Fall of viral and bacterial pneumonia hospitalizations following COVID-19 pandemic mitigation strategies: a central Italian Region retrospective study

Community-Acquired Pneumonia (CAP) represents one of the first causes of hospitalization and death in the elderly all over the world and weighs heavily on public health system. Since the beginning of the COVID-19 (CoronaVirus Disease-19) pandemic, everybody's behavior was forced to change, as the result of a global lockdown strategy and the obligation of using personal protection equipment (PPE). We aimed to evaluate how the mitigation strategies adopted to fight SARS-CoV-2 (Severe Acute Respiratory Coronavirus Syndrome 2) infection have influenced hospitalizations due to CAP in two different Local Health Boards (LHBs) of central Italy. We considered two main periods of observation: before and after the national start of lockdown, in two Abruzzo's LHBs. We analyzed 19,558 hospital discharge records of bacterial and viral CAP. Excluding SARS-CoV2 infection, a significant decrease in CAP hospitalizations was observed. Through the analysis of Diagnosis Related Group (DRG) values, we highlighted a significant saving of founds for the Regional Health Service. The enactment of social distancing measures to contain COVID-19 spread, brought down admissions for bacterial and viral pneumonia. Our study emphasizes that costs for hospitalizations due to CAP could be drastically reduced by mask wearing and social distancing.

Alteration of Inflammatory Parameters and Psychological Post-Traumatic Syndrome in Long-COVID Patients

The aim of our study is to evaluate the correlation between the psychological status of patients recovered from SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection (long-COVID patients) and their inflammatory status. Three months after hospital discharge, ninety-three patients were recruited and categorized into two distinct populations: control and long-COVID (COrona VIrus Disease) group. Patients belonging to the control group presented with an entering diagnosis of cardiovascular, metabolic, or respiratory disease and a negative history of SARS-CoV-2 infection, whereas the long-COVID population presented with a severe SARS-CoV-2 infection treated in the sub-intensive Care Unit. Psychological evaluation was performed through the administration of the Symptom Checklist-90 (SCL90) and LDH (Lactate dehydrogenase), ferritin, CRPhs (C-high sensitivity Reactive Protein), NLR (Neutrophil-to-lymphocyte ratio), PLR (Platelet-to-lymphocyte ratio), and SII (systemic immune-inflammation index) were investigated. We highlighted that beyond the first three months after contagion, patients recovered from SARS-CoV-2 infection are characterized by the persistence of a systemic inflammatory state and are at high risk for developing somatization, depression, anxiety, and sleep disturbances. Interestingly, ferritin value was strongly correlated with sleep disorders (p < 0.05). Our study emphasizes how COVID-19 strategies for risk stratification, prognosis, and therapy management of patients should be implemented with a psychological follow-up.

Carcass and Meat Quality Traits in an Embden×Toulouse Goose Cross Raised in Organic Dehesa

This study assessed the influence of genetic type (Embden-Anser anser, EE; Toulouse-Anser anser, TT and F1 cross, ET) for meat characteristics (carcass, meat quality and fatty acid (FA) profiles), of domestic geese "Anser anser domesticus" raised in dehesa as an alternative, organic feeding system. Carcass and breast muscle weight (p<0.01) were greater for the ET group at the same live weight. None of the groups showed differences in the production of fatty liver with this type of feeding. Higher values were found for maximum Warner-Bratzler shear force (between 7.62 and 8.87 kg/cm(2)), which implies the improvement of this parameter. High levels of oleic FAs were obtained, especially for the TT group. The polyunsaturated/saturated FA ratio was highest for the ET group (p<0.001), reflecting the optimum nutritional values as a component of a healthy consumer diet.

Genetic variation of adaptation to heat stress in two Spanish dairy goat breeds

Monthly test-day records of milk yield and composition in Murciano-Granadina (MG) and Payoya (PYA) dairy goats were combined with weather data from meteorological stations, to analyse the effects of heat stress on dairy traits, measured with an index of temperature and relative humidity (THI). A 'repeatability animal model' and a 'reaction norm animal model' were used to estimate genetic (co)variance components. Estimates obtained with both models were very similar. The h(2) of daily yields in MG did not vary throughout the THI scale, but the pattern of variation of content traits showed negative trends for increasing THI values. In PYA, a slight positive tendency throughout the THI scale was observed for the same traits. The genetic correlations between subsequent points in the THI scale were lower than 0.80 when they were computed between low and high THI points. The same reaction norm was observed for all traits. Using the 'reaction norm animal model', it was possible to identify those animals that show the same performance throughout the THI trajectory (robust) and those with varying performances (tolerant and non-tolerant to heat stress). Results in this study also show that heat tolerance decreases, while the genetic level for milk traits increases. Losses because of heat stress were equivalent to 1.9 and 3.1% in the yearly yield of fat and protein for MG and PYA, respectively.

Meat quality of tenderloin from Iberian pigs as affected by breed strain and crossbreeding

In 2007, a new National Quality Standard was published in Spain to regulate the products derived from the Iberian pig carcass, including for the first time fresh meat. In the same way, four different Iberian strains were recognized as official (Lampiño, Entrepelado, Retinto and Torbiscal). A batch (n=10) of each pig strain was selected using neutral DNA markers, and another batch of the most common crossbreeding pigs (Iberian×Duroc) was included into the study as a control. The main meat quality parameters of tenderloin, the most expensive meat cut for fresh consumption, from those five pig groups were analysed. Retinto and Lampiño strains showed the closest phenotypic distances, followed by Entrepelado strain. Meat from crossed and Torbiscal pigs had lower water holding capacity, L∗ and a∗, and higher SFA than meat from the other three strains. Crossbred pigs had the lowest protein, intramuscular fat and PUFA contents.

Influence of APOE polymorphism on cognitive and behavioural outcome in moderate and severe traumatic brain injury

AIM

To analyse the influence of apolipoprotein (APOE) epsilon4 status on the cognitive and behavioural functions usually impaired after moderate and severe traumatic brain injury (TBI).

METHODS

In all, 77 patients with TBI selected from 140 consecutive admissions were genotyped for APOE. Each patient was subjected to neuropsychological and neurobehavioural assessment at least 6 months after injury.

RESULTS

Performance of participants carrying the epsilon4 allele was notably worse on verbal memory (Auditory Verbal Learning Test), motor speed, fine motor coordination, visual scanning, attention and mental flexibility (Grooved Pegboard, Symbol Digit Modalities Test and part B of the Trail Making Test) and showed considerably more neurobehavioural disturbances (Neurobehavioral Rating Scale-Revised) than the group without the epsilon4 allele.

CONCLUSIONS

In particular, performance on neuropsychological tasks that are presumed to be related to temporal lobe, frontal lobe and white matter integrity is worse in patients with the APOE epsilon4 allele than in those without it. More neurobehavioural disturbances are observed in APOE epsilon4 carriers than in APOE epsilon2 and epsilon3 carriers.

[Socio-economic factors associated with preterm delivery. Results of the European project in Spain]

OBJECTIVES

The objectives of this paper were to analyse the effect of social, personal and medical risk factors on preterm birth (moderate versus very preterm) or on two preterm birth groups (spontaneous versus indicated).

METHODS

Results from the Spanish collaborating centre of the European multicentre case-control study EUROPOP (European Program of Occupational Risks and Pregnancy Outcome) are presented. All preterm births (529) between 22 and 36 completed weeks of amenorrhea and 788 births of 37 or more completed weeks of amenorrhea (control group) are included. Explicative variables are divided in social, personal and medical factors. A univariate and multivariate analysis by means of a logistic regression were carried out.

RESULTS

Very preterm birth risk was higher for women over 34 years, adjusted OR: 2.53 (1.42-4.52), with lower educational level, adjusted OR: 1.79 (1.07-2.98), for primigravid women or multigravid women with only first trimestre abortion, adjusted OR: 1.86 (1.13-3.04), and for multigravid women with previous preterm birth or second trimestre abortion, adjusted OR: 5.53 (2.97-10.35). A similar trend was observed for moderate preterm birth. Probability of spontaneous preterm birth was higher for mother over 34 years, adjusted OR: 1.51 (1.01-2.26), with lower income, adjusted OR: 1.75 (1.07-2.88) and for multigravid women with previous preterm birth or second trimestre abortion, adjusted OR: 2.96 (1.86-4.71). Results were similar for indicated preterm birth.

CONCLUSION

Social differences were found to be related to moderate and very preterm birth. No differences were observed between risk factors and kind of preterm birth: spontaneous or indicated.

Apo E influences declarative and procedural learning in age-associated memory impairment

Age-associated memory impairment (AAMI) is a clinical entity which was originally described to define memory problems linked to normal aging. Apolipoprotein E and ACE genes have both been associated with cognitive impairment in aging and dementia. The purpose of this study was to investigate memory and executive functions in AAMI according to the genetic background. We found that subjects carrying the Apo E epsilon4 allele exhibit lower memory performance on tests of both declarative and procedural memory. We did not find differences on frontal lobe tests. These findings give further support to the hypothesis concerning a genetic susceptibility for cognitive impairment in aging.

Clinician follow-up of children screened for lead poisoning

OBJECTIVES

This study assessed clinicians' compliance with Centers for Disease Control and Prevention recommendations for follow-up of children with blood lead (BPb) levels of 0.48 mumol/L (10 micrograms/dL) or higher.

METHODS

Clinicians' success at follow-up was determined for 3 BPb ranges: > or = 0.97 mumol/L, 0.73 through 0.92 mumol/L, and 0.48 through 0.68 mumol/L (> or = 20 micrograms/dL, 15-19 micrograms/dL, and 10-14 micrograms/dL, respectively).

RESULTS

A total of 410 children with elevated BPb levels were followed over a 12-month period; within 4 months, 71% of those with initial levels of 0.97 mumol/L or greater were retested and 57% and 34% of children with initial BPb levels of 0.73 through 0.92 mumol/L and 0.48 through 0.68 mumol/L, respectively, were retested.

CONCLUSIONS

Follow-up of children with elevated BPb levels is inadequate within an urban ambulatory care network.

[Cognitive changes in normal aging: nosology and current status]

INTRODUCTION AND OBJECTIVES

During the last 15 years several diagnostic categories have appeared to describe a group of adults with cognitive impairment compared to their age-matched standardized norms but without dementia. In this work, the main studies relating to these categories are reviewed and compared in order to establish if they define similar or different aged populations.

DEVELOPMENT

Differences in prevalence or in prognostic values among studies are probably due to the selection of diagnostic categories or the differences in the application of inclusion/exclusion criteria. Genetic and neuroimaging data have contributed to reinforce the validity of the proposed classifications to identify the age related cognitive decline.

CONCLUSIONS

The criteria used seems to be very important in the inclusion of subjects closer to normal aging or to dementia. In this respect further longitudinal studies and a consensus from previous described categories are need to reliably identify aged population with lower cognitive function compared to their age norms but different from patients in the initial stages of dementia.

[Apolipoproteins and cognitive deterioration]

Main studies which have shown an association between the variation in apolipoprotein genes and human neuropsychological impairement are reviewed in this work. Data from literature indicate a special relevance of apolipoprotein E (ApoE) in relation to Central Nervous System (CNS) functions, basically memory. ApoE epsilon 4 is a well documented risk factor for late-onset Alzheimer's Disease (AD). Memory changes in older adults and in AD are also associated with ApoE genotype. Furthermore, ApoE may play a role in formation or degeneration of some neural structures related to memory. In some studies a relation between ApoE's alleles and cerebral vascular disorders like ischemic, haemorrhagic, Vascular (VD) and Multi-infarct (MD) Dementias is also reported. The role of the remaining apolipoproteins in cognitive impairment is still unknown, and these molecules have been considered as risk factors associated with environmental factors in CNS pathologies, essentially the vascular ones.

Children with moderately elevated blood lead levels: a role for other diagnostic tests?

In this study we examined potential limitations of relying exclusively on blood lead (BPb) levels to evaluate children with moderately elevated BPb levels (1.21-2.12 micromol/l, or 25-44 microg/dl). We tested the following hypotheses: 1) such children without elevated erythrocyte protoporphyrin (EP) levels (>=0.62 micromol/l or >/= 35 microg/dl) are unlikely to respond to a chelating agent with a brisk urinary Pb diuresis; 2) those with elevated EP levels, but low hematologic indices consistent with iron deficiency, are also unlikely to respond to a chelating agent with a robust urinary Pb diuresis; and 3) those with elevated EP levels and iron sufficiency are more likely to respond to a chelating agent. To test these hypotheses, we performed retrospective analyses of the relationships between EP concentrations, hematologic indices, and urinary Pb excretion ratios (uPbr) in moderately Pb-poisoned children undergoing the CaNa2EDTA lead mobilization test (Pb-MT). Data from 122 children were available. Urinary Pb excretion was limited in children with an EP <0.62 micromol/l (<35 microg/dl); only 5% (1/21) of Pb-MTs were positive (uPbr >=0.6). In children with an EP >=0.62 micromol/l, low hematologic indices, such as a mean corpuscular hemoglobin (MCH) <23 pg, were associated with relatively little Pb excretion (0/14 positive Pb-MTs). In contrast, 32% (28/87) of Pb-MTs were positive in children with an EP >/= 0.62 micromol/l and iron sufficiency (p<0.01 by chi-square comparison between groups with EP >/= 0.62 micromol/l and either MCH <23 pg or MCH >/= 23 pg). We conclude that only a minority of moderately Pb-poisoned children will demonstrate enhanced urinary Pb excretion in response to chelation therapy. Some of the predicted nonresponders can be readily identified by adding the EP and complete blood count to the panel of tests performed.

Bone lead content assessed by L-line x-ray fluorescence in lead-exposed and non-lead-exposed suburban populations in the United States

Measurements of lead (Pb) in bone reflect cumulative Pb exposure, whereas blood Pb levels are indices of absorption during the previous 21-30 days. This study was undertaken to estimate bone Pb concentrations by L-line x-ray fluorescence (LXRF) in a United States suburban population which was exposed to unusually high levels of Pb in emissions from an adjacent factory during 1963-1981, compared with concentrations similarly estimated in a matched suburban community without unusual Pb exposure. The mean bone Pb value in 269 residents of the highly exposed suburb (15 ppm) was 3-fold greater than that of the reference suburb (5 ppm). LXRF estimates of bone Pb identified those individuals at risk for adverse effects of Pb, whereas blood Pb levels were uninformative. Average LXRF-estimated bone Pb concentrations in residents of the unusually exposed suburb approximated estimated values in workers at Pb-processing factories.

Educational intervention by computer in childhood asthma: a randomized clinical trial testing the use of a new teaching intervention in childhood asthma

To affect asthma-related knowledge, behavior, and morbidity, researchers tested a new educational intervention for children with asthma: an asthma-specific computer game called Asthma Command, which was specifically designed for this study. Sixty-five children with moderately severe asthma were randomly assigned to one of two groups, and 54 completed the study. Both groups were seen approximately six times during the 1 year of the study. Control subjects (n = 29) played routine computer games. Experimental subjects (n = 25) played Asthma Command. Compared with children in the control group, experimental subjects showed improvement in knowledge about asthma (P less than .001), behavior related to the management of asthma (P less than .008), and a trend toward the reduction of acute visits due to asthma (P less than .13). Children in the experimental group also scored higher on the assessment of behaviors related to the management of asthma that were specifically addressed by the intervention provided by Asthma Command (P less than .01). Differences between the control and experimental groups showed a greater improvement in the experimental group in 21 (84%) of the 25 outcome variables in the study (P = .004, Sign test). The study indicates that an asthma-specific computer game can significantly affect knowledge and behavior and may potentially affect morbidity in childhood asthma.