Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk

CONFRONTO TRA ONDATE DI COVID-19 IN OPERATORI SANITARI: STUDIO RETROSPETTIVO IN UN’AZIENDA OSPEDALIERO-UNIVERSITARIA ITALIANA

L’adozione di protocolli preventivi, volti a garantire la tutela della salute degli operatori sanitari durante la pandemia COVID-19, si è dimostrata un’efficace strategia per ridurre la circolazione del virus in un setting ad elevato rischio come quello assistenziale. Durante i primi mesi della pandemia, in Italia, tali misure hanno consentito di ottenere una prevalenza estremamente bassa di infezione da SARS-CoV-2 (0.4%) tra i circa 6000 operatori sanitari dell’Azienda Ospedaliera Universitaria di Bari, uno dei principali hub COVID-19 nel Sud Italia. Tale risultato è stato, tuttavia, ottenuto durante un periodo di bassa trasmissione comunitaria del virus nella Regione Puglia

Poor sleep hygiene practices are associated with a higher increase in sleep problems during the COVID‐19 pandemic: A latent change score model

The Coronavirus 2019 (COVID-19) pandemic significantly influenced physical and mental health worldwide. The present study aimed to investigate changes in sleep problems across three waves of the COVID-19 pandemic, and to identify potential predictors of the inter-individual variability around these changes, with a particular focus on the role of detrimental sleep hygiene practices. A total of 352 participants completed an online survey of self-report questionnaires at three different waves of the COVID-19 pandemic: T1 (Spring 2020); T2 (Autumn-Winter 2020); and T3 (Spring 2021). The questionnaires collected information on socio-demographic and COVID-19-related variables, psychological distress (i.e. the Depression Anxiety Stress Scale-21), sleep hygiene (i.e. the Sleep Hygiene Index) and sleep problems (i.e. the Medical Outcomes Study—Sleep Scale). Latent change score modelling revealed an average increase in sleep problems between T1 and T2 with significant inter-individual variability. No substantial changes were observed on average between T2 and T3. Notably, poorer sleep hygiene practices were associated with a more pronounced increase in sleep problems between T1 and T2 (β = 0.191, p = 0.013), even after controlling for relevant confounders such as demographic factors, COVID-19-related information and psychological distress. These findings expand on previous research regarding the detrimental effects of the pandemic on mental health, suggesting that interventions targeting sleep hygiene practices may be beneficial for mitigating its negative impact on sleep disruptions

Indoor Radon Concentration Levels in Healthcare Settings: The Results of an Environmental Monitoring in a Large Italian University Hospital.

The aim of the study is to determine the radon concentrations in the University Hospital of Bari, Apulia Region, Southern Italy. The monitoring took place from 2017 to 2018 for a total of 402 days and included 3492 premises. Radon environmental sampling was performed with passive dosimeters of the CR-39 type. The highest mean concentration was found in basement rooms (118.9 Bq/m3), followed by ground-floor rooms (88.2 Bq/m3), first-floor rooms (78.1 Bq/m3), second-floor rooms (66.7 Bq/m3), and third-floor rooms (68.9 Bq/m3). An average radon concentration lower than the WHO recommended level of 100 Bq/m3 was detected in 73.5% of monitored environments, while only 0.9% exceeded the reference level of 300 Bq/m3 set by the national law (Legislative Decree 101/2020). The frequency of environments in which radon concentrations exceed 300 Bq/m3 is significantly higher in the basement (p-value n = 401), most of the monitored environments had radon concentrations lower than the reference levels set by the new national law, and the risk to the healthcare workers' health derived from occupational exposure to radon could be considered acceptable

Comparison of Three Different Waves in Healthcare Workers during the COVID-19 Pandemic: A Retrospective Observational Study in an Italian University Hospital

Background: SARS-CoV-2 has infected many healthcare workers and (HCWs) worldwide. The aim of this study was to determine, analyze, and compare the frequency and characteristics of COVID-19 cases among HCWs of the University Hospital of Bari. Methods: A retrospective observational study was conducted after preventive protocol implementation. The SARS-CoV-2 infection frequency was determined by real-time reverse transcription-polymerase chain reaction on nasopharyngeal samples. Results: Overall, 519 HCWs (9%) tested positive among a total of 6030 HCWs during the three waves. The highest frequency of COVID-19 cases (n = 326; 63%) was observed during the 2nd wave, from September 2020 to December 2020, and the lowest (n = 34; 7%) was observed during the 1st wave, from March 2020 to August 2020 (p < 0.001). Working in a designated COVID-19 department was not a risk factor for infection. Conclusions: The correct use of personal protective equipment and the early identification of symptomatic workers are still essential factors to avoid nosocomial clusters, even in this current phase of vaccine availability

Infection Control among Healthcare Workers and Management of a Scabies Outbreak in a Large Italian University Hospital

This retrospective observational study describes the results of an ad-hoc designated prevention protocol aimed at containing the spread of the scabies infestation among healthcare workers (HCWs) of a large University Hospital in Italy. The outbreak started on October 2022 and a preventive protocol was set up thanks to a multidisciplinary approach. HCWs at high scabies risk were defined as subjects working in Operative Units with a scabies prevalence higher than 2%, close contacts of a confirmed case of scabies, or HCWs with signs and symptoms of the disease. All cases at high scabies risk underwent a dermatological examination, and the infested HCWs were suspended from work until definitive healing. Mass drug administration was established for all HCWs working in Operative Units with a scabies prevalence higher than 2%. Until March 2023, out of 183 screening dermatological examinations, 21 (11.5%) were diagnostic for scabies. Between 11 October 2022 (date of the first diagnosed scabies case) and 6 March 2023 (the end of incubation period related to the last case detected), the frequency of scabies was 0.35% (21 scabies cases/6000 HCWs). The duration of the outbreak in our hospital was 14.7 weeks. Statistical analysis shows a significant association between scabies and being a nurse and having an allergy to dust mites. We obtained a low frequency of scabies infection, limiting the duration of the outbreak and the related economic burden

Ortodonzia clinica e biomeccanica - Clinical orthodontics and biomechanics.

The tooth is not a nosological unit in itself, but it belongs to a three-dimensional structure with: alveolar bones, vessels, nerves, bones, muscles and skin, where each element perform a function or part of it, and the position of the teeth and the basal bone depends on a specific and general neuro-muscular balance (Giannì). Orthodontics is a specialized branch of dentistry that aims to achieve functional occlusion and improve the appearance by means of dental movements (orthodontics) and bones (orthopedics). The final purpose of any orthodontic and/or surgical treatment is to achieve a favorable restoration of normal dental occlusion by means of a balanced and contentive intercuspation and a satisfactory aesthetic result that gives well-being to the individual. This results in two complex and remarkable problems to be addressed and solved: one of a functional nature and one of an aesthetic nature. It is not always possible to achieve the ideal and therefore it is necessary to make compromises that resolve in acceptable terms, both aesthetic needs, particularly felt by patients, and functional needs; without prejudice to the principle, emphasized by Capozzi, that indulging in aesthetics to the complete detriment of function can be dangerous because of the risk of failure or recurrence

Simple Parameters from Complete Blood Count Predict In-Hospital Mortality in COVID-19

Introduction. The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions. Materials and Methods. In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients (F 260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded. Results. At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) (χ2 10.4; p4.68 was characterized by an odds ratio for in-hospital mortality OR=3.40 (2.40-4.82), while the OR for a RDW>13.7% was 4.09 (2.87-5.83); a platelet count>166,000/μL was, conversely, protective (OR: 0.45 (0.32-0.63)). Conclusion. Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment