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.

[The closure of oroantral fistulae by Celestnick's technic. Its applications and the authors' modifications]. / La chiusura delle fistole oro-antrali mediante la tecnica di Celestnick. Applicazioni e modifiche personali.

Occasionally an oroantral communication persists after rigorous standard therapy. This case report demonstrates the successful use of a personal method for the closing of persistent oroantral fistulas.

[Myocutaneous flaps of the greater pectoral muscle in cervico-maxillo-facial oncologic surgery]. / Il lembo miocutaneo del muscolo grande pettorale in chirurgia oncologica cervico-maxillo-facciale.

A number of clinical cases have been used to demonstrate the possibility of using the myocutaneous flap of the greater pectoral muscle in cervico-maxillo-facial oncological surgery. With this reconstructive possibility, neoplasias judged inoperable up to a short time ago can now be treated surgically, permitting more and more extensive demolition while at the same time guaranteeing first intention healing and acceptable functional and morphological healing. In all cases reported, results were always excellent. It is interesting to note that it was possible, where necessary, to complete and enrich the reconstructive procedure by associating other types of flaps, myocutaneous (deltopectoral) or free (Thiersch).

[Fracture of the mandibular condyle in childhood]. / La frattura del condilo mandibolare in età evolutiva.

Cases of mandibular condyle fracture have been reported in patients in evolutive age. Conservative and rehabilitative treatment was carried out with excellent anatomofunctional results in the course of growth.

[Tumors of the minor salivary glands. A clinical case and review of the literature]. / I tumori delle ghiandole salivari minori. Un caso clinico e revisione della letteratura.

A review of the literature showed statistical data that were not always in agreement because of the different disciplines--stomatological and oncological--of the authors. A clinical case of mixed tumour of the palate of unusual dimensions is reported. This brought problems in removal and plastic surgery of the palate.