Omega-3 long-chain polyunsaturated fatty acids supplementation on inflammatory biomakers: a systematic review of randomised clinical trials

Inflammation is part of the normal host response to infection and injury. Eicosanoids, cytokines, chemokines, adhesion molecules and other inflammatory molecules are frequently produced during this process. Numerous studies in humans have documented the inflammation-limiting properties of omega-3 fatty acids, but only a few have been randomised clinical trials. The aim of this study was to perform a systematic search of randomised clinical trials on omega-3 fatty acids and inflammatory biomarkers in all subjects including healthy and ill persons up to February 2011 using PubMed and LILACS databases, defined by a specific equation using MeSH terms and limited to randomised clinical trials; there was no any a priori decision to include some diseases and not others. The quality of each publication was validated by using the JADAD scale and the CONSORT checklist. Inflammatory biomarkers were considered as primary outcomes. Twenty-six publications of the last 10 years were selected. Studies included healthy subjects and patients with cardiovascular disease and other chronic and acute diseases; all reported the number of subjects, type of study, type and doses of omega-3 fatty acids, main outcomes and major inflammatory biomarkers. Dietary omega-3 fatty acids are associated with plasma biomarker levels, reflecting lower levels of inflammation and endothelial activation in cardiovascular disease and other chronic and acute diseases, including chronic renal disease, sepsis and acute pancreatitis. However, further research is required before definitive recommendations can be made about the routine use of omega-3 fatty acids in critically ill patients or with neurodegenerative or chronic renal disease.Instituto de Salud Carlos III del Ministerio de Ciencia e Innovacion Red SAMID, RETIC RD08/007

Doppia pena e doppio diritto? Il carcere al tempo della pandemia da Covid-19

The spreading of the new coronavirus pandemic (Covid-19) in Italy caused inevitable consequences also on our penitentiary system and on all the people that live and work there. Thoughts, experiences and strategies for coping with the emergency are reported through three testimonies of three Directors of Italian Penitentiary Institutes. In some cases, the crisis was managed using creativity, imagination and motivation. This attitude lead to valid treatments profiles and to functional communication systems between the prison and the outside world. The mediation of conflicts and the inevitable tensions caused by the pandemic emergency were well handled and the results are visible and concrete.L'emergenza legata al diffondersi della pandemia del nuovo coronavirus (Covid-19) anche in Italia ha portato inevitabili conseguenza anche sul nostro sistema penitenziario e su tutti coloro che ci vivono e lavorano. Attraverso le testimonianze di treDirettori di Istituti Penitenziari Italiani, vengono riportate riflessioni ed esperienze di fronteggiamento della emergenza dovutaal Covid-19. Laddove con fantasia, motivazione, creatività si è riusciti a stabilire e determinare, nonostante tutto, profili validi ditrattamento e anche sistemi di comunicazione validi e funzionali tra il mondo del carcere ed il mondo esterno, i risultati intermini di mediazione dei conflitti e delle inevitabili tensioni create dalla emergenza della pandemia sono stati visibili e concreti

Double penalty and double right? Prison at the time of the Covid-19

The spreading of the new coronavirus pandemic (Covid-19) in Italy caused inevitable consequences also on our penitentiary system and on all the people that live and work there.Thoughts, experiences and strategies for coping with the emergency are reported through three testimonies of three Directors of Italian Penitentiary Institutes. In some cases, the crisis was managed using creativity, imagination and motivation.This attitude lead to valid treatments profiles and to functional communication systems between the prison and the outside world.The mediation of conflicts and the inevitable tensions caused by the pandemic emergency were well handled and the results are visible and concrete

Tutela della salute in carcere, durante la pandemia Covid-19

Being detained in jail is an acknowledged risk factor for physical and psychiatric morbidity. The impact of COVID-19 pandemicon the penitentiary system, already characterized by criticalities in terms of healthcare, including high infectious risk, has beenconsidered a source of further danger within the prison and for the community. This problem has been raised by several observers, in the absence of a shared approach between states. The Italian Government enacted a series of measures aimed at penitentiary structures, to contain and manage health and safety risks. General precautions for infections prevention have been used, including frequent hands washing and environmental cleaning and disinfection procedures. Physical distancing in jail is extremely challenging, and we deem that it was still impossible to apply it, despite the release of almost 8000 detainees, among those at greater health risk. Measures have been also ordered to limit external contacts with detainees, including a substantial or absolute suspension of visits from relatives, operators and lawyers, replaced by video meetings. Quarantine and isolation of suspect cases has also been ordered, including new prisoners. Despite unfavorable premises the analysis we did on available data indicates lower infection rate and lethality rate in prison than in general population. In this paper a synthetic framework of the sanitary problems in detention will be provided, then the data will be analyzed, providing possible interpretations potentially useful for the management of the pandemic at the community level. Infectious surveillance, compliance with sanitation standards, early treatment of suspected cases, lower mean age, efficacious isolation and quarantine strategies may explain the better outcomes in Italian penitentiary system, also in the impossibility to systematically apply physical distancing. La restrizione in ambiente intramurario è un noto fattore di rischio in termini di morbidità per patologie fisiche e psichiche. L’impatto di una pandemia quale la COVID-19 sul sistema penitenziario, caratterizzato da plurime criticità in termini di gestione sanitaria, rischia potenzialmente di determinare gravi effetti sulla salute di detenuti e operatori. A livello internazionale tale problematica è stata sollevata e descritta, in assenza di un approccio condiviso tra gli stati dell’Unione Europea. In Italia, uno dei paesi maggiormente colpiti in termini di contagi e mortalità, si è assistito all’applicazione di una serie di misure dirette alle strutture penitenziarie, atte al contenimento ed alla gestione dei rischi per la salute e la sicurezza. L’ambiente carcerario, tuttavia, notoriamente caratterizzato da sovraffollamento e gravato da fattori di rischio specifici, rende problematico adottare una serie di misure che sono state invece previste per la popolazione generale. Il distanziamento fisico in carcere è estremamente problematico, e riteniamo che sia stato impossibile applicarlo, nonostante il rilascio di quasi 8000 detenuti, tra quelli a maggior rischio per la salute. Sono state inoltre disposte misure per limitare i contatti esterni con i detenuti, compresa una sospensione sostanziale o assoluta delle visite di parenti, operatori e avvocati, sostituita da videoconferenze. Sono stati ordinati anche la quarantena e l'isolamento dei casi sospetti, compresi i nuovi detenuti. Nonostante tali sfavorevoli premesse, l’analisi dei dati da noi effettuata circa i contagi ed i decessi in carcere, sino al 1° maggio 2020, indicano un tasso di infezione paragonabile alla popolazione generale, ed un tasso di letalità significativamente inferiore. Nel presente lavoro, dopo aver fornito un inquadramento sintetico delle problematiche sanitarie in ambito detentivo, si discuteranno i dati fornendo possibili interpretazioni di potenziale utilità per la gestione a livello comunitario.&nbsp