Heart Transplantation with Covid 19 Positive Donor Hearts

Coronavirus disease 2019 (COVID-19) causes a profound systemic inflammatory response and the transmissibility was unknown early in the pandemic;consequently, transplant centers were hesitant to utilize organs from COVID-19+ donors. This study aims to analyze short and medium-term outcomes in recipients of hearts from COVID-19+ donors. The Organ Procurement and Transplantation Network database was queried for all heart transplant recipients between January 1, 2020 and December 31, 2021. Recipients of COVID-19+ donor hearts were compared to recipients of COVID-19- donor hearts. Pediatric recipients, multiorgan transplants, donors without COVID-19 testing, and recipients allocated under the old heart allocation system were excluded. One to three propensity score matching was used to match COVID+ donor heart recipients to COVID- donor heart recipients. Over the study period, 4,621 heart transplant recipients met inclusion-exclusion criteria, including 62 recipients of COVID+ donor hearts. After matching on pre-transplant recipient and donor characteristics, the 59 COVID+ donor heart recipients were matched to 177 COVID- donor heart recipients. Baseline characteristics were similar following matching. Thirty-day survival was similar between groups (COVID- 95.5% vs. COVID+ 100.0%, log rank p=0.10) as was six-month survival (COVID- 93.2% vs. COVID+ 98.3%, log rank p=0.15;Figure 1). National COVID+ donor heart usage varied by region, with region 11 transplanting the largest proportion of COVID+ hearts [11/62 (17.7%)] and region 10 transplanting the least [1/62 (1.64%)]. COVID+ heart utilization per region was greatest in region 1 [7/249 (2.8%)] and least in region 10 [1/384 (0.26%)]. Thirty-day and six-month survival in recipients of COVID+ donor hearts is similar to that of COVID- donor hearts. These data should encourage increased utilization of COVID+ donor hearts. Further analyses are needed to determine if long-term outcomes are equivalent between groups. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Housing and Health in Urban Areas

Living environment, and especially dwellings, affect health in several ways end represent a key social determinant of health. The current COVID-19 pandemic has further highlighted its relevance. Factors linked to housing and neighborhood conditions that influence health, can be grouped into broad categories: the health impacts of residential instability;those related to housing internal conditions;the health impacts of context in which dwelling is located;the housing affordability. Many answers to these requirements can be offered by co-housing and social housing and Authors describe same examples from international experiences. These problems nowadays need to be assessed with a multidisciplinary approach, because of the complexity and wideness of its components. To guarantee good health standards it is also necessary to direct political and administrative choices to improve the overall conditions of the neighborhood and of the buildings, and, to dispose of a clear and updated regulatory system, since key factor to ensure health and social justice. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Housing and Health in Urban Areas

Living environment, and especially dwellings, affect health in several ways end represent a key social determinant of health. The current COVID-19 pandemic has further highlighted its relevance. Factors linked to housing and neighborhood conditions that influence health, can be grouped into broad categories: the health impacts of residential instability;those related to housing internal conditions;the health impacts of context in which dwelling is located;the housing affordability. Many answers to these requirements can be offered by co-housing and social housing and Authors describe same examples from international experiences. These problems nowadays need to be assessed with a multidisciplinary approach, because of the complexity and wideness of its components. To guarantee good health standards it is also necessary to direct political and administrative choices to improve the overall conditions of the neighborhood and of the buildings, and, to dispose of a clear and updated regulatory system, since key factor to ensure health and social justice. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Effectiveness of face masks for the population.

Background: Health authorities and organizations consider non-medical face masks as an additional passive means to prevent virus diffusion. Communication strategies disseminate information among the population that such masks are essential for mitigating virus diffusion. However, scientific studies are not conclusive in showing the undisputed filtration efficiency of fabric/cloth facial masks (both commercial and homemade). Objectives: This study examines scientific data about the effectiveness of face masks before and during the COVID-19 emergency. Present trends in the making of commercial and homemade fabric/cloth face masks are also examined. Methods: Statistical data of published studies are analyzed and compared. Main considerations and sugge-stions are also extracted and discussed. Current approaches are examined for assessing the characteristics and effectiveness of fabric/cloth commercial and homemade face masks intended for the population. Results: Conflicting data exist as to whether non-medical masks have a protective effect from the spread of respiratory viruses. Both medical masks (MDs) and respiratory personal protection equipment (PPE) show a given effectiveness value. Conclusion: Concerning commercial and homemade fabric/cloth masks, giving general indications on the choice of materials and their assemblage is difficult as it is not possible to assess the effectiveness of the filter media with respect to the kind of multiphase fluid that may be emitted upon breathing, sneezing, or coughing under different environmental conditions. This is particularly important because airflow rate, temperature, humidity, and duration of use will affect the performance of filter media. Moreover, while a mask may have excellent filter media, droplets may leak into the face-piece unless there is an adequate facial seal. In the presence of leaks, any type of mask may actually offer less protection independently of its nominal filtering effìciency.

How to foster cities resilient to the COVID-19 pandemic through Urban Health strategies

Background The ongoing pandemic of COVID-19, which nowadays has exceeded 2.5 million notified infections in the world and about 200,000 deaths, is a strong reminder that urbanization has changed the way that people and communities live, work, and interact, and it's necessary to make the systems and local capacities resilient to prevent the spread of infectious diseases. How we can re-design the concept of Public Health in relation to the built environment and the contemporary cities? Methods According to the previous statements and scenario, aim of this paper is to integrate the Urban Health strategic objectives, focusing the possible responses, both immediate and medium-long term, to the current environmental, social, and economic aspects of the “period” of physical distancing. Results Immediate Actions are 01. program the flexibility of city schedules;02. plan a smart and sustainable mobility network;03. define a neighborhood services' plan;04. develop a digitization of the urban context, promoting the smart communities;05. re-think the accessibility to the places of culture and tourism. Medium-long term Actions are 06. design the indoor flexibility of domestic living spaces;07. re-think building typologies, fostering the presence of semi-private or collective spaces;08. renovate the basic care services' network;09. integrate the existing environmental emergency plans, with those related to the health emergencies;10. improve stakeholders' awareness of the factors affecting Public Health in the cities. Conclusions The Decalogue of Public Health opportunities may provide a useful basis for Designers (Architects and Urban Planners), Policy Makers, Public Health experts and Local Health Agencies, in promoting actions and policies aimed to transform our cities in healthier and Salutogenic living environments. Key messages The strategies described in this paper are at the basis of a social and infrastructural rethinking of the city, careful to the Welfare and Public Health needs. The physical distancing imposed, may have amplified population's social and health inequalities.

SARS-CoV-2 indoor contamination: considerations on anti-COVID-19 management of ventilation systems, and finishing materials in healthcare facilities.

Abstract: Many of the devastating pandemics and outbreaks of last centuries have been caused by enveloped viruses. The recent pandemic of Coronavirus disease 2019 (COVID-19) has seriously endangered the global health system. In particular, hospitals have had to deal with a frequency in the emergency room and a request for beds for infectious diseases never faced in the last decades. It is well-known that hospitals are environments with a high infectious risk. Environmental control of indoor air and surfaces becomes an important means of limiting the spread of SARS-CoV-2. In particular, to preserve an adequate indoor microbiological quality, an important non-pharmacological strategy is represented by Heating, Ventilation and Air Conditioning (HVAC) systems and finishing materials. Starting from the SARS-CoV-2 transmission routes, the paper investigates the hospital risk analysis and management, the indoor air quality and determination of microbial load, surface management and strategies in cleaning activities, HVAC systems' management and filters' efficiency. In conclusion, the paper suggests some strategies of interventions and best practices to be taken into considerations for the next steps in design and management.

Face masks. Technical, technological and functional characteristics and hygienic-sanitary aspects related to the use of filtering mask in the community.

INTRODUCTION: The health emergency caused by the spread of SARS-COV-2 virus has required the adoption of passive measures against contagion, such as social distancing. The use of filtering masks, of the different types available on the market, such as surgical and facial filtering masks (FFP1, FFP2 and FFP3), is also recommended. OBJECTIVES: The aim of this paper, within the Italian and European regulatory reference framework, is to suggest a rational application of existing methodologies that enable to know and assess the features and/or make a face mask intended to be used by the community. In addition to this, the study aims to provide a correct regulatory framework and useful information for a correct use and disposal of face masks. Another purpose is the assessment of the hygienic, sanitary and regulatory aspects related to the use and disposal of face masks. METHODS: The analysis of filtering masks is based on the review of scientific literature, the state of art of technology and the filtering means/materials available. Reference is made to filtering mechanisms and devices, the testing methods, the technical, manufacturing and performance features, and to the Italian and European regulatory reference framework. Reference is also made to the hygienic, sanitary and regulatory aspects related to the use and disposal of face masks. RESULTS: Surgical masks or, alternatively, filtering masks with a filtration efficiency between 90% and 95% for 3-µm particles, are the most practicable choice with minor contraindications. The reusable type of mask is conceptually superior compared to single-use masks, but cleaning procedures to be followed are quite complex and not always described in a clear way. CONCLUSIONS: The definition of rigorous and repeatable tests on mask filtration capacity, breathability, wearability, duration of use, regeneration, as well as safe disposal methods, are the main way to provide users with correct selection and use criteria. The results must be disclosed and disseminated quickly.