A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania, Italy

The expansion of coronavirus disease 2019 (COVID-19) prompted measures of disease containment by the Italian government with a national lockdown on March 9, 2020. The purpose of this study is to evaluate the rate of hospitalization and mode of in-hospital treatment of patients with chronic limb-threatening ischemia (CLTI) before and during lockdown in the Campania region of Italy. The study population includes all patients with CLTI hospitalized in Campania over a 10-week period: 5 weeks before and 5 weeks during lockdown (n = 453). Patients were treated medically and/or underwent urgent revascularization and/or major amputation of the lower extremities. Mean age was 69.2 +/- 10.6 years and 27.6% of the patients were women. During hospitalization, 21.9% of patients were treated medically, 78.1% underwent revascularization, and 17.4% required amputations. In the weeks during the lockdown, a reduced rate of hospitalization for CLTI was observed compared with the weeks before lockdown (25 vs 74/100,000 inhabitants/year; incidence rate ratio: 0.34, 95% CI 0.32-0.37). This effect persisted to the end of the study period. An increased amputation rate in the weeks during lockdown was observed (29.3% vs 13.4%; p < 0.001). This study reports a reduced rate of CLTI-related hospitalization and an increased in-hospital amputation rate during lockdown in Campania. Ensuring appropriate treatment for patients with CLTI should be prioritized, even during disease containment measures due to the COVID-19 pandemic or other similar conditions

Does social cognition change? Evidence after 4 years from the Italian Network for Research on Psychoses

Background Deficits in social cognition (SC) are significantly related to community functioning in schizophrenia (SZ). Few studies investigated longitudinal changes in SC and its impact on recovery. In the present study, we aimed: (a) to estimate the magnitude and clinical significance of SC change in outpatients with stable SZ who were assessed at baseline and after 4 years, (b) to identify predictors of reliable and clinically significant change (RCSC), and (c) to determine whether changes in SC over 4 years predicted patient recovery at follow-up. Methods The reliable change index was used to estimate the proportion of true change in SC, not attributable to measurement error. Stepwise multiple logistic regression models were used to identify the predictors of RCSC in a SC domain (The Awareness of Social Inference Test [TASIT]) and the effect of change in TASIT on recovery at follow-up. Results In 548 participants, statistically significant improvements were found for the simple and paradoxical sarcasm of TASIT scale, and for the total score of section 2. The reliable change index was 9.8. A cut-off of 45 identified patients showing clinically significant change. Reliable change was achieved by 12.6% and RCSC by 8% of participants. Lower baseline TASIT sect. 2 score predicted reliable improvement on TASIT sect. 2. Improvement in TASIT sect. 2 scores predicted functional recovery, with a 10-point change predicting 40% increase in the probability of recovery. Conclusions The RCSC index provides a conservative way to assess the improvement in the ability to grasp sarcasm in SZ, and is associated with recovery

Luigi Settembrini. Periodico letterario educativo mensile. A. 2, n.1(1892)-A. 3, n.10(1894)

A.2, n.1(nov.1892): G. Olivieri, Ad Antonio Bartolini, P. 1-2 ; G. Olivieri, Prospero Viani, P. 2-11; R. Sabbatini, Ancora Quom o Quum?, P. 11-2 ; Pensieri del Settembrini, P. 12-3 ; E. Perito, Ad nubem, P. 13; F. Lagrance, Dell’educazione fisica, p. 14-15 ; Cronaca dell’Istituto L. Settembrini, P. 15-6.A. 2, n. 2(dic. 1892): G. Lanzalone, La morale nell’arte, P. 17-23 ; B. ( dal Bibliografo), Per i libri di testo nelle scuole elementari, P. 23-5 ; V. Notari, In Gutembergium artis typograficae inventorem, P. 25; Progressi della navigazione aerea, P. 26-8 ; Pensieri del Settembrini, P. 28-9 ; Il nostro concorso, P. 29 ; G. Lanzalone, La prima pioggia d’autunno, P. 30-1A. 2, n.3(gen. 1893): Bonghi, Una lettera del Bonghi, P. 33-4 ; G. Lanzalone, Ancora della morale nell’arte, P. 34-8 ; Pensieri del Settembrini, P. 38-9 ; C. Arlìa, Buon dì e tre anguille, P. 39-41 ; G. Lanzalone , All’amico G. Olivieri , P. 42-3 ; P. Lioy, Bagni e villeggiature, P. 43-5.A. 2, n. 4(feb. 1893): C. A. Alemagna, Per la morale nell’arte, P. 49-55.A. 2, n. 5(mar. 1893): R. Sabbatini, L’epistola di Saffo a Faone, P. 65-6 ; G. Lanzalone, Il drammaturgo(caricatura), P. 66-7 ; G. Lanzalone, Ancora per la morale dell’arte, P. 67-70 ; F. De Falco, Un’altra lettera!, P. 71-2 ; Il Settembrini, Per una petizione al Parlamento, P. 72; E. Perito, A mia sorella morta, P. 73-4.A. 2, n.6(apr. 1893): Il Settembrini, Petizione al Parlamento, P. 81-3 ; C. Arlia, Noterelle filologiche, P. 84-5 ; G. Bigoni, Ricordi Picentini (2 sonetti), P. 85 ; C. A. Alemagna, Lettera con annotazioni, P. 86-90 ; V. Caputo, Il giuramento, P. 90-1 ; A. Buscaino Campo, Il piè fermo di Dante, P. 92-3.A.2, n.7(apr. 1893): G. Lanzalone, Professori e maestri, P. 97-9 ; il Settembrini, Petizione al Parlamento, P. 100-2 ; Lista delle adesioni, P. 102-4 ; Guido Bigoni, Domenica Rusticana, P. 105 ; Pensieri del Settembrini, P. 105-7 ; Dal Gazzettino d’oro, Utili varietà, P. 107-8 ; G. Lanzalone, Al maggiore Vincenzo Notari, P. 108 ; V. Notarius, Risposta, P. 109 ; F. Accinelli, La poesia della vita, P. 109-10.A. 2, n.8(giu. 1893): C. Arlìa, Noterelle filologiche, P. 113-16 ; Guido Bigoni, La quercia del Tasso, P. 116 ; G. Lanzalone, La ginnastica con la neve, P. 116-17 ; Luigi Settembrini, Una lettera inedita di L. Settembrini, P. 118-19 ; V. Notaro, In Ariostum, P. 119 ; L’arte di respirare, P. 120-21 ; F. De Falco, Il suicidio e la religione, P. 122-24.A.2, n.9/10(lug.-ago. 1893): R. Mariano, Ad un banchetto nunziale, P. 129-132 ; G. Lanzalone, A Cristoforo Colombo, P. 132-34 ; C. Arlìa, Note filologiche, P. 135-36 ; G. Olivieri, Il terzo libro della vita di G. Cristo, P. 136-39 ; F. Persico, La pace, P. 140-41 ; L. A. Villari, Cesare Dalbono, P. 141-45.A.2, n.11/12(sett.-ott. 1893): Luigi Settembrini, Una lettera inedita di L. Settembrini, P. 153-54 ; A. De Leo, Vite di illustri salernitani, P. 154-62 ; G. Franciosi, I sogni, P. 162-63 ; A. Frabasile, Bozzetti ellenici, P. 164-70 ; L. A. Villari , Errori Giudiziari, P. 171-75 ; G. Lanzalone, Verismo, P. 175-76.A.3,n.1/2 (nov.-dic. 1893): M. Giordano, La pubblica educazione e l’ateismo, P. 1-4 ; il Settembrini, Concorso, P. 4 ; Per una forca conservata in un museo, P. 5 ; G. Lanzalone, L’Ora presente, P. 5 ; C. Mariano Pilar, Silvio Spaventa, P. 6-19 ; C. Arlìa, Note filologiche, P. 20-1 ; G. Grammatica, Ideale, P. 22 ; G. Olivieri, Funesta rimembranza, P. 31-2 ; G. Olivieri, La notte della vigilia del Natale, P. 32.A.3, n.3/4(gen.-feb. 1894): G. Lanzalone, E la nostra petizione?, P. 33-5 ; Dall’albo di Luigi Antonio Villari, P. 36 ; G. Olivieri, Una visita inaspettata, P. 37-46 ; A. Frabasile, Alla signora G. P., P. 47 ; M. Giordano, Il Governo, i Municipi e l’istruzione religiosa, P. 48-53 ; G. Lanzalone, Esercizi militari, P. 53 ; C. Arlìa, Note filologiche, P. 54 ; G. Lanzalone, Un dubbio proposto al prof. Sabbadini, P. 54-5 ; G. L., Risultato del passato concorso e concorso nuovo, P. 55-6 ; R. Galdi, Epistola di Catullo ad Ortalo, P. 57.A.3, n.5/6(mar-apr 1894): G. Lanzalone, Dell’educazione nelle scuole classiche, P. 65-70 ; G. L., Un epigramma di Leone XIII, P. 70-1 ; V. Caputo, Vita di borso, P. 72-6 ; C. Arlìa, Note filologiche, P. 76-7 ; G. Lanzalone, Amore, P. 78 ; Aniello Gaeta, Dulcissime Rerum, P. 79-81 ; Francesco De Falco, La duchessa Ravaschieri e il dormitorio, P. 81-2 ; Carmine Zottoli, Risultato del passato concorso e concorso nuovo, P. 82-6.A.3, n. 7/8(mag. – giu 1894): C. Arlìa, Note filologiche, P. 97-8 ; G. Lanzalone, Per il 1°Maggio, P. 98-101 ; M. Giordano, La libertà d’insegnamento e di coscienza, P. 101-10 ; L. A. Villari, Il capitano Tim- Tim, P. 111- 15 ; C. A. Alemagna, L’opera recente di Herbert Spencer, P. 115-16 ; Nicc. Castagna, Sospiro, P. 116 ; G. Cuomo, Sovra un passo del carme “I Sepolcri”, P. 117-20.A.3, n.9(lug. 1894): Concorso nuovo, P. 125 ; C. Arlìa, Note filologiche, P. 126-27 ; Il manicomio dei genii, P. 127 ; G. Lanzalone, Elena, P. 128 ; Giovanni Cuomo, Nunzio del giorno, P. 128-29 ; Giovanni Manfredi, Ofelia, P. 129 ; G. Lanzalone, Da Anacreonte, P. 139.A.3, n.10(ago. 1894): R. Sabbadini, L’anno della nascita di Gasparino Barziza, P. 141-42 ; G. Lanzalone, Il Discredito dei versi, P. 142-46 ; C. Arlìa, Note filologiche, P. 147-48 ; E. Perito, L’ultima rosa d’estate, P. 148 ; D’Aloja, L’arte e la critica, P. 149-51 ; Epigrammi, P. 151-52

The Use of Matriderm® for Scalp Full-Thickness Defects Reconstruction: A Case Series

Background: The scalp region represent a common area affected by benignant and malignant skin tumor, and it represents a surgical challenge when it is needed to be reconstructed. The aim of this study is to present our experience with full-thickness scalp skin defects, reconstructed using Matriderm® dermal substitute and split-thickness skin graft (STSG). Methods: A retrospective analysis of patients treated for scalp region reconstruction was conducted with 16 patients. All patients underwent the same procedure: scalp full-thickness tumor excision with simultaneous reconstruction with Matriderm® and the application of a split-thickness skin graft in the same surgical time. During follow-ups, the surgical outcome was evaluated by accurate clinical examination of the wound, adopting the Vancouver Scar Scale (VSS). Results: The outcomes obtained were satisfying: wound healing at the end of the procedures was optimal, grafted skin resulted similar to surrounding tissue, and pigmentation and vascularity showed a decrease in the period between 6 months and 1 follow-up. Conclusions: The use of Matriderm® and split-thickness skin grafting for scalp full-thickness defects reconstruction resulted in an optimal, stable, and safe procedure, suitable for elderly patients

Urological dysfunction in young women: an inheritance of childhood?

Objective: To investigate the correlation of a history of lower urinary tract symptomatology during childhood with lower urinary tract dysfunction in young adult women. Subjects and Methods: This was a multicentre, prospective, case–control study conducted between April 2013 and November 2015. A total of 300 women, aged 18–40 years, participated. The case group comprised women attending urogynaecology clinics for various lower urinary tract complaints and the control group was recruited from a healthy population. Exclusion criteria were designed to avoid common causes of lower urinary tract dysfunction and symptoms and included diabetes mellitus, neurological disease and pelvic inflammatory disease. All women completed a self-administered 77-item questionnaire, exploring childhood urological and bowel history, as well as current urological, bowel and sexual symptoms. Statistical analysis was performed using chi-squared and Fisher's exact tests to compare categorical variables. Multivariate logistic regression models were fit for the prediction of the adult outcomes, incorporating as explanatory variables all those that showed a significant P value in bivariate analysis. P values < 0.05 were considered statistically significant. Results: Women with childhood urinary voiding and storage symptoms had a higher prevalence of these symptoms in adult life compared with women without such history. Women with urinary tract infections (UTIs) during childhood had a higher incidence of adult UTIs compared with women without this problem in childhood. Conclusions: Lower urinary tract dysfunction in childhood seems to ‘persist’ in young adult life but the implications of this finding in clinical practice need to be defined in future studies

Nirmatrelvir/Ritonavir and Molnupiravir in the Treatment of Mild/Moderate COVID-19: Results of a Real-Life Study

Molnupiravir and nirmatrelvir were the first available oral antivirals (OAs) active against SARS-CoV-2. Trials evaluating the efficacy of OAs involved patients unvaccinated and infected with variants different from those currently circulating. We conducted a retrospective study on patients with confirmed SARS-CoV-2 infection treated with OAs during the omicron surge in Italy in order to provide real-life data on the efficacy and safety of OAs during the omicron surge of the COVID-19 pandemic. Among 257 patients, 56.8% received molnupiravir, while 43.2% received nirmatrelvir/ritonavir. Patients in the molnupiravir group were older, had a lower body mass index, and had a higher rate of chronic heart disease than those treated with nirmatrelvir/ritonavir. Three hospitalizations were recorded in the molnupiravir (2.1%) group and one in the nirmatrelvir/ritonavir (0.9%) group. One patient treated with molnupiravir died. The median time to negativity was 8 days in the nirmatrelvir/ritonavir group vs. 10 days in the molnupiravir group, p < 0.01. We recorded 37 ADRs (mainly dysgeusia, diarrhea, and nausea) in 31 individuals (12.1%). Only two patients (0.8%) treated with molnupiravir terminated treatment due to ADRs. In conclusion, in a population of mostly vaccinated patients treated with OAs, we observed a low rate of hospitalization, death, and adverse drug reactions. These rates were lower than those reported in pivotal trials

Comorbidity, Hospitalization, and Mortality in COPD: Results from a Longitudinal Study

We evaluated comorbidity, hospitalization, and mortality in chronic obstructive pulmonary disease (COPD), with special attention to risk factors for frequent hospitalizations (more than three during the follow-up period), and prognostic factors for death. Two hundred eighty-eight consecutive COPD patients admitted to respiratory medicine wards in four hospitals for acute exacerbation were enrolled from 1999 to 2000 in a prospective longitudinal study, and followed up until December 2007. The Charlson index without age was used to quantify comorbidity. Clinical and biochemical parameters and pulmonary function data were evaluated as potential predictive factors of mortality and hospitalization. FEV(1), RV, PaO(2), and PaCO(2) were used to develop an index of respiratory functional impairment (REFI index). Hypertension was the most common comorbidity (64.2%), followed by chronic renal failure (26.3%), diabetes mellitus (25.3%), and cardiac diseases (22.1%). Main causes of hospitalization were exacerbation of COPD (41.2%) and cardiovascular disease (34.4%). Most of the 56 deaths (19.4%) were due to cardiovascular disease (67.8%). Mortality risk depended on age, current smoking, FEV(1), PaO(2), the REFI index, the presence of cor pulmonale, ischemic heart disease, and lung cancer. Number and length of hospital admissions depended on the degree of dyspnea and REFI index. The correct management of respiratory disease and the implementation of aggressive strategies to prevent or treat comorbidities are necessary for better care of COPD patients

COVID-19 chest CT and laboratory features of B.1.617.2 (Delta variant) vs B.1.1.7 (Alpha variant) surge: a single center case-control study

To assess clinical, laboratory and radiological differences between Delta and Alpha SARS-CoV-2 variants