SARS-COV-2 comorbidity network and outcome in hospitalized patients in Crema, Italy

We report onset, course, correlations with comorbidities, and diagnostic accuracy of nasopharyngeal swab in 539 individuals suspected to carry SARS-COV-2 admitted to the hospital of Crema, Italy. All individuals underwent clinical and laboratory exams, SARS-COV-2 reverse transcriptase-polymerase chain reaction on nasopharyngeal swab, and chest X-ray and/or computed tomography (CT). Data on onset, course, comorbidities, number of drugs including angiotensin converting enzyme (ACE) inhibitors and angiotensin-II-receptor antagonists (sartans), follow-up swab, pharmacological treatments, non-invasive respiratory support, ICU admission, and deaths were recorded. Among 411 SARS-COV-2 patients (67.7% males) median age was 70.8 years (range 5-99). Chest CT was performed in 317 (77.2%) and showed interstitial pneumonia in 304 (96%). Fatality rate was 17.5% (74% males), with 6.6% in 60-69 years old, 21.1% in 70-79 years old, 38.8% in 80-89 years old, and 83.3% above 90 years. No death occurred below 60 years. Non-invasive respiratory support rate was 27.2% and ICU admission 6.8%. Charlson comorbidity index and high Creactive protein at admission were significantly associated with death. Use of ACE inhibitors or sartans was not associated with outcomes. Among 128 swab negative patients at admission (63.3% males) median age was 67.7 years (range 1-98). Chest CT was performed in 87 (68%) and showed interstitial pneumonia in 76 (87.3%). Follow-up swab turned positive in 13 of 32 patients. Using chest CT at admission as gold standard on the entire study population of 539 patients, nasopharyngeal swab had 80% accuracy. Comorbidity network analysis revealed a more homogenous distribution 60-40 aged SARS-COV-2 patients across diseases and a crucial different interplay of diseases in the networks of deceased and survived patients. SARS-CoV-2 caused high mortality among patients older than 60 years and correlated with pre-existing multiorgan impairment. Copyright

Arachnoid cysts: diagnosis and treatment

Twenty supratentorial and 10 infratentorial arachnoid cysts are reported. The patients were from 0 to 15 years of age. The commonest presenting symptoms in children were cranial enlargement, epileptic seizures, and psychomotor retardation. Neuroradiological evaluation included CT, metrizamide CT, cisternography, and angiography. Echography was performed in 5 newborns. Therapeutic criteria according to the clinical and neuroradiological findings are reviewed. Cystoperitoneal shunting in combination with ventriculoperitoneal shunting for associated hydrocephalus is considered the treatment of choice. \ua9 1987 Springer-Verlag

ARACHNOID CYSTS - RADIOLOGICAL AND SURGICAL CONSIDERATIONS

5nononenoneGAJNO, TM; LOCATELLI, D; BONFANTI, N; SFOGLIARINI, R; PEZZOTTA, SGajno, Tm; Locatelli, D; Bonfanti, N; Sfogliarini, R; Pezzotta,

Shunt in high-risk newborns

Twenty-four high-risk newborns with a low birth weight developed progressive hydrocephalus and underwent ventriculoperitoneal shunting (at the time of shunting they weighed 1,100-1,990 g, mean 1,541.5 g). The changes in hydrocephalus after shunting were determined by ultrasound examinations; preoperative examination was by CT. Of the factors evaluated for their relationship to shunt complication, we considered in particular babies with a CSF protein level of over 1.5 g/l (7 cases). These cases were treated with external drainage and later with ventriculoperitoneal shunting. Shunt infections occurred in 20.9%, in contrast with a low incidence of shunt blockage (8.3%), probably owing to previous external shunting in children with high CSF protein. There were 2 deaths (8.3%). All children underwent careful follow-up during the 1st year and serial checkups subsequently for 5 years. \ua9 1987 Springer-Verlag