Risk factors and incidence of long-COVID syndrome in hospitalized patients: does remdesivir have a protective effect?

BACKGROUND: The definition of 'long-COVID syndrome' (LCS) is still debated and describes the persistence of symptoms after viral clearance in hospitalized or non-hospitalized patients affected by coronavirus disease 2019 (COVID-19). AIM: In this study, we examined the prevalence and the risk factors of LCS in a cohort of patients with previous COVID-19 and followed for at least 6 months of follow-up. DESIGN: We conducted a prospective study including all hospitalized patients affected by COVID-19 at our center of Infectious Diseases (Vercelli, Italy) admitted between 10 March 2020 and 15 January 2021 for at least 6 months after discharge. Two follow-up visits were performed: after 1 and 6 months after hospital discharge. Clinical, laboratory and radiological data were recorded at each visit. RESULTS: A total of 449 patients were included in the analysis. The LCS was diagnosed in 322 subjects at Visit 1 (71.7%) and in 206 at Visit 2 (45.9); according to the post-COVID-19 functional status scale we observed 147 patients with values 2-3 and 175 with values >3 at Visit 1; at Visit 2, 133 subjects had the score between 2-3 and 73 > 3. In multivariate analysis, intensive care unit (ICU) admission (OR = 2.551; 95% CI = 1.998-6.819; P = 0.019), time of hospitalization (OR = 2.255; 95% CI = 1.018-6.992; P = 0.016) and treatment with remdesivir (OR = 0.641; 95% CI = 0.413-0.782; P < 0.001) were independent predictors of LCS. CONCLUSIONS: Treatment with remdesivir leads to a 35.9% reduction in LCS rate in follow-up. Severity of illness, need of ICU admission and length of hospital stay were factor associated with the persistence of PCS at 6 months of follow-up.

Hybrid Raman/Brillouin-optical-time-domain-analysis-distributed optical fiber sensors based on cyclic pulse coding.

We experimentally demonstrate the use of cyclic pulse coding for distributed strain and temperature measurements in hybrid Raman/Brillouin optical time-domain analysis (BOTDA) optical fiber sensors. The highly integrated proposed solution effectively addresses the strain/temperature cross-sensitivity issue affecting standard BOTDA sensors, allowing for simultaneous meter-scale strain and temperature measurements over 10 km of standard single mode fiber using a single narrowband laser source only.

Cyclic pulse coding for fast BOTDA fiber sensors.

A cyclic pulse coding technique is proposed and experimentally demonstrated for fast implementation of long-range Brillouin optical time-domain analysis (BOTDA). The proposed technique allows for accurate temperature and strain measurements with meter-scale spatial resolution over kilometers of standard single-mode fiber, with subsecond measurement times.

High-performance hybrid Raman/fiber Bragg grating fiber-optic sensor based on simplex cyclic pulse coding.

We propose and experimentally demonstrate the use of cyclic pulse coding to improve the performance of hybrid Raman/fiber Bragg grating (FBG) fiber-optic sensors, for simultaneous measurement of distributed static temperature and discrete dynamic strain over the same sensing fiber. Effective noise reduction is achieved in both Raman optical time-domain reflectometry and dynamic interrogation of time-division-multiplexed fiber FBG sensors, enhancing the sensing range resolution and providing real-time point dynamic strain measurement capabilities. The highly integrated sensor scheme employs broadband apodized low-reflectivity FBGs, a single narrowband optical source, and a shared receiver block.

Ion-exchanged Er3+/Yb3+ co-doped waveguide amplifiers longitudinally pumped by broad area lasers.

A multimode pumping scheme for Er(3+)/Yb(3+) co-doped waveguide amplifiers based on broad area lasers at around 980 nm is presented. The proposed amplifier is fabricated by ion-exchange (IE) technique on silicate and phosphate glasses. The highly efficient energy transfer from Yb(3+) to Er(3+) ions, combined with the use of low cost and high power broad area laser, allows the realization of high performance and cost-effective integrated amplifiers. The structure has been designed and numerically studied using a 3D finite element modelling tool, and over 3 dB/cm small signal gain has been predicted for an optimized amplifier. Preliminary characterization of an amplifier structure provides a first experimental evidence of the novel multimode longitudinal pumping.

[Is endovascular treatment of acute thoracic aortic disease possible in centers where extracorporal circulation is not available?]. / Le traitement endovasculaire des lésions urgentes de l'aorte thoracique descendante est-il possible dans un centre ne disposant pas de circulation extracorporelle?

OBJECTIVE: To determine whether access to extra-corporal circulation (ECC) is necessary to treat acute descending thoracic aorta disease. METHOD: From January 2004 to May 2006, 16 patients underwent endovascular stent-graft repair of the descending thoracic aorta, among them 13 (81%) were treated in an emergency setting (nine men, mean age: 75.4 years, range 30-94 years). The indication was traumatic aortic rupture (n=3, 23%), complicated acute type B dissection (n=4; 31%), symptomatic or ruptured thoracic aortic aneurysm (n=4; 31%), aorto-esophageal fistula (n=1; 7,5%) and aortic intramural haematoma (n=1; 7,5%). Computed tomography showed hemomediastin and/or hemothorax in five patients (38%). Transesophageal echocardiography and angiography were performed in two (15%) and one patients respectively. Cerebrospinal fluid drainage was performed for two patients (15%). RESULTS: Endovascular repair was successfully completed in 92.3% of cases. The 30-day mortality was 7.5% (n=1). There was one case (7.5%) of delayed paraplegia. Follow-up ranged between two and 24 months (mean 10.2), no rupture occurred. Three type I endoleaks were detected and only two were treated. Two none related additional mortalities were observed. None of these patients has needed ECC. CONCLUSION: The unavailability of ECC does not seem to be a compromising factor in the management of thoracic aorta disease, however a good experience in endovascular techniques is required.

Study of an efficient longitudinal multimode pumping scheme for Si-nc sensitized EDWAs.

We present an efficient multimode longitudinal pumping scheme which overcomes the main limitations of single-mode longitudinal pumping as well as top pumping in Si-nanoclusters sensitized Erbium-doped waveguide amplifiers. The proposed configuration is based on evanescent pump light coupling from a multimode waveguide to a Si-nanoclusters sensitized Er(3+)-doped active core. Theoretical predictions, based on propagation and population-rate equations for the coupled Er(3+)/Sinanoclusters system, point out that the proposed pumping scheme can provide high pump intensity within the active core, also ensuring good uniformity of the population inversion along the waveguide amplifier. Although longitudinal multimode pumping by high power LEDs in the visible can potentially lead to low cost integrated amplifiers, further material optimization is required. In particular, we show that when dealing with high pump intensities, confined carrier absorption seriously affects the amplifier performance, and an optimization of both Si-nc and Er(3+) concentrations is necessary.

Strength deficit of knee extensor muscles of individuals with Down syndrome from childhood to adolescence.

The isokinetic strength of the knee extensor muscles of both limbs, at the speed of 30 degrees/second, was evaluated in 25 children and adolescents with Down syndrome. Comparison with two control groups of 40 intellectually average individuals and 30 individuals with mental retardation of unknown origin showed that both children and adolescents with Down syndrome were weaker than were the control subjects. Moreover, by the age of 14 years, adolescents with Down syndrome failed to show the muscle strength increase that physiologically occurs by this age. Interlimb comparison of knee extensor muscles showed a strength dominance in the 44% of individuals with Down syndrome, with a prevalence for the left leg. In conclusion, our data suggest the presence of a dysfunction of the neuromuscular system both at the level of the pyramidal system and/or of the neuromuscular junction, possibly as an expression of premature ageing.

[Horton arteritis and Kaposi's sarcoma: description of a case]. / Arterite di Horton e sarcoma di Kaposi: descrizione di un caso.

Occurrence of Kaposi's sarcoma was observed in a 70-years-old patient with Horton's temporal arteritis after one year of corticosteroid therapy. The possibility that Kaposi's disease may be related to the steroid therapy is discussed.

[Gastro-esophageal reflux and asthma. Clinical experience]. / Reflusso gastro-esofageo ed asma. Esperienza clinica.

Gastroesophageal reflux (GER) may contribute to the persistence of asthma and may be triggered and/or exacerbated by treatment with bronchodilatory and cortisone drugs. For this reason, GER should be suspected in patients with asthma non-responsive to treatment. In fact in this series 24 hour pH monitoring revealed GER in 7 out of 9 (77%) patients with persistent asthma. The use of a personally developed diagnostic protocol permitted the identification of various situations in 4 patients who completed the study: one coincidental association, one GER caused by theophylline and constituting the main cause of the bronchial obstruction.