Re: "Endothelitis in COVID-19-positive patients after extremity amputation for acute thrombotic events"

Ilonzo et al reported, in their recent and interesting article, their clinical experience in 4 patients affected by COVID-19 and undergoing major limb amputation secondary to acute irreversible ischemia. On histological examination with hematoxylin/eosin they found inflammatory cells associated with endothelium/apoptotic bodies, mononuclear cells, small vessel congestion, and lymphocytic endotheliitis and concluded that the findings in these patients is more likely an infectious angiitis due to COVID-19. In our experience we have observed numerous cases of venous and arterial thromboembolism not only in the acute phase of COVID-19, but (even more interestingly) even after recovery. Whether SARS-CoV-2 is able to directly attack vascular endothelial cells expressing high levels of ACE2, and then lead to abnormal coagulation and sepsis, still needs to be explored

VWEB: verbalizzazione on-line di esami universitari

VWEB (UniPOS© web version), a service that allows to manage the university careers in a fully digital manner via web, is presented. The system has been recently adopted by the University of Milan, after a pilot project lasted about 18 months. In 6 months of use, approximately 5000 examinations have been managed and recorded by the system.Viene presentato il servizio VWEB (versione web della suite UniPOS©) che permette di gestire digitalmente tutto il processo di verbalizzazione degli esami di una carriera universitaria. Il sistema è stato recentemente adottato da Università degli Studi di Milano, dopo un progetto pilota durato circa 18 mesi. In 6 mesi di utilizzo, sono già stati verbalizzati circa 5000 esami

Disseminated rhodococcus equi infection in HIV infection despite highly active antiretroviral therapy

Abstract Background Rhodococcus equi (R.equi) is an acid fast, GRAM + coccobacillus, which is widespread in the soil and causes pulmonary and extrapulmonary infections in immunocompromised people. In the context of HIV infection, R.equi infection (rhodococcosis) is regarded as an opportunistic disease, and its outcome is influenced by highly active antiretroviral therapy (HAART). Case presentation We report two cases of HIV-related rhodococcosis that disseminated despite suppressive HAART and anti-rhodococcal treatment; in both cases there was no immunological recovery, with CD4+ cells count below 200/μL. In the first case, pulmonary rhodococcosis presented 6 months after initiation of HAART, and was followed by an extracerebral intracranial and a cerebral rhodococcal abscess 1 and 8 months, respectively, after onset of pulmonary infection. The second case was characterized by a protracted course with spread of infection to various organs, including subcutaneous tissue, skin, colon and other intra-abdominal tissues, and central nervous system; the spread started 4 years after clinical resolution of a first pulmonary manifestation and progressed over a period of 2 years. Conclusions Our report highlights the importance of an effective immune recovery, despite fully suppressive HAART, along with anti-rhodococcal therapy, in order to clear rhodococcal infection.</p

SARS-CoV-2 Infection in San Patrignano, the Largest European Drug Rehabilitation Community

Background: Studies on SARS-CoV-2 conducted in confined settings for prolonged times allow researchers to assess how the coronavirus spreads. San Patrignano (SP), Italy, is the largest European drug rehabilitation facility. Methods: Between 15 October and 31 December 2020, all SP residents were tested for SARS-CoV-2. We analyzed the relationships between individual characteristics and being SARS-CoV-2-positive. Three selected predictive models were used to calculate the number of expected hospitalizations. For each model, we summed the estimated individual risks to obtain the expected number of hospitalizations in our sample, and we tested whether the observed and expected numbers differed. Results: Of 807 residents, 529 (65.6%) were SARS-CoV-2-positive. Of these 323 (61.1%) were symptomatic. A strong relationship was found between being positive and living connections (p-value &lt; 0.001). No statistically significant relationship was found with age, sex, smoking history, or comorbidities. Although 9 to 17 hospitalizations were expected, no hospitalizations were observed (p-value &lt; 0.001). No one died of COVID-19. Conclusions: The peculiar characteristics of SP residents or the SP environment might at least partially explain the null hospitalization rates. Despite the extreme uniqueness of our population and despite the protected environment and all precautions that were taken, the fact that the virus was able to circulate and infect a large portion of the population highlights the fundamental role of social interactions in the spread of the disease

SARS-CoV-2 Infection in San Patrignano, the Largest European Drug Rehabilitation Community

BACKGROUND: Studies on SARS-CoV-2 conducted in confined settings for prolonged times allow researchers to assess how the coronavirus spreads. San Patrignano (SP), Italy, is the largest European drug rehabilitation facility. METHODS: Between 15 October and 31 December 2020, all SP residents were tested for SARS-CoV-2. We analyzed the relationships between individual characteristics and being SARS-CoV-2-positive. Three selected predictive models were used to calculate the number of expected hospitalizations. For each model, we summed the estimated individual risks to obtain the expected number of hospitalizations in our sample, and we tested whether the observed and expected numbers differed. RESULTS: Of 807 residents, 529 (65.6%) were SARS-CoV-2-positive. Of these 323 (61.1%) were symptomatic. A strong relationship was found between being positive and living connections ( p-value < 0.001). No statistically significant relationship was found with age, sex, smoking history, or comorbidities. Although 9 to 17 hospitalizations were expected, no hospitalizations were observed ( p-value < 0.001). No one died of COVID-19. CONCLUSIONS: The peculiar characteristics of SP residents or the SP environment might at least partially explain the null hospitalization rates. Despite the extreme uniqueness of our population and despite the protected environment and all precautions that were taken, the fact that the virus was able to circulate and infect a large portion of the population highlights the fundamental role of social interactions in the spread of the disease