Differential and synergistic effects of right and left atrial ganglionated plexi ablation in patients undergoing cardioneuroablation: results from the ELEGANCE multicenter study.

Background: Cardioneuroablation (CNA) treats reflex syncope by ablating ganglionated plexi (GPs) either confined to the right (RA) or left atrium (LA), or accessible from both. We assessed whether GP ablation in one atrium affects parasympathetic modulation in the other and how ablation sequence (RA then LA, or vice-versa) impacts efficacy.

Methods: Two propensity-matched groups of patients with reflex syncope or functional bradycardia were analyzed.

Impact of leaflet splitting on coronary access after redo-TAVI for degenerated supra-annular self-expanding platforms.

Background: Coronary access (CA) is a major concern in redo-transcatheter aortic valve implantation (TAVI) for failing supra-annular self-expanding transcatheter aortic valves (TAVs).

Aims: This ex vivo study evaluated the benefit of leaflet splitting (LS) on subsequent CA after redo-TAVI in anatomies deemed at high risk of unfeasible CA.

Methods: Ex vivo, patient-specific models were printed three-dimensionally.

Standard or Fin SIGN® nail? which option is better for the treatment of femoral fractures in low and middle-income countries?

Purpose: Femoral fractures are common in low and middle-income countries (LMIC), predominantly caused by high-energy trauma. The surgical implant generation network (SIGN®) program offers two different intramedullary nails in LMIC which are designed to be used without image intensifier free of charge for the patients: the SIGN standard nail (SSN®) and the SIGN Fin nail (SFN®). This study aimed to compare the results of the SSN® and the SFN® for the treatment of middle and distal shaft femoral fractures through a retrograde approach.

Patient-specific commissural alignment for ACURATE neo2 implantation in degenerated surgical bioprostheses.

Valve-in-valve TAVI to treat failing surgical aortic valves (SAVs) is increasingly performed, and commissural alignment is a key technical aspect in such procedures. Surgeons optimize valve alignment, accounting for potential coronary eccentricity and achieving a patient-specific optimized commissural orientation, representing the ideal target for TAVI alignment. Therefore, here we present a dedicated stepwise valve-in-valve implantation technique using the ACURATE neo2.

Spinal cord stimulator medullary compression-a very rare SCS complication and surgical treatment.

Introduction: The risk of spinal cord damage after Spinal Cord Stimulator (SCS) implant is a very rare event. In our case report, the patient was affected by a progressively worsening spinal stenosis due to SCS compression.

Case Report: The authors describe a progressive paraparesis in a 58-year-old woman with a long history of back pain and multiple spine surgeries.

How to Treat Repeated Subdural Hematomas after Lumbar Puncture?

Serious complications following spinal anesthesia (SA) are rare. However, surgeons and neurologist need to be aware that postsurgery headache refractory to conservative treatment or change in headache's characteristics could be due to serious intracranial complications such as a subdural hematoma. Any delay in diagnosis and treatment can be fatal.

Dual floor burr hole technique in deep brain stimulation: A retrospective study on 209 patients.

Background: Skin erosion/infections due to deep brain stimulation hardware are highly worrisome complications. They can lead to the removal of the entire deep brain stimulation device, and consequently hold the whole treatment in otherwise pharmacologically refractory patients. Several techniques have been used such as C-shape skin incision and dual floor burr hole or single passage of connecting cables to reduce the incidence of skin complications.

Management of mycoses in daily practice.

The guideline recommendations, albeit founded on thorough reviews of clinically relevant literature data, are often not immediately adaptable to everyday life. Considering the marked heterogeneity of superficial mycoses, each of them requires specific management in a real life context; in all cases diagnostic confirmation is required with microscopic and culture examination. In tinea capitis oral therapy is necessary (minimum six weeks) and should be continued until clinical and, above all, mycological healing.

Critical appraisal of the unmet needs in the treatment of chronic spontaneous urticaria with omalizumab: an Italian perspective.

Purpose Of Review: The humanized anti-IgE antibody omalizumab has been available for patients with chronic spontaneous urticaria (CSU) in Italy since 2015. This review summarizes the unresolved issues and unmet therapeutic needs associated with omalizumab and discusses practical recommendations for its use in the management of CSU.

Recent Findings: Although modern second-generation H1-antihistamines are the standard of care for patients with CSU, adjunctive treatments (including omalizumab) may be required for effective control of symptoms in many patients.

Parsing the phenotype of obsessive-compulsive tic disorder (OCTD): a multidisciplinary consensus.

Obsessive-Compulsive Disorder (OCD) and Tic Disorder (TD) are highly disabling and often comorbid conditions. Of note, the DSM-5 acknowledged a new 'tic-related' specifier for OCD, which might be referred to as Obsessive-Compulsive Tic Disorder (OCTD), raising new interest toward a better clinical characterisation of affected patients. Available literature indicates that early onset, male gender, sensory phenomena and obsessions of symmetry, aggressiveness, hoarding, exactness and sounds as well as comorbidity with Attention Deficit Hyperactivity Disorder (ADHD) may be of more frequent observation in patients with OCTD.

Contralateral interlaminar approach for intraforaminal lumbar degenerative disease with special emphasis on L5-S1 level: A technical note.

Background: Intraforaminal disc herniations at the L5-S1 level are extremely surgically challenging lesions. Intracanal approaches frequently require partial or total facetectomy, which may lead to instability. Solely extraforaminal approaches may offer limited visualization of the more medial superiorly exiting and inferiorly exiting nerve roots; this approach is also more complicated at L5-S1 due to the often large L5 transverse process and the iliac wing.