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Background Psoriatic Arthritis (PsA) is a chronic inflammatory form of Arthritis associated with enthesitis, dactylitis, nail dystrophy, uveitis, and osteitis. PsA is strongly associated with comorbidities such as obesity, metabolic syndrome, and cardiovascular disease. As usual PsA patients are assessed either by rheumatologist or dermatologist but a multiprofessional assessment for those subjects is important to improve their disease control and their quality-of-life. The multidimensional assessment is a new model of care for PsA patients in which a multiprofessional team (rheumatologist, dermatologist, internal medicine physician, nutritionist and a phycologist) with a nurse as case manager, assess patients in the main domains of PsA from the admission to the follow-up. Different validated tools are used by the team to assess different patients’ dimension as patient-reported-outcomes. This study aimed to evaluate the association between and among clinical variables and Patient-Reported Outcomes in a realworld sample of PsA patients evaluated according the Multidimensional Assessment. Methods A cross-sectional study was conducted. Patients with PsA who signed the informed consent were enrolled at the PsA clinic at the ARNAS Civico in Palermo (Italy) from March 2018 to October 2020. Clinical, pharmacological, anthropometric, laboratory variables, and patientreported outcomes were evaluated, including: • Health Assessment Questionnaire (HAQ); • Facit-Fatigue (FACIT-F); • Psoriatic Arthritis Impact of Disease Questionnaire (PsAID); • Patient Health Questionnaire-9 (PHQ-9); • Disease Activity in PSoriatic Arthritis score (Dapsa); • Patient global assessment (PGA) STATA 14.1 was used to perform logistic analysis. Results According to CASPAR Criteria, 158 patients aged 55.2 (53.3 – 57.1) affected by Psoriatic Arthritis were included in the study. All the collected variables were evaluated ad a strong association was observed between functional disability measured by HAQ >2 and central obesity [OR (95% CI) 16.94 (2.22 - 129.48); p < 0.004]. Moreover, data analysis showed an association between high impact of disease on life (PsAID >4) and central obesity [OR (95% CI) 3.33 (1.56 - 7.13); p

Diabetes mellitus (DM) is one of the fastest-growing health emergencies of the 21st century, and one of the chronic diseases with the highest socio-economic impact on health care systems. DM is the main cause of chronic kidney disease, and is associated with a significant increase in cardiovascular risk and clinical and care complexity. The presence of a constellation of cardiac, metabolic, and renal diseases, in a complex patient with DM, constitutes the CardioRenal Metabolic Syndrome (CRMS). The management of these patients should include a paradigm shift from a reactive strategy to a proactive approach, and the integration of territorial, hospital and social assistance services according to the Chronic Care Model (CCM). Complexity science suggests an alternative model in which disease and health arise from complex, dynamic, and unique interactions among the different components of the overall system. The hospital should be viewed as a highly specialized hub of the chronic care system, which interacts with the outpatient specialist and primary care. In order to create effective communication among territorial care units and highly specialized hospitals, levels of clinical complexity are here proposed and included in a multidimensional management model for the complex patient with diabetes and cardiorenal comorbidity.

More than one year has passed since the first cases of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome (SARS)-CoV-2 coronavirus were reported in Wuhan (China), rapidly evolving into a global pandemic. This infectious disease has become a major public health challenge in the world. Unfortunately, to date, no specific antivirals have been proven to be effective against COVID-19, and although a few vaccines are available, the mortality rate is not decreasing but is still increasing. One therapeutic strategy has been focused on infection prevention and control measures. In this regard, the use of nutraceutical supports may play a role against some aspect of the infection, particularly the inflammatory state and the immune system function of patients, thus representing a strategy to control the worst outcomes of this pandemic. For this reason, we performed an overview including meta-analyses and systematic reviews to assess the association among melatonin, vitamin C, vitamin D, zinc supplementation and inflammatory markers using three databases, namely, MEDLINE, PubMed Central and the Cochrane Library of Systematic Reviews. According to the evidence available, an intake of 50,000 IU/month of vitamin D showed efficacy in CRP. An amount of 1 to 2 g per day of vitamin C demonstrated efficacy both in CRP and endothelial function, and a dosage of melatonin ranging from 5 to 25 mg /day showed good evidence of efficacy in CRP, TNF and IL6. A dose of 50 mg/day of elemental zinc supplementation showed positive results in CRP. Based on the data reported in this review, the public health system could consider whether it is possible to supplement the current limited preventive measures through targeted nutraceutical large-scale administration.

A rigorous health technology assessment is necessary to evaluate a new technology. However, healthcare regulatory agencies have less restrictive rules about medical devices, despite some recent warnings about this relevant matter. The evaluation should have at least two key issues, which require attention. The first one is its effectiveness, and the second one is its economic sustainability. In this paper, we deal with a novel glucose-sensing technology as a case study to examine the matter in depth. An evidence-based point of view is used to highlight this important issue.