Ozone and growth factors in the treatment of arthralgias secondary to vaccination against Covid-19. Case report

Background: The use of vaccines as preventive agents for SARS-CoV-2 infection has generated collateral effects, including arthralgias. The objective of this case report was to describe the treatment and evolution of a patient with arthralgia secondary to vaccination with BNT162b2 (Pfizer - BioNTech), with ozone and ozonized growth factors. Methods: The patient was a 53-year-old, white male with no medical history who had received 2 doses of the BNT162b2 vaccine, with an interval of 6 weeks. After the second dose, the patient reported the permanence of arthralgia in the fifth finger of the right hand, and the third finger of the left hand with an intensity of 9-10 on the visual analog scale (VAS) scale. The patient was locally infiltrated with ozone 6 mg/mL (intra articular and with the glove technique), twice a week for 2 weeks, and was subsequently treated with platelet-derived growth factor, Silfradent (R) CGF (Concentrated Grow Factors) activated with ozone, in a single session. Results: The patient evolved satisfactorily with a final VAS reduction to a value of 1-2 and reduction of clinical symptoms. Medical ozone and regenerative medicine using CGF, can represent a useful complement in mitigating collateral effects such as post-vaccination arthralgias. Conclusions: Larger clinical studies are needed to demonstrate its clinical efficacy in this indication.

Proceedings of the VI National Meeting of the Italian Group of Paleopathology (GIPaleo)

The presence of numerous scientific contributions in the program is certainly demonstrative of the fact that research in the field of paleopathology and anthropology has not stopped since the beginning of Covid-19. Furthermore, the same emergency that we are still partially feeling, has pushed our community scientific research to question itself more intensely in connection to the epidemic relationship and measures that repeatedly led to profound transformations in the societies of the past from different points of view: demographic, economic, social and the history buried under the bioarchaeological strata is today more capable than ever to show this connection. It can do this by bringing to light the paleodemographic data that is obtained from the study of human remains. Today we will listen to many paleopathological stories and among these I am very happy to also present ours. Twenty years ago, the University of Insubria started a collaboration with the Archaeological Superintendence of Lombardy for the study of osteological remains found mostly during emergency archaeology recoveries. These experiences led us to reach those bioarchaeological sites again with the aim of extracting all those cemetery layers that remained there because they were not subjected at that time by building reclamation interventions. Returning to those sites that in the past brought to light fragmentary anthropological data means allowing oneself the possibility of obtaining new palaeodemographic and palaeopathological data which are decisive for reconstructing the demographic and epidemiological history of the populations of the past. These new interventions led us to create an operational model that immediately intended to underline the importance of an evident continuity between the archaeological recovery and the anthropological study of the finds through the setting up of physical anthropology and paleopathology laboratories directly on the sites of the finds. All this in harmony with the final design of the projects or the museumization of bioarchaeological sites in their complexity aimed at enhancing cultural tourist routes in the area. In this regard, I would like to thank the community foundation of Varese and the Cariplo foundation for supporting our current initiatives. These include the project financed by the emblematic provincial tender and which has as its final objective the enhancement of three bioarchaeological sites in Valcuvia: the medieval sites of San Biagio in Cittiglio, Sant’Agostino in Caravate, and the modern crypt of the church of the Convent of Azzio. Today, our Research Centre works in Piedmont in different sites in the province of Vercelli and Alessandria. Aware of the importance of a physical anthropological approach in the field, our young Centre goes beyond the continental borders to reach Eritrea, the ancient city of Adulis, because it is in dissecting the taphonomic events and the funeral actions that will make it possible to identify the funerary ritual adopted by the ancient populations. The operational model of paleopathological research, which gradually enriches itself thanks to the multidisciplinary nature of the interventions and thanks to the individual experiences in the field, is thus continuously transferred and adapted to other anthropological contexts that retain potential both in terms of investigative and enhancement of the bioarchaeological heritage. Through the musealization of the sites it is also possible to acquire an attractive force towards all those potentially bioarchaeological areas but which today are in conditions of neglect because they are marginal with respect to the conventionally understood cultural tourist good. And we all know how important it is to transfer the study data even outside the academic context because making this aspect of archaeology, the truly human one, usable too, cannot fail to arouse a strong awareness of our past. We also know how much more we will have to work, following in the footsteps of the professors who started this path, to ensure that the d sciplines of paleopathology and physical anthropology arrive within all those degree courses still discovered today by these teachings to heal an important lack: knowing the human past from a physical and pathological point of view allows us to understand the evolutionary path of some pathologies, especially those of infectious nature. If my title of the speech “Paleopathology and osteoarchaeology in the province of Varese” does not respond to what is being said today, it is because my feeling about paleopathology and osteoarchaeology in the province of Varese is understood as that of carrying out research, what I could feel everywhere, through the operational model, the enthusiasm for paleopathological research and of course the people I am lucky enough to work with. The Morgagni Museum of Pathological Anatomy of the University of Padua preserves a wide series of pathological specimens, mostly from the second half of the 19th century and the early 20th century. The Museum was recently renewed, as the result of an intervention of enhancement of the museum and cultural heritage of the University of Padua and its Medical School, being also testimony to the history and evolution of human pathology and past population lifestyle. In the collection of the Morgagni Museum there are several specimens affected by atherosclerotic lesions. Atherosclerosis is characterized by a chronic inflammatory disease in which different factors are involved, such as lipoproteins, immune cells and endothelial damage. The main clinical syndromes related to atherosclerosis are angina pectoris, acute myocardial infarction, transient ischemic attack, cerebral stroke, intermittent claudication, aortic aneurysm and nephro-vascular hypertension. Atherosclerosis was believed to be a modern disease, related almost exclusively to age and current lifestyle. The cases from the Morgagni Museum are therefore useful for studying the presence of the atherosclerosis in a recent past population. In the collection there were identified six atherosclerotic cases: an atherosclerotic aneurysm of the ascending aorta: the specimen highlights the left ventricular outflow tract and the aortic root. There is a severe atherosclerosis of the ascending aorta with saccular aneurysm including a large thrombus;a syphilitic aortitis complicated by atherosclerosis: the finding highlights the left ventricular outflow tract and aortic root. It is possible to note the intima of the ascending aorta with ulcer-calcific atherosclerotic plaques and “tree-bark” whitish areas;an atherosclerotic aneurysm of the abdominal aorta: abdominal aorta with saccular atherosclerotic aneurysm, proximal to the iliac bifurcation;a case of aortic atherosclerosis: aorta with severe atherosclerosis complicated by calcification and thrombosis;a case of aortic atherosclerosis: massive dissemination of atheromatous-calcific plaques;a case of aortic atherosclerosis with parietal thrombi: widespread presence of plaques along the aortic wall. Thanks to this collection, it is possible to notice the spread of pathology on an atheromatous basis in the recent past populations. Moreover, current paleopathological investigations on ancient populations mummified remains also showed traces of atherosclerotic lesions in both sexes and different ages. It is therefore possible to support a ubiquitous diffusion in space and time of this complex multifactorial pathology which has so far considered to be almost an exclusive prerogative of old age and current lifestyle. The Morgagni Museum of Pathological Anatomy of the University of Padua, founded by Lodovico Brunetti (1813-1899) in the 1860s, gathers important pathological specimens mainly from the 19th century. Among them, there is a very peculiar preparation: it consists of a dried head representing a case of argyria dating back to 1873. The specimen is preserved in a sealed jar, all the skin has a blue-gray coloration with white-blonde hair and beard. The eyes are not preserved, but since the ocular cavities remain open, it is possible to presume that origin lly there were glass eyes. Two glass sticks are inserted inside the mouth to show that also tongue and gums have the same blue-gray pigmentation as the face. The upper teeth are strongly eroded. Argyria is a rare disease caused by chronic absorption of products with a high silver content, which surpass body’s renal and hepatic excretory capacities, leading to silver granules being deposited in the skin and its appendages, mucosae and internal organs. It is characterized by blue-gray or black staining of the skin and mucous membranes. Our case was first mentioned in 1862 as a syphilitic man who was treating himself with some caustic silver nitrate, the so called “infernal stone”, since 1840s. According to him, this medicament cured the syphilis, but turned him into a “graphite man”. The patient died in 1873 of an intestinal infection, most likely related to the prolonged ingestion of the silver nitrate. This case was described as “spectacular” by Austrian dermatologist Isidor Neumann (1832-1906), who studied a sample of the tongue of the specimen sent by Brunetti. In fact, Brunetti performed the autopsy on the body of the individual and prepared also a plaster cast of the head along with the sample for Neumann. Thus, we can assume Brunetti was also the one who preserved the original head, taxidermizing it (so-called stuffed head preparation) in order to preserve the skin color, because his famous tannisation method would not maintained the original characteristics. Human taxidermy is quite rare, and it is limited to a few cases in the 19th century. Moreover, there are just a few known human stuffed heads in the world, making the Paduan specimen particularly unique both for the pathology and the technique used for the preparation.

Generalized epidemiological compartmental models: guaranteed bounds via optimal control

We consider a class of epidemiological models in which a compartmental linear system, including various categories of infected individuals (e.g. asymptomatic, symptomatic, quarantined), is fed back by a positive feedback, representing contagion. The positive feedback gain decreases (in a sort of negative feedback) as the epidemic evolves, due to the decrease in the number of susceptible individuals. We first propose a convergence result based on a special copositive Lyapunov function. Then, we address a major problem for this class of systems: the deep uncertainty affecting parameter values. We face the problem adopting techniques from optimal and robust control theory to assess the sensitivity of the model. For this class of systems, the optimal control solution has a peculiar decoupling property that no shooting procedure is required. Finally, we exploit the obtained bounds to assess the effectiveness of possible epidemic control strategies, including intermittent restrictions adopted during the COVID-19 pandemic.

The social pandemic from SARS-CoV-2 among Italian university students: a pilot study

The impact of restrictions on movement resulting from the SARS-CoV-2 pandemic may contribute to a disruption of mental health in young people during this era. In March 2021, lockdown restrictions were enforcing national policies of tackling the infectious disease across the globe. In the early stages of the vaccination rollout, public enquires on confidence to endure the virus pandemic have shown high levels of psychological distress. Under the above circumstances, 333 university students were asked to fill in an online-based survey on alcohol consumption, compulsive behavior as a loss of control over eating, fear of weight changes, excessive sleepiness and sleep deprivation. Text mining and multiple correspondence analysis were employed to analyze qualitative data on the lived experience against the occurrence of healthrelated behaviors. Data analyses have showed that the pandemic was associated with a mixed breakup of clustered lemmas based on sex, age, and relationship status. The extent to which the participants have reported a lower degree of satisfaction on living arrangements, intimate and family relationships were interpreted as meaningfully related with a more negative lived experience. Social confinement has resulted as an immediate action for mitigating a public health crisis from the SARS-CoV-2 disease. Incidentally, social measures to mitigate the virus transmission have sought to protect internal collapse of the health care systems by reducing the number of casualties. Conversely, these findings provide new evidence on the social determinants of health among youth and consequently highlight the potential interference from missing social interactions in the COVID-19 pandemic response. © Author (s).

Prognostic value of right ventricular dilatation in patients with COVID-19: A multicentre study

Introduction: Although cardiac involvement has prognostic significance in COVID-19 and is associated with severe presentations, few studies have explored the prognostic role of transthoracic echocardiography (TTE). We investigated the link between TTE parameters and prognosis in COVID-19. Method: Consecutive patients with COVID-19 admitted in 24 French hospitals were retrospectively included. Comprehensive data, including clinical and biological parameters, were recorded at admission. Focused TTE was performed during hospitalization, according to clinical indication. Patients were followed-up for a primary composite outcome of death or transfer to intensive care unit (ICU) during hospitalization. Results: Among 2878 patients, 445 (15%) underwent TTE. Most had cardiovascular risk factors, a history of cardiovascular disease, and were under cardiovascular medications. Dilatation and dysfunction were observed in12% (48/412) and 23% (102/442) of patients for the left ventricle, and in 12% (47/407) and 16% (65/402) for the right ventricle (RV), respectively. Primary composite outcome occurred in 44% (n = 196) of patients (9% [n = 42] for death without ICU transfer and 35% [n = 154] for admission to ICU). RV dilatation was the only TTE parameter associated with the primary outcome. After adjustment, male sex (hazard ratio [HR] 1.56, 95% CI 1.09 − 2.25;P = 0.02), higher body mass index (HR 1.10, 95% CI 1.02 − 1.18;P = 0.01), anticoagulation (HR 0.53, 95% CI 0.33 − 0.86;P = 0.01), and RV dilatation (HR 1.66, 95% CI 1.05 − 2.64;P = 0.03) remained independently associated with the primary outcome (Fig. 1). Conclusion: Echocardiographic evaluation of RV dilatation could be useful for assessing the risk of inhospital death or transfer to ICU in severe hospitalized COVID-19 patients.

Challenges and Future Directions in Pandemic Control

In this letter, we describe some of the most important objectives and needs in pandemic control. We identify the main open problems in the different stages of the decision making process, as well as the most significant challenges to overcome them, leading to promising future research directions. We provide a concise review of the most recent literature describing such challenges, highlighting the main results, achievements and methodologies that can be employed to address them. In particular, we discuss some promising recent techniques that have been successfully applied to the Covid-19 pandemic and could be very valuable in the design of novel methodologies to face similar challenges infuture pandemics. IEEE

A Retrospective Analysis of the COVID-19 Pandemic Evolution in Italy

Late 2019 saw the outbreak of COVID-19, a respiratory disease caused by the new coronavirus SARS-CoV-2, which rapidly turned into a pandemic, killing more than 2.77 million people and infecting more than 126 million as of late March 2021. Daily collected data on infection cases and hospitalizations informed decision makers on the ongoing pandemic emergency, enabling the design of diversified countermeasures, from behavioral policies to full lockdowns, to curb the virus spread. In this context, mechanistic models could represent valuable tools to optimize the timing and stringency of interventions, and to reveal non-trivial properties of the pandemic dynamics that could improve the design of suitable guidelines for future epidemics. We performed a retrospective analysis of the Italian epidemic evolution up to mid-December 2020 to gain insight into the main characteristics of the original strain of SARS-CoV-2, prior to the emergence of new mutations and the vaccination campaign. We defined a time-varying optimization procedure to calibrate a refined version of the SIDARTHE (Susceptible, Infected, Diagnosed, Ailing, Recognized, Threatened, Healed, Extinct) model and hence accurately reconstruct the epidemic trajectory. We then derived additional features of the COVID-19 pandemic in Italy not directly retrievable from reported data, such as the estimate of the day zero of infection in late November 2019 and the estimate of the spread of undetected infection. The present analysis contributes to a better understanding of the past pandemic waves, confirming the importance of epidemiological modeling to support an informed policy design against epidemics to come.