Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

La Rerum Novarum. Il documento-evento dell'insegnamento sociale della Chiesa

Nella ricorrenza del secondo centenario della nascita di Leone XIII e dei centoventi anni dalla pubblicazione della Rerum Novarum, l'omonima rivista, il cui primo numero è uscito nel 2000, con il sottotitolo di Quaderni di studi sociali dell'istituto culturale Leone XIII, riprende le pubblicazioni con un numero doppio, come annali 2010-2011 e in una nuova veste grafica. Sulla base di una ricca e inedita documentazione dell'Archivio segreto vaticano, Carlo Felice Casula ricostruisce la lunga gestazione dell'enciclica leonina e ripercorre, con la sua riconosciuta competenza e con indubbia capacità di sintesi, l'evoluzione dell'insegnamento sociale della Chiesa, da Leone XIII a Giovanni Paolo II. Due giovani studiosi, Federica Cianfriglia e Vittorio V. Alberti, dipingono un quadro di grande interesse sugli echi e sulle polemiche nella stampa italiana dell'epoca suscitati dalla Rerum Novarum. In appendice è ripubblicato un capitolo del notissimo libro di Edoardo Soderini, Il pontificato di Leone XIII, edito da Mondadori nel 1932

Pio XII visto da vicino. Con un diario inedito del 1954

Cardinal Domenico Tardini, Secretary of State of John XXIII, in the book Pius XII reconstructed, in 1961, with a rich set of documents, the figure and work of Pius XII, of whom he had been the closest collaborator, together with monsignor Giovanni Battista Montini. The book, translated into many/various languages, is now republished in an anastatic edition with an introduction that reconstructs its publishing success and the appreciation of scholars. It is followed by a very interesting unpublished diary of 1954, the year of the long and painful illness of the Pope, in which Tardini annotates the conversations that took place in the audiences. As evidenced in the introduction, the complex dynamics of the Curia and the limits of the late pontificate of Pius XII and his solitudinarian government of the Church emerge from the lucid powerful reports of the papal audiences. In these encounters with Pius XII seen up close, Tardini captures the rich human and religious personality of the suffering pope with psychological finesse

Education for peace and missed Nobel Price for Maria Montessori-Educazione alla pace e mancato Premio Nobel per Maria Montessori

For three years (1949-1950-1951), Maria Montessori was candidate to Nobel Price for Peace without succeeding. These Events, which have not been sufficiently studied in the personal and intellectual biography of Maria Montessori, are reconstructed in the present essay, basing on the documents from Nobel Price.org, from Unesco Archive and from Historical Archive of Luigi Sturzo Institute, where the documents of Maria De Unterrichter Jervolino are kept, who was the most convinced and influential supporter of the Maria Montessori’s nomination. The national and international political contexts of these events are reconstructed, on the view of the most general evolution of the montessorian elaboration and practices. The contribute of Maria Montessori to the education for peace is examined on his essential aspects, starting from her writings from the Thirties