Background During the intensive care units’ (ICUs) reorganization that was forced by the COVID-19 emergency, attention to traditional infection control measures may have been reduced. Nevertheless, evidence on the effect of the COVID-19 pandemic on healthcare-associated infections (HAIs) is still limited and mixed. In this study, we estimated the pandemic impact on HAI incidence and investigated the HAI type occurring in COVID-19 patients. Methods Patients admitted to the main ICU of the Umberto I teaching hospital of Rome from March 1st and April 4th 2020 were compared with patients hospitalized in 2019. We assessed the association of risk factors and time-to-first event through multivariable Fine and Grey’s regression models, that consider the competitive risk of death on the development of HAI (Model 1) or device related-HAI (dr-HAI, Model 2) and provide estimates of the sub-distribution hazard ratio (SHR) and its associated confidence interval (CI). A subgroup analysis was performed on the 2020 cohort. Results Data from 104 patients were retrieved. Overall, 59 HAIs were recorded, 32 of which occurred in the COVID-19 group. Patients admitted in 2020 were found to be positively associated with both HAI and dr-HAI onset (SHR: 2.66, 95% CI 1.31–5.38, and SHR: 10.0, 95% CI 1.84–54.41, respectively). Despite being not confirmed at the multivariable analysis, a greater proportion of dr-HAIs seemed to occur in COVID-19 patients, especially ventilator-associated pneumonia, and catheter-related urinary tract infections. Conclusions We observed an increase in the incidence of patients with HAIs, especially dr-HAIs, mainly sustained by COVID-19 patients. A greater susceptibility of these patients to device-related infections was hypothesized, but further studies are needed.

Mindfulness-based interventions have emerged as unique approaches for addressing a range of clinical and subclinical difficulties such as stress, chronic pain, anxiety, or recurrent depression. Moreover, there is strong evidence about the positive effects of yoga practice on stress management and prevention of burnout among healthcare workers. The aim of this study was to conduct a single-arm clinical trial to assess the effectiveness of an intervention based on mindfulness-based stress reduction and yoga in improving healthcare workers' quality of life. Healthcare workers of two hospitals in Rome were enrolled in a 4-week yoga and mindfulness course. Four questionnaires were administered at different times (Short Form-12 (SF-12), State-Trait Anxiety Inventory (STAI) Y1 and Y2, and Positive and Negative Affect Schedule (PANAS)) to evaluate the efficacy of the intervention. Forty participants took part to the study (83.3 %). The Mental Composite Score-12, that is part of the quality of life assessment, passed from a median of 43.5 preintervention to 48.1 postintervention (p = 0.041), and the negative affect passed from a score of 16 in the preintervention to 10 in the postintervention (p < 0.001). Both the forms of the STAI questionnaires showed a decrease after the intervention. Yoga and mindfulness administered together seem to be effective to reduce stress and anxiety in healthcare workers, providing them with more consciousness and ability to manage work stressful demands.anxiety, or recurrent depression [1-3]. Mindfulness can be described as a moment-to-moment awareness that is cultivated by purposefully paying attention to the present experience with a nonjudgmental attitude. It can be implemented through structured programs, including group and individual mental training, and is generally considered to entail the two core components of attention and acceptance [4]. More in details, mindfulness consists of formal meditation exercises (e.g., paying attention to the body, lying on the ground, or walking slowly with a sense of awareness of one's surroundings) as well as informal exercises (e.g., paying full attention to what one is doing or experiencing at a certain moment) [5]. Moreover, adaptive changes in brain functioning and structure (functional and neural plasticity) related to mindfulness training have been reported in several neuroscientific studies [6,7]. MBIs were initially developed for clinical contexts, but several studies have demonstrated that these interventions improve cognitive performance and emotional reactivity also in nonclinical populations [8,9]. Other studies have shown the effectiveness of MBIs for stress reduction and the enhancement of well-being within the workplace setting [10,11]. Finally, several cross-sectional studies provide indirect evidence that regular mindfulness practice may counteract cognitive ageing, which is indicated by preserved performance in various cognitive tasks as well as preserved neural tissue in older meditators compared to age-matched individuals [12,13]....

Several studies show the positive effects of new non-medical therapies known as complementary and alternative medicines (CAMs). In this context, the discipline of tai chi is obtaining a wider consensus because of its many beneficial effects both on the human body and mind. The aim of this study was to perform a systematic review of the scientific literature concerning the relationship between tai chi practice and wellness of health care workers (HCW) in their professional setting. The research was performed in September 2019, investigating the databases Cinahl, Scopus, Web of Science, and PubMed. Full-text articles, written in English language and published after 1995, were taken into account. No restrictions regarding the study design were applied. A quality assessment was developed using AMSTAR, Jadad, Newcastle–Ottawa Scale, INSA, and CASE REPORT scale. Six papers were finally included: Three clinical trials, one observational study, one systematic review, and one case report. The methodological quality of the included studies was judged as medium level. In conclusion, this systematic review suggests the potential impact of interventions such as tai chi as tools for reducing work-related stress among healthcare professionals. Further research will be needed in order to gain robust evidence of its efficacy.

Evidence suggests that physical activity (PA) influences the human gut microbiota composition, but its role is unclear because of dietary interference. The aim of this review is to clarify this issue from this new perspective in healthy individuals. Articles analyzing intestinal microbiota from fecal samples by 16S rRNA amplicon sequencing were selected by searching the electronic databases PubMed, Scopus, and Web of Science until December 2020. For each study, methodological quality was assessed, and results about microbiota biodiversity indices, phylum and genus composition, and information on PA and diet were considered. From 997 potentially relevant articles, 10 met the inclusion criteria and were analyzed. Five studies involved athletes, three were performed on active people classified on the basis of habitual PA level, and two among sedentary subjects undergoing exercise interventions. The majority of the studies reported higher variability and prevalence of the phylum Firmicutes (genera Ruminococcaceae or Fecalibacteria) in active compared to inactive individuals, especially in athletes. The assessment of diet as a possible confounder of PA/exercise effects was completed only in four studies. They reported a similar abundance of Lachnospiraceae, Paraprevotellaceae, Ruminococcaceae, and Veillonellaceae, which are involved in metabolic, protective, structural, and histological functions. Further studies are needed to confirm these findings.

Background: Many patients admitted to a Department of Internal Medicine have different degrees of heart and kidney dysfunction. Mortality, morbidity and cost of care greatly increase when cardiac and renal diseases coexist. Methods: A retrospective cohort study was conducted on 1,087 patients admitted from December 2009 to December 2012 to evaluate the prevalence of the cardiorenal syndrome (CRS) and clinical features. Results: Out of 1,087 patients discharged from our unit during the study period, 190 (17.5%) were diagnosed as having CRS and classified into five types. CRS was more common in males (68.9%). CRS type 1 was associated with higher age (79.9 ± 8.9 years) and accounted for 61.5% of all deaths (p < 0.001), representing a risk factor for mortality (OR 4.23, 95% CI 1.8-10). Congestive heart failure was significantly different among the five CRS types (p < 0.0001) with a greater frequency in type 1 patients. Infectious diseases were more frequent in CRS types 1, 3 and 5 (p < 0.05). Pneumonia presented a statistically higher frequency in CRS types 1 and 5 compared to other classes (p < 0.01), and community-acquired infections were statistically more frequent in CRS types 1 and 5 (p < 0.05). The distribution of community-acquired pneumonia was different among the classes (p < 0.01) with a higher frequency in CRS types 1, 3 and 5. Conclusion: CRS is a condition that is more frequently observed in the clinical practice. The identification of predisposing trigger factors, such as infectious diseases, particularly in the elderly, plays a key role in reducing morbidity and mortality. An early recognition can be useful to optimize therapy, encourage a multidisciplinary approach and prevent complications.