Post-COVID-19 Syndrome or Long COVID: From Patient Symptoms to Current Pathophysiological Hypotheses

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L’influenza di programmi di attività motoria sulla performance lavorativa: uno studio sperimentale su E-tutors

The aim of the study was to investigate the relationship between the systematic practice of physical activity in workers and the physical and mental well-being, in general, and the work performance, particularly. Health, physical and mental well-being are the result of the combination of social, economic and cultural factors. The Life-style is one of the elements to be considered for a general well-being. In the concept of life-style, we include nutrition, physical activity and the use or no-use of harmful substances. In this study, we consider, particularly, the physical activity, as an important factor for the physical and mental well-being. The international scientific literature demonstrates that the physical activity improve the physical and mental conditions and that a positive relationship between physical activity and work performance exists. The study was carried out within the H.E.R.A.C.L.E Center of Niccolò Cusano Net University. It was conducted with 20 employees working in the university and a total of 10 employees agreed to participate in the physical activity. The findings and implications are discussed below.L’obiettivo di questo studio è indagare la relazione esistente tra la pratica sistematica di un’attività motoria e il benessere psico-fisico in generale e la performance lavorativa, più in particolare. La salute e il benessere psico-fisico di una persona sono il risultato di un insieme di fattori di tipo sociale, economico, medico e culturale. Lo stile di vita è uno deglielementi da tenere in debita considerazione per lo sviluppo del benessere di ogni individuo.All’interno dello stile di vita, rientrano aspetti quali la nutrizione,  l’attività fisica e l’uso o meno di sostanze dannose. In questo studio, verrà presa in considerazione, in modo particolare, l’attività motoria quale variabile importante nello sviluppo del benessere. La ricerca internazionale, dimostra ampiamente che la salute psico-fisica riceve giovamento dall’attività motoria e che esiste una relazione positiva tra attività motoria e performance lavorativa.Lo studio, qui proposto, è stato realizzato all’interno del laboratorio H.E.R.A.C.L.E. dell’Università Telematica Niccolò Cusano, Lo studio è stato condotto su 20 impiegati dell’Università e un totale di 10 impiegati ha aderito al programma di attività motoria. Le variabili prese in considerazione sono state di tipo fisiologico (altezza, peso, Indice di Massa Corporea, Rapporto Vita/fianchi, percentuale di grasso totale e in eccesso) e di tipo psicologico (livello di stress percepito, indice di abilità lavorativa e performance lavorativa). Irisultati e le relative implicazioni vengono descritti di seguito

Train teachers in digital citizenship to facilitate a sustainable education system

The technological development of the last twenty years, starting in Europe from the increased availability of Internet resources to the concept of the digital citizen, has involved our society at all levels, affecting politics, businesses, families and all forms of education and teaching at each and every level. The COVID pandemic that began in 2020 has led to further acceleration, so much so that both the Digital Agenda for information technology in public administration 2020-2022 (AGID) and the Action Plan for Digital Education 2021-2027 focus on a strong digital component in everyday life. A psychoeducational protocol for digital skills in teachers is hereby provided, tested on a sample over the course of 8 weeks. In order to be able to assess initial and final competences, a questionnaire on digital competences has been developed and validated, based on DigComp 2.1. Formare gli insegnanti alla cittadinanza digitale per facilitare un sistema educativo sostenibile. Lo sviluppo tecnologico degli ultimi vent'anni, a partire in Europa dalla maggiore disponibilità di risorse Internet fino al concetto di cittadino digitale, ha coinvolto la nostra società a tutti i livelli, interessando la politica, le imprese, le famiglie e tutte le forme di istruzione e didattica ad ogni livello. La pandemia di COVID iniziata nel 2020 ha portato a un'ulteriore accelerazione, tanto che sia l'Agenda Digitale per le tecnologie dell'informazione nella pubblica amministrazione 2020-2022 (AGID) sia il Piano d'Azione per l'Educazione Digitale 2021-2027 si concentrano su una forte componente digitale nella vita di tutti i giorni. Viene fornito un protocollo psicoeducativo per le competenze digitali degli insegnanti, testato su un campione nel corso di 8 settimane. Per valutare le competenze iniziali e finali è stato sviluppato e validato un questionario sulle competenze digitali, basato su DigComp 2.1

The Discovery of Highly Potent THP Derivatives as OCTN2 Inhibitors: From Structure‐Based Virtual Screening to In Vivo Biological Activity

A mismatch between β‐oxidation and the tricarboxylic acid cycle (TCA) cycle flux in mitochondria produces an accumulation of lipid metabolic intermediates, resulting in both blunted metabolic flexibility and decreased glucose utilization in the affected cells. The ability of the cell to switch to glucose as an energy substrate can be restored by reducing the reliance of the cell on fatty acid oxidation. The inhibition of the carnitine system, limiting the carnitine shuttle to the oxidation of lipids in the mitochondria, allows cells to develop a high plasticity to metabolic rewiring with a decrease in fatty acid oxidation and a parallel increase in glucose oxidation. We found that 3‐(2,2,2‐ trimethylhydrazine)propionate (THP), which is able to reduce cellular carnitine levels by blocking both carnitine biosynthesis and the cell membrane carnitine/organic cation transporter (OCTN2), was reported to improve mitochondrial dysfunction in several diseases, such as Huntington’s disease (HD). Here, new THP‐derived carnitine‐lowering agents (TCL), characterized by a high affinity for the OCTN2 with a minimal effect on carnitine synthesis, were developed, and their biological activities were evaluated in both in vitro and in vivo HD models. Certain compounds showed promising biological activities: reducing protein aggregates in HD cells, ameliorating motility defects, and increasing the lifespan of HD Drosophila melanogaster

Familial Polyposis Coli: The Management of Desmoid Tumor Bleeding

There is currently no standard treatment for desmoid tumors (DTs) associated with familial polyposis coli (FAP). Familial adenomatous polyposis in DT patients is sometimes a life-threatening condition

Harmonic focus versus conventional electrocautery for femoral artery exposure: a "direct" comparison on the same patients

Surgical access complications during endovascular aneurysm repair (EVAR) are reported relatively frequent. HARMONIC FOCUS® (HF; Ethicon EndoSurgery Inc., Cincinnati, Ohio, USA) is a device developed to improve bleeding control and reduce heat-related damage stemming from surgical preparation. The aim of this study was to evaluate outcomes and safety of HF versus conventional haemostasis with electrocautery, both techniques used in the same patient. Five patients developed bilateral wound’s thickening (13.9%) demonstrated at the CT scan, two of whom had no clinical manifestation while in three cases the thickening was associated with lymphocele (4.54%), 2 of which were in the side where the EC was used (5.5%), and 1 case (2.7%), in the HF applied side. One isolated lymphocele occurred at the left groin (2.7%) (tables n.2-3). A Fisher’s exact test was conducted between EC and HF on the occurrence of wound healing complications (3/36 for EC and 1/36 for HF) that resulted statistically significant at p<0.05. Focus Harmonic Scalpel has certain advantages than conventional haemostasis in avoiding surgical access complications

Standard carotid endarterectomy versus carotid artery stenting with closed-cell stent design and distal embolic protection: does the age matter?

Carotid artery endarterectomy (CEA) is considered the gold standard for treatment of symptomatic and asymptomatic carotid disease. Carotid artery stenting (CAS) is a less invasive approach and therefore could be considered a viable alternative to CEA, especially in high-risk patients or those with relative contraindications to CEA (i.e. actinic stenosis, post-CEA restenosis, previous neck or tracheostomy surgery, contralateral laryngeal nerve paralysis, etc.). Methods – The aim of this study is to evaluate the short- and medium-term outcomes of CAS performed with a single type of closed-cell stent design and distal filter protection by comparing the procedure with CEA based upon 3 endpoints: overall survival rate, stroke free survival rate and restenosis free survival rate. The same endpoints were also evaluated in 2 different age groups, more and less than 70 years, to show possible age-based differences on outcomes. Among 105 patients (77 males, 28 females), 74 were submitted to CEA and 31 were subject to CAS. In all cases the same self-expanding stent with closed-cell design (XACT Carotid Stent, Abbott Vascular) and the same distal embolic protection device (Emboshield NAV, Abbott Vascular) were employed. Results – At 12 months, no statistically significant difference was observed in overall survival rates (CEA 93.2% vs CAS 93.5%, p=0.967) and restenosis free survival rates (CEA 94.5% vs CAS 96.8%, p=0.662). An increased stroke free survival rate was observed in the CEA group when compared to the CAS group (CEA 100.0% vs CAS 93.5%, p=0.028). The age-based endpoints didn’t show any significant difference. Conclusion - These results suggest that CEA still remains the gold standard of treatment for carotid stenosis given its greater efficacy in the prevention of stroke CAS. However, CAS could be considered as an alternative treatment to CEA to be used in select cases only

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P &lt; .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients