Reshaping care in the aftermath of the pandemic. Implications for cardiology health systems

In the last two years, the COVID-19 pandemic has undeniably changed everyday life and significantly reshaped the healthcare systems. Besides the direct effect on daily care leading to significant excess mortality, several collateral damages have been observed during the pandemic. The impact of the pandemic led to staff shortages, disrupted education, worse healthcare professional well-being, and a lack of proper clinical training and research. In this review we highlight the results of these important changes and how can the healthcare systems can adapt to prevent unprecedented events in case of future catastrophes

Measurement of Sea Waves

Sea waves constitute a natural phenomenon with a great impact on human activities, and their monitoring is essential for meteorology, coastal safety, navigation, and renewable energy from the sea. Therefore, the main measurement techniques for their monitoring are here reviewed, including buoys, satellite observation, coastal radars, shipboard observation, and microseism analysis. For each technique, the measurement principle is briefly recalled, the degree of development is outlined, and trends are prospected. The complementarity of such techniques is also highlighted, and the need for further integration in local and global networks is stressed

Small vessel microembolization and acute glomerulonephritis following infection of aesthetic filler implants

Background: The systemic consequences of esthetic filler injections are poorly understood. Case presentation: We report a patient with a past history of subcutaneous injection of aesthetic filler material in the lower legs, who presented with post-infectious glomerulonephritis following necrotic leg ulcers at the injection site. Kidney biopsy revealed the presence of translucent, non-birefringent microspherical bodies compatible with polymethylmetacrylate (PMMA) microspheres in some capillary lumens. This had not previously been described. PMMA is a biphasic aesthetical filler composed of polymethylmetacrylate microspheres suspended in a biodegradable bovine collagen carrier. The solid phase (PMMA microspheres) persists in tissues for years. Although PMMA was thought to not disseminate systemically, tissue necrosis may have favored systemic dissemination of the microspheres, although entry in the circulation and microembolization at the time of administration cannot be ruled out. Conclusions: In conclusion, aesthetic filler implants may cause microembolization into small vessels. Recognition of the characteristic morphology may expedite diagnosis and avoid unnecessary further testing.AO and CMC were supported by ISCIII and FEDER funds PI13/00047, REDinREN RD012/0021, Comunidad de Madrid CIFRA S2010/BMD-2378 and Programa Intensificación Actividad Investigadora. BFF by ISCIII Joan Rodes

Percutaneous Edge-to-Edge Mitral Valve Repair with the Mitraclip System in Barlow's Disease

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Editoriale

TranScript è una rivista internazionale che si propone di essere un luogo di discussione sul tema della traduzione, con particolare attenzione ai secoli fra l’XI e il XV. Accogliamo con favore contributi sulla ‘traduzione’ dall’oralità alla scrittura, fra diverse tradizioni culturali, dal latino ai volgari e alle lingue moderne. TranScript is an international journal providing a forum for discussion on the theme of translation, with a special focus on the centuries spanning from the 11th to the 15th. We welcome contributions on the translation of cultures from orality to script, on the ‘translation’ among different cultural traditions, from Latin into vernaculars, and across modern languages

Cardiology of the future: xenotransplantation with porcine heart

The reduced availability of human donor hearts compared with the needs of patients with advanced heart failure refractory to medical therapy has promoted the search for therapeutic alternatives to cardiac allografts. Porcine heart xenotransplantation represents one of the most promising frontiers in this field today. From the first researches in the 1960s to today, the numerous advances achieved in the field of surgical techniques, genetic engineering and immunosuppression have made it possible at the beginning of 2022 to carry out the first swine-to-human heart transplant, attaining a survival of 2 months after surgery. The main intellectual and experimental stages that have marked the history of xenotransplantation, the latest acquisitions in terms of genetic editing, as well as the improvement of immunosuppressive therapy are discussed analytically in this article in order to illustrate the underlying complexity of this therapeutic model

Conduction system pacing: promoting the physiology to prevent heart failure

Cardiac conduction system pacing provides physiological ventricular activation by directly stimulating the conduction system. This review describes the two types of conduction system pacing: His bundle pacing (HBP) and left bundle area pacing (LBAP). The most significant advantage of HB pacing is that it can provide a regular, narrow QRS; however, the disadvantages are challenging implantation and a high risk of re-intervention due to lead dislodgement and the development of high pacing threshold. LBAP provides optimum physiological activation of the left ventricle by engaging the left bundle/fascicular fibers. LBAP is more physiological than traditional RV apical pacing and could be an attractive alternative to conventional cardiac resynchronization therapy (CRT). The advantages of LBAP are a relatively more straightforward implantation technique than HBP, better lead stability and pacing thresholds. HBP and LBAP are more physiological than right ventricular pacing and may be used instead of conventional pacemakers. Both HBP and LBBP are being investigated as alternatives to conventional CRT

Podocyte and tubular involvement in AngioJet-induced kidney injury

Altres ajuts: Sociedad Española de Nefrología, Fundacion Renal Iñigo Álvarez de Toledo and Comunidad de Madrid CIFRA2 B2017/BMD-3686.The AngioJet technique combines localized thrombolysis and percutaneous mechanical thrombectomy (PMT). However, PMT may cause acute kidney injury (AKI), which has been ascribed to severe mechanical haemolysis, although no renal biopsies have been reported. We now report the first renal biopsy in a patient with AKI following PMT. There is histological evidence of haemoglobin (Hb)-induced tubular injury and podocyte stress characterized by intracellular Hb and staining for ferritin and hemo-oxygenase-1, suggestive of an adaptive response to oxidative stress. This confirms that Hb is involved in kidney cell injury and supports the existence of several different kidney cellular targets

I mobility scooter: da ausili per la mobilità di disabili e anziani a nuovi veicoli per una mobilità sostenibile?

I mobility scooter, in particolare quelli cabinati, sono potenzialmente un ausilio formidabile per la mobilità a breve e medio raggio delle persone sia abili che disabili, con innegabili benefici anche per il traffico urbano e l’ambiente, ma a condizione di una drastica revisione normativa. La modifica all’art. 46 del Codice della Strada intervenuta nel 2010, che ha demandato genericamente la definizione delle “macchine per uso di invalidi” (non considerate veicoli) a “vigenti disposizioni comunitarie” (che invece equiparano i mobility scooter ad autoveicoli), sembra aver sortito un risultato opposto al suo intento chiarificatore, con implicazioni finanche inquietanti per quanto riguarda la possibilità che i mobility scooter siano effettivamente ammessi a circolare in aree aperte al pubblico. Il recente decreto per la sperimentazione su strada dei dispositivi per la micromobilità elettrica, che ha ignorato il dispositivo obiettivamente più versatile, sicuro e “serio”, ha perso una grande occasione, ma si può ancora rimediare. La loro classificazione come “veicoli” adatti sia agli abili che ai disabili – anche ai sensi dell’orientamento comunitario – ed una specifica regolamentazione della loro circolazione nelle aree pubbliche attraverso una serie di modifiche al Codice della Strada, al suo Regolamento di attuazione ed al decreto per la sperimentazione su strada dei dispositivi di micromobilità elettrica, nonché l’individuazione di un organismo di controllo e informazione, porrebbero facilmente fine ad un pericoloso vuoto normativo ed alla confusione e disinformazione che ne sono derivate, favorendo finalmente la meritata diffusione dei mobility scooter: ciò contribuirebbe anche ad abbattere i costi d’acquisto dei moderni e versatili scooter cabinati, ancora relativamente elevati seppur inferiori a quelli di un’autovettura elettrica, a tutto vantaggio delle categorie spesso non abbienti per cui questi dispositivi sono stati originariamente concepiti