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To explore the 2020-2021 influenza season by describing the case of Italy.FluNet was searched for Italian data on virological samples. French, German, and Spanish data were collected for comparison. InfluNet was used for Italian epidemiological data on influenza-like illness (ILI). Data were extracted for the period from the 42nd week of 2020 to the 16th week of 2021 and for the previous 5-year period. The Containment and Health Index were used to describe the containment measures.Among 6818 samples, 0% were positive in Italy in the 2020-2021 season (28.8% in the previous 5-year period; the percentage change in the total number of tested specimens was -51.3%). In France, Germany, and Spain, the percentage change was -23%, -7%, and -61%, respectively. The Italian ILI incidence remained below the baseline levels (mean 0.0144/100,000 inhabitants; range 0.0085-0.0204). In the previous 5-year period, the mean incidence was 0.041/100,000 inhabitants. With the increase in containment measures, a deflection of ILI incidence was described (P = .015).Despite the reduced number of collected specimens compared to previous seasons and a slight rise in influenza vaccination rates, containment measures represent the most likely factor that helped to reduce cases in the 2020-2021 influenza season in Italy.

Introduction Transition of care represents the transfer from child to adult care. An effective transition maintains continuity of care and presents better clinical outcomes. This process has assumed growing relevance, thanks to improved survivorship of chronic paediatric patients. Actually, there is no a one-size model fitting for all transitions, but each Service organizes its own clinical pathway. Aim The study proposes an organizational model for transition, differentiated according to patient complexity. Methods The working group discussed, through regular meetings, the appropriate transitional model for our Hospital. The working group defined a common scheme of transition and elaborated a synthetic document for patients. Then, the common model is adapted, through clinicians’ contribution, for different diseases. The complexity assessment includes clinical data, nursing and social information. Results The working group defined a common model identifying the main information to be included and detailed in each transition report. The team defined two pathways based on patient’s complexity. In case of good compensation and autonomous management, the adolescent is addressed towards standard transition process, a smoother transition from paediatric to adult care with direct connection among healthcare professionals. In case of complex clinical and/or social conditions, an Interdisciplinary Transition Group (ITG) is activated. The group preventively evaluates each patient in periodic meetings and provides a personalized planning of care. In order to define the complexity of a patient, clinical and social determinants are considered. Some diseases are considered complex by default, while others require ITG involvement in case of multiple comorbidities, severe clinical situation, concomitant social criticality and/or cognitive impairment. Discussion Transition of care represents an important phase in chronic diseases management. The proposed model assures a multidisciplinary approach, involving all specialists of both paediatric and adult teams. A key determinant of transition is information transmission. Then, the model proposes a common transition report format. Finally, a further perspective study is already in program, in order to assess clinical effectiveness.

Background One of the most critical phases of carotid endarterectomy (CEA) is the carotid cross-clamping test, which is a concrete evaluation of efficacy of collateral cerebral perfusion. Some studies revealed a strong correlation between tolerance to carotid cross-clamping and postoperative transient ischemic attack (TIA)/stroke complications. The aim of the study is to make a global analysis of supra-aortic trunks (SAT) and circle of Willis (CoW) patency to predict the tolerance to carotid cross-clamping preoperatively. Methods We observed retrospectively 503 patients who underwent CEA under local anesthesia between January 2012 and 2017. We analyzed single preoperative risk factors, drug therapy, and vessels patency of the group of patients who did or did not present neurological symptoms at carotid cross-clamping. Afterward, we created a cerebral perfusion score (PTOT) to estimate the efficacy of collateral cerebral perfusion and we compared the results from both groups. The score ranges from 0 (hypothetical total occlusion of the SAT and CoW) to 0.65 in case of patency of all arterial districts. Moreover, we evaluated postoperative complication rates. Results Patients with previous neurological symptoms, female gender, and diabetes correlate with a lower tolerance to carotid cross-clamping (odds ratio: 2.57, 2.78, and 2.57, respectively; P value Conclusions The efficacy of cerebral mechanisms of compensation during carotid cross-clamping reflects the capability of the brain to adapt to ischemic insults, and this also correlates with the postoperative risk of TIA/stroke. It is possible to identify preoperatively patients with a higher risk of neurological intolerance at carotid cross-clamping. This score could be a useful method to make a further stratification of risk of neurological complications and eventually to prefer a general anesthesia and the use of shunt for those with PTOT

This study aimed to explore the consequences of the pandemic lockdown among the Italian general population by focusing on depression and emotional overeating (EO).QuarantEat was an Italian, nationwide, cross-sectional study conducted using a computer-assisted web interview method (May 6-31, 2020). The 40-item questionnaire included the five-item World Health Organization Wellbeing Index and EO Questionnaire-5. Multivariable logistic regressions were performed.A total of 1865 adults participated in the study. Depression and EO were reported by 57.6% and 49.3%, respectively, of the sample. When considering multivariable models, women, students, participants who smoked more/equal during lockdown, and individuals with EO were more likely to report depression. Following a healthier diet or exercising during lockdown reduced the probability of depression. The likelihood of EO was higher for participants who were female, consumed more food, had a less healthy diet, were overweight and obese, consumed more chocolate, consumed more snacks between meals or before going to sleep/during the night, and were at risk for depression. Increasing age, having a relationship, and not having increased television/computer watching time while eating reduced the odds of EO.QuarantEat highlighted high levels of depression and EO right after the end of pandemic lockdown measures, and outlined the importance of the relationships between mental health and health risk behaviors, such as smoking, exercise, diet, and changes in eating behaviors due to the pandemic lockdown. Planning interventions using a holistic approach and reaching every individual to overcome the limits caused by the restrictive lockdown measures is essential.

Background: Since the beginning of the coronavirus disease 2019 (COVID-19) outbreak, healthcare workers (HCWs) have been the workers most likely to contract the disease. Intensive focus is therefore needed on hospital strategies that minimize exposure and diffusion, confer protection and facilitate early detection and isolation of infected personnel. Methods: To evaluate the early impact of a structured risk-management for exposed COVID-19 HCWs and describe how their characteristics contributed to infection and diffusion. Socio-demographic and clinical data, aspects of the event-exposure (date, place, length and distance of exposure, use of PPE) and details of the contact person were collected. Findings: The 2411 HCWs reported 2924 COVID-19 contacts. Among 830 HCWs who were at ‘high or medium risk’, 80 tested positive (9.6%). Physicians (OR=2.03), and non-medical services resulted in an increased risk (OR=4.23). Patient care did not increase the risk but sharing the work environment did (OR=2.63). There was a significant time reduction between exposure and warning, exposure and test, and warning and test since protocol implementation. Hospital managers were the main source of infection due to the high number of interactions. Interpretation: A proactive system that includes prompt detection of contagious staff and identification of sources of exposure helps to lower the intra-hospital spread of infection. A speedier return to work of staff who would otherwise have had to self-isolate as a precautionary measure improves staff morale and patient care by reducing the stress imposed by excessive workloads arising from staff shortages. Funding Statement: This research was funded by University of Torino. Declaration of Interests: All the authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. Ethics Approval Statement: All data were anonymized, and the hospital directorate approved data collection and analysis. The research followed ethical principles for medical research involving human subjects expressed by the Declaration of Helsinki.

Alexithymia, difficulties in facial emotion recognition, poor socio-relational skills are typical of anorexia nervosa (AN). We assessed patients with AN and healthy controls (HCs) with mixed stimuli: questionnaires (Toronto Alexithymia Scale-TAS, Interpersonal Reactivity Index-IRI), photographs (Facial Emotion Identification Test-FEIT) and dynamic images (The Awareness of Social Inference Test-TASIT). TAS and IRI Personal Distress (PD) were higher in AN than HCs. Few or no differences emerged at the FEIT and TASIT, respectively. Larger effect sizes were found for the TAS results. Despite higher levels of alexithymia, patients with AN seem to properly acknowledge others' emotions while being inhibited in the expression of their own.

Background Aortic aneurysm repair is a resolutive and effective surgical operation, which can be associated with severe postoperative complications. Procalcitonin (PCT) in clinical practice could play a role in early diagnosis and monitoring of therapy for complications, especially infections, making for timely and more effective interventions. Our aim was to investigate whether PCT could be a predictive marker in early diagnosis of infectious complications after open abdominal aortic surgery. Methods Eighty-three consecutive patients who underwent elective open aortic repair at our institution were enrolled. Blood samples were taken before surgery, and each day over the 7-day postoperative period, and measurement of serum PCT, C-reactive protein (CRP), and leukocytes levels were carried out. Data regarding clinical progress, instrumental examinations, and blood chemistry were prospectively collected. Results Postoperative infectious complications occurred in 24 patients. Within 30 days, 1 death occurred. In the study sample, we found a significant difference in PCT curves of patients with and without infectious complications, especially on third postoperative day (POD; P = 0.004). On analysis of the area under the curve (AUC curve), PCT was shown to be a fair predictor in distinguishing cases with infectious complications (AUC, 0.765 on third POD; CI, 0.638–0.877). Conversely, other inflammatory markers commonly used (leucocytes and CRP) had similar trends in patients with and without postoperative infections. Conclusions On the basis of the results collected in this pilot study, despite some limitations, PCT could be considered a better marker of infectious complications after open abdominal aortic repair, when compared with other routinely used parameters.

Since the new millennium, the number of e-health users has significantly increased. Among these, a particular category of people who are interested by this phenomenon is the one of pregnant women. The aim of the present study is to assess the sociodemographic and geographic differences existing in a sample of Italian pregnant women who search for information on the web.Multicenter cross-sectional survey.The present study has been conducted from November 2011 to September 2012, in seven Italian cities, located in the North, in the Centre and in the South of Italy. Data were collected through an anonymous questionnaire, administered in waiting rooms of outpatient departments by trained medical doctors. Data were analysed through multivariate logistic regression models.Overall, 1347 responders were interviewed. Eighty-six percent of them declared to surf the internet to retrieve pregnancy-related information. The most searched topics were fetal development (51.3%), healthy lifestyle during pregnancy (48.7%), physiology of pregnancy (39.8%), generic and specific tips/advices during pregnancy (37.2%) and lactation (36.8%). Statistically significant differences (P 0.05) according to geographic origin, age and educational level were found with regard to the most frequently searched information on the Web, the reasons that pushed pregnant women to practice e-health, and the possibility to change lifestyles after e-health.Our findings suggest that the phenomenon of pregnancy e-health is widespread and show social and geographic differences, in particular about city of residence, age and educational level. It might encourage healthcare professionals to be more available and exhaustive during routine visits and to be more careful about web content on this topic, also addressing the different needs into different geographic contexts.

The aim of this study was to evaluate the incidence of acute kidney injury (AKI) after open and endovascular abdominal aortic aneurysm repair according to the Aneurysm Renal Injury Score classification.We retrospectively evaluated 431 patients undergoing elective open aortic repair (OAR; n = 285) or endovascular repair (n = 146) for infrarenal aortic aneurysm. All data regarding preoperative and postoperative serum creatinine concentrations and postoperative outcomes were assessed. Univariate and multivariate logistic regression models investigated the association between AKI and different risk factors and complications.The incidence of AKI was significantly higher after OAR (26.3% vs 5.5%; P .001). A significant share of patients who experienced AKI were restored to preoperative renal function at discharge (62.5% vs 77.5% in the endovascular and OAR groups, respectively; P = .37). Preoperative serum creatinine concentration was significantly higher in those patients who further developed AKI (1.25 vs 1.04 mg/dL; P .001). At the multivariate analysis, AKI was significantly associated with current smoking (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.19-3.52; P = .01), hypertension (OR, 2.46; 95% CI, 1.21-4.3; P = .01), chronic renal disease (OR, 2.53; 95% CI, 1.42-4.53; P .001), OAR (OR, 7.3; 95% CI, 3.25-16.42; P .001), and arrhythmias (OR, 3.16; 95% CI, 1.09-9.13; P = .03). AKI stage did not affect postoperative outcomes, except for a longer hospital stay in patients in stage 2 and stage 3 compared with stage 1.AKI is a common but often reversible complication, especially after OAR. There is an urgent need of a common classification for AKI after aortic surgery. New diagnostic markers for AKI should be evaluated in large-scale studies to assess their reliability.