emisiones de Vehículos , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Animales , Abejas , Polvo , Humanos , Italia , Tamaño de la Partícula , Material Particulado/análisis , Material Particulado/toxicidad , Emisiones de Vehículos/análisis , Emisiones de Vehículos/toxicidad
9.
Orv Hetil ; 161(45): 1899-1907, 2020 11 08.
Artículo en Húngaro | MEDLINE | ID: mdl-33161388

RESUMEN

Összefoglaló. A 2020. év elején kirobbant COVID-19-világjárvány többek között ráirányította a figyelmet az életmento-életfenntartó kezelések igazságos elosztásának érzékeny kérdésére is. Európán belül elsoként Olaszországot sújtotta a katasztrófa, a válsághelyzetben pedig az érzéstelenítés, fájdalomcsillapítás, újraélesztés és intenzív ellátás területén tevékenykedo szakemberek olasz társasága, a SIAARTI 2020. március 6-án közzétett egy 15 pontos ajánlást. E szerint utilitarista megközelítéssel a rendelkezésre álló szukös eroforrásokat azon betegek kezelésére kellene fordítani, akik túlélési esélye nagyobb, valamint több életévre számíthatnak a jövoben, mert ez biztosíthatja a leheto legtöbb ember számára a leheto legnagyobb hasznot. A javaslat komoly szakmai vitát robbantott ki, amely egyértelmuvé tette, hogy az orvosi eszközök igazságos elosztására vonatkozó diskurzust feltétlenül folytatni kell, nemcsak Olaszországon belül, hanem a pandémiától sújtott többi államban is. Orv Hetil. 2020; 161(45): 1899-1907. Summary. Among other queries, the explosion of the COVID-19 pandemic at the beginning of 2020 has firmly put in focus the sensitive issue of how to allocate scarcely available life-saving treatments in a fair and just manner. The first European country to face an emergency caused by the pandemic was Italy. In a rapidly escalating crisis, on 6th March 2020, the Italian Society of Anaesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) issued a series of 15 recommendations, suggesting that a utilitarian approach should be adopted in Italian health care and the extremely scarce resources should be reserved for patients with a greater probability of survival and life expectancy, in order to maximize the benefits for the largest possible number of people. The recommendations generated a heated debate among health care professionals, thereby evidencing that similar discussions must be initiated and pursued in all countries affected by the pandemic. Orv Hetil. 2020; 161(45): 1899-1907.


Asunto(s)
Infecciones por Coronavirus/terapia , Asignación de Recursos para la Atención de Salud/ética , Neumonía Viral/terapia , Justicia Social , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Humanos , Italia , Pandemias , Neumonía Viral/epidemiología
10.
Ig Sanita Pubbl ; 76(4): 275-280, 2020.
Artículo en Italiano | MEDLINE | ID: mdl-33161423

RESUMEN

In the next months, the risk of coinfection with f lu virus and Sars-CoV-2 is high. Despite the number of studies dealing with the consequences of the interaction between the two viruses, the impact of this coexistence on human health is still uncertain. However, achieving high f lu vaccination coverage would mean avoiding hospital overload due to hospitalizations for f lu complications and facilitating a timely differential diagnosis that allows a quick and appropriate treatment of CoViD-19 cases. These are two valid reasons for actively promoting f lu vaccination, particularly this year when the risk of a "twindemic" determined by f lu and CoViD-19 is high. In Italy this year, for the first time, f lu vaccination is offered free of charge also to people aged 60 to 64, expanding individuals entitled to free vaccination. Furthermore, it is strongly recommended to healthcare workers and to elderly who live in residential or long-term care facilities.


Asunto(s)
Infecciones por Coronavirus , Vacunas contra la Influenza , Gripe Humana/prevención & control , Pandemias , Neumonía Viral , Vacunación , Anciano , Betacoronavirus , Personal de Salud , Humanos , Italia , Persona de Mediana Edad
11.
Artículo en Inglés | MEDLINE | ID: mdl-33142740

RESUMEN

(1) Background: The emergency linked to the spread of COVID-19 in Italy has led to inevitable consequences on the penitentiary system. The risks of this emergency in prisons is mainly related to the problem of persistent overcrowding that makes social distancing difficult and the isolation of any contagion hard to arrange. The Department of Protection for Adults and Minors of the ASL Salerno Criminal Area has taken steps in order to perform screening operations and minimize the risks for prisoners and operators. (2) Methods: We conducted a two-phase observational study. In the first phase, we offered and then executed serum COVID-19 screening to all the convicted inmates. For those who had a doubtful or positive result, a swab was executed in the shortest time possible. In the second phase, a pharyngeal swab was offered and executed to all the police officers, the penitentiary administrative staff and the medical personnel working in the prison. (3) Results: In the first phase, we executed 485 COVID-19 blood tests on prisoners, 3 (0.61%) of which were positive. The three positive inmates underwent nasopharyngeal swabbing, which ultimately were negative. After that, we executed 276 nasopharyngeal swabs on the prison personnel, penitentiary administrative staff and medical personnel-all were negative. (4) Conclusion: All tests (blood tests and swabs) that were carried out on the prisoners and on the staff were negative for COVID-19. We believe that all prisons in Italy and in the world should take action to ensure preventive and control measures in order to safeguard the health of the prison population and of all the people who work there.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Tamizaje Masivo/estadística & datos numéricos , Nasofaringe/virología , Pandemias , Neumonía Viral/diagnóstico , Prisioneros , Gestión de Riesgos/métodos , Adulto , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Humanos , Italia , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Prisiones
12.
Artículo en Inglés | MEDLINE | ID: mdl-33167479

RESUMEN

The spread of coronavirus disease 2019 (COVID-19) has called for unprecedented measures, including a national lockdown in Italy. The present study aimed at identifying psychological changes (e.g., changes in depression, stress, and anxiety levels) among the Italian public during the lockdown period, in addition to factors associated with these changes. An online follow-up survey was administered to 439 participants (original sample = 2766), between 28 April and 3 May 2020. A paired sample t-test tested for differences in stress, anxiety, and depression over the period. Multivariate regression models examined associations between sociodemographic variables, personality traits, coping strategies, depression, and stress. Results showed an increase in stress and depression over the lockdown, but not anxiety. Negative affect and detachment were associated with higher levels of depression and stress. Higher levels of depression at the start of the lockdown, as well as fewer coping strategies and childlessness, were associated with increased depression at follow-up, whereas higher levels of stress at the start of the lockdown and younger age were associated with higher stress at follow-up. These results may help us to identify persons at greater risk of suffering from psychological distress as a result lockdown conditions, and inform psychological interventions targeting post-traumatic symptoms.


Asunto(s)
Infecciones por Coronavirus/psicología , Depresión/epidemiología , Neumonía Viral/psicología , Distrés Psicológico , Ansiedad/epidemiología , Betacoronavirus , Estudios de Seguimiento , Humanos , Italia/epidemiología , Pandemias , Aislamiento Social
13.
Cephalalgia ; 40(13): 1459-1473, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33146039

RESUMEN

OBJECTIVE: The present Italian multicenter study aimed at investigating whether the course of primary headache disorders in children and adolescents was changed during the lockdown necessary to contain the COVID-19 emergency in Italy. METHODS: During the lockdown, we submitted an online questionnaire to patients already diagnosed with primary headache disorders. Questions explored the course of headache, daily habits, psychological factors related to COVID-19, general mood and school stress. Answers were transformed into data for statistical analysis. Through a bivariate analysis, the main variables affecting the subjective trend of headache, and intensity and frequency of the attacks were selected. The significant variables were then used for the multivariate analysis. RESULTS: We collected the answers of 707 patients. In the multivariate analysis, we found that reduction of school effort and anxiety was the main factor explaining the improvement in the subjective trend of headache and the intensity and frequency of the attacks (p < 0.001). The greater the severity of headache, the larger was the clinical improvement (p < 0.001). Disease duration was negatively associated with the improvement (p < 0.001). It is noteworthy that clinical improvement was independent of prophylaxis (p > 0.05), presence of chronic headache disorders (p > 0.05) and geographical area (p > 0.05). CONCLUSIONS: Our study showed that lifestyle modification represents the main factor impacting the course of primary headache disorders in children and adolescents. In particular, reduction in school-related stress during the lockdown was the main factor explaining the general headache improvement in our population.


Asunto(s)
Infecciones por Coronavirus , Cefalea/epidemiología , Cefalea/psicología , Estilo de Vida , Pandemias , Neumonía Viral , Aislamiento Social/psicología , Adolescente , Ansiedad/etiología , Ansiedad/psicología , Betacoronavirus , Niño , Femenino , Humanos , Italia/epidemiología , Masculino , Encuestas y Cuestionarios
14.
Ital J Pediatr ; 46(1): 165, 2020 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-33148304

RESUMEN

BACKGROUND: The timing of puberty in girls is occurring at an increasingly early age. While a positive family history is recognised as a predisposing factor for early or precocious puberty, the role of environmental factors is not fully understood. AIMS OF THE STUDY: To make a retrospective evaluation of the incidence of newly diagnosed central precocious puberty (CPP) and the rate of pubertal progression in previously diagnosed patients during and after the Italian lockdown for COVID-19, comparing data with corresponding data from the previous 5 years. To determine whether body mass index (BMI) and the use of electronic devices increased during lockdown in these patients. PATIENTS AND METHODS: The study included 49 females with CPP. We divided the patients into two groups: group 1, patients presenting a newly diagnosed CPP and group 2, patients with previously diagnosed slow progression CPP whose pubertal progression accelerated during or after lockdown. We collected auxological, clinical, endocrinological and radiological data which were compared with data from two corresponding control groups (patients followed by our Unit, March to July 2015-2019). Patients' families completed a questionnaire to assess differences in the use of electronic devices before and during lockdown. RESULTS: Thirty-seven patients presented newly diagnosed CPP (group 1) and 12, with previously diagnosed but untreated slow progression CPP presented an acceleration in the rate of pubertal progression (group 2). The number of new CPP diagnoses was significantly higher than the mean for the same period of the previous 5 years (p < 0.0005). There were no significant differences between patients in group 1 and control group 1 regarding time between appearance of B2 and CPP diagnosis, although group 1 patients had a significantly earlier chronological age at B2, a more advanced Tanner stage at diagnosis (p < 0.005), higher basal LH and E2 levels, higher LH peak after LHRH test (p < 0.05) and increased uterine length (p < 0.005) and ovarian volume (p < 0.0005). The number of patients with previously diagnosed CPP whose pubertal development accelerated was also statistically higher compared to controls (p < 0.0005). In this group, patients' basal LH (p < 0.05) and E2 levels (p < 0.0005) became more markedly elevated as did the LH peak after LHRH test (p < 0.05). These patients also showed a significantly accelerated progression rate as measured by the Tanner scale (p < 0.0005), uterine length (p < 0.005), and ovarian volume (p < 0.0005). In both group 1 and group 2, BMI increased significantly (p < 0.05) and patients' families reported an increased use of electronic devices (p < 0.0005). CONCLUSION: Our data show an increased incidence of newly diagnosed CPP and a faster rate of pubertal progression in patients with a previous diagnosis, during and after lockdown compared to previous years. We hypothesize that triggering environmental factors, such as the BMI and the use of electronic devices, were enhanced during lockdown, stressing their possible role in triggering/influencing puberty and its progression. However, more studies are needed to determine which factors were involved and how they interacted.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Pubertad Precoz/epidemiología , Pubertad , Aislamiento Social , Índice de Masa Corporal , Niño , Femenino , Humanos , Incidencia , Italia/epidemiología , Pubertad Precoz/diagnóstico , Estudios Retrospectivos
15.
J Prev Med Hyg ; 61(3): E313-E320, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33150220

RESUMEN

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the microorganism responsible for the aggressive Coronavirus Disease (COVID-19) pandemic. During the such pandemic, discharge and community reintegration of patients are critical phases in guaranteeing public health. A review of the international and Italian experiences that represent the best available evidence was carried out, mainly focusing on the precise allocation of tasks and related responsibilities. The report provides a proposal for a systematic management pathway dedicated to COVID-19 patients. The original result is a logigramme to guide health practitioners on discharge and community reintegration of COVID-19 patients. To standardize clinical attitudes helps in ensuring quality of care and patient safety, should be a core element even during a public health emergency. The logigramme suggests, after discharge, 14 days of further isolation with regular health monitoring and, finally, the execution of a nasopharyngeal swab for identification of SARS-CoV-2 viral RNA. Home-cared patients should be placed on 7 days of further isolation after at least 2 negative RT-PCR tests for respiratory tract samples (nasopharyngeal swab). The logigramme is already used in the Department of Prevention - Local Health Agency of Lecce (Apulia) but it will be updated according to the latest research findings.


Asunto(s)
Infecciones por Coronavirus , Monitoreo Ambulatorio , Pandemias , Alta del Paciente/normas , Neumonía Viral , Cuarentena , Enfermedades Asintomáticas , Betacoronavirus , Técnicas de Laboratorio Clínico , Convalecencia , Infecciones por Coronavirus/diagnóstico , Femenino , Humanos , Italia , Masculino , Nasofaringe/virología , Factores de Tiempo
16.
Chirurgia (Bucur) ; 115(5): 677-680, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33138906

RESUMEN

The spread of SARS-CoV-2 in Italy has been rapid, with over 230.000 infections and 33.000 deaths (May 31st, 2020). The full impact of COVID19 on surgery is still unknown, as its effects on healthcare strategy, hospital infrastructure, staff, regional economy and colorectal disease progression, may not be evident before several months. No systematic reports are available about a higher incidence of COVID19 infections in patients with cancer. However, available data indicate that older people are more vulnerable, particularly when there are underlying health conditions such as chemotherapy or active cancer. Herein, we present the case of a patient with rectal cancer treated with pull-through technique low anterior rectal resection and coloanal anastomosis with protective loop ileostomy, complicated with Sars-CoV-2 infection and late (31st post-operative day) colic ischemia with colo-vaginal fistula. Late intestinal ischemia is a rare complication and can be secondary to several traditional factors, but certainly small vessel thrombosis related to Coronavirus disease must be taken into consideration.


Asunto(s)
Colon/patología , Infecciones por Coronavirus/complicaciones , Isquemia/cirugía , Neumonía Viral/complicaciones , Fístula Vaginal/cirugía , Anciano , Betacoronavirus , Colon/cirugía , Femenino , Humanos , Isquemia/complicaciones , Italia , Pandemias , Resultado del Tratamiento , Fístula Vaginal/complicaciones
17.
Int Immunopharmacol ; 88: 106995, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33182059

RESUMEN

There is recent evidence that interleukin-6 (IL-6) levels are elevated in cases of complicated COVID-19, but it is also possible that this cytokine may have a far more important role in the pathogenesis of viral infection. IL-6 is known to be modulated by Vitamin D, and there is preliminary evidence that deficiency of this vitamin is linked to poorer outcomes. To identify whether IL-6 levels prior to infection might predict outcome, early data on COVID-19 mortality from Italy and the UK were compared with previously published results of mean IL-6 levels from these countries as well as from the USA. There was a highly significant correlation (r = 0.9883; p = 0.00025) between age-stratified mortality rates and IL-6 levels from previously published data on healthy individuals. To determine whether Vitamin D may be beneficial at lowering IL-6 levels in patients, a limited analysis of trials examining the relationship between these entities published since 2015 was undertaken. Eight out of 11 studies described a significant lowering effect of Vitamin D on IL-6. Given that IL-6 likely facilitates viral cell entry and replication, levels prior to infection may predict mortality. This provides a rationale for prophylactic and therapeutic measures directed at lowering IL-6, including Vitamin D prescription.


Asunto(s)
Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/mortalidad , Interleucina-6/sangre , Neumonía Viral/sangre , Neumonía Viral/mortalidad , Vitamina D/uso terapéutico , Vitaminas/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/epidemiología , Reino Unido/epidemiología , Adulto Joven
18.
BMC Pulm Med ; 20(1): 301, 2020 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-33198751

RESUMEN

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly reached pandemic proportions. Given that the main target of SARS-CoV-2 are lungs leading to severe pneumonia with hyperactivation of the inflammatory cascade, we conducted a prospective study to assess alveolar inflammatory status in patients with moderate to severe COVID-19. METHODS: Diagnostic bronchoalveolar lavage (BAL) was performed in 33 adult patients with SARS-CoV-2 infection by real-time PCR on nasopharyngeal swab admitted to the Intensive care unit (ICU) (n = 28) and to the Intermediate Medicine Ward (IMW) (n = 5). We analyze the differential cell count, ultrastructure of cells and Interleukin (IL)6, 8 and 10 levels. RESULTS: ICU patients showed a marked increase in neutrophils (1.24 × 105 ml- 1, 0.85-2.07), lower lymphocyte (0.97 × 105 ml- 1, 0.024-0.34) and macrophages fractions (0.43 × 105 ml- 1, 0.34-1.62) compared to IMW patients (0.095 × 105 ml- 1, 0.05-0.73; 0.47 × 105 ml- 1, 0.28-1.01 and 2.14 × 105 ml- 1, 1.17-3.01, respectively) (p < 0.01). Study of ICU patients BAL by electron transmission microscopy showed viral particles inside mononuclear cells confirmed by immunostaining with anti-viral capsid and spike antibodies. IL6 and IL8 were significantly higher in ICU patients than in IMW (IL6 p < 0.01, IL8 p < 0.0001), and also in patients who did not survive (IL6 p < 0.05, IL8 p = 0.05 vs. survivors). IL10 did not show a significant variation between groups. Dividing patients by treatment received, lower BAL concentrations of IL6 were found in patients treated with steroids as compared to those treated with tocilizumab (p < 0.1) or antivirals (p < 0.05). CONCLUSIONS: Alveolitis, associated with COVID-19, is mainly sustained by innate effectors which showed features of extensive activation. The burden of pro-inflammatory cytokines IL6 and IL8 in the broncho-alveolar environment is associated with clinical outcome.


Asunto(s)
Líquido del Lavado Bronquioalveolar/inmunología , Infecciones por Coronavirus/inmunología , Inflamación/inmunología , Interleucina-6/inmunología , Interleucina-8/inmunología , Leucocitos/inmunología , Pulmón/inmunología , Macrófagos Alveolares/inmunología , Neumonía Viral/inmunología , Adenosina Monofosfato/análogos & derivados , Adenosina Monofosfato/uso terapéutico , Corticoesteroides/uso terapéutico , Anciano , Alanina/análogos & derivados , Alanina/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antivirales/uso terapéutico , Betacoronavirus , Lavado Broncoalveolar , Líquido del Lavado Bronquioalveolar/citología , Líquido del Lavado Bronquioalveolar/virología , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/terapia , Combinación de Medicamentos , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Unidades de Cuidados Intensivos , Interleucina-10/inmunología , Italia , Leucocitos Mononucleares/virología , Lopinavir/uso terapéutico , Pulmón/citología , Pulmón/virología , Linfocitos/inmunología , Masculino , Microscopía Electrónica de Transmisión , Persona de Mediana Edad , Neutrófilos/inmunología , Pandemias , Neumonía Viral/terapia , Pronóstico , Estudios Prospectivos , Respiración Artificial/métodos , Ritonavir/uso terapéutico , Glicoproteína de la Espiga del Coronavirus/metabolismo , Tasa de Supervivencia , Virión/metabolismo , Virión/ultraestructura
20.
Cien Saude Colet ; 25(11): 4237-4248, 2020 Nov.
Artículo en Portugués | MEDLINE | ID: mdl-33175033

RESUMEN

Sex workers become increasingly economically vulnerable due to the restrictive measures implemented to combat the coronavirus pandemic. In this respect, the scope of this study is to analyze the content of prostitution websites and advertisements regarding measures related to the COVID-19 pandemic. It involved a description of the visits and analysis of content of communications on websites that advertise commercial sex transactions. The percentage change in the number of visits for three periods from 02/2019 to 04/2020 was calculated. Subsequently, ads with the terms "corona," "pandemic" and "quarantine" on websites that offer search engines were extracted. The Bardin method was then used for content analysis. There was an increase in the number of visits to prostitution websites between 2019 and 2020, followed by a decrease with the advent of the coronavirus pandemic crisis. With regard to the protection measures during the pandemic, health recommendations and the incentive to engage in virtual sex are highlighted. Of the 1,991,014 advertisements, 0.51% mention the COVID-19 crisis regarding noncompliance with social distancing, protection measures and the offer of online sex.


Asunto(s)
Publicidad/estadística & datos numéricos , Betacoronavirus , Infecciones por Coronavirus/prevención & control , Internet/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Trabajo Sexual/estadística & datos numéricos , Publicidad/métodos , Publicidad/tendencias , Infecciones por Coronavirus/epidemiología , Francia , Humanos , Italia , América Latina , Neumonía Viral/epidemiología , Portugal , Motor de Búsqueda/estadística & datos numéricos , España
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