69 research outputs found

    Remdesivir treatment in hospitalized patients affected by COVID-19 pneumonia: a case-control study

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    Background: to date the optimal antiviral treatment against severe coronavirus disease 2019 (COVID-19) has not been proven; remdesivir is a promising drug with in vitro activity against several virus, but in COVID-19 the clinical results are currently not definitive. Methods: in this retrospective observational study we analyzed the clinical outcomes (survival analysis, efficacy and safety) in a group of hospitalized patients with COVID-19 treated with remdesivir in comparison with a control group of patients treated with other antiviral or supportive therapies. Results: we included 163 patients treated with remdesivir and 403 subjects in the control group; the baseline characteristics were similar in the two groups; mortality rate was higher in control group (24.8% vs 2.4%, p<0.001), the risk of intensive-care-unit (ICU) admission was higher in control group (17.8% vs 9.8%, p=0.008); hospitalization time was significantly lower in patients treated with remdesivir (9.5 vs 12.5 days, p<0.001). The safety of remdesivir was good and no significant adverse events were reported. In multivariate analysis the remdesivir treatment was independently associated with a 34% lower mortality rate (OR=0.669; p=0.014). Conclusions: in this analysis the treatment with remdesivir was associated with lower mortality, lower rate of ICU admission, shorter time of hospitalization. No adverse events were observed. This promising antiviral treatment should also be confirmed by other studies. This article is protected by copyright. All rights reserved

    Obesity and Circulating Levels of Vitamin D before and after Weight Loss Induced by a Very Low-Calorie Ketogenic Diet

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    Background: Vitamin D plays a pivotal role in calcium and phosphorus metabolism, also influencing bone tissue. Several studies have reported that vitamin D blood levels were significantly lower in people with obesity, probably due to its uptake by the adipose tissue. Clinical studies that investigated the changes of circulating levels of vitamin D following weight loss reported controversial data. A very low-calorie ketogenic diet is acknowledged as a reliable treatment to achieve a rapid weight loss. Therefore, we investigated the effect of weight loss, consequent to a very low-calorie ketogenic diet, on vitamin D blood concentrations. Methods: A cohort of 31 people with obesity underwent a very low-calorie ketogenic diet for 10-12 weeks. The serum concentrations of vitamin D, parathormone, calcium and phosphorous were measured before and after weight loss; they were compared to a control group of 20 non-obese, non-diabetic, age- and gender-matched persons. Results: Patients with obesity had a higher habitual intake of vitamin D than the control group (p &lt; 0.05). However, the vitamin D blood levels of the obese group were significantly lower than those of the control group (p &lt; 0.005) and they increased after weight loss (p &lt; 0.001). At baseline, vitamin D blood concentrations of the persons with obesity were significantly correlated with both fat mass-kg (r = -0.40; p &lt; 0.05) and body mass index (r = -0.47; p &lt; 0.01). Following very low-calorie ketogenic diet, the change in vitamin D serum concentrations was correlated only with the change in fat mass-kg (r = -0.43; p &lt; 0.01). Conclusion: This study confirmed that patients with obesity have lower vitamin D levels that normalize after significant weight loss, supporting the hypothesis that vitamin D is stored in the adipose tissue and released following weight loss

    Motor neuron degeneration, severe myopathy and TDP-43 increase in a transgenic pig model of SOD1-linked familiar ALS

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    Amyotrophic Lateral Sclerosis (ALS) is a neural disorder gradually leading to paralysis of the whole body. Alterations in superoxide dismutase SOD1 gene have been linked with several variants of familial ALS. Here, we investigated a transgenic (Tg) cloned swine model expressing the human pathological hSOD1G93A allele. As in patients, these Tg pigs transmitted the disease to the progeny with an autosomal dominant trait and showed ALS onset from about 27 months of age. Post mortem analysis revealed motor neuron (MN) degeneration, gliosis and hSOD1 protein aggregates in brainstem and spinal cord. Severe skeletal muscle pathology including necrosis and inflammation was observed at the end stage, as well. Remarkably, as in human patients, these Tg pigs showed a quite long presymptomatic phase in which gradually increasing amounts of TDP-43 were detected in peripheral blood mononuclear cells. Thus, this transgenic swine model opens the unique opportunity to investigate ALS biomarkers even before disease onset other than testing novel drugs and possible medical devices

    Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

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    Dysregulated systemic inflammation is the primary driver of mortality in severe COVID-19 pneumonia. Current guidelines favor a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg·day-1. A comparative RCT with a higher dose and a longer duration of intervention was lacking

    Efficacy of a new technique - INtubate-RECruit-SURfactant-Extubate - "IN-REC-SUR-E" - in preterm neonates with respiratory distress syndrome: Study protocol for a randomized controlled trial

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    Background: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69&nbsp;%. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an "optimal" functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs. Therefore, the aim of this study is to compare the application of a recruitment maneuver using the high-frequency oscillatory ventilation (HFOV) modality just before the surfactant administration followed by rapid extubation (INtubate-RECruit-SURfactant-Extubate: IN-REC-SUR-E) with IN-SUR-E alone in spontaneously breathing preterm infants requiring nasal continuous positive airway pressure (nCPAP) as initial respiratory support and reaching pre-defined CPAP failure criteria. Methods/design: In this study, 206 spontaneously breathing infants born at 24+0-27+6 weeks' gestation and failing nCPAP during the first 24&nbsp;h of life, will be randomized to receive an HFOV recruitment maneuver (IN-REC-SUR-E) or no recruitment maneuver (IN-SUR-E) just prior to surfactant administration followed by prompt extubation. The primary outcome is the need for mechanical ventilation within the first 3&nbsp;days of life. Infants in both groups will be considered to have reached the primary outcome when they are not extubated within 30&nbsp;min after surfactant administration or when they meet the nCPAP failure criteria after extubation. Discussion: From all available data no definitive evidence exists about a positive effect of recruitment before surfactant instillation, but a rationale exists for testing the following hypothesis: a lung recruitment maneuver performed with a step-by-step Continuous Distending Pressure increase during High-Frequency Oscillatory Ventilation (and not with a sustained inflation) could have a positive effects in terms of improved surfactant distribution and consequent its major efficacy in preterm newborns with respiratory distress syndrome. This represents our challenge. Trial registration: ClinicalTrials.gov identifier: NCT02482766. Registered on 1 June 2015

    All in the Game. The Wire: un campo di ricerca sociologica

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    Analyzing with an ethnographic approach The Wire, one of the most important TV series on American ghettos, to understand and question the sociological perspective that emerges from the series, positioning it into the broader scientific debate. This is, in a nutshell, the work presented in the book It's all in the Game, the outcome of a laboratorial research activity carried out in 2020 by students and teachers of the Sociology of Communities and Urban Neighborhoods class, at the University of Bologna. The text is structured into four chapters, resulting from the four topics used to analysis the TV series: forms of social capital, the relationship between structural forces- culture of poverty and individual agency, neighborhood effects mechanism and the relationship between statistics and political action. Four subjects that are the core of many neighborhood- studies related researches and on which the TV series makes a clear stand. We analyzed those topics through a critical perspective, not considering them as a truth about ghettos, but as a very precise way of thinking about life in the American suburbs

    Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

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    Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p &lt; .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p &lt; .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

    Giorgione e il mistero dell'acqua: una webquest di storia dell'arte

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    L’articolo tratta lo sviluppo di una webquest di Storia dell’Arte all’interno di un Liceo Scientifico. Questa attività, complessa nella progettazione e nella gestione, permette però risultati tali a livello di conoscenze, competenze e incremento motivazionale, da giustificarne i costi in termini di tempo ed energie. Nel testo sono illustrate le motivazioni, l’organizzazione e soprattutto i risultati. Se nell’insegnamento della Storia dell’Arte uno strumento come la webquest, basato su un percorso strutturato per problemi, può dare risposta al bisogno didattico specifico legato al percorso storico, può anche essere visto come un’attività in grado di rispondere a esigenze formative più complesse in grado di sviluppare la capacità creativa, l’autonomia nella lettura critica delle opere d’arte e del linguaggio visivo in generale. La tecnologia, in questo caso può creare un ambiente stimolante e di collaborazione e permettere allo studente un approccio attivo nella costruzione delle conoscenze
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