Deep Serratus Anterior Plane Block for Multimodal Analgesia in Minimally Invasive Mitral Valve Surgery Performed via Right Anterior Mini-Thoracotomy.

Objective: This study investigated if the serratus anterior plane block (SAPB) within a multimodal analgesia scheme would reduce acute post-operative pain and intravenous opioid consumption in patients admitted to the intensive care unit after isolated minimally invasive mitral valve surgery.

Design: Retrospective study.

Setting: Patients were admitted to the intensive care unit (ICU) of the University Hospital of Siena (Italy).

Pulmonary Arterial Hypertension Incidence in Scleroderma Patients Treated with Bosentan for Digital Ulcers: Evidence from the Italian SPRING Registry.

Objective: Bosentan (BOS) is approved for treating pulmonary arterial hypertension (PAH) and preventing digital ulcers (DU) in systemic sclerosis (SSc). Our study aimed to evaluate whether BOS prescribed for DU could reduce the incidence of PAH in a large SSc cohort from the SPRING registry.

Methods: Patients with SSc from the SPRING registry, meeting ACR/EULAR 2013 classification criteria with data on PAH onset, DU status, BOS exposure, and at least a one-year follow-up between 2015 and 2020, and no known PAH at baseline were included.

Critical Issues in the Management of CRMS/CFSPID Children: A National Real-World Survey.

Background: Notwithstanding guidance from the European Cystic Fibrosis (CF) Society (ECFS) neonatal screening (NBS) working group, significant variation persists in the evaluation and management of Cystic Fibrosis Screen Positive, Inconclusive Diagnosis (CFSPID) subjects, leaving many aspects of care under debate. This study reports the results of a national survey investigating management and treatment approaches of pre-school CFSPIDs in Italy.

Methods: In February 2024, a comprehensive questionnaire was distributed to all Italian CF centers.

Effectiveness and Predictors of Long-Term Treatment Response to Tofacitinib in Rheumatoid Arthritis Cohort: General Analysis and Focus on High-Cardiovascular-Risk Subgroup-A Multicenter Study.

The treatment landscape for Rheumatoid Arthritis (RA) has evolved significantly with the introduction of Janus kinase inhibitors (JAKi), such as Tofacitinib (TOFA), which offer a new therapeutic option for patients who have failed or are intolerant to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). Safety concerns, particularly related to cardiovascular and cancer risks, prompted a need for additional investigation in real-world clinical settings. This study aimed to evaluate the long-term effectiveness and predictors of response to TOFA in two subpopulations of RA patients, categorized by differing cardiovascular risk profiles.

Establishing an Extracorporeal Cardiopulmonary Resuscitation Program.

Extracorporeal cardiopulmonary resuscitation (ECPR) is a complex, life-saving procedure that uses mechanical support for patients with refractory cardiac arrest, representing the pinnacle of extracorporeal membrane oxygenation (ECMO) applications. Effective ECPR requires precise patient selection, rapid mobilization of a multidisciplinary team, and skilled cannulation techniques. Establishing a program necessitates a cohesive ECMO system that promotes interdisciplinary collaboration, which is essential for managing acute cardiogenic shock and severe pulmonary failure.

Articulating Video Stylets in the Setting of Simulated Traumatic Cervical Spine Injury: A Comparison with Four Other Devices and Approaches to Endotracheal Intubation.

Simulation offers the opportunity to train healthcare professionals in complex scenarios, such as those with as traumatized patients. We conducted an observational cross-sectional research simulating trauma with cervical immobilization. We compared five techniques/devices: direct laryngoscopy (DL), videolaryngoscopy (VLS, Glidescope or McGrath), combined laryngo-bronchoscopy intubation (CLBI) and articulating video stylet (ProVu).

Automated and reference methods for the calculation of left ventricular outflow tract velocity time integral or ejection fraction by non-cardiologists: a systematic review on the agreement of the two methods.

Echocardiography is crucial for evaluating patients at risk of clinical deterioration. Left ventricular ejection fraction (LVEF) and velocity time integral (VTI) aid in diagnosing shock, but bedside calculations can be time-consuming and prone to variability. Artificial intelligence technology shows promise in providing assistance to clinicians performing point-of-care echocardiography.

Uncommon but Significant: Onset, Characteristics and Management of Vasculitis and Connective Tissue Diseases Induced by Immunomodulators during Cancer Treatment.

The introduction of immunomodulators as adjuvant therapies in cancer treatment has represented a significant advancement in oncology, improving therapeutic response and patient survival. Emerging targets and molecules could provide new therapeutic opportunities for cancer patients. However, these agents can induce immunological side effects, including vasculitis and connective tissue diseases, which, while uncommon, present significant clinical challenges.

Comprehensive Clinical and Genetic Characterization of Kabuki Syndrome: A Case Series Study.

Kabuki syndrome is a rare congenital disorder characterized by a distinctive combination of craniofacial features, developmental anomalies, and intellectual disabilities. This study aims to provide a comprehensive exploration of Kabuki syndrome through a meticulous case series analysis focusing on its clinical features and genetic underpinnings. A cohort of 9 Kabuki syndrome patients was identified through a retrospective examination of medical records spanning from 1996 to 2022.

Effects of very early hyperoxemia on neurologic outcome after out-of-hospital cardiac arrest: A secondary analysis of the TTM-2 trial.

Purpose: Hyperoxemia is common in patients resuscitated after out-of-hospital cardiac arrest (OHCA) admitted to the intensive care unit (ICU) and may increase the risk of mortality. However, the effect of hyperoxemia on functional outcome, specifically related to the timing of exposure to hyperoxemia, remains unclear.

Methods: The secondary analysis of the Target Temperature Management 2 (TTM-2) randomized trial.

Adaptive servo-ventilation for the treatment of intrathecal baclofen-induced central sleep apnea: A case report.

Baclofen is a common muscle relaxant agent used in a number of neurological disorders acting at central level and potentially causing adverse respiratory events, still largely unknown at therapeutic doses. We present the case of a young woman with spastic tetraparesis secondary to perinatal asphyxia treated with a standard dose of intrathecal baclofen who developed nocturnal symptoms, somnolence and memory loss during the day. Nocturnal cardio-respiratory sleep monitoring showed a high number of central sleep apneas (CSA).

Recommendations for fast-track extubation in adult cardiac surgery patients: a consensus statement.

Introduction: Enhanced recovery after cardiac surgery in selected low-risk patients, has the potential to improve outcomes and reduce the burden of healthcare costs. Anesthesia-related challenges play a major role in the successful implementation of Enhanced Recovery After Surgery (ERAS) protocols, with particular emphasis placed on fast-track extubation. Acknowledging the importance of this practice, the Italian Association of Cardiac Anesthesiologists and Intensive Care (ITACTAIC) has advocated for an initiative to establish a consensus offering practical recommendations for fast-track extubation after adult cardiac surgery.

AO/OTA B and C articular fractures of the distal humerus: What are the boundaries between Total Elbow Arthroplasty and ORIF?

Background: Nowadays, an increasing number of Total Elbow Arthroplasty (TEA) surgeries have been selected as the primary intervention for distal humerus joint fractures. TEA has demonstrated favorable outcomes in elderly osteoporotic patients and has been associated with fewer complications and reduced stiffness when compared to Open Reduction Internal Fixation (ORIF) surgeries. This retrospective cohort study aimed to analyze differences in terms of functional outcomes, complications, and reoperation rates of distal fractures of the humerus treated with ORIF and TEA.

Psychometric Characteristics of the Quality of Oncology Nursing Care Scale (QONCS): A Validation Study.

Objectives: Quality care in healthcare settings shortens hospitalization, reduces infection rates and complication risks, and improves patients' ability to manage their symptoms. Due to the absence of tools for assessing care quality in Italian oncology settings, this study aimed to evaluate the psychometric properties of the Italian version of the Quality of Oncology Nursing Care Scale (QONCS).

Methods: The study comprised 4 phases.

Aztreonam and avibactam combination therapy for metallo-β-lactamase-producing gram-negative bacteria: a comprehensive review.

Background: Carbapenem-resistant gram-negative bacteria represent a challenging healthcare threat, accounting for metallo-β-lactamases (MBL) production increase across the world. MBL-producing Enterobacterales and Pseudomonas aeruginosa represent the main target for ultimate antibiotics combinations due to the difficulty to include carbapenems within the antimicrobial treatment.

Objectives: To provide a comprehensive review of the current knowledge about the aztreonam/avibactam (ATM-AVI) combination, which has emerged as a promising option for treating MBL-producing bacteria.

Familial Mediterranean fever in children from central-southern Italy: a multicentric retrospective cohort study.

Introduction: Although familial Mediterranean fever (FMF) is a relevant disease in countries surrounding the Mediterranean Sea, there are still few reports from Italy.

Methods: We retrospectively evaluated patients with FMF diagnosed according to the EuroFever/PRINTO classification criteria in three pediatric rheumatology referral centers in central-southern Italy. Logistic regression analysis assessed the associations between age at disease onset and symptoms.

Issues with Cefiderocol Testing: Comparing Commercial Methods to Broth Microdilution in Iron-Depleted Medium-Analyses of the Performances, ATU, and Trailing Effect According to EUCAST Initial and Revised Interpretation Criteria.

Background: The rise of multi-drug-resistant Gram-negative bacteria necessitates the development of new antimicrobial agents. Cefiderocol shows promising activity by exploiting bacterial iron transport systems to penetrate the outer membranes of resistant pathogens.

Objectives: This study evaluates the efficacy of cefiderocol testing methods and trailing effect impact using a ComASP Cefiderocol panel, disk diffusion (DD), and MIC test strips (MTS) compared to iron-depleted broth microdilution (ID-BMD).

SICOB Italian clinical practice guidelines for the surgical treatment of obesity and associated diseases using GRADE methodology on bariatric and metabolic surgery.

Obesity is a chronic disease associated with increased morbidity and mortality and reduced quality of life. Pharmacotherapy can be associated with life style changes in increasing and maintaining weight loss and ameliorating obesity-related complications and comorbidities. In patients affected by obesity and uncontrolled obesity-associated complications or high degrees of BMI (> 40 Kg/m), metabolic bariatric surgery can be a valid therapeutic option.

Molecular diversity in fusidic acid-resistant Methicillin Susceptible .

Objectives: The recent emergence of fusidic acid (FA)-resistant has underscored the importance of active surveillance in isolating these strains. The molecular basis of fusidic acid resistance and the carriage of virulence factors in four borderline oxacillin-resistant (BORSA) clinical strains was assessed through phenotypical and genotypical methods.

Methods: All clinical strains were obtained from various hospital units in Sicily antibiotic susceptibility testing was conducted.

Infrarenal Aortic Treatment With AFX2 Endograft: Results From a Multicentric, International, Non-Randomized, Prospective Registry-the AFX2-LIVE Study.

Introduction: To confirm real-world clinical practice results reported with anatomically fixed bifurcated endograft, a physician-initiated study was designed-AFX2-LIVE registry.

Materials And Methods: From November 2019 to August 2021, investigators enrolled all consecutive patients treated with AFX2 (Endologix Inc., Irvine, CA, USA) endograft.

Is artificial intelligence prepared for the 24-h shifts in the ICU?

Integrating machine learning (ML) into intensive care units (ICUs) can significantly enhance patient care and operational efficiency. ML algorithms can analyze vast amounts of data from electronic health records, physiological monitoring systems, and other medical devices, providing real-time insights and predictive analytics to assist clinicians in decision-making. ML has shown promising results in predictive modeling for patient outcomes, early detection of sepsis, optimizing ventilator settings, and resource allocation.

Cerebellar tDCS combined with augmented reality treadmill for freezing of gait in Parkinson's disease: a randomized controlled trial.

Background: Parkinson's disease (PD) is often accompanied by gait disorders and freezing of gait (FoG), disabling symptoms that are resistant to conventional dopamine treatments. Given the cerebellum's connectivity with the motor cortex and basal ganglia, and its implication in PD, combining transcranial direct current stimulation targeting the cerebellum (ctDCS) with physical exercise might improve gait and balance.

Objective: This study aimed to evaluate the effectiveness of a novel rehabilitation approach that combines noninvasive cerebellar stimulation with motor-cognitive training via an augmented reality treadmill (C-Mill VR) in individuals with PD and FoG.