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SARS-CoV-2 is a single-stranded RNA virus, known to be the causative agent of COVID-19. As the resulting disease shows a very heterogeneous range of clinical manifestations, the identification of early biomarkers allowing patients stratification according to the expected disease severity is still an unmet clinical need.In this observational prospective cohort study, 137 consecutive patients, testing positive for SARS-CoV-2 infection by nasopharyngeal swab RT-PCR or antigenic test, were enrolled to evaluate their plasma viral load at the time of hospitalization.Even if all of them had a molecular diagnosis of COVID-19, only 29 patients showed a detectable plasma SARS-CoV-2 RNAemia. Such viremic patients also showed other clinical and laboratory finding alterations (increased troponin I, IL-6, RDW-CV, and creatinine levels along with decreased platelet count and glomerular filtration rate). A plasma detectable RNA viral load predicted in hospital death or ICU admission with an odds ratio of 3.53 (CI: 1.44-8.64, P=0.0058), while the lack of a detectable viral load was associated with a faster recovery, with an odds ratio of 4.06 (CI: 1.72-9.59, P=0.0014). These findings were confirmed in multivariate models including age, sex and baseline National Early Warning Score 2 and arterial oxygen tension over inspired oxygen fraction ratio.Our data thus suggest that plasma viral RNA load at the time of hospital admission could represent a useful independent biomarker allowing early patients' stratification according to the expected disease evolution, and driving clinical decisions tailored on the specific needs of the individual patient.

Aim of this study was to assess by clinical evaluation and by Bispectral Index (BIS) the tranquillizing properties of diazepam injected intravenously, and midazolam by intranasal route according to the body weight in dental patients.A group of 34 patients undergoing implantology were divided at random into 2 groups of 17. They were evaluated physically, clinically and psychologically. The psychomotor activity was measured by the Newman's test. Preoperative anxiety was treated with chlordemethyldiazepam (CHDDZ) per os, administered before induction of conscious sedation. In the first group, conscious sedation was accomplished by induction with titrated doses of i.v. diazepam, and in the second group with 0.1 mg/kg of intranasal midazolam. BIS values were analysed as Area Under the Curve (AUC).The AUC BIS values after CHDDZ presedation were overlapping in both groups. AUC after midazolam decreased after induction of the conscious sedation (P0.05), during anesthesia (P0.01) and during intervention (P0.01) compared to the diazepam treatment. In the midazolam group the BIS values were on average lower than 90, while in the diazepam group they were on average higher than 95 (P0.01). The psychomotor recovery was more impaired after midazolam.The study shows that nasal route ensures the quick absorption of midazolam as revealed during the first 3 min from drug administration. The depressant effect of midazolam increased as a function of time, reaching the highest levels during intervention. The results suggest that midazolam is endowed with sedative effects which may compromise the state of consciousness of the patient and be incompatible with the definition of conscious sedation in dentistry.

The aim of this study was to evaluate the effects of sedation with benzodiazepines in a large population of patients undergoing oral surgery and age-related implications.A group of 1 179 consecutive patients undergoing oral surgery in the Dental Clinic of the University of Padua between 2001 and 2003 was evaluated by analysing their anaesthesiological records. The patients were divided into 5 age groups. All were pre-sedated with chlordemethyldiazepam per os, while induction of maximum subjective tranquillity was obtained with fractionated doses of intravenous diazepam. Arterial pressure (AP), heart rate (HR), anxiety level, pathologies, drugs taken, types of intervention, techniques of loco-regional anaesthesia, immediately preoperative AP and HR and tranquillity, intraoperative AP and HR, data regarding postoperative psychomotor recovery, complications and drugs used for the treatment of perioperative pain, were evaluated in each group.Most of the patients (679) were in the 45-64 year-old group. Cardiovascular, respiratory and digestive pathologies proved to be age-dependent. Control AP and HR respectively increased and decreased with age. The doses of chlordemethyldiazepam used induced age-dependent preoperative tranquillity levels. The doses of i.v. diazepam necessary to obtain maximal preoperative subjective tranquillity fell as a function of age. The AP and HR values respectively increased during intervention and decreased in the first hour of intervention. Normal psychomotor recovery was less evident in older patients. The most significant corrective intraoperative interventions consisted of the administration of sublingual hypotensive drugs and in the immediate treatment of some cases of orthostatic hypotension and vaso-vagal syncope.The sedation technique and the antistress procedures employed proved safe and the intra- or postoperative complications almost non-existent. The variations observed in the parameters considered are compatible with the greater age of the treated subjects.

Impedance-based sensors represent a promising tool for cell monitoring to improve current invasive biological assays. A novel research field is represented by measurements performed in dynamic conditions, monitoring cells (e.g., myocytes) for which the mechanical stimulus plays an important role for promoting maturation. In this picture, we applied printed and stretchable electronics principles, developing a system able to evaluate cells adhesion during substrate cyclic strain. Cytocompatible and stretchable sensors were ink-jet printed using carbon-based ink on crosslinked poly([Formula: see text]-caprolactone) electrospun mats. Moreover, a customized stretching device was produced, with a complete user interface to control testing condition, validated in order to correlate impedance changes with myoblasts — i.e., myocytes precursors — adhesion. Overall system sensitivity was evaluated using three different cell concentrations and DAPI imaging assay was performed to confirm myoblast adhesion. Preliminary results showed the possibility to correlate an average increase of impedance magnitude of 1[Formula: see text]k[Formula: see text] every 15,000 cells/cm2 seeded, suggesting the possibility to discriminate between different cell concentrations, with a sensitivity of 80[Formula: see text]m[Formula: see text]/(cells/cm2). In conclusion, the present system might be generalized in the development of future applications, including the differentiation process of cardiac myocytes with the aid of mechanical stimuli.

Background and Purpose— The etiology of spontaneous cervical artery dissection (sCAD) is still unknown, even though an underlying arteriopathy impairing vasomotion has often been suspected. This study was undertaken to investigate: (1) spontaneous, (2) endothelial-dependent, and (3) endothelial-independent vasodilation in patients with multiple sCAD. Methods— In 19 consecutive patients with multiple carotid or vertebral artery dissections high-resolution ultrasound was used to assess spontaneous and endothelial-independent dilations (isosorbide dinitrate-mediated) in the common carotid, vertebral and brachial arteries, and endothelial-dependent dilation (flow-mediated arterial dilation) in the brachial arteries alone. The same parameters were measured in 19 healthy subjects matched for age, sex, and height (controls). Ultrasound studies were performed by one investigator, and off-line analysis by another investigator who was blinded to the clinical data and study status (patient or control). Results— Spontaneous and endothelial-independent dilations were significantly impaired in the carotid ( P =0.0006 and P P =0.0121 and P =0.0047, respectively) of patients as compared with controls, whereas no statistically significant differences were found in the brachial arteries; conversely, endothelial-dependent dilation of the brachial arteries was significantly lower in patients as compared with controls ( P Conclusions— Patients with multiple sCADs have a significantly impaired vasomotion, which may predispose to dissection.