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6.
Ann Ig ; 2022 May 06.
Article in English | MEDLINE | ID: covidwho-1835652

ABSTRACT

Background: The SARS-CoV-2 pandemic has affected also the school environment. Prolonged closures and the weakness of available data prevent a definitive answer to the question of school transmission. We report our experience of responding to COVID-19 cases in the school setting, presenting a case study of the management of an outbreak in a large school. Methods: The LHA/ASL Roma 1 has organized the School Units with a structure firmly rooted in the territory. At the local level, the District Unit mainly manages the relationship with schools, while the Hygiene and Public Health Service of the Prevention Department holds a coordinating and facilitating role. The HPHS carries out contact tracing activities facilitated by the schools, through the figure of the COVID-19 Contact Person, who is specifically trained to manage the preliminary stages of the reports. Results: Following several reports of COVID-19 suspect cases from two schools and, after a complex phase of contact tracing, it was possible to identify the major transmission chains. Furthermore, we performed a population-based screening on the entire school. Beyond the known transmission chains, for which quarantine was already in place, only five additional cases emerged, all asymptomatic, out of 1,231 swabs tested with RT-PCR. Conclusions: Our experience confirms that an active interaction between the school and the School Unit made it possible to quickly control a potentially dangerous outbreak. The large-scale screening test demonstrated the substantial absence of collateral transmission chains. Effective contact tracing allowed to set forth a successful response. Our model of intervention can be used to support public health protocols regarding school outbreaks.

7.
J Eur Acad Dermatol Venereol ; 36(8): 1292-1299, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1807159

ABSTRACT

BACKGROUND: Moderate-to-severe atopic dermatitis (AD) in the adolescence is a high burden disease, and its treatment can be very challenging due to paucity of approved systemic drugs for this age and their side-effects. Dupilumab was recently approved for treatment of adolescent AD. OBJECTIVES: A multicentre, prospective, real-world study on the effectiveness and safety of dupilumab in adolescents (aged from ≥12 to <18 years) with moderate-to-severe AD was conducted. The main AD clinical phenotypes were also examined. METHODS: Data of adolescents with moderate-to-severe AD treated with dupilumab at label dosage for 16 weeks were collected. Treatment outcome was assessed by EASI, NRS itch, NRS sleep loss and CDLQI scores at baseline and after 16 weeks of treatment. The clinical scores were also evaluated according to clinical phenotypes. RESULTS: One hundred and thirty-nine adolescents were enrolled in the study. Flexural eczema and head and neck eczema were the most frequent clinical phenotypes, followed by hand eczema and portrait-like dermatitis. Coexistence of more than 1 phenotype was documented in 126/139 (88.5%) adolescents. Three patients (2.1%) contracted asymptomatic SARS-CoV-2 infection and 1 of the discontinued dupilumab treatment before the target treatment period. A significant improvement in EASI, NRS itch, NRS sleep loss and CDLQI was observed after 16 weeks of treatment with dupilumab. This outcome was better than that observed in clinical trials. Dupilumab resulted effective in all AD phenotypes, especially in diffuse eczema. Twenty-eight (20.1%) patients reported adverse events, conjunctivitis and flushing being the most frequent. None of patients discontinued dupilumab due to adverse event. CONCLUSIONS: Dupilumab in adolescent AD showed excellent effectiveness at week 16 with consistent improvement of all clinical scores. Moreover, dupilumab showed a good safety profile also in this COVID-19 pandemic era.


Subject(s)
COVID-19 , Dermatitis, Atopic , Eczema , Antibodies, Monoclonal, Humanized , COVID-19/drug therapy , Dermatitis, Atopic/drug therapy , Double-Blind Method , Humans , Pandemics , Prospective Studies , Pruritus , SARS-CoV-2 , Severity of Illness Index , Treatment Outcome
9.
Digestive and Liver Disease ; 53:S109, 2021.
Article in English | EMBASE | ID: covidwho-1554122

ABSTRACT

Background and aim: Access to liver transplantation (LT) can beaffected by several barriers resulting in delayed referral and increased risk of mortality. Therefore, hub-and-spoke networks have been implemented in order to manage patients with liver disease. COVID-19 pandemic may have significantly changed this scenario, as most of medical resources have been allocated for the care of patients with SARS-CoV-2 infection. This study aimed to assess the influence of COVID-19 pandemic on referrals of patients with liver disease to a LT Center.Materials and methods: An integrated referral program was developed since 10.2017 at Multivisceral Transplant Unit, PadovaUniversity. All consecutive adult patients with liver disease referred for the first time using this program from 10.2017 to 12.2020 were prospectively collected. Clinical characteristics were analyzedoverall and according to era of referral (pre-COVID-19 era:10.2017-02.2020;COVID-19 era:03.2020-12.2020).Results: 231 patients with liver disease were referred over the study period (men 61%, mean ± SD age: 54±10 years). End-stage liver disease was the most common underlying condition (78.3%), followed by acute liver injury/acute liver failure (17.3%). During COVID-19 pandemic, the rate of referred patients showed a stable trend, if compared with the previous period (5.1 patients/monthvs. 6.1 patients/month), also when only in-patient referrals wereconsidered (pre-COVID-19 era vs.COVID-19 era: 2.9 vs. 3.2 patients/month). Considering 181 patients with cirrhosis, underlying etiology (p=0.22), severity of liver disease (MELD score: 21±7 vs. 20±8;p=0.44), and inpatient referrals (42% vs. 51%;p=0.34) did not differ between pre-COVID-19 and COVID-19 eras. There was a decreasing rate of ICU admission for cirrhosis-related complicationsduring COVID-19 pandemic (22% vs. 34%;p=0.3), with an increased in-hospital transplant-free mortality (41% vs. 30%;p=0.3).Conclusions: Conclusion: Our results did not show a significant decrease in the number of referrals and type of indications during the COVID-19 pandemic;however, the in-hospital transplant free mortality showed an increasing trend, which could be the consequence of a decreasing rate of ICU admissions. Taken together, thesefactors confirmed the importance of a referral network for the care of patients with liver disease, but also how the COVID-19 pandemic may influence the short-term outcome of patients with liver disease.

10.
Humanidades & Inovacao ; 8(44):139-147, 2021.
Article in Portuguese | Web of Science | ID: covidwho-1431548

ABSTRACT

Introduction: The SARS-COV2 pandemic will leave traces in our society. Lives, both personal and professional, will suffer the consequences of this time for a significant period of life. The flexibility of social isolation, promotes the need for actions for the safe resumption of business activities, providing care that ensures the well-being and safety of employees. In this context, the study intends to collaborate with managers in the dissemination of procedures that can form a security protocol that allows corporate action in the "new corporate normal". Methodological Procedures: Based on an applied research, using the action research strategy, bibliographic review and highlighting the Diagnosis of environments (AD);Workforce assessment (AFT) on resumption of activities and Physical implementation of environmental sanitation solutions Expected Results: The study allowed the structuring of an AD and AFT protocol for the resumption of organizational activities with Safety, Health and Quality of Life, mitigating the possible cost of health costs and collaborating with innovative methodologies in population health management. General Considerations: In this new pandemic scenario, some immediate and perhaps innovative measures should be taken. It is believed that these measures, if conducted correctly, will not only promote immediate results around the work of employees in relation to Health and Quality of life. Based on this method indicated for returning to work, it will be up to companies to use the implementation of an information system so that the managers of each company monitor risk management and health promotion programs.

14.
Digestive & Liver Disease ; 26:26, 2021.
Article in English | MEDLINE | ID: covidwho-1209545

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.

15.
Eurosurveillance ; 25(47):10, 2020.
Article in English | Web of Science | ID: covidwho-993166

ABSTRACT

Background: Veneto was one of the Italian regions hit hardest by the early phase of the coronavirus disease (COVID-19) pandemic. Aim: This paper describes the public health response and epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the Veneto Region from 21 February to 2 April 2020. Methods: Information on the public health response was collected from regional health authorities' official sources. Epidemiological data were extracted from a web-based regional surveillance system. The epidemic curve was represented by date of testing. Characteristics of hospitalised COVID-19 cases were described and compared to those never admitted to hospital. Age- and sex-stratified case fatality ratios (CFRs) were calculated. Results: Key elements of the regional public health response were thorough case-finding and contact tracing, home care for non-severe cases, creation of dedicated COVID-19 healthcare facilities and activation of sub-intensive care units for non-invasive ventilation. As at 2 April 2020, 91,345 individuals were tested for SARS-CoV-2 and 10,457 (11.4%) were positive. Testing and attack rates were 18.6 per 1,000 and 213.2 per 100,000 population, respectively. The epidemic peaked around 20 to 24 March, with case numbers declining thereafter. Hospitalised cases (n=3,623;34.6%) were older and more frequently male compared with never-hospitalised cases. The CFR was 5.6% overall, and was higher among males and people > 60 years of age. Conclusion: In the Veneto Region, the strict social distancing measures imposed by the Italian government were supported by thorough case finding and contact tracing, as well as well-defined roles for different levels of care.

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