Grantobrien8511

Schools' closure during covid-19 pandemic implemented almost all over the world, together with social distances measures and lockdown to reduce transmission, could have had negative impact on youths' health.

Summarize the most relevant data from a literature systematic review on the impact on youths' physical health of the 2020 school closure and social distances measures implemented in response to covid-19 pandemic.

Authors of the original review searched on 11 international databases up to 1st September 2020 to retrieve cohort studies, cross sectional surveys, uncontrolled pre-post studies and modelling studies. Methodological quality has been assessed with validated checklists.

Forty-two studies reporting the impact on physical health have been finally included. They have been conducted in 14 countries, most of which in Italy (30.9%) and UK (30.9%). The majority were cohort studies (40.5%) and the overall methodological quality, irrespective of study designs, was high for the 71.4% of the studies. Fingolimod order should be taken into account by implementing policies to safeguard their health.The therapeutic and rehabilitative use of neurotechnologies against disabling diseases for which common treatments are partially or completely ineffective is developing more and more rapidly. Projects for the installation of brain-computer interfaces capable of enhancing perceptions, saving memories, amplifying and canceling them selectively are now a reality. The mental domain, which has always been considered the private sphere par excellence, the last territory inaccessible even to the rampant intrusiveness of "datism", is in serious danger. The ethical implications of such possible derives are not addressable by existing protections and rules. New specific rights are needed for the neural domain, real neuro rights, to define and realize the extent of change, one of the greatest challenges of our time, in an ethically and socially shareable way, in order not to allow violating the last bulwark of the subjective identity of humanity, the mental privacy.The Italian Medicines Agency has started, since the first months of 2020, a monitoring of drug use during the covid-19 pandemic. This made it possible to identify specific trends in hospital and local purchases, such as the extensive use of off-label drugs with little evidence of efficacy during the first weeks of the epidemic, and to progressively assess the degree of implementation of regulatory and ministerial recommendations.Fin dalle prime fasi dell'emergenza covid-19 è emersa per l'Agenzia Italiana del Farmaco (AIFA) la necessità di monitorare in modo specifico l'uso dei farmaci utilizzati nel corso dell'epidemia. È infatti fondamentale, in un contesto caratterizzato da grande incertezza e da continui aggiornamenti delle linee guida, disporre di informazioni utili a una corretta lettura e interpretazione dei dati. È stato quindi realizzato un primo rapporto dell'Osservatorio Nazionale sull'Impiego dei Medicinali (OsMed) sull'uso dei farmaci utilizzati, a livello ospedaliero e territoriale, nella fase iniziale dell'epidemia1. Questo metteva a confronto i consumi relativi al periodo compreso tra marzo a maggio del 2020 con quelli del trimestre immediatamente precedente, da dicembre 2019 a febbraio 2020. In seguito, il 4 marzo 2021, è stato pubblicato un aggiornamento dei dati in riferimento alle fasi successive dell'epidemia2. Il monitoraggio ha preso in considerazione diverse categorie di farmaci, andando a valutare le oscillazioni negli acquisti in riferimento al progressivo aggiornamento degli indirizzi regolatori. I volumi osservati per ciascun farmaco sono stati standardizzati per 10.000 abitanti/die, andando a valutare le differenze pre- e post-covid-19 in termini di differenza assoluta, differenza percentuale e di p-value (p).Long covid syndrome is increasingly studied and debated. link2 The number of scientific publications is growing and groups and associations of patients affected by the syndrome are increasingly active. link3 There is concern that international attention to this syndrome could lead to an excess of diagnostic procedures and unnecessary medical interventions. On the other hand, we have a robust body of evidence of a constellation of symptoms and ailments suffered by patients recovered from covid-19. Tackling this problem therefore means tackling coexistence with covid-19 in the long term, annexing this pathology in a chronic perspective. The collection and analysis of data, therefore, could already allow a stratification of populations at risk, putting social and services in a position to respond adequately to the demand for assistance that is expected to be received by a very large number of patients. But it is essential that real-world evidence goes hand in hand with the selection, analysis and interpretation of information collected in administrative databases, disease registers and databases developed by universities and institutions to promote public health truly personalized.The direct impact of covid-19 on the health of children and adolescents has not been very strong. Nevertheless, children and adolescents have suffered the consequences of health policies aimed at guaranteeing social distancing from limitations to mobility to the interruption of face-to-face teaching activities. High levels of stress can influence the psychophysical development of children and adolescents, especially in low-income families. With regard to the most affected children and adolescents, rehabilitation must consist in the reconstruction of daily life we cannot abolish poverty or pandemics, but it is necessary to prevent and understand the needs of vulnerable people. The strictly health dimension of the doctor's work must be linked to social interventions towards the people most at risk, implementing a sort of "gentle revolution" capable of concretely intervening at the level of families, schools and local contexts.

Schizophrenia is a very disabling condition that may result in a significant impairment of individual, professional and social adjustments. Antipsychotics (APs) are the first-line treatment for schizophrenia that may modify the course of the disease in most cases, by decreasing the institutionalization risk, although they may induce severe side effects. It is worth noting that APs may well control positive symptoms, while their efficacy on negative and cognitive symptoms is low. Cariprazine is one of the latest third-generation APs acting as a partial agonist at dopamine receptor of the type 2 and 3 with a broader spectrum of activities, recently approved for the treatment of adult schizophrenia.

The aim of this paper was to review and comment on the available literature on the effectiveness and tolerability of cariprazine in schizophrenia, with a main focus on possibly specific symptoms, as well as in those peculiar patients' populations that could mostly benefit from this latest AP, when compared with por schizophrenic spectrum disorders.Antipsychotic drugs represent a fundamental aid for the treatment of schizophrenia and other psychiatric disorders. However, the definition of antipsychotics includes molecules that are extremely heterogeneous when considering their mechanism of action and the clinical implications. While in the first part of this review the major critical issues in the treatment of schizophrenia will be highlighted, the attention will then focus on the major pharmacological 'innovation' in recent years, which is represented by the development of partial agonists for the D2 and D3 receptors, a strategy that may guarantee a 'stabilization' of impaired dopaminergic function in the schizophrenic patient. One such drug is cariprazine that differs from other molecules due to its greater affinity for the dopaminergic D3 receptor. Next, it will be described receptor and functional mechanisms that characterize the action of cariprazine, both with respect to other partial agonists as well as with respect to second-generation antipsychotics. More specifically, it will be highlighted the peculiarities of cariprazine and how these mechanisms could modify the functionality of specific brain circuits associated with major functional domains that are altered in schizophrenia. The activity of partial agonist at dopaminergic D3 receptors, which is dominant as compared to other receptor mechanisms, represents the mechanism that is most likely associated with the improvement of negative symptoms and of specific components such as motivational deficits. Furthermore, this mechanism together with the binding to other receptors is also compatible with a positive effect on cognitive deficits, often associated with reduced functionality of the prefrontal cortex, as well as in the substance abuse, a relevant problem of co-morbidity with schizophrenia.Clostridioides difficile infection occurs when the bacterium produces toxin that causes diarrhea and inflammation of the colon. These guidelines indicate the preferred approach to the management of adults with C. difficile infection and represent the official practice recommendations of the American College of Gastroenterology. The scientific evidence for these guidelines was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation process. In instances where the evidence was not appropriate for Grading of Recommendations Assessment, Development, and Evaluation but there was consensus of significant clinical merit, key concept statements were developed using expert consensus. These guidelines are meant to be broadly applicable and should be viewed as the preferred, but not the only, approach to clinical scenarios.

Patients with disorders of gut-brain interaction (DGBIs) are high users of health care. Past studies exploring predictors of utilization have lacked patient-level clinical data. The aim of the current study is to identify demographic, clinical, and psychological predictors of health care utilization in patients with irritable bowel syndrome (IBS), functional constipation (FC), and functional diarrhea (FDr).

Consecutive new patients diagnosed with IBS, FC, and FDr (using Rome IV criteria) completed questionnaires assessing health care utilization as well as clinical and psychological symptoms. Health care utilization was assessed using a 13-item measure inquiring about the previous 6 months. Patient-Reported Outcome Measures Information System (PROMIS) was used to assess severity of abdominal pain, constipation, diarrhea, anxiety, depression, and sleep disturbance.

Of the 507 patients diagnosed with IBS, FC, or FDr, 434 completed the health care utilization questionnaire (mean age of 44 years, 79.5% female, and 73.5% IBS). In the final multivariable models, more severe abdominal pain and higher depression scores were significantly associated with increased utilization of (i) total outpatient visits, (ii) outpatient visits for gastrointestinal (GI) symptoms, and (iii) number of medications for GI symptoms. More severe abdominal pain was also significantly predictive of GI-related emergency department visits. Altered bowel habits were not consistent predictors of health care utilization.

Severity of abdominal pain and depressive symptoms, but not bowel habits, is a primary driver of increased care-seeking behavior in patients with IBS, FC, and FDr.

Severity of abdominal pain and depressive symptoms, but not bowel habits, is a primary driver of increased care-seeking behavior in patients with IBS, FC, and FDr.