Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes.

BACKGROUND: The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in Rome. METHODS: This is a single-center, retrospective study performed in the Sant'Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65-80 years old; Very Elderly > 80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher's exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH) s and clinical outcomes. RESULTS: We found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease. CONCLUSION: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered.

Sevoflurane analgesia in obstetrics: a pilot study.

Continuous and intermittent administration of inhalational anesthetics has been successfully employed for treating pain during labor. We conjectured that intermittent sevoflurane administration would be effective for pain relief during labor without side effects to the mother or fetus. Fifty parturients breathed a mixture of 2-3% sevoflurane, oxygen and air before each uterine contraction began. The patients assessed the quality of analgesia by using a visual analogue scale (0-10) before the administration of sevoflurane and after each uterine contraction. All parturients but one were satisfied, demonstrating a mean visual analogue score before and after sevoflurane administration of 8.7 +/- 1.1 and 3.3 +/- 1.5, respectively. Apgar scores at 1 and 5 min were 9 (range 5-9) and 10 (range 8-10), respectively. Our findings suggest that sevoflurane could be effective for the treatment of labor pain.

[Giorgio Baglivi's family and correspondents from Lecce]. / Pietro Angelo Baglivo e i corrispondenti leccesi di Giorgio Baglivi.

Some information on Baglivi's family, particularly on Pietro Angelo, and on Giorgio Baglivi's correspondents from Lecce are given. New published and unpublished sources useful to reconstruct the Slav doctor's biography are also indicated. Moreover the warning of a manuscript by the Provincial Library in Lecce let us add new information on the stories concerning Giorgio Baglivi's correspondence.

Osteocondroma subungueal del primer artejo / Subungueal osteochondroma of the 1th phalanx

El osteocondroma, bien estudiado en ambiente traumatológico, es poco conocido para los dermatólogos. La localización subungueal de esta afección es la menos frecuente. Por ello nos parece de interés presentar este caso que puede prestarse a diversos diagnóstico diferenciales: encondroma, quiste epidérmico, glomangioma, lipoma, botriomicoma, timor de Koenen, carcinoma espinocelular, melanoma melanótico, condrosarcoma, verruga subungueal, lesioens quísticas y seudotumorales