Background: Extreme weather events due to human activities have significantly increased the frequency and severity of hydrological disasters like floods, impacting human health and healthcare systems worldwide. This study analyses the patterns of emergency service utilisation of the May 2023 flood in Romagna, Italy, and specifically investigates the differences in emergency department (ED) visits and mortality between individuals exposed and not exposed to the flood.
Methods: A retrospective cohort study was conducted including 813 724 citizens of Romagna, Italy, from 15 May to 31 August 2023 (ie, 14 weeks after flood inception).
Physical activity highly impacts the neuroendocrine system and hormonal secretion. Numerous variables, both those related to the individual, including genetics, age, sex, biological rhythms, nutritional status, level of training, intake of drugs or supplements, and previous or current pathologies, and those related to the physical activity in terms of type, intensity, and duration of exercise, or environmental conditions can shape the hormonal response to physical exercise. The aim of this review is to provide an overview of the effects of physical exercise on hormonal levels in the human body, focusing on changes in concentrations of hormones such as cortisol, testosterone, and insulin in response to different types and intensities of physical activity.
View Article and Find Full Text PDFIntroduction: Disease-modifying therapies (DMTs) have been shown to improve disease outcomes in multiple sclerosis (MS) patients. They may also impair the immune response to vaccines, including the SARS-CoV-2 vaccine. However, available data on both the intrinsic immune effects of DMTs and their influence on cellular response to the SARS-CoV-2 vaccine are still incomplete.
View Article and Find Full Text PDFIntern Emerg Med
April 2024
Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disorder characterized by flares-ups/remissions with a complex clinical picture related to disease severity and organ/tissue injury, which, if left untreated, may result in permanent damage. Enhanced fatigue and pain perception, worsened quality of life (QoL) and outcome are constant, albeit symptoms may differ. An aberrant SLE immunoprofiling, note as "interferon (IFN)α-signature", is acknowledged to break immunotolerance.
View Article and Find Full Text PDFScience
December 2022
Despite much progress in training artificial intelligence (AI) systems to imitate human language, building agents that use language to communicate intentionally with humans in interactive environments remains a major challenge. We introduce Cicero, the first AI agent to achieve human-level performance in , a strategy game involving both cooperation and competition that emphasizes natural language negotiation and tactical coordination between seven players. Cicero integrates a language model with planning and reinforcement learning algorithms by inferring players' beliefs and intentions from its conversations and generating dialogue in pursuit of its plans.
View Article and Find Full Text PDFIntern Emerg Med
January 2023
We assessed long-term mortality and its association with chronic alcohol-related diseases in patients admitted to the emergency department (ED) because of acute alcoholic intoxication (AAI). A retrospective cohort study was performed at the ED of Sant'Orsola-Malpighi Hospital, Bologna, Italy. 3304 patients, corresponding to 6415 admissions for AAI, who accessed the ED from January 1, 2005, to December 31, 2017, were studied.
View Article and Find Full Text PDFMonitoring immune responses to SARS-CoV-2 vaccination and its clinical efficacy over time in Multiple Sclerosis (MS) patients treated with disease-modifying therapies (DMTs) help to establish the optimal strategies to ensure adequate COVID-19 protection without compromising disease control offered by DMTs. Following our previous observations on the humoral response one month after two doses of BNT162b2 vaccine (T1) in MS patients differently treated, here we present a cross-sectional and longitudinal follow-up analysis six months following vaccination (T2, n=662) and one month following the first booster (T3, n=185). Consistent with results at T1, humoral responses were decreased in MS patients treated with fingolimod and anti-CD20 therapies compared with untreated patients also at the time points considered here (T2 and T3).
View Article and Find Full Text PDFBackground: Freezing of Gait (FOG) is one of the most disabling motor complications of Parkinson's disease, and consists of an episodic inability to move forward, despite the intention to walk. FOG increases the risk of falls and reduces the quality of life of patients and their caregivers. The phenomenon is difficult to appreciate during outpatients visits; hence, its automatic recognition is of great clinical importance.
View Article and Find Full Text PDFThis commentary elaborates on different methodological aspects complicating the interpretation of epidemiological data related to the current COVID-19 pandemic, thus preventing reliable within and across-country estimates. Firstly, an inaccuracy of epidemiological data maybe arguably be attributed to passive surveillance, a relatively long incubation period during which infected individuals can still shed high loads of virus into the surrounding environment and the very high proportion of cases not even developing signs and/or symptoms of COVID-19. The latter is also the major reason for the inappropriateness of the abused "wave" wording, which gives the idea that health system starts from scratch to respond between "peaks".
View Article and Find Full Text PDFThe design of efficient combination therapies is a difficult key challenge in the treatment of complex diseases such as cancers. The large heterogeneity of cancers and the large number of available drugs renders exhaustive in vivo or even in vitro investigation of possible treatments impractical. In recent years, sophisticated mechanistic, ordinary differential equation-based pathways models that can predict treatment responses at a molecular level have been developed.
View Article and Find Full Text PDFA 3-year analysis released in August 2021 by the WHO indicated that more than 700 healthcare workers and patients have died (2,000 injured) as a result of attacks against health facilities since 2017. The COVID-19 pandemic has made the risks even worse for doctors, nurses, and support staff, unfortunately. According to the latest figures from the International Committee of the Red Cross, 848 COVID-19-related violent incidents were recorded in 2020, and this is likely an underrepresentation of a much more widespread phenomenon.
View Article and Find Full Text PDFIntroduction And Aim: As first receivers of suspected coronavirus disease 2019 (COVID-19) patients, clinicians of the Emergency Department (ED) have to rapidly perform the first clinical assessment evaluating the intensity of care needed. So far, clear management guidelines still lack. We identified variables associated with hospitalization in order to give a quick tool to assist clinicians in stratifying cases based on the severity at their arrival at the ED and in predicting the need for hospital care.
View Article and Find Full Text PDFBackground: Evidence is lacking about the impact of subsequent COVID-19 pandemic waves on Emergency Departments (ED). We analyzed the differences in patterns of ED visits in Italy during the two pandemic waves, focusing on changes in accesses for acute and chronic diseases.
Methods: We conducted a retrospective study using data from a metropolitan area in northern Italy that includes twelve ED.
The COVID-19 pandemic forced healthcare services organization to adjust to mutating healthcare needs. Not exhaustive data are available on the consequences of this on non-COVID-19 patients. The aim of this study was to assess the impact of the pandemic on non-COVID-19 patients living in a one-million inhabitants' area in Northern Italy (Bologna Metropolitan Area-BMA), analyzing time trends of Emergency Department (ED) visits, hospitalizations and mortality.
View Article and Find Full Text PDFDisaster Med Public Health Prep
August 2020