Coronary tortuosity: normal variant or pathological condition?

HighlightsCoronary tortuosity is a common coronary angiography finding. The aetiology and the clinical significant are not well defined, generally considered a normal variant. We showed a case of marked tortuosity of all coronary arteries associated with myocardial ischemia. </p

Coronary tortuosity: normal variant or pathological condition?

Coronary tortuosity is a common coronary angiography finding. The aetiology and the clinical significant are not well defined, generally considered a normal variant. We showed a case of marked tortuosity of all coronary arteries associated with myocardial ischemia

MUSIC THERAPY REDUCES ANXIETY AND PAIN AND IMPROVES SATISFACTION IN PATIENTS UNDERGOING PERCUTANEOUS RENAL BIOPSY

BACKGROUND AND AIMS Percutaneous kidney biopsy (PRB) is an invasive procedure performed under local anaesthesia that often creates anxiety, stress and pain in the patient before, during and after the procedure. Music therapy (MT), defined as the clinical- and evidence-based use of music, is administered by a trained professional to achieve individualized goals within a therapeutic relationship between patient, music and music therapist. MT can be used as a complementary non-drug intervention to prevent and treat emotional distress and pain. The main objectives of the study were 1. evaluate the effectiveness of MT in managing anxiety, pain and satisfaction in patients undergoing PRB. 2. investigate the effect of MTI on heart rate variability (HRV). METHOD This study was a two-arm, single-centre, parallel-group and pre–post PRB randomized controlled trial. Patients programmed for PRB were enrolled (n = 80) and assigned to the MT intervention group (MG, n = 40) or standard treatment [control group (CG), n = 40]. MG received, from a FAMI-certified music therapist, a personalized playlist administered during the PRB, adapted to the individual patient. Patient anxiety was assessed before and after PRB using the State Y-1 Trait Anxiety Inventory (STAI-Y1). A visual analog scale (VAS) was used for self-assessment of pain (VAS-P) and satisfaction (VAS-S). Physiological stress parameters (PRE–POST) were assessed using HRV (SDNN, RMSSD, LH/HF, SD1, SD2) from E4 wristbands—Empatica Inc.1. The bracelet was placed 5 min before the patient entered the operating room for the procedure and removed after the completion of the PRB. The data of each session were divided into two segments: (1) pre, before the administration of the local anesthetic and (2) post, after the conclusion of the biopsy. RESULTS A statistically significant difference in anxiety levels was observed between the MG and CG groups (35.35 ± 6.208 versus 42.83 ± 9.027; P &lt; 0.001, Fig. 1). The MG group showed significantly lower VAS-P values ​​(4.95 ± 1.377 versus 6.28 ± 1.281; P &lt; 0.001, Fig. 2) and higher VAS-S values ​​(7.75 ± 0.981 versus 6.03 ± 0.800; P &lt; 0.001) after PRB compared with the CG group (Fig. 3). The SDNN (P &lt; 0.034), RMSDD (P &lt; 0.04) and SD2 (P &lt; 0.027) measurements of HRV were significantly higher in MG than in CG, while LF/HF decreased (P &lt; 0.033). CONCLUSION This study supports the efficacy of MT in reducing anxiety and pain and improving satisfaction in patients undergoing PRB. MT modulates the autonomic nervous system, reducing sympathetic activity, increasing parasympathetic activity and inducing physiological relaxation

Convalescent plasma therapy in aHUS patient with SARS-CoV-2 infection

Endotheliosis, thrombotic microangiopathy and complement system over activation have been described as pathologic features of tissue damage in the setting of coronavirus disease. Interestingly, complement-mediated cell injury is also a typical feature of atypical Hemolytic Uremic Syndrome. Indeed, a growing body of literature has described a higher risk of microangiopathy recurrence, in aHUS patients who test positive for SARS-CoV-2. The correct clinical and therapeutic management patients with a history of HUS and SARS-CoV-2 infection is not well established.We report a case of SARS-CoV-2 infection in an aHUS patient who did not develop a recurrence of the disease and that was successfully treated with convalescent immune plasma therapy