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  1. Article ; Online: The effects of the COVID-19 pandemic on the use of the performance-enhancing drugs.

    Negro, Francesca / Di Trana, Annagiulia / Marinelli, Susanna

    Acta bio-medica : Atenei Parmensis

    2022  Volume 92, Issue 6, Page(s) e2021401

    Abstract: The coronavirus disease (COVID-19) pandemic has been impacting the whole society in every aspect of the daily life, comprising the sport field. Several restrictive strategies have been implemented by governments in an effort to stem the spread of the ... ...

    Abstract The coronavirus disease (COVID-19) pandemic has been impacting the whole society in every aspect of the daily life, comprising the sport field. Several restrictive strategies have been implemented by governments in an effort to stem the spread of the disease and salvage public health. Such efforts have severely constrained access to non-essential services, leading to the closure of non-essential points of gathering and business and the enforcement of rigorous social distancing and prolonged lockdowns, in addition to masking and stay-at-home mandates. However necessary, there is no denying that such extremely rigorous, and to most people unprecedented, measures have adversely affected the global economy and the daily lives of everyone of us, including professional and amateur athletes (1). The most important sport events were postponed or cancelled, including the 2020 Tokyo Olympic Games. But how was the phenomenon of performance-enhancing drug (PED) use impacted and how was the most concerning issue affecting the integrity of sport affected by the pandemic control restrictions? The World Anti-doping Agency (WADA) was established in 1999, whereas its code was implemented in 2004 in order to articulate and enforce doping control initiatives and provide educational strategies aimed at preventing PED use (2). Nonetheless, it is worth noting that the prevalence of PED use among athletes is mostly unchanged since the foundation of WADA. Unfortunately, the use of the performance-enhancing drugs is not limited to athletic performances, but it concerns other settings as well. Nowadays, several strategies for doping control are adopted such as education, deterrence, detection, enforcement and rule of law (3), but the most important anti-dissemination strategy is constituted by information campaigns, especially addressed to youngsters, meant to raise awareness as to the serious health risks involved in PED use. Currently, the primary drivers of anabolic androgenic steroids (ASA) use are 1) the determination to improve performances and prevail no matter what the cost may be; 2) the economic benefits, popularity and fame; 3) greater stamina and resistance. This public health issue has raised particular concerns due to the recent ASA market developments, which is somewhat similar to the illicit market of narcotic drugs. Moreover, it has to be considered that the higher stress and psychosocial condition related to pandemic social restrictions has fueled and exacerbated substance use disorders (4). The prevalence of doping in sport causes unfairness and damages the very fabric of our society, especially insofar as it involves children and young adults who look up to athletes as role models. In this concern, the impact of the COVD-19 pandemic may have led to substantial modifications in substance use patterns and an increased risk of substitution, adulteration, contamination, and dilution with a potentially harmful substance (5, 6). During the COVID-19 lockdown, WADA and stakeholders suspended or scaled down doping control programs, testing and other activities. As a consequence, athletes have seen the unexpected opportunity to misuse AAS without the possible risk of testing positive (7). This has been controversial, considering the measures taken by governments to flatten the pandemic curve in order to safeguard public health. Indeed, all the technologies implemented for teleworking, such as teaching students on-line, telehealth applications, prescriptions and referrals, and treating patients in hospitals/care homes via video links can also be applied to enhance and uphold sport integrity. Conversely, anti-doping testing for professional competitive athletes has increased, due to the lockdown raising suspicion about doping opportunities. The U.S. Anti-doping Agency has put in place novel measures to combat the lack of anti-doping testing during the pandemic: these include a "in-home self-test" that requires athletes to provide urine and small blood samples at home to be tested in the anti-doping laboratory, under supervision provided by video-conference (8). As such, reports from forensic science and toxicology laboratories are crucial for the early detection and response to such events. Furthermore, toxicology laboratories should assure their continue effort in providing new methods and technologies designed to tackle the consumption of illicit substances and to monitor the constantly changing illegal drug markets (9). The most recent WADA code revision has certainly brought about important progress in the ongoing fight against PED abuse. Indeed, it has introduced the possibility to store the samples for 10 years after the first analysis, maintaining the same legal value if re-tested and use for prosecution purposes (10). In that regard, the prospect of re-testing the same sample with newly developed analytical methods based on innovative technologies may represent a strong deterrent for doping users, since anti-doping research rapidly evolves (6), largely by implementing the same approaches used to fight new psychoactive substances (NPS) use (11,12). It is worth noting that the NPS phenomenon bears several similarities with doping, especially due to the constant emergence of new substances and methods aimed at circumventing current legal restrictions. In Italy, the National Antidoping Organization (NADO-Italia) is in charge of guaranteeing compliance with WADA rules and the transposition of the List of Prohibited Substances and Methods. However, the gap between elite athletes and amateur athletes is still broad and unaddressed, since non-professional sport competitions are not adequately overseen, and neither are the competing athletes . This difference may give rise to an important public health issue, on account of the adverse effects of uncontrolled doping agents consumption. In this concern, the Italian anti-doping law created the "Section of the Technical Health Committee for Supervision and Control on Doping and for Health Protection in Sport Activities", that carries out, among its other tasks, the following activities on amateur sport: 1) updating each year the list of banned substances and practices, adapting it to the WADA list; 2) determining cases, criteria and methodologies for anti-doping controls; 3) promoting research projects and information/training campaigns meant to protect health in sports and tackle doping (13). In conclusion, regarding the highly complex dynamics triggered by the pandemic, new and unexpected challenges have come to the fore in the ongoing fight against substance abuse in its every aspect, such as NPS (14), ASA consumption by amateur athletes, or other substance abuse settings, e.g. driving under the influence of psychotropic substances (15). The current Italian antidoping approach for amateur athletes seems to be a promising strategy to bridge the gap between professional sports and amateur sports. Moreover, youngsters should be thoroughly educated as to the threats posed by such substances, so that they can realize how profoundly and severely drug abuse can affect not only their sport career, but their health and well-being overall.
    MeSH term(s) Athletes ; Athletic Performance ; COVID-19 ; Child ; Communicable Disease Control ; Humans ; Pandemics/prevention & control ; Performance-Enhancing Substances ; SARS-CoV-2
    Chemical Substances Performance-Enhancing Substances
    Language English
    Publishing date 2022-01-19
    Publishing country Italy
    Document type Letter
    ZDB-ID 2114240-3
    ISSN 2531-6745 ; 0392-4203
    ISSN (online) 2531-6745
    ISSN 0392-4203
    DOI 10.23750/abm.v92i6.12377
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: New Psychoactive Substances and receding COVID-19 pandemic: really going back to "normal"?

    Napoletano, Simona / Basile, Giuseppe / Lo Faro, Alfredo Fabrizio / Negro, Francesca

    Acta bio-medica : Atenei Parmensis

    2022  Volume 93, Issue 2, Page(s) e2022186

    Abstract: To the Editor, The ongoing rise of New Psychoactive Substances (NPS), i.e. psychotropic molecules devised and synthesized to replicate the effects of traditional drugs of abuse in order to circumvent banned substances schedules, has been posing a ... ...

    Abstract To the Editor, The ongoing rise of New Psychoactive Substances (NPS), i.e. psychotropic molecules devised and synthesized to replicate the effects of traditional drugs of abuse in order to circumvent banned substances schedules, has been posing a challenge of enormous magnitude to substance detection systems and law enforcement worldwide. Still, it would be remiss to ignore the role played by the unprecedented public health emergency relating to the COVID-19 pandemic in the exacerbation of the NPS crisis. The diversion of resources has in fact hindered conventional approaches to drug monitoring, surveillance, control, and public health responses. The dangerous path ahead in our struggle against NPS abuse is best exemplified by the rather recent emergence of isotonitazene, an analogue of a benzimidazole class of analgesic compounds, powerful synthetic opioid and full mu-opioid receptor agonist belonging to the 2-benzylbenzimidazole group of compounds, which comprises the structurally different clonitazene, metonitazene and etonitazene (1). Isonitazene has reportedly been detected on European markets in at least five different forms and could even supplant fentanyl derivatives (2). Currently available data on isonitazene-related abuse and fatalities seem to be emblematic of the volatile, elusive nature of NPS: deaths in which isotonitazene was involved in fact presented substantial differences from casualties arising from synthetic opioids abuse. Case reports have highlighted how flualprazolam was detected in most fatalities associated with isotonitazene whereas flualprazolam was involved in only 8% of other synthetic opioid overdose deaths (3). Rather than rising background use, such a finding seems to suggest likely co-use or co-distribution of flualprazolam and isotonitazene. The key element of polysubstance involvement is rife in synthetic opioid overdose deaths. That being said, significantly more substances were implicated in isotonitazene-related deaths than fatalities linked to other synthetic opioid overdose (4, 5). Such dynamics and mortality patterns further stress the urgency of expanding health services for those suffering from opioid addiction disorders. Fine-tuned and standardized detection mechanisms relying on specialized assays based on sensitive instrumentation are essential for the timely and accurate characterization of such novel synthetic opioids (6-8). Isotonitazene in fact cannot be detected by common fentanyl testing strips (9). Hence, the essential nature of clinical and toxicological cannot be overstated, if we are to effectively deal with the public health risks arising from new substances or classes, along with the healthcare and social costs thereof (10). As new substances appear on illicit markets and are detected, their distinctive traits can only be identified by user experience, in the early stages (11-13). Nonetheless, the pandemic scenario has brought about a profound alteration of substance abuse patterns, and opened up new avenues of supply and demand for which our surveillance/detection systems may not be fully prepared or well-suited. As the pandemic appears to recede and hopefully turn into an endemic context based on coexistence with the SARS-CoV-2 and its less harmful variants, it would be a mistake to take for granted that drug abuse/trafficking dynamics will also get back to where they were before the pandemic. Putting in place policies aimed at monitoring web-based platforms and social media can potentially constitute a valuable tool in terms of keeping in check emerging substances, given how during the COVID-19 pandemic many interactions between traffickers and buyers have moved online (14). After all, social media have been playing an increasingly relevant role as interacting platforms, which users and drug dealers can take advantage of in order to discuss drug prices, substance purity, distinctive traits of the "high" (i.e. desired drug effects) they are seeking, ways of taking the substances, dosages, and characteristics of any new NPS becoming available on such back-alley marketing channels (15). Softwares designed and specifically programmed to sift through and analyze all detectable online information in that regard may prove valuable to figure out evolving dynamics of trafficking, purchases and use. Probing social media users has proven effective tool for public health concerns, e.g. drug checking services which have been harnessed due to their harm reduction potential in places estimated to be at risk, with large crowds gathering (concerts, clubs and the like). Nonetheless, research efforts need to be directed towards the new realm of criminality, the "Dark Web", in which all sorts of illegal exchanges and interactions are known to take place. A 2020 study has highlighted the appalling risks for drug users who choose to pursue that option in order to buy drugs (16). Three dealers were selected on a specific "Dark Web" marketplace, and NPS were ordered through such a channel. All these exchanges were thoroughly documented, and an analysis was undertaken of all the substances thus bought, totaling nine samples, by NMR, HRMS, LC-UV, and two also by x-ray diffraction. It was ultimately concluded that four out of five substances bought had been labeled with NPS names that did not match the actual substance, and two out of three samples of substances sold as new (i.e. unscheduled) NPS were instead found to be already documented substances, mislabeled and peddled under false pretenses. Drug dealers were therefore either deceiving their clients or were unaware as to the actual substances which they were selling. In light of such extremely worrisome findings, it is not hard to understand the implications and the major public health risks that such new trends of trafficking and abuse may entail. It is therefore incumbent upon the scientific community and law enforcement agencies to adapt and strive to meet the new challenges brought by the new criminal ecosystems in terms of drug enforcement, first and foremost the impervious environment known as "Dark Web" relying on untraceable cryptocurrencies for illegal transactions.
    MeSH term(s) Analgesics, Opioid/adverse effects ; COVID-19 ; Ecosystem ; Fentanyl ; Humans ; Opiate Overdose ; Pandemics ; SARS-CoV-2
    Chemical Substances Analgesics, Opioid ; Fentanyl (UF599785JZ)
    Language English
    Publishing date 2022-05-11
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2114240-3
    ISSN 2531-6745 ; 0392-4203
    ISSN (online) 2531-6745
    ISSN 0392-4203
    DOI 10.23750/abm.v93i2.13008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Influence of choline chloride-based NADES on the composition of Myristica fragrans Houtt. essential oil

    Lanari, Daniela / Zadra, Claudia / Negro, Francesca / Njem, Rima / Marcotullio, Maria Carla

    Heliyon. 2022 May, v. 8, no. 5

    2022  

    Abstract: Natural deep eutectic solvents (NADES) have emerged as green extracting solvents in recent years. In this study, a variety of choline chloride (ChCl)-based natural deep eutectic solvents (NADES) were used as co-solvents for the hydrodistillation of ... ...

    Abstract Natural deep eutectic solvents (NADES) have emerged as green extracting solvents in recent years. In this study, a variety of choline chloride (ChCl)-based natural deep eutectic solvents (NADES) were used as co-solvents for the hydrodistillation of nutmeg with the aim to obtain M. fragrans essential oil (EO) in higher yield and with a lower content of toxic phenylpropenoids (e.g. myristicin and safrole). The influence of ChCl-based NADES as additives in the hydrodistillation process was studied. The results showed that NADES additives improved the yield of the extracted essential oil and influenced its composition leading to a decrease in toxic phenylpropenoids. Best results were achieved by using ChCl-CA NADES ultrasound-assisted pretreatment coupled with traditional 2 ​h Clevenger hydrodistillation that increased the yield of the EO from 0.98% (traditional) to 1.41% and a decrease of the phenylpropenoids amount in the essential oil.
    Keywords Myristica fragrans ; choline ; choline chloride ; essential oils ; hydrodistillation ; nutmeg ; safrole ; toxicity ; ultrasonic treatment
    Language English
    Dates of publication 2022-05
    Publishing place Elsevier Ltd
    Document type Article
    ZDB-ID 2835763-2
    ISSN 2405-8440
    ISSN 2405-8440
    DOI 10.1016/j.heliyon.2022.e09531
    Database NAL-Catalogue (AGRICOLA)

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  4. Article ; Online: Medically assisted procreation in times of COVID-19: what impact on health care system organization and the reproductive rights of couples?

    Rallo, Giuseppe / Negro, Francesca / Consalvo, Francesca / Piersanti, Valeria / Marinelli, Susanna

    Acta bio-medica : Atenei Parmensis

    2021  Volume 92, Issue 5, Page(s) e2021275

    Abstract: Background and aim: The emergency caused by the spread of COVID-19 has overwhelmed health care facilities and required the reorganization of health systems in many nations worldwide. A year after its appearance, measures aimed at further containing ... ...

    Abstract Background and aim: The emergency caused by the spread of COVID-19 has overwhelmed health care facilities and required the reorganization of health systems in many nations worldwide. A year after its appearance, measures aimed at further containing disease transmission through massive vaccination campaigns. In pregnancy, vaccination should be administered with caution, in light of the lack of reliable data, since pregnant women have been excluded from experimentation. The pandemic has had a significant impact on assisted reproduction procedures in Italy. Methods: The authors have set out to analyze the measures issued by the Italian government in order to counter the spread of COVID-19, in addition to the national and international guidelines on assisted reproduction.
    Discussion: The purpose of these documents is precautionary in nature: such measures are based on the principles of responsibility and solidarity, essential to stave off the saturation of health systems, curb contagion, but also to lay out a set of rules to starting a pregnancy while preserving the health of couples, operators and newborns. The authors also expound upon the rights claimed by couples seeking access to MAP (i.e. the right to become a parent, the couple's right to health, interest in demographic development). Conclusions: The coronavirus disease 2019 (COVID-19) has had a major impact on infertile couples. Since the pandemic broke out, Italy, like most European countries, has interrupted most ordinary activities of the centers operating in the field of assisted fertilization. We believe that access to assisted fertilization techniques by sterile and infertile couples should be part of the right to health rather than of the supposed right to become parents or the increase in the birth rate, also evoked as the COVID-19 pandemic unfolded. The current system of compensation and reimbursements needs to be reconfigured in order to prevent any form of discrimination.
    MeSH term(s) COVID-19 ; Delivery of Health Care ; Female ; Humans ; Infant, Newborn ; Italy ; Pandemics ; Pregnancy ; Reproduction ; Reproductive Rights ; SARS-CoV-2
    Language English
    Publishing date 2021-11-03
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2114240-3
    ISSN 2531-6745 ; 0392-4203
    ISSN (online) 2531-6745
    ISSN 0392-4203
    DOI 10.23750/abm.v92i5.11900
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Influence of choline chloride-based NADES on the composition of

    Lanari, Daniela / Zadra, Claudia / Negro, Francesca / Njem, Rima / Marcotullio, Maria Carla

    Heliyon

    2022  Volume 8, Issue 5, Page(s) e09531

    Abstract: Natural deep eutectic solvents (NADES) have emerged as green extracting solvents in recent years. In this study, a variety of choline chloride (ChCl)-based natural deep eutectic solvents (NADES) were used as co-solvents for the hydrodistillation of ... ...

    Abstract Natural deep eutectic solvents (NADES) have emerged as green extracting solvents in recent years. In this study, a variety of choline chloride (ChCl)-based natural deep eutectic solvents (NADES) were used as co-solvents for the hydrodistillation of nutmeg with the aim to obtain
    Language English
    Publishing date 2022-05-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2835763-2
    ISSN 2405-8440
    ISSN 2405-8440
    DOI 10.1016/j.heliyon.2022.e09531
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Conscientious objection to abortion: how to strike a legal and ethical balance between conflicting rights?

    Negro, Francesca / Varone, Maria Cristina / Del Rio, Alessandro / Marinelli, Susanna / Basile, Giuseppe

    Acta bio-medica : Atenei Parmensis

    2022  Volume 93, Issue 4, Page(s) e2022279

    Abstract: The Italian Supreme Court ruling no. 18901 of May 13, 2021 has determined that doctors who are opposed to abortion can refuse to perform it on grounds of conscience, but such a refusal does not exempt them from providing assistance to the woman before ... ...

    Abstract The Italian Supreme Court ruling no. 18901 of May 13, 2021 has determined that doctors who are opposed to abortion can refuse to perform it on grounds of conscience, but such a refusal does not exempt them from providing assistance to the woman before and after the procedure itself. The legalization of abortion should be considered within a broader strategy to put an end to underground and unsafe abortions, to raise awareness and enhance reproductive education and accessibility to contraceptive methods. The authors have set out to briefly analyze the legal and ethical complexities inherent in the effort to reconcile women's reproductive autonomy and freedom of choice with conscience-based refusal on the part of numerous healthcare professionals. Such an apparent conflict highlights the need for an ethically tenable solution that takes into account the dignity of unborn children, based on the conviction of many healthcare professionals primarily based on moral and religious tenets, that life begins at conception as well as the reproductive freedom and autonomy of women.
    MeSH term(s) Conscience ; Female ; Health Personnel ; Humans ; Italy ; Morals ; Pregnancy ; Refusal to Treat
    Language English
    Publishing date 2022-08-31
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2114240-3
    ISSN 2531-6745 ; 0392-4203
    ISSN (online) 2531-6745
    ISSN 0392-4203
    DOI 10.23750/abm.v93i4.13477
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: End-of-life in the operational functioning of public healthcare: ethical and legal issues.

    Basile, Giuseppe / De Nina, Angelo / Montana, Angelo / Negro, Francesca / Straccamore, Marco / Napoletano, Gabriele / Marinelli, Enrico

    Acta bio-medica : Atenei Parmensis

    2023  Volume 94, Issue 2, Page(s) e2023110

    Abstract: Background and aim: The article aims to outline the current scenario relative to the medical role in end-of-life issues. In order to do this, historical-legal references have been drawn upon relating to technical, legal and scientific thought and ... ...

    Abstract Background and aim: The article aims to outline the current scenario relative to the medical role in end-of-life issues. In order to do this, historical-legal references have been drawn upon relating to technical, legal and scientific thought and doctrine, as it has come down to us in the medical field through the evolution of ethical and philosophical frameworks.
    Methods: The authors have conducted a thorough analysis of end-of-life legislative initiatives, in Italy and across the EU, and court rulings to outline possible ways to harmonize and reconcile the current medical ethics frameworks with the needs and rights of all, especially the most vulnerable among us. To that end, the necessary operational choices and adjustments have not yet been made by our legal system, from a technical, as well as moral, standpoint.
    Results: An operational proposal has therefore been laid out to protect both healthcare providers and patients, in a relationship that goes beyond treatment in the strict sense, which prioritizes mutual needs as an integral part of a common, essential path.
    Conclusions: In order for doctors to consider themselves complete, they should in fact deal not only with life, but also with death.
    MeSH term(s) Humans ; Ethics, Medical ; Italy ; Physicians ; Delivery of Health Care ; Death
    Language English
    Publishing date 2023-04-24
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2114240-3
    ISSN 2531-6745 ; 0392-4203
    ISSN (online) 2531-6745
    ISSN 0392-4203
    DOI 10.23750/abm.v94i2.14207
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Posthumous sperm retrieval: a procreative revolution.

    Negro, Francesca / Beck, Renata / Cotoia, Antonella / Varone, Maria Cristina

    Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina

    2020  Volume 18, Issue 1, Page(s) 114–121

    Abstract: Aim Postmortem sperm retrieval with consequent artificial insemination has become a technically possible option for future use in assisted reproductive technology (ART). The authors have set out to discuss the social and ethical significance of ... ...

    Abstract Aim Postmortem sperm retrieval with consequent artificial insemination has become a technically possible option for future use in assisted reproductive technology (ART). The authors have set out to discuss the social and ethical significance of posthumous sperm retrieval, and the laws currently in force in Italy, the United States and elsewhere. Methods International literature from 1997 to 2020 has been reviewed from Pubmed database, Google Scholar and Scopus, drawn upon American, Italian and international sources (an ethically acceptable solution can only be achieved through an overhaul of the laws currently in effect). One of the most contentious issues was about donor consent. In Italy, a donor's will to retrieve his sperm in the event of premature disappearance can be proven according to the Law 219/2017, through advance health care directives. Results A substantial increase, both in requests and protocols, was documented in the United States. In Italy, over the last two years, three rulings were issued concerning posthumous insemination. However, no official standardized protocols, guidelines or targeted legislation exist at the national level to regulate medical activity in that realm, whereas established laws often set implicit limitations. Conclusion Current legal frameworks appear to be inadequate, because in most cases they were conceived under conditions that have radically changed. The need for newly-updated regulatory frameworks to promptly bridge that gap is increasingly clear, if current social needs related to reproductive rights are to be met in the foreseeable future.
    MeSH term(s) Humans ; Posthumous Conception ; Reproductive Techniques, Assisted ; Sperm Retrieval ; United States
    Language English
    Publishing date 2020-11-04
    Publishing country Bosnia and Herzegovina
    Document type Journal Article
    ZDB-ID 2378942-6
    ISSN 1840-2445 ; 1840-0132
    ISSN (online) 1840-2445
    ISSN 1840-0132
    DOI 10.17392/1256-21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Does the EU COVID Digital Certificate Strike a Reasonable Balance between Mobility Needs and Public Health?

    Montanari Vergallo, Gianluca / Zaami, Simona / Negro, Francesca / Brunetti, Pietro / Del Rio, Alessandro / Marinelli, Enrico

    Medicina (Kaunas, Lithuania)

    2021  Volume 57, Issue 10

    Abstract: The need to fight a highly aggressive virus such as SARS-CoV-2 has compelled governments to put in place measures, which, in the name of health protection, have constrained many freedoms we all enjoy, including freedom of movement, both nationally and ... ...

    Abstract The need to fight a highly aggressive virus such as SARS-CoV-2 has compelled governments to put in place measures, which, in the name of health protection, have constrained many freedoms we all enjoy, including freedom of movement, both nationally and within the European Union. In order to encourage and facilitate the return to free movement, the European Parliament has launched a "COVID-19 digital certificate". A spirited debate centered around the use of this certificate is still ongoing among scholars, many of whom have pointed out the uncertainties relative to COVID-19 immunity, privacy issues and the risk of discriminatory effects. The authors, while highlighting some critical aspects, argue that the COVID digital certificate in its current approved version can effectively help prevent the spread of the infection and promote free movement, while upholding the right to health as much as possible. However, they also stress the need for a thorough information campaign to illustrate the advantages and limitations of this document in order to avoid creating a false sense of security in the public opinion, who may wrongly assume that the emergency has been overcome for good.
    MeSH term(s) COVID-19 ; European Union ; Humans ; Privacy ; Public Health ; SARS-CoV-2
    Language English
    Publishing date 2021-10-09
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2188113-3
    ISSN 1648-9144 ; 1010-660X
    ISSN (online) 1648-9144
    ISSN 1010-660X
    DOI 10.3390/medicina57101077
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Rehabilitation strategies for low anterior resection syndrome. A systematic review.

    Bulfone, Giampiera / Del Negro, Francesca / Del Medico, Elena / Cadorin, Lucia / Bressan, Valentina / Stevanin, Simone

    Annali dell'Istituto superiore di sanita

    2020  Volume 56, Issue 1, Page(s) 38–47

    Abstract: Objective: To summarize the evidence in the literature about rehabilitative treatments that reduce low anterior resection syndrome (LARS) symptoms in patients who underwent surgery for colorectal cancer.: Methods: We have search in PubMed, Cochrane ... ...

    Abstract Objective: To summarize the evidence in the literature about rehabilitative treatments that reduce low anterior resection syndrome (LARS) symptoms in patients who underwent surgery for colorectal cancer.
    Methods: We have search in PubMed, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health and Scopus databases. Studies selected were limited to those including only patient undergone low rectal resection with sphincter preservation and with pre-post assessment with a LARS score. Five articles fit the criteria.
    Results: The percutaneous tibial nerve stimulation demonstrated moderate results and sacral nerve stimulation was found to be the best treatment with greater symptom improvement. Only one study considered sexual and urinary problems in the outcomes assessment.
    Conclusions: In clinical practice patients should evaluate with the LARS and other score for evaluation of urinary and sexual problems. Future research must be implemented with higher quality studies to identify the least invasive and most effective treatment/s.
    MeSH term(s) Adenocarcinoma/drug therapy ; Adenocarcinoma/radiotherapy ; Adenocarcinoma/surgery ; Antineoplastic Agents/therapeutic use ; Colectomy/adverse effects ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/radiotherapy ; Colorectal Neoplasms/surgery ; Combined Modality Therapy ; Defecation ; Exercise Therapy ; Fecal Incontinence/etiology ; Fecal Incontinence/rehabilitation ; Female ; Follow-Up Studies ; Humans ; Implantable Neurostimulators ; Lumbosacral Plexus/physiopathology ; Male ; Middle Aged ; Postoperative Complications/rehabilitation ; Prospective Studies ; Quality of Life ; Rectum/surgery ; Retrospective Studies ; Syndrome ; Tibial Nerve/physiopathology ; Transcutaneous Electric Nerve Stimulation ; Urination Disorders/etiology ; Urination Disorders/rehabilitation
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2020-04-02
    Publishing country Italy
    Document type Journal Article ; Systematic Review
    ZDB-ID 950344-4
    ISSN 2384-8553 ; 0021-2571
    ISSN (online) 2384-8553
    ISSN 0021-2571
    DOI 10.4415/ANN_20_01_07
    Database MEDical Literature Analysis and Retrieval System OnLINE

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