Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors. A multicentre retrospective study (CoViDiab II)

Background: Cardiometabolic disorders may worsen Covid-19 outcomes. We investigated features and Covid-19 outcomes for patients with or without diabetes, and with or without cardiometabolic multimorbidity. Methods: We collected and compared data retrospectively from patients hospitalized for Covid-19 with and without diabetes, and with and without cardiometabolic multimorbidity (defined as ≥ two of three risk factors of diabetes, hypertension or dyslipidaemia). Multivariate logistic regression was used to assess the risk of the primary composite outcome (any of mechanical ventilation, admission to an intensive care unit [ICU] or death) in patients with diabetes and in those with cardiometabolic multimorbidity, adjusting for confounders. Results: Of 354 patients enrolled, those with diabetes (n = 81), compared with those without diabetes (n = 273), had characteristics associated with the primary composite outcome that included older age, higher prevalence of hypertension and chronic obstructive pulmonary disease (COPD), higher levels of inflammatory markers and a lower PaO2/FIO2 ratio. The risk of the primary composite outcome in the 277 patients who completed the study as of May 15th, 2020, was higher in those with diabetes (Adjusted Odds Ratio (adjOR) 2.04, 95%CI 1.12-3.73, p = 0.020), hypertension (adjOR 2.31, 95%CI: 1.37-3.92, p = 0.002) and COPD (adjOR 2.67, 95%CI 1.23-5.80, p = 0.013). Patients with cardiometabolic multimorbidity were at higher risk compared to patients with no cardiometabolic conditions (adjOR 3.19 95%CI 1.61-6.34, p = 0.001). The risk for patients with a single cardiometabolic risk factor did not differ with that for patients with no cardiometabolic risk factors (adjOR 1.66, 0.90-3.06, adjp = 0.10). Conclusions: Patients with diabetes hospitalized for Covid-19 present with high-risk features. They are at increased risk of adverse outcomes, likely because diabetes clusters with other cardiometabolic conditions

Assessment of Intra- and Inter-observer Measurement Variability in a Radiographic Metacarpophalangeal Joint Osteophytosis Scoring System for the Horse

The study evaluated the intra- and inter-observer measurement variability of an osteophytosis metacarpophalangeal joint scoring system. Ten (n = 10) dorso/palmar, latero/medial, and oblique views of equine metacarpophalangeal joints affected by osteoarthritis were examined. Nine assessment points were graded (scale: 0-3) twice by five veterinary students (inexperienced group, I) and four equine veterinary surgeons (expert group, E). The grades for each of the nine factors were summed to obtain the osteophytosis score. The variability between the two measurements was -2.04 ± 3.5, 95% CI -3.04 to -1.03 for the I group. For the E group, they were 0 ± 1.43, 95% CI -0.45 to 0.45. In the evaluation of the same radiographs, the I group had a coefficient of variability (CV) of 37.29%. The correlation was r = 0.90%. The CV between groups was 28.85%. The mean difference between the two observations was -0.03 ± 0.29 in the E group and 0.22 ± 0.77 in the I group. The I group showed a greater CV when the score was low (r = -0.78) compared to the E group, where the CV was independent of severity of osteophytosis (r = -0.47). The osteophytosis scoring system is an easily applicable and feasible system to be used by observers with different levels of experience, but inexpert observers may need additional training or may need to be helped by reference images. These data are validated by the low inter- and intra-observer measurement variability results in the E group. Therefore, the scoring system proposed seems to be a repeatable instrument applicable to the radiographic score of the severity of metacarpophalangeal joint osteoarthritis

High mortality in foals associated with Salmonella enterica subsp. enterica Abortusequi infection in Italy

Salmonella enterica subsp. enterica serovar Abortusequi is frequently reported as a cause of abortion in mares and neonatal septicemia and polyarthritis in Asian and African countries, but only sporadically in Europe and the United States. We report an outbreak of S. Abortusequi in foals in Italy, characterized by high mortality. In a herd of Murgese horses, 10 of 34 newborns died at birth and a further 7 died, after developing severe clinical signs, during the first 10 d of life. Tissue specimens from different organs of 2 dead foals, synovial fluids from 4 sick foals, and vaginal and rectal swabs from their dams were cultured. A total of 16 isolates, all as pure cultures, were obtained and identified as Salmonella. The isolates exhibited the same antimicrobial resistance pattern and the same sequence type, ST251, a type that has been associated with S. Abortusequi. Six of 16 isolates were serotyped and found to be S. Abortusequi 4,12:-:e,n,x. Equine practitioners should be aware of S. Abortusequi infection as a cause of neonatal mortality in foals

Reduced early response to SARS-CoV2 vaccination in people with type 1 and type 2 diabetes, a six months follow-up study. The CoVaDiab study I

Introduction: Diabetes mellitus worsens the prognosis of SARS-CoV-2 infection, and vaccination has been the major tool for reducing the risk of hospitalisation, and mortality. The primary aim of this study was to evaluate the response to the SARS-CoV-2 vaccine in subjects with diabetes and controls. Differences between type 1 (T1D) and type 2 (T2D) diabetes and clinical determinants of vaccination response were also evaluated. Methods: 128 subjects with diabetes (60 with T1D and 62 with T2D) and 202 subjects acting as controls who completed a full vaccination cycle with two doses of mRNA vaccine were enroled. People with previous SARS-CoV-2 infection were excluded. Antibodies (Ab) directed against the spike protein of the SARS-CoV-2 were evaluated at one and 6 months after vaccination. Results: In the whole cohort, the Ab level was higher among women than in men (p = 0.011) and negatively correlated with age (rho = -0.155, p = 0.005). Subjects with diabetes showed decreased levels of Ab after one month compared to controls (1217[747-1887]BAU/mL vs. 1477[942-2556]BAU/mL, p = 0.002), even after correction for age and gender (p = 0.002). No difference was found between subjects with T1D and T2D. After 6 months, antibody levels significantly decreased in people with and without diabetes, with no differences between groups, although some subjects were lost at follow-up. In subjects with diabetes, only a significant correlation was found between Ab level and renal function (rho 0.190, p = 0.042). Conclusions: Both T1D and T2D are associated with a reduced early response to vaccination. The serum concentration of Ab significantly reduced over time in both groups, highlighting the relevance of vaccination boosters independently of the presence of diabetes

La corruzione nelle politiche sociali. Il caso Roma

L'ordine della corruzione nelle politiche sociali a Roma

Supervised Component Generalized Linear Regression using a PLS-extension of the Fisher scoring algorithm

International audienc

PediaVirus chatline: all together against COVID-19

On occasion of the COVID-19 pandemic, in Italy, during the outbreak period, 140 professionals, including paediatricians (the majority), general health practitioners, infectious diseases specialists, epidemiologists, neuropsychiatrists, neurologists, psychologists, pharmaceutical representatives, magistrates, predominantly Italian but also from other countries in Europe and beyond, created a chatline to share their own experiences.The results of such investigation have been reported in this report

Asthma in patients admitted to emergency department for COVID-19: prevalence and risk of hospitalization

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