Antonio Di Lorenzo

Lower respiratory tract infections (LRTIs) account for a large share of pediatric antimicrobial prescriptions. The BIOFIRE FILMARRAY Pneumonia Panel (FAPN; BioMérieux) detects 33 respiratory pathogens within approximately 1 h. We investigated the clinical impact of its systematic introduction—combined with antimicrobial stewardship education. A retrospective cohort study was conducted at a tertiary pediatric center in Japan, enrolling all children aged P < 0.001). Adjusted GLM regression identified a significant reduction in broad-spectrum antibiotic DOTs (adjusted β: −0.41; 95% CI: −0.66 to −0.05; P = 0.001), while narrow-spectrum antibiotic DOTs were unchanged. ITSA also confirmed a significant reduction in antimicrobial prescription rate (β: −0.53; 95% CI: −0.84 to −0.21; P = 0.001). The FAPN, combined with structured stewardship education, was significantly associated with reduced antimicrobial prescribing and a shift away from broader-spectrum antimicrobials. These findings support the clinical value of rapid multiplex PCR diagnostics in pediatric LRTIs when integrated with a strong antimicrobial stewardship program. IMPORTANCE: A strong stewardship education program may need to be combined with the introduction of a multiplex PCR test for pediatric pneumonia. With a clear decision flowchart, clinicians could successfully reduce antimicrobial use and shift their antimicrobial prescriptions to narrower ones.

Objectives.: Resilience is a key psychological resource for work ability, especially in medical students confronting cognitive and emotional pressures. Aim of the study is to assess resilience in university students and examine its associations with physical activity, sleep quality, and Mediterranean diet. Methods.: A cross-sectional study involved 331 medical students at University of Bari. Resilience was measured using the Dispositional Resilience Scale-15 (DRS-15); lifestyle through PREDIMED, IPAQ, and PSQI. Pearson’s correlation and regression were performed. Results.: Low resilience was found in 52.78% of participants. Resilience was directly correlated with Mediterranean diet (weak, r: 0.20; p<0.001), physical activity (very weak, r: 0.15; p<0.01), and inversely correlated with sleep quality (weak, r: −0.34; p<0.001). Regression identified no predictors. Conclusions.: Resilience in medical students correlates with modifiable lifestyle behaviours, justifying early preventive interventions to enhance long-term occupational health.

Background and Objectives: Knee osteoarthritis (KOA) and other degenerative chondropathies are major causes of pain and disability. When core conservative treatments are insufficient, intra-articular hyaluronic acid (HA) and platelet-rich plasma (PRP) are commonly used as adjunctive options, although evidence remains difficult to interpret because of heterogeneity in patients, products, preparation protocols, and treatment schedules. This exploratory retrospective study described short-term clinical outcomes after two standardized intra-articular protocols, hybrid HA and autologous PRP, in a real-world outpatient physiatry setting. Materials and Methods: This monocentric retrospective study included 40 treated knees (19 HA, 21 PRP) from 31 unique patients at the Policlinico di Bari between October 2022 and November 2024. The HA group received two injections of a hybrid high-/low-molecular-weight HA formulation, whereas the PRP group received three injections of autologous PRP. Outcomes were pain intensity, assessed by the Numerical Rating Scale (NRS), and function, assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), from baseline to end-of-cycle follow-up. Results: Both groups showed short-term clinical improvement. Mean NRS scores decreased from 6.26 to 2.26 in the HA group and from 6.76 to 2.29 in the PRP group, with no significant between-group difference in change from baseline (p = 0.509). WOMAC improved by 25.42 ± 20.39 points in the HA group and 20.19 ± 16.18 points in the PRP group (p = 0.372). In the main regression analysis, treatment type was not a significant predictor of outcome; unadjusted and age-/sex-adjusted WOMAC sensitivity models suggested a possible HA advantage that was not retained after full adjustment. Conclusions: In this small exploratory cohort, both protocols were associated with short-term improvements, without definitive fully adjusted evidence of between-group superiority. These findings should not be interpreted as evidence of equivalence or definitive comparative efficacy.

Need for increasing uptake of influenza vaccination and investing in novel vaccines for paediatric influenza prevention

Objectives: This study aimed to evaluate the effects of AMCOP® elastodontic appliances on cephalometric parameters of skeletal divergence and upper airway dimensions in growing patients, comparing treated individuals with an untreated control group. Methods: A total of 60 subjects (30 treated with AMCOP® devices and 30 controls) were selected, with mean ages of 8.67 ± 1.3 and 9.19 ± 0.8 years, respectively. The AMCOP® appliances, designed for mixed dentition, were worn for 1 h during the day and throughout the night for 6–8 months. Cephalometric analyses were conducted at the beginning (T0) and end (T1) of treatment. Statistical analyses were performed using multivariable linear regression models to assess changes in skeletal and airway parameters, with significance set at p < 0.05. Results: Significant reductions were observed in Ans-Snp^Go-Gn (p = 0.0351), SN^Go-Gn (p = 0.0091), and FMA (p < 0.001) in the treated group compared to controls, indicating improved mandibular rotation. Upper airway spaces (SPAS, MAS, IAS) increased significantly, suggesting enhanced airway patency. Regression models confirmed the positive impact of AMCOP® therapy on skeletal and airway outcomes, particularly in subjects with pronounced vertical discrepancies. Conclusions: AMCOP® elastodontic devices effectively promote anterior mandibular rotation and reduce mandibular plane inclination in hyperdivergent patients, contributing to balanced craniofacial growth. The expansion of pharyngeal spaces indicates potential respiratory benefits. Future research is needed to confirm long-term stability and address variability in treatment response.

Background/Objectives: Sex and gender minorities (SGMs) include individuals who do not comply with sexual binarism and heteronormative standards. They represent a high-risk population for Human Papillomavirus (HPV) infection and potential target of an HPV vaccine offer. This study investigates SGMs’ knowledge, awareness and vaccination attitude regarding HPV. Methods: This is a cross-sectional, questionnaire-based study. The target population was represented by SGMs living in Italy and using social media platforms of SGM rights associations. The study questionnaire was based on the literature and disseminated via said associations’ social media. It included items regarding knowledge and awareness, expressed as seven-point Likert scales, and questions about personal information, sexual anamnesis and vaccination attitude. Data collection started on 1 November 2023 and ended on 8 December 2023. Results: The questionnaire was answered by 177 people. Knowledge and awareness scores were generally high (45.98 ± 6.14 and 34.21 ± 4.62, respectively). Regarding attitude, 31.64% of participants reported being hesitant or refusing HPV vaccination, mainly due to prohibitive costs or low perception of the vaccine’s utility. Higher education was associated with a higher knowledge score (coeff.: 2.25; 95%CI: 0.69–3.82); likewise, a history of HPV-related lesions positively influenced the score (coeff.: 2.47; 95%CI: 0.20–4.75). The awareness score was only increased by a greater number of sexual partners (coeff.: 0.06; 95%CI: 0.01–0.11). Older age was proven to significantly increase the odd of vaccine hesitancy (OR: 1.07; 95%CI: 1.02–1.12). Conclusions: Despite a good level of knowledge and awareness, the study population manifested significant barriers to vaccination. The main ones were related to the vaccine’s cost and lack of medical information. Future efforts should focus on reinforcing vaccine offers to SGMs.

Aims: This study aimed to explore the direct and indirect effects of secondary traumatic stress (STS) on nurses' perceived work ability and the effect of these two variables on job satisfaction, organisational turnover intention and intention to leave the nursing profession.Design: A cross‐sectional study was conducted from June to November 2023.Method: Data were collected by sending an online survey to a convenience sample of nurses. Instruments for data collection included a 37‐item questionnaire divided into three sections: (i) socio‐demographics, job satisfaction, organisational turnover intention, and intention to leave the profession; (ii) perceived work ability assessed through the Work Ability Index (WAI); (iii) STS measured with the Secondary Traumatic Stress Scale.Results: Two hundred seventy‐one nurses completed the questionnaire. STS negatively and statistically impacted on WAI, and it was a direct determinant of intention to leave the nursing profession. WAI showed a direct, positive and significant impact on job satisfaction and it was a significant partial mediator in the relationship between STS and job satisfaction. Job satisfaction mediated between WAI, the intention to leave the nursing profession, and the organisational turnover intention.Conclusion: STS negatively impacted nurses' work ability, influencing their job satisfaction through the mediation of WAI, whereas job satisfaction independently affected nurses' organisational turnover intention. Moreover, STS was a positive and direct determinant of the intention to leave the nursing profession.Impact: Nurses, as helping professionals, are exposed to extreme stressful events resulting from the traumatic experiences of patients. STS in nurses can lead to emotional exhaustion, turnover intention, job dissatisfaction and reduced work ability. The findings from this study offer insights that can help shape organisational health policies aimed at reducing STS, preserving nurses' work ability, enhancing job satisfaction and mitigating turnover intentions within and outside the nursing profession.Reporting Method: This study followed the STROBE checklist guidelines for cross‐sectional studies.Patient or Public Contribution: No Patient or Public Contribution.

Background: Rhizarthrosis is the most frequent form of osteoarthritis and is responsible for pain, disability and reduced functionality. Recent studies support the possibility of providing Extracorporeal Shock Wave Treatment in patients suffering from osteoarthritis. Shock wave biostimulation may be able to modulate joint inflammation and stimulate chondorocytes in a reparative sense. The aim of the study is to investigate the clinical effects of shock wave treatment in patients suffering from arthritis of the first finger. Methods: A prospective clinical study was designed, in which seventy-two patients suffering from rhizoarthrosis were randomized to treatment with shock waves or exercises; in both groups an immobilization brace of the first finger was used. At recruitment and at 1, 3 and 6 months, patients received assessments of pain (VAS), functionality (FIHOA), disability (DASH); furthermore, the perception of improvement was monitored during follow-ups (Roles and Maudsley Score). Results: In both groups there was a significant improvement in all scores in the comparison between recruitment and 6 months; this improvement was confirmed for VAS, FIHOA and DASH in the comparison between individual time points in both groups, except for the comparison between 3 and 6 months for all scales in the exercise group and for FIHOA in both groups. The perception of improvement was statistically better in the shock wave group than in the exercise group at 1, 3 and 6 months. The regression analysis showed that the reduction of VAS and DASH are statistically influenced by shock wave treatment (p<0.001). Conclusions: Both shock waves and exercises, together with the use of the brace, are effective in managing pain, functionality and disability in patients suffering from arthritis of the first finger. The shock wave treatment ensured further improvement at 6 months