Returning to sport after anterior cruciate ligament reconstruction in amateur sports men: a retrospective study.

BACKGROUND: According to the literature, 95% of professional athletes return to their sport after anterior cruciate ligament (ACL) reconstruction surgery. The main objective of this study was to verify the return to sport after ACL reconstruction in a homogenous group of amateur sportsmen and sportswomen in a series of Italian patients. MATERIALS AND METHODS: We designed a retrospective study in which we analyzed the amateur sports patients operated for ACL reconstruction. We verified whether they had returned to sporting activities by comparing the pre- and post-operative Tegner activity scores. We then analyzed the average time to restart the sporting activity and the Lysholm and International Knee Documenting Committee (IKDC) scores. RESULTS: We analyzed 80 subjects: 47.5% restarted a sports activity, on average after eight months, with a significant reduction of their competitive level or physical commitment, as expressed by the Tegner activity score (pre-operative: 6.9; post-operative: 3.9; p<0.01). The functional knee recovery was good, as expressed by the average score of the Lyshom Knee Scoring Scale (93.5) and the IKDC (74.7). CONCLUSIONS: In the literature, a return to sport for international case studies and amateur sports is higher than our data. In our population we found the lack of information provided by the medical staff at discharge and follow-up. The assessment at a short-term follow up allowed us to verify that at the end of the post-surgical rehabilitation program the patients were uninformed about the timing and the ability to resume a sporting activity. An efficacious relationship between orthopedic doctor, physiotherapist and a doctor in motorial science may ensure proper treatment the patient after ACL reconstruction. It is important to guarantee the restarting of the sports activity to have a better quality of life in amateur sports. Level of evidence: V

Risk of infectious mononucleosis among agonistic swimmers: a cross-sectional study

BACKGROUND: The risk of infectious mononucleosis among athletes is quite debated. Some personal observations seem to suggest an increase risk of mononucleosis among athletes, because they attend always close settings with an high probability of respiratory pathogens transmission; overtraining has been also proposed as risk factor. STUDY DESIGN: Cross-sectional study in a group of swimmers (aged 11-14 years) of the University Sport Centre of Bari. METHODS: 40 swimmers were interviewed by healthcare personnel at the end of training courses; demographic characteristics, personal habits, information about sport training and diagnosis of mononucleosis were analysed. RESULTS: The life-time incidence of mononucleosis was around 40%; multivariate analysis showed the association between mononucleosis and use of bottles of other persons (aOR=8.2; 95% CI=1.4-49.2; z=2.32; p=0.021) and average duration of training session was longer among subjects who reported mononucleosis than in subjects who did not indicate this disease. CONCLUSIONS: Future multi-centric studies are needed to better define the epidemiology of the mononucleosis in sport settings and to formulate appropriate recommendations to prevent the spreading of this disease

In Response to: Measles Can Destroy a Dream: The Case of the Settebello

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Safety of heterologous ChAdOx1-S/BNT162b2 primary schedule versus homologous BNT162b2 vaccination: Insights from an Italian post-marketing study, 2021

During COVID-19 vaccination campaign, possible ChAdOx1-S-associated risks of thrombosis with thrombocytopenia syndrome led to implement ChAdOx1-S/BNT162b2 heterologous vaccination, despite the limited information on its reactogenicity and safety. We conducted a prospective observational post-marketing surveillance study to assess the safety of this heterologous schedule. A casually selected sample of recipients (n: 85; age: 18–60 years) of ChAdOx1-S/BNT162b2 at the vaccination hub of the Foggia Hospital, Italy, was matched with an equal sample of recipients of homologous BNT162b2. Safety was evaluated 7 days, 1 month and 14 weeks after the primary vaccination series using an adapted version of the “V-safe active surveillance for COVID-19 vaccine safety” CDC standardized questionnaire. After 7 days, local reactions were highly frequent (>80%) in both groups, and systemic reactions were less common (<70%). Moderate or severe pain at the injection site (OR = 3.62; 95%CI, 1.45–9.33), moderate/severe fatigue (OR = 3.40; 95%CI, 1.22–9.49), moderate/severe headache (OR = 4.72; 95%CI, 1.37–16.23), intake of antipyretics (OR = 3.05; 95 CI%, 1.35–6.88), inability to perform daily activities and work (OR = 2.64; 95%CI, 1.24–5.62) were significantly more common with heterologous than homologous vaccination. No significant difference in self-reported health status was recorded 1 month or 14 weeks after the second dose with BNT162b2 or ChAdOx1-S/BNT162b2. Our study confirms the safety of both heterologous and homologous vaccination, with a slight increase in some short-term adverse events for the heterologous regimen. Therefore, administering a second dose of a mRNA vaccine to the recipients of a previous dose of viral vector vaccine may have represented an advantageous strategy to improve flexibility and to accelerate the vaccination campaign

Association of socio-economic deprivation with COVID-19 incidence and fatality during the first wave of the pandemic in Italy: lessons learned from a local register-based study

Abstract Background COVID-19 has been characterised by its global and rapid spread, with high infection, hospitalisation, and mortality rates worldwide. However, the course of the pandemic showed differences in chronology and intensity in different geographical areas and countries, probably due to a multitude of factors. Among these, socio-economic deprivation has been supposed to play a substantial role, although available evidence is not fully in agreement. Our study aimed to assess incidence and fatality rates of COVID-19 across the levels of socio-economic deprivation during the first epidemic wave (March–May 2020) in the Italian Province of Foggia, Apulia Region. Methods Based on the data of the regional active surveillance platform, we performed a retrospective epidemiological study among all COVID-19 confirmed cases that occurred in the Apulian District of Foggia, Italy, from March 1st to May 5th, 2020. Geocoded addresses were linked to the individual Census Tract (CT) of residence. Effects of socio-economic condition were calculated by means of the Socio-Economic and Health-related Deprivation Index (SEHDI) on COVID-19 incidence and fatality. Results Of the 1054 confirmed COVID-19 cases, 537 (50.9%) were men, 682 (64.7%) were 0–64 years old, and 338 (32.1%) had pre-existing comorbidities. COVID-19 incidence was higher in the less deprived areas (p  65 years (p < 0.001), cases having a connection with a nursing home (p < 0.05) or having at least 1 comorbidity (p < 0.001). On the other hand, a significant protection for healthcare workers was apparent (p < 0.001). Conclusions Our findings show that deprivation alone does not affect COVID-19 incidence and fatality burden, suggesting that the burden of disease is driven by a complexity of factors not yet fully understood. Better knowledge is needed to identify subgroups at higher risk and implement effective preventive strategies