Aortic septotomy with scissor-technique

Viene descritta tecnica innovativa per il ridurre le complicanze legate alla dissezione aorta toracic

The negative effects of reduced attention to standard guidelines for screening and surgery of abdominal aortic aneurysms during the coronavirus disease 2019 pandemic

Si pone in evidenza l'importanza dello screening nella popolazione per aneurismi dell'aorta addominale

Re: "Endothelitis in COVID-19-positive patients after extremity amputation for acute thrombotic events"

Ilonzo et al reported, in their recent and interesting article, their clinical experience in 4 patients affected by COVID-19 and undergoing major limb amputation secondary to acute irreversible ischemia. On histological examination with hematoxylin/eosin they found inflammatory cells associated with endothelium/apoptotic bodies, mononuclear cells, small vessel congestion, and lymphocytic endotheliitis and concluded that the findings in these patients is more likely an infectious angiitis due to COVID-19. In our experience we have observed numerous cases of venous and arterial thromboembolism not only in the acute phase of COVID-19, but (even more interestingly) even after recovery. Whether SARS-CoV-2 is able to directly attack vascular endothelial cells expressing high levels of ACE2, and then lead to abnormal coagulation and sepsis, still needs to be explored

Endovascular Surgery during COVID 19 virus pandemic as a valid alternative to open surgery

Lo studio sottolinea i vantaggi della chirurgia endovascolare durante la fase acuta della pandemia da COVID1

Abdominal aorta angiosarcoma after endovascular aneurysm repair

Primary tumors originating within the wall of the arteries are rare and they frequently manifest late, making effective treatment a challenge. We describe here a case of Abdominal Aorta AngioSarcoma masqueraded as an infected EndoVascular Aortic Repair. The knowledge of this pathology from vascular surgeons and radiologist is crucial, because a prompt diagnosis and treatment can improve the prognosis

Acute arterial and deep venous thromboembolism in COVID-19 patients. Risk factors and personalized therapy

The Lombardy region suffered severely during the acute phase of the coronavirus diease 2019 outbreak in Italy (Mar-Apr 2020) with 16,000 diagnosed coronavirus disease 2019-related deaths (49% of the total coronavirus disease 2019-related deaths in Italy). In the area surrounding Pavia during the critical stage of the outbreak (Mar-Apr 2020), 1,225 of the documented 4,200 deaths were related to coronavirus disease 2019 infection, with a mortality rate of 181/100,000 inhabitants and an increase in deaths of 138% compared with the same period during previous years. Our aim was to report the experience of the Department of Vascular Surgery of Pavia (Lombardy, Italy), including the lessons learned and future perspectives regarding the management of coronavirus disease 2019 patients who developed severe acute ischemia with impending lower limb loss or deep vein thrombosis

Rationale and design of an independent randomised controlled trial evaluating the effectiveness of aripiprazole or haloperidol in combination with clozapine for treatment-resistant schizophrenia

<p>Abstract</p> <p>Background</p> <p>One third to two thirds of people with schizophrenia have persistent psychotic symptoms despite clozapine treatment. Under real-world circumstances, the need to provide effective therapeutic interventions to patients who do not have an optimal response to clozapine has been cited as the most common reason for simultaneously prescribing a second antipsychotic drug in combination treatment strategies. In a clinical area where the pressing need of providing therapeutic answers has progressively increased the occurrence of antipsychotic polypharmacy, despite the lack of robust evidence of its efficacy, we sought to implement a pre-planned protocol where two alternative therapeutic answers are systematically provided and evaluated within the context of a pragmatic, multicentre, independent randomised study.</p> <p>Methods/Design</p> <p>The principal clinical question to be answered by the present project is the relative efficacy and tolerability of combination treatment with clozapine plus aripiprazole compared with combination treatment with clozapine plus haloperidol in patients with an incomplete response to treatment with clozapine over an appropriate period of time. This project is a prospective, multicentre, randomized, parallel-group, superiority trial that follow patients over a period of 12 months. Withdrawal from allocated treatment within 3 months is the primary outcome.</p> <p>Discussion</p> <p>The implementation of the protocol presented here shows that it is possible to create a network of community psychiatric services that accept the idea of using their everyday clinical practice to produce randomised knowledge. The employed pragmatic attitude allowed to randomly allocate more than 100 individuals, which means that this study is the largest antipsychotic combination trial conducted so far in Western countries. We expect that the current project, by generating evidence on whether it is clinically useful to combine clozapine with aripiprazole rather than with haloperidol, provides physicians with a solid evidence base to be directly applied in the routine care of patients with schizophrenia.</p> <p>Trial Registration</p> <p><b>Clincaltrials.gov Identifier</b>: NCT00395915</p

Factors Involved in the Etiology of Abdominal Aortic aneurysm

Gli Autori descrivono i fattori di rischio per la rottura di aneurismi dell'aorta addominal

Adapting guidelines for elective repair of asymptomatic abdominal aortic aneurysms

Si sottolineano la possibilità di diversi momenti etiologici per gli aneurismi dell'aorta addominale e la necessità di modificare le indicazioni all'intervento chirurgico in base alle stess