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Dysphonia has been described in patients affected by coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the prevalence of dysphonia, and its severity and extent, of voice fatigue and of dysphagia in non hospitalized patients affected by COVID-19 in Lombardy, the Italian region most hit by the first explosive outbreak of COVID-19 in Europe.

Demographic and clinical data of 160 consecutive patients, with COVID-19 diagnosis confirmed by nasal swabs processed by reverse transcription polymerase chain reaction, were gathered by means of telephone interviews performed by physicians in charge of daily follow-up. General and specific symptoms concerning voice and swallowing impairment were investigated. Dysphonia grade and duration were graded on 4-point scales, while voice fatigue was graded on a 5-point scale.

Dysphonia was reported by 70 (43.7%) patients and was positively associated with voice fatigue (P < 0.001), cough (P=0.005), rhinitis (P=0.01), and dyspnea (P=0.06); it was mild and/or moderate in 69 patients, but its duration was > 2 weeks in 33/70 (47.1%) patients and >1 month in 11/70 (15.7%). Grade and duration of dysphonia were positively associated with cough and rhinitis (all P values < 0.01). Voice fatigue was reported by 43/160 patients (26.8%) and its severity was correlated with dysphonia (P < 0.0001), cough (P=0.02), rhinitis (P=0.02), dyspnea (P < 0.001), and loss of appetite (P=0.01). Dysphagia was encountered in 27/160 patients (16.9%) and was associated with dysgeusia, cough, arthralgia, myalgia and loss of appetite but not with dysphonia.

Dysphonia was a highly prevalent and long-lasting symptom in this series; it has been underestimated to date. Further studies might shed light on the pathophysiology of voice disorders in COVID-19 patients.

Dysphonia was a highly prevalent and long-lasting symptom in this series; it has been underestimated to date. Further studies might shed light on the pathophysiology of voice disorders in COVID-19 patients.

Migraine attacks have a high impact on daily activities. There is limited research on the burden of migraine on sexual functioning.

To determine the prevalence of sexual dysfunction in patients with migraine and its relationship with migraine features and comorbidities.

This is a cross-sectional study. We included migraine patients between 18 and 60 years-old from 8 Headache Clinics in Spain. We recorded demographic data and migraine features. Patients fulfilled a survey including comorbidities, Arizona Sexual Experiences Scale, Hospital Anxiety and Depression Scale and a questionnaire about migraine impact on sexual activity. A K-nearest neighbor supervised learning algorithm was used to identify differences between migraine patients with and without sexual dysfunction.

We included 306 patients (85.6% women, mean age 42.3±11.1 years). A 41.8% of participants had sexual dysfunction. Sexual dysfunction was associated with being female (OR [95% CI] 2.42 [1.17-5.00]; p<0.001), being older than 46.5 yeedication are not directly associated with sexual dysfunction. Instead, risk factors for sexual dysfunction were female gender, higher age, menopause and depression.

To identify the innovations in teaching of Geriatrics at the Spanish Medical Schools.

Interviews with those responsible for Geriatrics teaching at the Spanish Medical Schools through a short online survey. Existing Geriatrics curricula and responsible professors were identified by reviewing the curricula of the different Medical Schools.

35 of the 42 Medical Schools incorporated teaching in Geriatrics in 2019 with an answer rate of 94.3%. Regarding Geriatrics training it stand out classic methods (master classes, clinical rotations, and theoretical seminars), followed by innovation of teaching programs (clinical simulation and use of new technologies). While OSCE and portfolio stand out among the innovative evaluation tools of Geriatrics teaching. Of the 33 Medical Schools with Geriatrics teaching surveyed, 60.6% of them included the use of at least one innovative teaching or evaluation methodology.

Although the classical model predominates as a teaching methodology in Geriatrics, different innovations are also used in the undergraduate teaching in Spain. It is necessary to continue working in this area that may help a better level of skills in Geriatrics for our students.

Although the classical model predominates as a teaching methodology in Geriatrics, different innovations are also used in the undergraduate teaching in Spain. It is necessary to continue working in this area that may help a better level of skills in Geriatrics for our students.

Enhanced recovery pathways aim to reduce postoperative opioid use and opioid-related complications. These pathways often include epidural analgesia (EA). This study examines postoperative opioid use after elective laparotomy with and without EA.

Retrospective chart review of elective laparotomies performed by General Surgery at a tertiary academic center during 2017 was completed. Primary outcome was postoperative opioid usage. Secondary outcomes were time to mobilization, duration of urinary catheterization and postoperative ileus.

Among 236 patients, 213 (90%) received EA. There was no significant difference in mean total oral morphine equivalent (OME) usage between EA and non-EA groups. Mean OME use on postoperative day three was higher in the EA group (38.0 vs 22.4mg, p=0.02). On multivariate analysis, preoperative opioid use was associated with increased postoperative OME consumption (regression coefficient 147.5, p<0.001).

In this cohort, epidural analgesia did not reduce postoperative opioid consumption.

In this cohort, epidural analgesia did not reduce postoperative opioid consumption.

COVID-19 acute respiratory distress syndrome (ARDS) shares the common histological hallmarks with other forms of ARDS. selleck kinase inhibitor However, the chronology of the histological lesions has not been well established.

To describe the chronological histopathological alterations in the lungs of patients with COVID-19 related ARDS.

A prospective cohort study was carried out.

Intensive Care Unit of a tertiary hospital.

The first 22 consecutive COVID-19 deaths.

Lung biopsies and histopathological analyses were performed in deceased patients with COVID-19 related ARDS. Clinical data and patient course were evaluated.

The median patient age was 66 [63-74] years; 73% were males. The median duration of mechanical ventilation was 17 [8-24] days. COVID-19 induced pulmonary injury was characterized by an exudative phase in the first week of the disease, followed by a proliferative/organizing phase in the second and third weeks, and finally an end-stage fibrosis phase after the third week. Viral RNA and proteins were detected in pneumocytes and macrophages in a very early stage of the disease, and were no longer detected after the second week.