ABSTRACT
Background: SARS-CoV2 pneumonia with respiratory failure may evolve to ARDS. The effects of high PEEP on respiratory compliance varies in different patients. Our study is based on the high accurancy and sensitivity of Lung Ultrasound (LUS) in evaluating the heterogeneous distribution of aeration loss, and use of LUS to individualize PEEP titration to produce the best lung aeration. Method(s): Retrospective trial on two cohorts of patients (15+15) with SARS-CoV2 ARDS mild-to-moderate(according to Berlin Criteria), aged 18 to 80 y.o. In Group I(GI) PEEP titration was LUS guided, in Group II(GII) titration was SpO2-guided. In GI LUS score was calculated dividing lungs in six regions per hemithorax. Patients were treated with NIV or CPAP Helmet. In GII FiO2 was initially set at 40% and increased if target oxygenation was not met. In GI PEEP was set at 5 cmH2O and guided by LUS aeration. Cases were managed by PEEP values from 7.5-15 cmH2O. Determination of optimal PaO2/FiO2 was the primary outcome. Secondary outcomes were adverse event: incidence of barotrauma/pneumothorax/pneumomediastinum, haemodynamics (MAP and HR), time spent on NIV/ CPAP, length of stay, weaning categories, and mortality at day 28. Result(s): P/F ratio was 282+/-38.6 in GI, and 243+/-43.2 in GII. We didn't detect significant statistical differences between the two groups in terms of mortality (6.2% in Gi vs 6.8% in GII) nor in time to weaning (5+/-6 in GI vs 16+/-4.5 in GII). In-stead there were fewer AE in GI vs GII. Length of stay was reduced with mean value of 4.3 days. Conclusion(s): Compared to SpO2-guided PEEP titration, LUS-based titration was associated with favorable effects on rate of adverse events and length of hospital stay.
ABSTRACT
BACKGROUND: Physical inactivity is a highly prevalent condition in the world and has been associated with increased susceptibility to develop comorbidities and present with severe respiratory distress syndrome due to COVID-19. OBJECTIVE: To identify the factors present in the family environment and the personal reasons associated with physical inactivity in young people during confinement at home due to COVID-19. MATERIAL AND METHODS: A cross-sectional study analyzed data from 1,326 young people, ages 15 - 18. To collect information, a questionnaire was constructed using the Google Forms tool and distributed through the WhatsApp application and email to collect the information. RESULTS: The prevalence of physical inactivity was 43.4%. Approximately 24.4% were overweight, and 8.8% were obese. Near 43.0% of young people reported living in an environment with a dysfunctional family. The multivariate logistic regression analysis showed that suffering from obesity, does not have space at home, or devices to exercise and present a change in emotions, are related to the physical inactivity of young people during confinement at home due to the COVID-19 pandemic. CONCLUSIONS: It is important to promote a harmonious environment within the family and the personal development of a healthy lifestyle, during the period of application of the contingency plan due to the presence of a pandemic, in order to maintain a better healthy physical and mental state.
ABSTRACT
Viral hepatitis C is an important public health problem and its elimination by 2030, defined by the World Health Organization, is an ambitious goal. The chance of free screening for HCV infection represents an important achievement that requires a successful State-Regions coordination and an effective regional organisation, that guarantees an interdisciplinary course between local and specialized healthcare. A structured communication program to increase the sensitivity of target populations as well as health professionals is the key for success. The implementation of the proactive screening, defined by the Milleproroghe Law, is crucial because it will define the tracks for the whole HCV costeffective screening strategies (1948-1988 birth cohorts) required to achieve the HCV elimination targets in Italy by 2030.
ABSTRACT
Although Italy has been on track for Hepatitis C Virus (HCV) elimination since 2019, it fell off track due to the decrease in the number of treated patients. HCV elimination in Italy will be possible if immediate action is taken. A health policy was implemented beginning in 2021, consisting of screening among key populations and birth cohorts (1969-1989), estimated to have a high prevalence of undiagnosed individuals. The active screening requires regional governance that manages the processes' complexity integrating a well-organized network between territory assistance and hospital to achieve an effective HCV care cascade. This document aims to support the regional decision-making process by defining paths for screening and linkage-to-care. Implementing active screening strategies beyond a risk-based approach is required as a General Practitioners' task. Simplified paths must be drawn for the key populations screening. The infrastructure built for COVID-19 vaccination could be used also for HCV screening. According to a multidisciplinary care delivery, screening should be supplemented with rapid linkage-to-care and treatment of newly diagnosed patients. The realization of the proactive screening during the first two years is vital because it will define the tracks for the whole HCV cost-effective screening of 1948-1988 birth cohorts in Italy.