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Case report Dust is a known mixture and carrier of multiple allergens and an epidemiologic study demonstrated the presence of peanut proteins in school cafeterias and classrooms, suggesting that schools may play an important role in exposure to environmental food allergens. While inhalation of food allergens is a known trigger of IgE-mediate acute respiratory reaction as rhinitis and wheezing, little is known about persistent allergic asthma and/or rhinitis induced by chronic inhalation of food allergens. Here we report two cases of teenagers with nuts allergy presenting with persistent respiratory symptoms when exposed to closed and dusty environments. The first case concerns a 12-year-old boy allergic to walnut and hazelnut (specific IgE > 100 and 81.70 kU/l, respectively). For some years he has had a persistent mild asthma, frequent nasal occlusion and rhinorrhea, without any allergic sensitization to aeroallergens. Symptoms occurred exclusively during school period when he required maintenance therapy with inhaled and nasal steroids. He was asymptomatic and did not need any treatment during summer. During the lockdown period due to Covid-19 pandemic, he did not attend school for several months and he was able to discontinue inhaled corticosteroid therapy without recurrence of asthma and rhinitis symptoms. Asthma recurred after he returned to school, but with only mild intermittent symptoms, probably thanks to the use of masks and the frequent airing of the classrooms. On a single occasion he experienced nasal occlusion and rhinorrhea after that a parent had eaten hazelnut cream in the same room where he was. The second case deals with a 17-year-old boy with a history of several food allergies (milk, egg, wheat, banana, nuts, hazelnuts) and mild persistent asthma in absence of sensitization to aeroallergens. He successfully underwent oral desensitization for milk, egg and wheat in previous years. Asthma symptoms improved over the years together with progressive development of oral tolerance to food allergens for which oral immunotherapy had been done. On the other hand, he referred persistence of allergic rhinitis especially during the school year and his symptoms got worse in classroom. Exhaled nitric oxide was quite increased with evidence of eosinophils in nasal smears. In-vitro and in-vivo tests only detected food allergens sensitizations, in particolar to walnuts and hazelnuts (specific IgE were 61.00 and 55.50 kU/l respectively). These two clinical cases suggest that food allergens might be causative agents of allergic persistent asthma and/or rhinitis as aeroallergens do.
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In the last years, the entire world has been affected by the SARS-COV-2 pandemic, that represents the etiologic agent of Coronavirus disease 2019 (CoViD-19), which degenerated into a global pandemic in 2020. CoViD-19 has also had a strong impact on cancer patients. Our analysis has been performed at the Department of Oncology of the AORN "Cardarelli” in Naples, collecting data from all patients who had access in 2019–2020. We aim to understand how CoViD-19 affected hospital admissions. The statistical analysis showed that between 2019 and 2020 there was an increase in urgent hospitalizations and a decrease in scheduled hospitalization, probably to decrease the risk of infection, particularly in this category of susceptible patients. Indeed, as recommended by the European Society of Medical Oncology, during the pandemic, it was necessary to reorganize healthcare activities, ensure adequate care for patients infected with CoViD-19. Therefore telemedicine services were implemented and clinic visits were reduced. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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In December 2019, SARS-CoV-2 broke out, which raised great attention worldwide. In fact, it was essential to reorganize the management of economic, infrastructural and medical resources to deal with the inadequate preparation of medical practitioners for this emergency. It was evident that the global health, medical and scientific communities were not adequately prepared for this emergency, so during the pandemic. In this paper, data extracted from hospital discharge records of the Department of Urology of the A.O.R.N "Cardarelli” in Naples, Italy, were used. This work is an extension of a previous work, whose goal concerned how admission procedure in the Urology department of the "San Giovanni di Dio and Ruggi d'Aragona” hospital has been affected by COVID-19 pandemic. In this work we compare the results obtained for the patients of the University Hospital "San Giovanni di Dio and Ruggi d'Aragona” of Salerno and the patients of the A.O.R.N. "Antonio Cardarelli” of Naples (Italy). Data have been extracted from both hospitals discharge records of the Departments of Urology. Experimental analysis performed comparing pre-pandemic data with those collected during the epidemic showed an in-crease in the number of emergency hospitalizations and a decrease in planned pre-admission hospitalizations. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The Coronavirus 2 (SARS-CoV-2), causing severe acute respiratory syndrome, is the source of the global pandemic known as Coronavirus Disease-2019 (COVID-19). The comorbidities, such as diabetes mellitus, cardiovascular disorders such hypertension, kidney disease, lung disease, and age, affect COVID-19 effects severity (1-3). This new disease has changed surgery practice in most countries around the world. (4) In order to maintain social distance, surgery departments may take a variety of steps, such as canceling face-To-face outpatient and nonurgent appointments, screening scheduled clinic visits, conducting telephone consultations with patients who have nonurgent conditions, and rescheduling appointments for a few months. (5) The focus of this work is to analyze the activity of the Department of liver transplant surgery in "A.O.R.N. Antonio Cardarelli"of Naples (Italy) was analyzed. In particular, the data-set obtained in the year 2019 (pre-pandemic) was compared with that in the following year 2020 (pandemic). The data refers to patients undergoing liver transplantation. © 2022 ACM.
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CoViD-19 pandemic caused a severe changing of healthcare facilities activities. Specifically, one of the most affected areas are the Department of Emergency Surgery that have been reorganized to face the emergency giving priority to urgent procedures at cost of those which could be deferred. This study evaluates the impact of the pandemic on the departments of two different Italian Hospitals: "San Giovanni di Dio and Ruggi d'Aragona” University Hospital in Salerno and the AORN "A. Cardarelli” of Napoli. Two different analyses (statistical and machine learning) have been provided for investigating patients in 2019, as an example of the normal activity before the pandemic, and those recorded in 2020, in which the pandemic reached its peak. The evaluation performed showed an increase in the urgent hospitalization and Diagnostic Related Group while transfers to Social Care Residences (RSA) decreased in both the Hospitals, even if the steepness of these changes are consistent with the starting values. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The main phenomenon that impacted people's lives was the COVID-19 pandemic, having strong consequences on national health systems. Since the beginning of the Covid-19 pandemic, hospital admissions dropped precipitously in 2020. Our aim concerns the analysis about how the COVID-19 affects the activity of the Department of General Surgery, Day Surgery and Breast Unit in the University Hospital "San Giovanni di Dio and Ruggi d'Aragona” of Salerno and the hospital "A.O.R.N. Antonio Cardarelli” of Naples (Italy). In the work data for the year 2019 (in the absence of pandemic) and in the year of pandemic 2020 were considered. This work used the logistic regression technique to study the following variables: age, gender, length of stay (LOS), relative weight of DRG, admission procedure, mode of discharge and the results about both hospitals were used to make a comparison. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The aim of the present work is to assess the impact of the Covid-19 epidemic on the activity of the Department of Plastic Surgery in the University Hospital "San Giovanni di Dio and Ruggi d'Aragona” of Salerno and the hospital "A.O.R.N. Antonio Cardarelli” of Naples (Italy). Coronavirus disease 2019 (COVID-19), has spread since December 2019 and is a respiratory infection that has changed the healthcare environment, in fact hospitals have had to reorganize departments to better manage resources and make processes efficient. In order to assess the effect that Covid-19 had on the department, data were collected for the year 2019 (in the absence of Covid-19) and in the year of the pandemic 2020. In the work was used the logistic regression technique to study the following variables: age, gender, length of stay (LOS), relative weight of DRG, admission procedure, and the results of the two hospitals were used to make a comparison. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The purpose of the present work was to assess the impact of the Covid-19 epidemic on the activity of the Department of General Medicine in the University Hospital "San Giovanni di Dio and Ruggi d'Aragona” of Salerno and the hospital "A.O.R.N. A. Cardarelli” of Naples (Italy). COVID-19 is a specific disease affecting subject respiratory system is a respiratory infection that changed the health context. Because of the pandemic hospitals had to reorganize departments to better manage resources. In order to make a comparison with and without Covid-19, the data for the year 2019 (in the absence of Covid-19) and in the year of the pandemic 2020 have been collected. In the work was used the logistic regression technique to study the following variables: age, sex, LOS, weight of DRG, mode of discharge and type of hospitalization. In addition, the results of the two hospitals were used to make a comparison. For both hospitals in the year 2020 the number of patients admitted is lower than the previous year, and this shows that there has been appropriate management and control to establish patients who really needed hospitalization. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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This work aims to report how COVID-19 pandemic affects the operations of the department of Otolaryngology, in two hospitals in Campania: University Hospital "San Giovanni di Dio and Ruggi d'Aragona” of Salerno and at the hospital "A.O.R.N. A. Cardarelli” of Naples (Italy). In the last years, COVID-19 has become the main type of disease affecting subjects with possible lung infections (pneumonia). SARS-cov-2 infection has been reported as severe acute respiratory syndrome that mainly affects the respiratory system and lungs, but the virus also involved other organs such as cardiac, renal and nervous ones. In the study the attention is turned to the department of Otolaryngology because the operators are very exposed. Data were collected for the year 2019, in the absence of Covid-19, and in the year of the pandemic, 2020. The purpose of the work was to make a comparison between the situation of the department before and during the epidemic from Covid-19 to the individual hospital, in addition a comparison was made between the two hospitals. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Introduction: COVID-19-related physical isolation, fear and anxiety determined de novo mental illnesses, by potentially facilitating the emergence of Hikikomori traits (i.e., a severe social withdrawal condition). Objective(s): The present study aims at screening a cohort of university students for the Hikikomori traits and assessing a set of psychopathological determinants associated with Hikikomori, particularly boredom and loneliness dimensions. Method(s): A cross-sectional web-based survey was carried out by administering Hikikomori Questionnaire (HQ-11), Italian Loneliness Scale (ILS), Multidimensional State Boredom Scale (MSBS), Depression Anxiety Stress Scale (DASS-21) and Toronto Alexithymia Scale (TAS-20). Result(s): 1,148 respondents (767 women and 374 men, mean age: 23.2+/-SD=2.8 years old) were recruited. 70.7% declared to have experienced psychological distress. HQ-11 average total score was 18.4+/-SD=7.5 with statistically significant higher values in the males (p=0.017) and amongst students studying Informatics, Mathematics/Physics/Chemistry, Science of Communication and Engineering. The HQ-11 positively correlated with ILS (r=0.609), MSBS (r=0.415), TAS-20 (r=0.482) and DASS-21 (r=0.434). Conclusion(s): This study represents the first screening of the Hikikomori phenomenon in Italian university students. Hikikomori traits appear to be particularly represented in the Italian youth population and should be carefully investigated in future studies.
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The current COVID-19 pandemic presents one of the greatest challenges in human history. There is a consensus that the rapid and accurate diagnosis of COVID-19 directly affects procedures to avoid dissemination, promote treatments, and favor the prognosis of infected patients. This interdisciplinary study aims at designing new synthetic peptides inspired by the SARS-CoV-2 spike protein (SARS-CoV-2S) to produce rapid detection tests relying on nanomaterial-based colorimetric properties. Hence, in silico analyses of SARS-CoV-2S were performed using advanced bioinformatic simulation tools and algorithms. Five novel peptide sequences were proposed, and three were selected (P2, J4, and J5) based on their prospective reactivity against positive serum from naturally COVID-19-infected humans. Next, hyperimmune sera against the selected peptides were produced in rabbits. Concurrently, gold nanoparticles (AuNP) were synthesized using a green aqueous method under mild conditions through in situ reduction by trisodium citrate salt. They were extensively characterized by their morphological, physicochemical, and optical properties. The AuNPs demonstrated colloidal chemical stability in aqueous media, with an average size of approximately 29 nm (metallic core), and zeta potential before and after bioconjugation of −43 mV and −31 mV, respectively. Moreover, they presented an intense reddish-bluish color due to the surface plasmon resonance (SPR) effect, with maxima at λ = 525 nm and 536 nm, before and after bioconjugation, respectively, evidencing their applicability as colorimetric biomarkers for antigen–antibody immunoassay detection. To develop a rapid COVID-19 diagnosis test using lateral flow assay (LFA), semi-purified anti-SARS-CoV-2S sera against the three selected peptides were bioconjugated to the AuNPs as the highly optically sensitive agents using a considerably low antibody concentration (0.2 mg mL−1). All tested peptide sequences (P2, J4, and J5) induced antibodies capable of identifying the presence of SARS-CoV-2 virus inactivate suspensions (1 : 10, 1 : 100, or 1 : 1000 dilutions). For LFA positive test control, an anti-rabbit antibody was used. In summary, this research comprises several contributions and advances to the broad and multidisciplinary field of nanomaterials-based immunodiagnosis tools, encompassing: (a) the novelty of designing and synthesizing new immunogenic peptides inspired by SARS-CoV-2 virus epitopes using in silico bioinformatics;(b) the peptides induced the immune response in rabbit animal model producing hyperimmune serum;(c) the semi-purified hyperimmune serum rendered effective antibodies to detect SARS-CoV-2 virus in cell suspension;(d) colloidal gold nanoparticles were produced and bioconjugated to the antibodies for qualitative colorimetric detection. As the overall result of this study, it was designed, developed, produced, and validated a new simple, rapid, and sensitive LFA diagnostic test for the SARS-CoV-2 virus using a nanotechnology-based qualitative colorimetric assay, which can be envisioned as promising nanoplatforms for detecting other diseases. The current COVID-19 pandemic presents one of the greatest challenges in human history.
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Background According to the WHO recommendations, children and adolescents should perform at least 60 minutes per day of moderate to vigorous physical activity (PA). Active Breaks (ABs) interventions, short physical activity breaks of 5-15 minutes during school hours, have been examined in primary school children as a potential strategy to counteract a sedentary lifestyle, with minimal disruption to school learning activities. The aim of the BRAVE STUDY is to investigate the feasibility of ABs in a secondary school setting from the students’ point of view. Methods In December 2020, 10 students (age 12-13, 6 females and 4 males) attending the second and third grade of secondary schools located in Bologna province (Italy) were involved in a focus group (FG). The FG was conducted online because of COVID-19 and the answers transcribed for a later analysis. Students’ opinions were probed on the role of PA in school and possible facilitators/barriers to implementation of ABs in the school. Results Students reported they wanted to be more active as a consequence of time spent in class sitting at a desk. Students also reported that an organized activity like ABs conducted in the classroom setting provides an excellent opportunity to improve social relations with classmates. Students also highlighted the possible psycho-physical well-being benefits arising from PA. Among the potentially negative aspects reported, students underlined the possible confusion that would be created in classroom and the time subtracted from academic learning activities. Conclusions The FG represents an ideal mean to obtain in-depth information on how people feel about a pending program or a change in their routine. The current FG reinforces positive outcomes from exposure to a PA program that can be intertwined with their daily classroom activities. ABs programs can help to reconcile the needs of students that arise during the day with the PA objectives recommended by the WHO. Key messages • ABs can be a zero-cost intervention strategy to achieve WHO recommendations and would create conditions for a greater psycho-physical benefits in classrooms. • A qualitative approach, such as FGs, provides a mean to collect information not obtainable with quantitative methods, that could be useful to co-design interventions for children and adolescents.
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Introduction: Multisystem Inflammatory Syndrome (MIS-C) is a rare complication in children with temporal association with COVID 19. MIS-C criteria include: persistent fever, multisystem involvement and elevated markers of inflammation. Renal involvement is a rare reported manifestation of MIS-C, most commonly presented as acute kidney injury (AKI) and seldom as hematuria, proteinuria and pyuria. The aim of this case is is to evaluate the diversity of renal clinical manifestations of MISC. Material(s) and Method(s): We consulted the databases of PubMed and Google Scholar using the keywords: kideny, MIS-C, AKI. The following parameters were noted from the studies including MIS-C patients: renal impairment, treatment, and outcome. Result(s): We present a case of 11 years old girl without comorbidities, who presented to our pediatric emergency for persistent fever, abdominal pain, hematuria. Her recent medical history included exposure to SARSCOV2 infection in December 2021. At the physical examination, she was febrile and well appearing. Blood tests showed neutrophilic leukocytosis, elevated markers of inflammation, troponin, proBNP, D-dimers, fibrinogen, creatinine and urea. Urine test showed hematuria, associated with proteinuria and pyuria. Positive IgG SARS-COV2 confirmed clinical suspicion of MIS-C. Within the next 2 days, her condition worsened with AKI, oligoanuria and left ventricular systolic dysfunction (EFLV 40%). The patient was admitted to pediatric intensive care to initiate inotropic support and she was treated with intravenous immunoglobulin (IVIG) and high-dose cortisone, with instantaneous clinical and laboratory improvement. Conclusion(s): Despite numerous reports of MIS-C cases in children, there are still many uncertainties regarding clinical presentation. AKI is the most commonly clinical manifestation of renal involvement in patients with MIS-C, specially among patients with cardiac dysfunction. Pathogenesis of AKI appears to be predominantly pre-renal, but abnormal urinalysis with hematuria and proteinuria is an indicator of renal parenchymal injury. We believe that reporting various manifestations in MIS-C patients will lead to improve diagnosis, treatment and outcome of this novel condition.
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Background: Physical distancing and no-visitor policies adopted to prevent COVID-19 spread in hospital wards have deeply impacted communication with patients and their relatives. Whereas in pre-COVID-19 era family-clinician meetings were held in person, during the SARSCoV- 2 pandemic interactions often take place over the phone. The frequently unilateral direction of the communication might cause feelings of uncertainty and distress to those who are at home. Until now little data about this topic have been collected, and most of them refer to COVID-19 patients. Literature about hospital communication with non-COVID-19 patients and their relatives during the pandemic is lacking. Material and methods: After no-visitor policy was adopted in the Onco-Hematological Unit of Modena, inpatients' relatives were contacted daily for clinical updates. After discharge, a telephone satisfaction survey was administered to all relatives of patients consecutive admitted between December 2020 and January 2021 (n=97). Mean score of response and potential statistically significative differences depending on respondents' characteristics were assessed. Suggestions were collected. Results: Most relatives were satisfied with the communication received, with a mean score over all items of 4.69 on a 5-point Likert scale (standard deviation: 0.60). Results showed high satisfaction rate with both the informative (mean?}SD: 4.66?}0.64) and emotional (mean?}SD: 4.66?}0.58) content, with no significant difference depending on respondents' demographic characteristics (p>0.05). Among suggestions, 13% found it useful to organize more video calls;12% would have preferred to have always talked to the same clinician;4% suggested the first meeting be held in person and 2% would have liked to have seen the patient before discharge, especially after a long hospital stay. Conclusions: Our findings show that a structured telephone- based interaction might help overcome communication barriers imposed by pandemic-related restrictions. We believe that these findings could stimulate other clinicians to think about ways to involve relatives in continuous care of their loved ones when personal contact is impossible and might lead to other studies with a higher number of participants. In our view, anything that can help with the identification of relational and communication strategies that have worked during the pandemic will contribute to the creation of a precious know-how in view of future crises.
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Laryngectomized patients showed an unconventional response to SARS-CoV-2 viral infection. Here, we describe five different patient cases along with our interpretation of the phenomena and suggestions for their safe management.