Hip fracture is a common condition in older adults, leading to disability and mortality. Several studies have demonstrated the association between nutritional status and the risk of a negative health outcome after fractures. In this systematic review, we evaluated the association between malnutrition and mortality, changes in mobility/living arrangements, and postoperative complications, such as delirium, in older patients with hip fractures. A literature search on the PubMed, Web of Science, and Scopus databases, up to September 2023, was conducted to identify all studies involving older subjects that reported an association between MNA/GNRI/PNI/CONUT and health outcome after hip fracture. Meta-analysis was performed by a random-effects model using risk values (RR, OR, and HR) extracted from the 14 eligible selected studies. Malnutrition significantly increased the risk of any analyzed adverse outcome by 70% at 1 month, and up to 250% at 1 year. Malnutrition significantly increased delirium risk by 275% (OR = 2.75; 95% CI 1.80–4.18; p ≤ 0.05), mortality risk by 342% (OR = 3.42; 95% CI 2.14–5.48; p ≤ 0.05), mortality hazard risk by 351% (HR = 3.51; 95% CI 1.63–7.55; p ≤ 0.05) at 1 month, and transfer-to-more-supported-living-arrangements risk by 218% (OR = 2.18; 95% CI 1.58–3.01; p ≤ 0.05), and declined mobility risk by 41% (OR = 1.41; 95% CI 1.14–1.75; p ≤ 0.05), mortality risk by 368% (OR = 3.68; 95% CI 3.00–4.52; p ≤ 0.05), and mortality hazard risk by 234% (HR = 2.34; 95% CI 1.91–2.87; p ≤ 0.05) at 1 year. Malnutrition of older patients increases the risk of death and worsens mobility and independence after hip fractures. The results of the present study highlight the importance of nutritional status evaluation of older subjects with hip fractures in order to prevent potential adverse outcomes (Registration No: CRD42023468751).

Background/Objectives: Cytomegalovirus (CMV) is widespread and mostly causes asymptomatic infections in immunocompetent hosts, but it may lead to severe and life-threatening diseases in immunocompromised individuals, such as transplant patients and congenitally infected children, representing a significant public health concern. Although there are no licensed CMV vaccines, the development of a CMV vaccine is considered a high priority due to its potential to reduce the burden associated with CMV-related complications, and several approaches are under investigation. The objective of this systematic review was to synthesize the evidence on various CMV vaccines currently under clinical development. Methods: According to the PRISMA guidelines (PROSPERO ID: CRD42024516601), a comprehensive literature search was conducted to identify all the randomized controlled trials that have evaluated the safety, immunogenicity, and efficacy of vaccine candidates compared to a placebo. A total of 26 studies were identified: 11 on transplant patients and 15 on healthy individuals. Results: Several vaccine candidates have shown encouraging results in terms of safety and specific immune responses, notably adjuvanted gB vaccines and DNA vaccines targeting gB and pp65. The results were divided into RCTs on healthy individuals and those on transplant recipients, because the CMV-specific immune response to a vaccine is complex and varies depending not only on the type of vaccine, but also on the immunological status of the individual. Conclusions: Challenges remain in achieving broad efficacy across diverse populations, particularly for immunocompromised patients. Thus, the present work seeks to support future decisions and guide further research in the development of an effective and widely available CMV vaccine.

Background: Hip fracture is a common condition among elderly and one of the leading causes of disability. Malnutrition is widely present in older patients and has been identified in several studies as an important and modifiable prognostic factor for several medical conditions, including hip fracture. The aim of the present study is to evaluate the association between malnutrition, assessed by validated tools, and selected health outcomes for different follow-up intervals from hip fracture, in particular: mortality, changes in mobility/living arrangements and postoperative delirium. Methods: A literature search on PubMed, Web of Science and Scopus databases up to September 2023, was conducted to identify all studies involving older subjects that reported an association between MNA/GNRI/PNI/CONUT score and health outcome after hip fracture. Meta-analysis was performed by a random-effects model using risk values (RR/OR/HR) extracted from 14 eligible selected studies. Results: Malnutrition significantly increased the risk of any adverse outcome by 70% at 1 month, and up to 250% at 1 year, showing an increasing trend with longer follow-up periods. One month after hip fracture, malnutrition significantly increased the risk of postoperative delirium by 275% (OR = 2.75; 95% CI 1.80-4.18; p ≤ 0.05), mortality by 342% (OR = 3.42; 95% CI 2.14-5.48; p ≤ 0.05) and mortality hazard risk by 351% (HR = 3.51; 95% CI 1.63-7.55; p ≤ 0.05). One year after hip fracture, malnutrition significantly increased the risk of transfer to more supported living arrangements by 218% (OR = 2.18; 95% CI 1.58-3.01; p ≤ 0.05), declined mobility by 41% (OR = 1.41; 95% CI 1.14-1.75; p ≤ 0.05), mortality by 368% (OR = 3.68; 95% CI 3.00-4.52; p ≤ 0.05) and mortality hazard risk by 234% (HR = 2.34; 95% CI 1.91-2.87; p ≤ 0.05). Conclusions: These findings underscore that malnutrition worsens outcomes after hip fracture in elderly, emphasizing the importance of nutritional assessment to mitigate potential adverse consequences. Key messages: • The results of the present study underscore that malnutrition increases the risk of death and worsens mobility and independence after hip fracture in older adults. • Routine nutritional status evaluation could prove beneficial in the management of hip fracture older patients in order to prevent potential adverse outcomes.

Medical residents constitute a vulnerable population susceptible to mental health disorders. In Italy, this was evident during the COVID-19 pandemic, when medical residents served on the front line and provided significant support to healthcare services. Therefore, the working group on “Public Mental Health” of the Medical Residents’ Council of the Italian Society of Hygiene, Preventive Medicine, and Public Health (S.It.I.) designed the “Residents’ mental health investigation, a dynamic longitudinal study in Italy” (ReMInDIt). This longitudinal study aims to assess the mental status of medical residents and to explore potential cause–effect relationships between risk/protective factors (identified among sociodemographic, residency program, and lifestyle characteristics) and mental health outcomes (anxiety and depressive symptoms). Data will be collected from a study population of 3615 residents enrolled in Italian residency programs in public health, occupational medicine, and forensic medicine through an online questionnaire that includes validated tools, requires 10 min for completion, and is disseminated by the residents’ Councils. It will be followed by a follow-up administration after 12 months. The ReMInDIt study will play a significant role in generating evidence crucial for enhancing mental health services and promoting protective factors for the mental well-being of this important segment of healthcare professionals.

Background/Objectives: Herpes zoster (HZ) represents a substantial public health burden, particularly among older adults and individuals at increased risk of severe disease. Despite effective vaccines, uptake remains suboptimal. This systematic review aimed to update evidence on HZ vaccination willingness, acceptance, and hesitancy, and to classify determinants according to the 5C model: Confidence, Complacency, Constraints, Calculation, and Collective Responsibility. Methods: A systematic literature search was conducted in PubMed, Web of Science, and Scopus from the date of the most recent relevant review (2022) to 15 June 2026. Eligible studies were observational studies assessing HZ vaccine hesitancy, willingness, acceptance, and related determinants among adults. Studies included in the previous systematic review were also reassessed. Study selection and data extraction were independently performed, and methodological quality was assessed using a modified Newcastle–Ottawa Scale. Due to substantial heterogeneity, findings were synthesized qualitatively. Results: Thirty-seven studies were included. Actual HZ vaccine uptake was generally low, despite moderate-to-high willingness in several populations. Healthcare professional (HCP) recommendation was the most consistent facilitator of vaccination. Within the 5C framework, low perceived susceptibility and severity of HZ, particularly its complications, were frequently associated with hesitancy, while vaccine cost, out-of-pocket payment, and limited access represented major constraints. Greater knowledge and awareness of HZ and HZ vaccination were generally associated with greater willingness, although knowledge alone did not consistently overcome hesitancy. Collective Responsibility was the least investigated domain. Conclusions: HZ vaccination uptake remains suboptimal despite favorable vaccination intentions. Strengthening HCP recommendations, reducing financial and structural barriers, and improving risk communication may enhance uptake. The 5C model provides a useful framework for understanding HZ vaccine hesitancy and informing targeted adult immunization strategies.