Anemia management and transfusion strategy in internal medicine units: Less is more.

Blood transfusion is one of the most overused procedures, especially in elderly patients. Despite the current transfusion guidelines recommending a restrictive transfusion strategy in stable patients, the clinical practice varies according to physicians' experience and implementation of patient blood management. This study aimed to evaluate the anemia management and transfusion strategy in anemic elderly hospitalized and the impact of an educational program.

Clinical Characteristics and Outcomes of Patients with Acute Respiratory Failure Due to SARS-CoV-2 Interstitial Pneumonia Treated with CPAP in a Medical Intermediate Care Setting: A Retrospective Observational Study on Comparison of Four Waves.

Background: In COVID-19 patients non-invasive-positive-pressure-ventilation (NIPPV) has held a challenging role to reduce mortality and the need for invasive mechanical ventilation (IMV). The aim of this study was to compare the characteristics of patients admitted to a Medical Intermediate Care Unit for acute respiratory failure due to SARS-CoV-2 pneumonia throughout four pandemic waves.

Methods: The clinical data of 300 COVID-19 patients treated with continuous positive airway pressure (CPAP) were retrospectively analysed, from March-2020 to April-2022.

Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis.

Portal hypertension is the consequence of cirrhosis and results from increased sinusoidal vascular resistance and hepatic blood inflow. Etiological therapies represent the first intervention to prevent a significant increase in portal pressure due to chronic liver damage. However, other superimposed pathophysiological drivers may worsen liver disease, including inflammation, bacterial translocation, endothelial dysfunction, and hyperactivation of hemostasis.

Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors.

Urticarial eruptions and angioedema are the most common cutaneous reactions in patients undergoing mRNA COVID-19 vaccinations. The vasoactive peptide bradykinin has long been known to be involved in angioedema and recently also in urticaria. Bradykinin is mainly catabolized by angiotensin-converting enzyme (ACE), which is inhibited by ACE inhibitors, a commonly employed class of antihypertensive drugs.

Mortality in Patients with COVID-19 on Renin Angiotensin System Inhibitor Long-Term Treatment: An Observational Study Showing that Things Are Not Always as They Seem.

Introduction: At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, controversial data were reported concerning angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) that induced a number of physicians to stop using them in patients with COVID-19. Although large-scale studies have ruled out this concern, it is common experience that patients with COVID-19 taking ACE inhibitors or ARBs are at increased risk of death. The aim of this study was to investigate the reasons for this apparently high mortality rate.

[Syndactyly: an angiographic study].

Systematic angiographic examination (87 angiographies) done in all the congenital malformations of the hand and in particular in cases of syndactyly in patients 6-11 years of age, has given the authors the opportunity to observe anomalies of the vascular topography of the hand (distal displacement of the bifurcation of the common digital arteries, anomalies of excess or lack of arteries of the palm: common digital arteries, proper digital arteries, etc.) and of performing surgery carefully according to the angiographic appearance of the malformation.

[Morgagni-Larrey hernia (2 personal cases)].

Morgagni-Larrey hernia is a rare diaphragmatic form whose time of onset is almost impossible to determine. Its symptoms, if any, are not easy to interpret. A standing X-ray of the chest is the only way in which its presence may be suspected and diagnosis must be confirmed by the use of contrast media.

[2 cases of isolated traumatic rupture of the pancreas].

The clinical progression and treatment of two cases of isolated rupture of the pancreas are described. This lesion is rare and of unusual aetiology. Its symptomatology is often modest.

[Various radiological aspects of spontaneous biliary-digestive fistulas].

A number of significant radiological pictures of spontaneous biliodigestive fistula are presented. The aetiopathogenesis, pathological anatomy and clinical medicine of the condition are reviewed and the techniques available for the radiological investigation of biliodigestive short-circuits considered; the most frequent radiological signs and corresponding pictures are discussed and the complications and differential diagnosis with duodeno-biliar reflow examined.