Breast Regional Anesthesia Practice in the Italian Public Health System (BRA-SURVEY): A Survey-Based National Study.

Background: Breast cancer is the most common malignancy in women. Surgery is a mainstay therapy unfortunately burdened by complications as severe postoperative pain. Regional anesthesia may play a role in a multimodal strategy for prevention and treatment of postoperative pain.

Right Heart Thrombus in an Adult COVID-19 Patient: A Case Report.

Introduction: Right heart thrombus (RiHTh) can be considered a rare and severe condition associated with thromboembolic phenomena. A case is described of a COVID-19 patient presenting with an isolated thrombus in the right ventricle.

Case Presentation: An 80-years-old Caucasian male was admitted in an intensive care unit (ICU) for COVID-19 related acute respiratory distress syndrome.

[Sudden cardiac death in athletes: is it always not preventable?].

Sudden cardiac death (SCD) in athletes is a rare but tragic event particularly considering that in some cases it is preventable. In young athletes with cardiovascular disease the risk of SCD is 2,5 times higher than in non-athletes. In young athletes (<35 years old), the most common causes of SCD are related to pre-existing cardiovascular disorders including hypertrophic cardiomyopathy, congenital coronary anomalies, arrhythmogenic right ventricular dysplasia, commotio cordis, some channelopathies and cardiac sarcoidosis.

Left ventricular non compaction: epidemiology, clinical findings, diagnosis and therapy.

Left ventricular non compaction (LVNC) is a cardiomyopathy due to an arrest of the normal development of myocardium which determines the persistence of fetal myocardium in postnatal life in at least 2/3 of the wall (criterion known as non compacted/ compacted ratio greater than 2). Although in absence of a confirmed prevalence of LVNC, reviewing literature shows an increasing number of reports over the years, though diagnosed cases represent just the tip of a realistically far wider phenomenon. Clinical manifestations are variable, ranging from the absence of any symptom to congestive heart failure, arrhythmias and systemic thromboembolism.

[Morpho-volumetric assessment of the right ventricle: a comparison between three-dimensional echocardiography and cardiac magnetic resonance].

The morpho-volumetric assessment of the right ventricle (RV) is useful in the diagnosis and prognosis of many congenital and acquired cardiovascular diseases. The complexity of the right ventricular shape does not allow an adequate and satisfactory evaluation of the RV. Two-dimensional (2D) echocardiography is the most used tool for the assessment of RV function, as it is a noninvasive, reproducible and widespread technique, but the geometric assumptions required for measurement of RV volumes reduce its accuracy.

[Diagnosis, prognosis and treatment of "myocardial bridging": state of the art and unresolved issues].

The current gold standard for the diagnosis of myocardial bridging is conventional coronary angiography; however, it shows only indirect signs of the disease, due to the systolic compression of the artery caused by the myocardial bridge with narrowing of the lumen and diastolic relaxation. On the other hand, computed tomography coronary angiography, even though exposing to radiation, clearly demonstrates the intramural course, the overlying muscular bands and the surrounding tissues also in asymptomatic patients and in absence of systolic compression. The prognosis of patients with myocardial bridge is usually good, but further studies are needed to evaluate the long-term prognosis of these patients, the adequate diagnostic and preventive approach and to better discern which patients should be candidate to medical, percutaneous or surgical treatment.

Role of bisoprolol in patients with long QT syndrome.

Background: Long QT syndrome (LQTS) is a disorder of ventricular repolarization usually treated with β-blockers, mostly with propanolol and nadolol. The aim of our study was to evaluate the role of bisoprolol in LQTS patients.

Methods: A total of 34 patients were evaluated in an average follow-up time of 93 months: 31 months without treatment, 31 months in treatment with nadolol or propanolol and 31 months in treatment with bisoprolol.

Drugs to be avoided in patients with long QT syndrome: Focus on the anaesthesiological management.

Long QT syndrome incidence is increasing in general population. A careful pre-, peri- and post-operative management is needed for patients with this syndrome because of the risk of Torsades de Pointes and malignant arrhythmias. The available data regarding prevention of lethal Torsades de Pointes during anesthesia in patients with long QT syndrome is scant and conflicting: only case reports and small case series with different outcomes have been published.

[Cardiorenal syndrome: the role of new biochemical markers].

Cardiorenal syndrome is a pathophysiological heart and kidney disorder, in which acute or chronic dysfunction of one organ induces a damage in the other. It's a syndrome more and more often encountered in clinical practice and this implies the need to recognize the syndrome through biochemical markers with a good sensitivity and specificity, since its earliest stages in order to optimize therapy. In addition to widely validated biomarkers, such as BNP, pro BNP, creatinine, GFR and cystatin C, other promising molecules are available, like NGAL (neutrophil gelatinase-associated lipocalin, KIM-1 (kidney injury molecule-1), MCP-1 (monocyte chemotactic peptide), Netrin-1, interleuchin 18 and NAG (N-acetyl-β-glucosa-minidase).

Striatonigral suppression of focal hippocampal epilepsy.

Both caudate nucleus (CN) and substantia nigra (SN) appear to be involved in the control of epileptogenic events. Previous investigations had demonstrated that both CN and SN stimulations are able to induce hippocampal theta (theta) rhythm and an inhibition of epileptiform spikes. Since the two structures are reciprocally linked by fibre pathways, experiments were carried out to test the possibility that CN influences the hippocampus via SN or vice versa.

A study of caudate inhibition on an epileptic focus in the cat hippocampus.

The mechanisms whereby the caudate nucleus modifies hippocampal spiking activity have been studied. Epileptiform activity was induced in the cat hippocampus by topical application of sodium penicillin in different concentrations. The frequency of induced spikes appeared to be directly correlated to the two doses of epileptogenic agent.

Pigeon oesophageal EMG activity: analysis of intramural neural control.

The effects of agonist and antagonist cholinergic and adrenergic drugs on spontaneous electrical activity of transverse muscular strips of pigeon cervical oesophagus were examined. Tetrodotoxin failed to affect EMG activity. Cholinomimetics produced excitatory effects.

Study of spindle-spike interactions: features of basal ganglia control.

Changes in cortical spindle distribution following penicillin (PCN) injections were studied in feline generalized PCN epilepsy. PCN activation caused no substantial changes in spindle duration, frequency and intraburst frequency, while significant reductions in the amplitude of the negative waves were noted. At the same time combinations of spindle waves and epileptic complexes were recorded with one or more spikes randomly occurring at the beginning, in the middle, or at the end of a spindle envelope.

Hippocampal seizures and striatal regulation: a possible functional pathway.

Experimental findings have suggested the possibility of a functional relationship between the basal ganglia and the hippocampus. Previous research has revealed a predominantly inhibitory action of the caudate nucleus (CN) and an excitatory effect of the globus pallidus (GP) on electrically induced hippocampal afterdischarges (HAD). The effects of electrolytic destruction of the CN on the threshold and duration of HAD has been studied in the 'encéphale isolé' cat.

Relations between basal ganglia and hippocampus: action of substantia nigra and pallidum.

Several interrelationships exist between basal ganglia and hippocampus. The ventral striatum appears to be involved in the control of the dopaminergic nigro-striatal pathway. The caudate, in turn, seems to influence the hippocampal theta rhythm and to inhibit hippocampal spikes.

Modulation of paroxysmal activity in the hippocampus by caudate stimulation in the chronic cat.

Afterdischarges in the dorsal hippocampus (HADs) were studied in freely-moving cats with implanted electrodes following threshold stimulation of the mirror-image point on the contralateral side. Marked inhibition, similar so that seen in acute animals, was observed when the test stimulation was immediately preceded by a conditioning stimulus applied to the caudate nucleus. The inhibitory effect appeared to be larger in these chronic animals than in the acute preparations previously studied, probably because of the total absence of anaesthesia during the recording session.

Effects of caudate nucleus on paroxysmal activity in hippocampus of cat.

Electrically induced afterdischarges (ADs) were evoked in cat's dorsal hippocampus. The effect of the conditioning prestimulation of the caudate head on AD duration was tested. A strong inhibitory action was observed when conditioning caudate stimulation immediately preceded hippocampal test stimulation.

[Contrasting effects of stimulation of the caudate nucleus and globus pallidus on paroxysmal hippocampal activity in the cat].

The different actions exerted by pallidum and caudate nucleus on electrically induced epileptic activity of hippocampus were analyzed. Caudate appeared to inhibit hippocampal after discharges duration (HAD) while the globus pallidus exerted a facilitatory effect on HAD duration. Both effects were maximal when conditioning stimulation immediately preceded hippocampal test stimulation.

[Effect of the globus pallidus on hippocampal epilepsy in the cat].

The action of the pallidum on electrically induced afterdischarge of the hippocampus (HAD) was studied. Significant facilitatory influences on HAD duration were observed when pallidal conditional stimulation immediately preceded hippocampal test stimulation. The phenomenon appeared to be into correlation with the interval between conditioning and test stimulation.

Role of glossopharyngeal nerve on the control of pigeon cervical esophagus motility.

The effects of i) glossopharyngeal section on the occurrence of the primary peristalsis and ii) electrical efferent stimulation of glossopharyngeal nerve on the EMG activity were studied in the pigeon cervical esophagus. The results pointed out that glossopharyngeal nerve is an indispensable requirement for the primary peristalsis occurrence and that motor sequence is centrally programmed.

Interrelations between globus pallidus and hippocampal epilepsy in the cat.

Electrically induced afterdischarge (ADs) were evoked in the cats' dorsal hippocampus. The action of the conditioning prestimulation of the pallidus nucleus on AD duration was studied. A significant facilitatory influence was observed when pallidal conditioning stimulation immediately preceded hippocampal test stimulation.