Il coraggio degli infermieri ai tempi del COVID-19

La diffusione del SARS-COV-2 è stata annunciata a partire dal 9 gennaio 2020, quando l'Organizzazione Mondiale della Sanità (OMS) ha dichiarato che le autorità sanitarie cinesi avevano individuato un nuovo ceppo di coronavirus mai prima identificato nel genere umano. Il virus è stato chiamato dapprima 2019-nCoV, per poi essere ufficialmente e definitivamente classificato con il nome di SARS-CoV-2. La sua diffusione è stata associata a un focolaio di polmoniti segnalato il 31 dicembre 2019 in Cina, nella sua parte centrale, nella città di Wuhan. La malattia respiratoria causata dal nuovo coronavirus ha preso il nome di COVID-19 con dichiarazione dell'OMS del seguente 11 febbraio. I primi due casi presenti in Italia sono stati confermati dall'Istituto Superiore di Sanità (ISS) in data 30 gennaio, successivamente il 21 febbraio è stato individuato un nuovo caso, identificato come il primo caso autoctono su territorio nazionale1. In seguito alla velocità e alla dimensione del contagio da parte del nuovo virus, l’OMS, in data 11 marzo 2020 ha dichiarato che l’infezione internazionale poteva essere considerata una pandemia. Dall’inizio della diffusione del virus, la pandemia ha creato danni enormi in tutti i Paesi del globo, con milioni di persone che hanno perso la vita. Gli infermieri e gli operatori dei sistemi sanitari nazionali di tutti i Paesi colpiti hanno visto stravolgere le proprie vite e i propri setting lavorativi in maniera repentina per far fronte con coraggio a questa pandemia, spesso non senza conseguenze. Infatti, basti considerare che in Italia il 72,2% dei contagi sul lavoro avvengono nel settore sanitario e di questi l’83% è rappresentato dagli infermieri, e in totale si contano una percentuale che ha superato, in alcune fasi della pandemia, anche il 15% di tutti i casi di COVID19 su territorio nazionale.La diffusione del SARS-COV-2 è stata annunciata a partire dal 9 gennaio 2020, quando l'Organizzazione Mondiale della Sanità (OMS) ha dichiarato che le autorità sanitarie cinesi avevano individuato un nuovo ceppo di coronavirus mai prima identificato nel genere umano. Il virus è stato chiamato dapprima 2019-nCoV, per poi essere ufficialmente e definitivamente classificato con il nome di SARS-CoV-2. La sua diffusione è stata associata a un focolaio di polmoniti segnalato il 31 dicembre 2019 in Cina, nella sua parte centrale, nella città di Wuhan. La malattia respiratoria causata dal nuovo coronavirus ha preso il nome di COVID-19 con dichiarazione dell'OMS del seguente 11 febbraio. I primi due casi presenti in Italia sono stati confermati dall'Istituto Superiore di Sanità (ISS) in data 30 gennaio, successivamente il 21 febbraio è stato individuato un nuovo caso, identificato come il primo caso autoctono su territorio nazionale1. In seguito alla velocità e alla dimensione del contagio da parte del nuovo virus, l’OMS, in data 11 marzo 2020 ha dichiarato che l’infezione internazionale poteva essere considerata una pandemia. Dall’inizio della diffusione del virus, la pandemia ha creato danni enormi in tutti i Paesi del globo, con milioni di persone che hanno perso la vita. Gli infermieri e gli operatori dei sistemi sanitari nazionali di tutti i Paesi colpiti hanno visto stravolgere le proprie vite e i propri setting lavorativi in maniera repentina per far fronte con coraggio a questa pandemia, spesso non senza conseguenze. Infatti, basti considerare che in Italia il 72,2% dei contagi sul lavoro avvengono nel settore sanitario e di questi l’83% è rappresentato dagli infermieri, e in totale si contano una percentuale che ha superato, in alcune fasi della pandemia, anche il 15% di tutti i casi di COVID19 su territorio nazionale

L'eredità di Florence Nightingale nel 2020, Anno Internazionale dell'infermiere: una revisione narrativa

Background: Nurses guarantee assistance using different nursing theories, which present different conceptual frameworks, but which have a common vision in the whole of the human being, his holistic needs and the connection with the environment. Florence Nightingale was the first to introduce aspects of the scientific method, structuring a theory focused on the connection between the management of the physical environment and the actions of nurses. Methods: The aim is the evaluation of Nightingale's theory in reference to its contemporary integration, through a narrative review of the literature. Results: The action of nurses on the environment according to Nightingale's theory in care settings and hand hygiene are identified as fundamental in the fight against the spread of infections and in the implementation of the holistic vision. Discussion: Nightingale's theory shows elements of applicability and modernity, such as the acquisition of a greater awareness of healthcare professionals in relation to the care of environments and hand hygiene. Conclusions: Florence Nightingale's theory presents aspects of validity, but further studies are needed to contribute to the evolution of her model, especially in its contemporary contextualization

Phenotype and genotype of 87 patients with Mowat-Wilson syndrome and recommendations for care

Mowat-Wilson syndrome (MWS) is a rare intellectual disability/multiple congenital anomalies syndrome caused by heterozygous mutation of the ZEB2 gene. It is generally underestimated because its rarity and phenotypic variability sometimes make it difficult to recognize. Here, we aimed to better delineate the phenotype, natural history, and genotype-phenotype correlations of MWS.MethodsIn a collaborative study, we analyzed clinical data for 87 patients with molecularly confirmed diagnosis. We described the prevalence of all clinical aspects, including attainment of neurodevelopmental milestones, and compared the data with the various types of underlying ZEB2 pathogenic variations.ResultsAll anthropometric, somatic, and behavioral features reported here outline a variable but highly consistent phenotype. By presenting the most comprehensive evaluation of MWS to date, we define its clinical evolution occurring with age and derive suggestions for patient management. Furthermore, we observe that its severity correlates with the kind of ZEB2 variation involved, ranging from ZEB2 locus deletions, associated with severe phenotypes, to rare nonmissense intragenic mutations predicted to preserve some ZEB2 protein functionality, accompanying milder clinical presentations.ConclusionKnowledge of the phenotypic spectrum of MWS and its correlation with the genotype will improve its detection rate and the prediction of its features, thus improving patient care.GENETICS in MEDICINE advance online publication, 4 January 2018; doi:10.1038/gim.2017.221

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background and objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19-related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p < 0.001), RR = 2.19 for ICU admission (p < 0.001), and RR = 2.43 for death (p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Phenotype and genotype of 87 patients with Mowat–Wilson syndrome and recommendations for care

Purpose: Mowat–Wilson syndrome (MWS) is a rare intellectual disability/multiple congenital anomalies syndrome caused by heterozygous mutation of the ZEB2 gene. It is generally underestimated because its rarity and phenotypic variability sometimes make it difficult to recognize. Here, we aimed to better delineate the phenotype, natural history, and genotype–phenotype correlations of MWS. Methods: In a collaborative study, we analyzed clinical data for 87 patients with molecularly confirmed diagnosis. We described the prevalence of all clinical aspects, including attainment of neurodevelopmental milestones, and compared the data with the various types of underlying ZEB2 pathogenic variations. Results: All anthropometric, somatic, and behavioral features reported here outline a variable but highly consistent phenotype. By presenting the most comprehensive evaluati