Summary:Our study analyzes the mobilization of hematopoietic stem cells after two chemotherapeutic regimens in nonHodgkin's lymphoma (NHL) patients. The study included 72 patients with NHL (42 follicular and 30 large cells). The mean age was 37 years (range 17-60). Sixty-four patients (88.9%) had stage III-IV disease. Forty-eight patients (66.7%) had bone marrow involvement. Systemic B symptoms were present in 42 patients (58.3%). Mobilization chemotherapy regimens were randomly assigned as DHAP in 38 patients (52.7%) or cyclophosphamide (CPM) (5 g/m 2 ) in 34 (47.2%) and the results of 132 procedures were analyzed. At the time of PBSC mobilization, 46 patients (63.9%) were considered to be responsive (complete remission, partial remission or sensitive relapse) and 26 (36.1%) not responsive (refractory relapse or refractory to therapy). Pre-apheresis CD34 + blood cell count and number of previous chemotherapy treatments were used to predict the total number of CD34 + cells in the apheresis product. The mobilizing regimens (CPM or DHAP) were similar in achieving the threshold CD34 + cell yield, for optimal engraftment. Since DHAP was very effective as salvage treatment, we suggest using DHAP as a mobilizing regimen in patients with active residual lymphoma at the time of stem cell collection. ( toxicity. [5][6][7][8] In the literature, high-dose cyclophosphamide (CPM) seems to be the gold standard for mobilizing hematopoietic progenitor cells in lymphoproliferative disorders. 9,10 Single high doses of alkylating agents (high-dose CPM or melphalan) have been used as mobilizing chemotherapy in NHL and other malignancies. [9][10][11][12] Combination chemotherapy regimens such as DHAP or MAD or ESHAP have also been used for stem cell harvesting. [13][14][15] In a previous study the DHAP protocol has already shown real efficacy in debulking and in vivo purging in refractory or in partial remission NHL. 16,17 The DHAP regimen was thus integrated into various treatment plans tailored for NHL patients as a second-line therapy and salvage chemotherapy for PR patients, or as an intensification and mobilizing regimen in CR high risk patients. 16,17 In our previous experience, we used the DHAP protocol as salvage treatment in patients in PR or with refractory NHL. Few randomised studies report a comparison of mobilizing capacity of two different chemotherapeutic regimens such as ESHAP or ifosfamide vs CPM in lymphoproliferative disorders. [18][19][20] In our study 72 NHL patients undergoing PBSC transplantation were prospectively randomized to mobilize PBSC with the DHAP regimen or with high-dose CPM in order to evaluate whether there were any differences in the number of mononuclear cells harvested (× 10 8 /kg), CD34 + cells (×10 6 /kg), colony-forming units granulocyte-macrophage (CFU-GM) (×10 4 /kg) obtained or engraftment speed. Bone Marrow Transplantation Patients and methodsThe following parameters were examined in the two different mobilized groups: (1) Clinical: (i) type of mobilizing regimen (DHAP (cisplatin 100 mg/...

The COVID‐19 pandemic has had a strong impact on healthcare workers (HCWs), affecting their physical and mental health. In Italy, HCWs have been among the first exposed to unprecedented pressure, dealing with large numbers of infections during the first pandemic wave. However, the severe psychological consequences on HCWs find little evidence in the literature, especially in terms of comparison to the status quo ante pandemic. The aim of this study was to provide an assessment of the mental health burden in a cohort of Italian HCWs during the COVID‐19 pandemic, comparing their condition with that before the emergency, to direct the promotion of mental well‐being among HCWs worldwide. In this retrospective study, we included physicians, physical therapists, and nurses working in the Respiratory Intensive Care Unit, Neurology Unit, and Rehabilitation Unit from a Southern Italy University Hospital. All study participants underwent a battery of psychological tests, aimed at verifying their state of mental health during the COVID‐19 emergency and before it. Depressive, anxiety, and burnout symptoms were assessed using the following questionnaires: Maslach Burnout Inventory, Patient Health Questionnaire‐9 (PHQ‐9), and General Anxiety Disorder‐7. Depressive, anxiety, and burnout clinical relevance symptoms were present in HCWs during the COVID‐19 pandemic more than those before the emergency. Fifty percent of the HCWs obtained a score clinically significant during the emergency. Moreover, a depersonalization factor showed a statistically significant increase in average scores ( p < 0.0001). The PHQ‐9 scale showed that 47.1% of the operators reported depressive state presence. The number of operators scoring above the cut‐off for the anxiety scale tripled during the emergency ( p < 0.0001). The female gender conferred greater risks for depression. Taken together, the findings of this study showed that our sample of Italian HCWs showed a greater risk for depression, anxiety, and stress during the COVID‐19 pandemic. These data might be a starting point to plan mental health monitoring and prevention programs for HCWs, thus ensuring patients receive the best possible care performances even during healthcare crises such as the current pandemic.

Gymnastics athletes are exposed to a high risk of injury, but also of developing musculoskeletal pain. These data are still little investigated in the available scientific literature. An online survey was distributed to 79 professional athletes who practiced artistic and rhythmic gymnastics. The survey collected demographic and anthropometric data, information about the sport practice, the training sessions, the prevalence of musculoskeletal pain gymnastics-related, and lifestyle habits. Musculoskeletal pain had a high prevalence, involving 65 of 79 athletes (82.3%). A significant correlation was found between musculoskeletal pain and the duration of sports practice, both for general pain (p = 0.041) and for specific districts: right wrist pain (p = 0.031), left wrist pain (p = 0.028), right shoulder (p = 0.039), left hip (p = 0.031), right thigh (p = 0.031), and left knee (p = 0.005). Another statistical association was found between right wrist pain and BMI (p = 0.001), and hip pain and BMI (p = 0.030). Hours spent in a sitting position were also correlated with the incidence of pain (p = 0.045). Wrist pain and right shoulder pain had a statistically significant association with the age of the athletes (right wrist pain: p = 0.038; left wrist pain: p = 0.004; right shoulder pain: p = 0.035). The more the gymnasts practice this sport, the more likely they are to develop musculoskeletal pain. Increased age and a higher BMI, as well as daily prolonged sitting position, seem to be potential risk factors for the onset of musculoskeletal pain. Future studies could plan training strategies aimed at preventing musculoskeletal pain associated with gymnastics, in order to promote its further spread.

The restrictions and social distancing measures due to the COVID-19 pandemic have created many obstacles in the practice of outdoor physical activity (OPA) throughout the world, particularly for the most vulnerable people, such as those with disabilities. The aim of this study was to explore the impact of pandemic-related limitations on the OPA of an Italian cohort of people with disabilities practicing sports. A retrospective observational study was conducted using an online survey. The questionnaire was distributed to 121 disabled athletes who practiced different outdoor physical activities. A total of 96 completed the survey, which collected demographic data, information about daily outdoor physical activity and sports habits, and about physical and psychological health before and during the pandemic. The frequency of daily OPA per week, along with the hours of physical activity, significantly decreased during the pandemic compared to those of the year before (p < 0.0001). A statistically significant deterioration was also found in the physical and mental well-being of disabled athletes during the pandemic (p < 0.0001) when compared to those from the year before the advent of COVID-19. This research demonstrated the negative impact of COVID-19 restrictions on OPA levels and on the physical and mental well-being of athletes with disabilities. It also highlighted a new challenge regarding the sustainability and integration of the national health system, demonstrating the necessity of improving the consistent accessibility of people with disabilities to OPA, both under normal conditions and emergency situations, in order to guarantee their psychophysical well-being.