Background The clinical presentation of COVID-19 in patients admitted to hospital is heterogeneous. We aimed to determine whether clinical phenotypes of patients with COVID-19 can be derived from clinical data, to assess the reproducibility of these phenotypes and correlation with prognosis, and to derive and validate a simplified probabilistic model for phenotype assignment. Phenotype identification was not primarily intended as a predictive tool for mortality. MethodsIn this study, we used data from two cohorts: the COVID-19@Spain cohort, a retrospective cohort including 4035 consecutive adult patients admitted to 127 hospitals in Spain with COVID-19 between Feb 2 and March 17, 2020, and the COVID-19@HULP cohort, including 2226 consecutive adult patients admitted to a teaching hospital in Madrid between Feb 25 and April 19, 2020. The COVID-19@Spain cohort was divided into a derivation cohort, comprising 2667 randomly selected patients, and an internal validation cohort, comprising the remaining 1368 patients. The COVID-19@HULP cohort was used as an external validation cohort. A probabilistic model for phenotype assignment was derived in the derivation cohort using multinomial logistic regression and validated in the internal validation cohort. The model was also applied to the external validation cohort. 30-day mortality and other prognostic variables were assessed in the derived phenotypes and in the phenotypes assigned by the probabilistic model. Findings Three distinct phenotypes were derived in the derivation cohort (n=2667)-phenotype A (516 [19%] patients), phenotype B (1955 [73%]) and phenotype C (196 [7%])-and reproduced in the internal validation cohort (n=1368)phenotype A (233 [17%] patients), phenotype B (1019 [74%]), and phenotype C (116 [8%]). Patients with phenotype A were younger, were less frequently male, had mild viral symptoms, and had normal inflammatory parameters. Patients with phenotype B included more patients with obesity, lymphocytopenia, and moderately elevated inflammatory parameters. Patients with phenotype C included older patients with more comorbidities and even higher inflammatory parameters than phenotype B. We developed a simplified probabilistic model (validated in the internal validation cohort) for phenotype assignment, including 16 variables. In the derivation cohort, 30-day mortality rates were 2•5% (95% CI 1•4-4•3) for patients with phenotype A, 30•5% (28•5-32•6) for patients with phenotype B, and 60•7% (53•7-67•2) for patients with phenotype C (log-rank test p<0•0001). The predicted phenotypes in the internal validation cohort and external validation cohort showed similar mortality rates to the assigned phenotypes (internal validation cohort: 5•3% [95% CI 3•4-8•1] for phenotype A, 31•3% [28•5-34•2] for phenotype B, and 59•5% [48•8-69•3] for phenotype C; external validation cohort: 3•7% [2•0-6•4] for phenotype A, 23•7% [21•8-25•7] for phenotype B, and 51•4% [41•9-60•7] for phenotype C).Interpretation Patients admitted to hospital with COVID-19 can be classified into three...

This study identifies a specific psychological burden experienced by hand eczema patients, highlighting the need for focused psychosocial interventions. Physicians in particular should be aware of the need to identify anxiety and depression in female patients.

Background and Objectives: We analyzed the EEG recordings of a sample of fibromyalgia patients, with the goal of looking for new, more objective indicators on the diagnosis and severity assessment of this pathology, and looking also to establish the relationship of these new indicators with different psychological and neuropsychiatric tests. Methods: We compared the EEG recordings of a group of 13 fibromyalgia patients with a normalized database built into the software of the equipment used (Neuronic), and also with a control group of 13 individuals; both groups were selected under the same criteria of inclusion-exclusion. Patients and controls underwent quantitative EEG (eyes closed), according to international 10-20 EEG system and were specifically evaluated throughout various neuropsychiatric and psychological questionnaires. Results: We obtained the absolute powers of QEEG (quantitative) for the different electrode sites and frequency bands, we determined the corresponding values of the deviation from normal (Z-scores), and estimated various indicators and ratios, as well as correlations with the results of psychological tests. Interestingly, the ratios of theta and beta frequencies in relation with alpha appear as one of the most relevant indicators of the severity of the pathology; significant differences were also found in the peak frequency (maximum power per Hz) of the alpha band, and in the frequency peak of the total spectrum. Conclusions: The consistency of the abnormal EEG patterns of fibromyalgia patients revealed the presence of systemic dysfunction at the central nervous system level, beyond possible peripheral anomalies and specific tissue pathologies. Among the indicators and benchmarks achieved, the most important changes concern the frequencies theta, alpha and beta, and still more significant were the values of their ratios in the comparison between patients and controls. The relative values of peak frequencies are also of interest. The promising results achieved suggest that it is necessary to continue the investigation to validate these new diagnostic indicators.

Purpose The purpose of this paper was to detect the most significant factors associated with each living alternative to improve socialization and mental health of the elderly. The measurements included affective evaluation, cognitive assessment, anxiety level, physical functionality, quality of life and social relationships. Individuals in home nursing residences were older and had worse affective status, functionality, cognitive state and quality of life. Social relationships in community people were better than in the institutionalized condition, particularly for less aged people. Design/methodology/approach Comparative descriptive study realized in 200 people older than 70 years in home nursing placement versus community dwelling conditions. Findings Multivariate analysis and logistic regression indicated that greater disability and poorer quality of social relationships were the main factors influencing the institutionalization process. Specifically, the Sociotype Questionnaire appeared as an efficient tool concerning the detection of social isolation effects as well as an acceptable integrator of prosocial information about home nursing placement. Originality/value The Geriatric Sociotype survey has shown usefulness in the evaluation of the social network of elderly people, both from the point of view of assessment and prognosis. In this sense it is considered that one of the main contributions of this study is to have included the qualitative evaluation of social relations, and to observe the differences according to the place of residence.

Jorge naVarro lóPez * fIesta, alcohol y entretenImIento PoPular. crítIca y PráctIcas festIVas del PartIdo obrero socIalIsta (chIle, 1912-1922) resumen Con el objetivo de ampliar el enfoque sobre la politización obrera y de aportar a la historia cultural de los trabajadores, en este artículo analizo, en primer lugar, la posición crítica del Partido Obrero Socialista respecto al consumo de alcohol entre la clase obrera. Como su crítica buscaba modificar las pautas culturales que entendían como obstáculos para la emancipación de los trabajadores, en segundo lugar se examina el despliegue de las prácticas de entretención alternativa que implementó este partido entre 1912 y 1922 con la intención de proveer de experiencias festivas a las familias obreras para superar las condiciones de explotación. Sostengo la hipótesis que entre la cultura popular y la cultura socialista existía una relación conflictiva debido a las contradicciones entre las costumbres populares y el discurso obrero ilustrado, propuesta que se analiza a partir de la revisión de los periódicos partidistas..