Risk of SARS-CoV-2 transmission in the close contacts in a small rural area in the Veneto Region (NE-Italy): past evidence for future scenarios

BackgroundDuring the first pandemic phase of COVID-19, an epidemiological study, named First survey, was conducted on the population of a small rural area in northern Italy. In spring 2020, the results showed how a prolonged lockdown slowed down the spread of the virus.MethodsAfter contacting positive First Survey subjects and their families, those who decided to join voluntarily underwent a blood test to assess the presence of qualitative lgG about 2 months after the previous one. This was to determine if IgG persisted in individuals who tested positive in the First Survey as well as to assess the antibody status of their close family members, to determine if they were unintentionally infected.ResultsBased on serological analysis, 35.1% of the samples contained blood IgG. In subjects who tested positive during the First Survey, 62.5% remained IgG positive more than 2 months later. Among family members who were exposed to a positive relative, 23.7% were infected. Linear regression analysis showed that the presence of an infected person within a household resulted in the infection spreading to the others, but not excessively. Induced isolation extinguished the infection regardless of the extent of the contagion (intra-family or extra-family). Micro-outbreaks of SARS-Cov-2 infection which arose in the same household from extra-familial infections played a decisive role on the statistical significance of IgG-positive subjects (p < 0.001).DiscussionThe study reveal 52.6% of the IgG-positive subjects in the Second Survey came from the First Survey and 47.4% were family members previously in contact with positive subjects. Data suggest that there have been undiagnosed patients feeding the spread of the virus since the beginning of the pandemic. In conclusion, for future pandemics, it will be necessary: i) to ensure the rapid isolation of symptomatic patients and the early identification of their close contacts, ii) to carry out the maximum number of tests in the shortest possible time, both on symptomatic and asymptomatic subjects, and iii) to implement information campaigns to make people aware of their risks, and implement clear, non-conflicting communication

SARS-COV-2 Pandemic: How to Maintain a COVID-free Hospital

The emergence of severe acute respiratory syndrome type 2 coronavirus (SARS-CoV-2) and its complications have demonstrated the devastating impact of a new infectious pathogen since the first months of 2020, especially on Health Systems. The work to maintain a COVID-free hospital in terms of reorganization of operational processes and surveillance against SARS-CoV-2 has allowed us to maintain the structure suitable for activities for non-positive patients. The commitment related to this reorganization (not only in terms of costs) is largely satisfied by the responses to the health needs of non-COVID patients. The results obtained during the First Pandemic phase at the Giovanni XXIII Hospital in Monastier di Treviso have allowed the maintenance of the status of a COVID-free hospital. These results are supported by multiple studies in other parts of the world

Il trauma epatico: dal trattamento conservativo al trapianto di fegato Analisi di centro

By this study, the results of our treated hepatic trauma patients are conformed to international applicative standards. Particular technologycal aspects than interventistic radiological procedures, surgeon techniques, emergency laparoscopic approach as hepidemiologic or ethyopatogenetic aspects, "golden hour" treatment and other clinical aspects are determinant for successful management of hepatic trauma. Apart from non operative treatment in patients with not complex injuries and hemodynamic clinical stability, and conservative operative techniques that allow successful management in most cases, liver transplantation in severe trauma complicated with acute hepatic insufficiency and ather alternative treatment as packing or laparoscopic approach reduced morbility and mortality with improvement of survival in most of liver trauma patients

Assoziationen zwischen altersspezifischer Schlafdauer, Schlafqualität und körperlicher Aktivität bei 6- bis 12-jährigen Schulkindern in Côte d’Ivoire. Eine Querschnittsstudie.

Hintergrund: Der Schwerpunkt dieser Arbeit beruht auf den Assoziationen zwischen den beiden Schlafkomponenten Schlafqualität und Schlafdauer sowie der körperlichen Aktivität bei Kindern. Das Ziel der vorliegenden Abhandlung bestand darin, herauszufinden, ob eine geringe oder hohe altersspezifische Schlafdauer sowie eine bessere Schlafqualität mit einem positiven oder negativen Einfluss auf die körperliche Aktivität bei Kindern assoziiert ist. Zusätzlich werden deren Alter und Geschlecht berücksichtigt. Ferner wurden Auswirkungen der Untersuchung hinsichtlich nicht übertragbarer Krankheiten (NCDs) diskutiert. Methode: Die in dieser Arbeit benutzten Daten stammen aus dem Baseline-Assessment der KaziAfya-Studie. Der Stichprobenumfang umfasste 456 Kinder im Alter zwischen sechs und zwölf Jahren in Côte d’Ivoire. Für die Schlafdauer wurden die Eltern bezüglich der Einschlaf- und Aufwachzeit ihres Kindes befragt. Die Schlafqualität wurde mit Hilfe eines validierten Fragebogens von den Kindern beantwortet. Für die Messung der körperlichen Aktivität wurde ein Accelerometer-Gerät (Actigraph wGT3x-BT, Shalimar, FL, USA) eingesetzt. Mehrfaktorielle Kovarianzanalysen anhand einer ANCOVA sowie T-Tests wurden verwendet, um Assoziationen zu prüfen. Ergebnisse: In der Untersuchung konnte kein signifikanter Zusammenhang zwischen einer geringen oder erhöhten altersspezifischen Schlafdauer und der körperlichen Aktivität der Kinder identifiziert werden. Es liess sich ebenfalls kein Zusammenhang zwischen besserer und schlechterer Schlafqualität hinsichtlich der körperlichen Aktivität bei Kindern feststellen. Es wurde jedoch ein Einfluss der Schlafqualität auf das sitzende Verhalten bei Kindern gefunden. Schlussfolgerung: Obwohl keine Zusammenhänge von Schlafdauer und Schlafqualität in Bezug auf MVPA identifiziert werden konnten, scheint der Schlaf ein bedeutsamer Faktor im Gesundheitswesen, insbesondere in low-income-countries wie in Côte d’Ivoire, zu sein. Es scheint, dass eine schlechte Schlafqualität einen Einfluss auf mehr sitzendes Verhalten hat. Ob eine geringe oder höhere Schlafdauer einen Einfluss auf ein tieferes körperliches Aktivitätsniveau hat, bleibt unbeantwortet. Es ist wünschenswert, dass zukünftige Arbeiten den Fokus auf die Beziehung zwischen Schlafdauer und der körperlichen Aktivität legen und den Zusammenhang zwischen schlechter Schlafqualität und sitzendem Verhalten genauer untersuchen

Pesticides monitoring in biological fluids: Mapping the gaps in analytical strategies

Pesticides play a key-role in the development of the agrifood sector allowing controlling pest growth and, thus, improving the production rates. Pesticides chemical stability is responsible of their persistency in environmental matrices leading to bioaccumulation in animal tissues and hazardous several effects on living organisms. The studies regarding long-term effects of pesticides exposure and their toxicity are still limited to few studies focusing on over-exposed populations, but no extensive dataset is currently available. Pesticides biomonitoring relies mainly on chromatographic techniques coupled with mass spectrometry, whose large-scale application is often limited by feasibility constraints (costs, time, etc.). On the contrary, chemical sensors allow rapid, in-situ screening. Several sensors were designed for the detection of pesticides in environmental matrices, but their application in biological fluids needs to be further explored. Aiming at contributing to the implementation of pesticides biomonitoring methods, we mapped the main gaps between screening and chromatographic methods. Our overview focuses on the recent advances (2016-2021) in analytical methods for the determination of commercial pesticides in human biological fluids and provides guidelines for their application

A paper-based device for glyphosate electrochemical detection in human urine: A case study to demonstrate how the properties of the paper can solve analytical issues

In the ever-growing demand for agricultural production, the use of pesticides and the consequential health risks is an issue that remains in the spotlight. The biomonitoring of pesticides in biological matrices is a mandatory task to point out the adverse effects on those people that are particularly exposed (i.e., occupational exposure) and to customize the use of pesticides for safer and more aware agricultural practices (i.e., precision agriculture). To overcome the bottleneck of costs and long sample treatments, we conceived a paper-based analytical device for the fast and smart detection of glyphosate in human urines, which is still the most widespread pesticide. Importantly, we demonstrate how to face the analytical interference given by uric acid to develop an electrochemical sensor for glyphosate detection using paper as a multifunctional material. To this purpose, a sample treatment was pointed out and integrated into a paper strip to decrease the level of uric acid in urines, finally delivering a ready-to-use device that combines lateral and vertical flow. The effective decrease of uric acid after the paper-integrated treatment is verified by direct oxidation in differential pulse voltammetry, whereas glyphosate detection can be carried out by enzyme inhibition assay in chronoamperometry. The system showed a limit of detection for glyphosate of 75 μg/L and a linear range of 100 - 700 μg/L. Additionally, the sustainability of the paper device was assessed and compared with reference chromatographic methods. Overall, this work provides an example of how to design green sensing solutions for addressing analytical challenges in line with the White Analytical Chemistry principles

Thermal homeostasis and liver transplantation

Thermal homeostasis represents the major issue during liver transplantation (OLT) since severe hypothermia may have a deleterious effect on both liver recipient organism and postoperative graft functioning. Because of the known negative influence of hypothermia on intraoperative cardiovascular activity and coagulation system, numerous methods have been suggested to reduce intraoperative heat loss and promote active warming (continuous temperature monitoring, external heat sources, improvement in surgical technique and technologies). A good intraoperative OLT course has an obvious influence on post OLT graft function recovery, but thermal homeostasis has also an essential direct effect on the graft as a constitutive component of conventional cold preservation methods. Hypothermia, however, contributes directly to the graft ischemia-reperfusion injury particularly in marginal and partial organs by several angiogenic mechanisms. For these reasons, on the light of the development of new strategies to increase the donor pool, clinical research is focusing on new preservation methods such as extracorporeal circuits with normothermic oxygenated perfusion

Multimodal therapy before liver transplantation for hepatocellular carcinoma

: The use of orthotopic liver transplantation (OLT) for the treatment of patients with hepatocellular carcinoma (HCC) remains controversial because of the risk of both exclusion from the waiting list due to tumor progression and post OLT HCC recurrence. The aim of the present study was to evaluate the effect of an aggressive HCC treatment during the waiting list time on overall and recurrence-free survival of HCC transplanted patients in a single institutional study

Liver Transplantation for the Treatment of Moderately or Well-Differentiated Hepatocellular Carcinoma

OBJECTIVE: To determine the long-term results of liver transplantation for well- or moderately differentiated hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA: HCC patient selection for liver transplantation remains controversial, and deciding exclusively on the strength of criteria such as number and size of nodules appears prognostically inaccurate. METHODS: Since 1991, preoperative tumor grading has been used at our center to establish whether a patient with HCC is fit for transplantation. Poorly differentiated HCC cases were excluded, while size and number of nodules were not considered as absolute selection criteria. Thirty-three patients with moderately or well-differentiated HCC were prospectively studied after liver transplantation. A group of 15 patients with incidental HCC transplanted during the same period were also evaluated and compared with the 33 patients with preoperatively diagnosed HCC. RESULTS: On histologic examination, 38% of the entire group of 48 patients did not meet the “Milan criteria” and 42% were pTNM stages III and IV. The median follow-up was 44 months. The 5-year actuarial survival rate was 75% and recurrence-free survival was 92%. HCC recurred in only 3 patients (6%). The only histomorphologic variable differing significantly between incidental and nonincidental HCC was nodule size. The timing of diagnosis (incidental vs. nonincidental HCC), the Milan criteria, and the TNM stage revealed no statistically significant impact on overall and recurrence-free survival rates. CONCLUSIONS: The routine pre-orthotopic liver transplantation tumor grading may represent a valid tool in the selection of unresectable HCC patients for transplantation