Repair Versus Replacement in Mitral Valve Papillary Muscle Rupture: A Multicenter Study.

Objectives: Papillary muscle rupture (PMR) is a rare but potentially fatal mechanical complication after acute myocardial infarction (AMI). Although surgery is considered the gold-standard treatment for post-AMI PMR, the optimal surgical strategy remains unclear.

Methods: Data from post-AMI PMR patients submitted to mitral valve replacement (MVR) or mitral valve repair (MVr) surgery in the period between 2001 and 2019, from 20 international centres, were collected in the CAUTION study database.

History and Application of Mechanical Assist Devices as a Bridge to Heart Transplant: A Review and Perspectives in Brazil.

Mechanical circulatory support (MCS) devices have evolved significantly over the past decades and play a vital role in managing end-stage heart failure, especially as a bridge to heart transplantation. From the pioneering heart-lung machines to third-generation ventricular assist devices (VADs), MCS technology has advanced to provide more durable, efficient, and safer options for both shortand long-term support. This review outlines the historical development of mechanical assist devices, the types of available supports - ranging from intra-aortic balloon pumps and extracorporeal membrane oxygenation to implantable devices like HeartMate 3 - and their clinical indications and complications.

Management and Outcomes of Blunt Renal Trauma: A Retrospective Analysis from a High-Volume Urban Emergency Department.

Renal trauma accounts for approximately 3-5% of all trauma cases, predominantly affecting young males. The most common etiology is blunt trauma, particularly due to road traffic accidents, and it frequently occurs as part of polytrauma involving multiple organ systems. Management strategies are primarily dictated by hemodynamic stability, overall clinical condition, comorbidities, and injury severity graded according to the AAST classification.

Minimally invasive approach versus open approach in the management of necrotizing acute pancreatitis: A systematic review and meta-analysis.

Acute pancreatitis is one of the most common gastrointestinal diseases, with necrotizing pancreatitis affecting 10% to 15% of patients. Over recent years, the management of pancreatic necrosis has evolved significantly, with a growing shift towards minimally invasive approaches. The aim of this study was to evaluate the effectiveness of minimally invasive approach compared to open surgical approach in managing necrotizing acute pancreatitis.

[Impella 5.5®: the latest innovation in the field of left ventricular assist systems].

The Impella 5.5® (Abiomed Inc., Danvers, MA, USA) is a temporary mechanical circulatory support device utilized for the management of cardiogenic shock.

Electric Scooter Trauma in Rome: A Three-Year Analysis from a Tertiary Care Hospital.

Electric motorized rental scooters (ES) were introduced in Italy in 2019 as an alternative form of urban transportation, aiming to reduce traffic congestion and air pollution. As their popularity has grown, a parallel increase in ES-related injuries has been observed. This study aims to investigate the types and patterns of ES-related injuries and to identify potentially modifiable risk factors.

A neural approach to the Turing Test: The role of emotions.

As is well known, the Turing Test proposes the possibility of distinguishing the behavior of a machine from that of a human being through an experimental session. The Turing Test assesses whether a person asking questions to two different entities, can tell from their answers which of them is the human being and which is the machine. With the progress of Artificial Intelligence, the number of contexts in which the capacities of response of a machine will be indistinguishable from those of a human being is expected to increase rapidly.

Management of high-surgical-risk patients with acute cholecystitis following percutaneous cholecystostomy: results of an international Delphi consensus study.

Background: The management of high-surgical-risk patients with moderate to severe acute cholecystitis is challenging in clinical practice. Early laparoscopic cholecystectomy is considered the gold standard for patients who do not respond to conservative treatment. However, for those unfit for surgery due to high risk, alternative treatment options, such as percutaneous cholecystostomy (PC), are available.

Myocardial revascularization in patients with chronic kidney disease: a systematic review and meta-analysis of surgical versus percutaneous coronary revascularization.

Objectives: To compare outcomes of two different revascularization strategies in chronic kidney disease (CKD) patients: coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI).

Methods: We conducted this meta-analysis according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and registered with PROSPERO (CRD42021238659), evaluated studies comparing CABG and PCI in patients with CAD and CKD (defined by KDIGO guidelines). Data were extracted from PubMed, EMBASE and Cochrane from 2000 to 2023.

Electrochemotherapy for Cancers Affecting the Skin: Ten Years of Experience in a Tertiary Referral Hospital.

Aim: Electrochemotherapy (ECT) combines chemotherapy with an electric pulse to directly target tumor cells by increasing cell membrane permeability, facilitating the efficient uptake of chemotherapeutic agents by tumor cells and improving their therapeutic efficacy. It is widely used for treating skin metastatic nodules or metastases of subcutaneous tissue. Therefore, the aim of this study is to report the experience regarding the use of ECT in a tertiary referral hospital and explore its safety and efficacy in treating skin cancer.

Prevalence of Rouvière's sulcus and its anatomical variations: our experience and systematic review/meta-analysis.

Introduction: Rouvière's sulcus, an anatomical landmark, has been proposed as a potential aid in enhancing surgical safety. This study aims to assess the prevalence of RS and its anatomical variations both in the existing literature and within our clinical practice.

Evidence Acquisition: A systematic literature search was conducted, and relevant studies were identified.

Is the Use of Tourniquets More Advantageous than Other Bleeding Control Techniques in Patients with Limb Hemorrhage? A Systematic Review and Meta-Analysis.

Trauma, particularly uncontrolled bleeding, is a major cause of death. Recent evidence-based guidelines recommend the use of a tourniquet when life-threating limb bleeding cannot be controlled with direct pressure. Prehospital hemorrhage management, according to the XABCDE protocol, emphasizes the critical role of tourniquets in controlling massive bleeding.

Comparison of Hernia Sac Transection and Full Sac Reduction for the Treatment of Inguinal Hernias: A Systematic Review and Meta-Analysis of Clinical Trials.

Background: The history of inguinal hernia repair has been marked by the description of several therapies over ages, each with its own approach to managing the hernial sac. An analysis of hernia sac transection (with or without high ligation) versus reduction (invagination) in adults who underwent Lichtenstein open tension-free inguinal hernia repair and in adult and pediatric patients who underwent suture repair has been the primary aim of this systematic review and meta-analysis.

Methods: The authors conducted a comprehensive review and meta-analysis.

Sutureless FOCUS harmonic scalpel versus clamp-and-tie techniques for thyroidectomy: a meta-analysis of 43 randomized controlled trials.

Background: One of the most important surgical steps during thyroidectomy is the safe ligation of vessels. In fact, it is crucial to avoid postoperative bleeding and nerves' injury. The "clamp and tie" technique was first introduced in the 19th century.

A Review of the Literature on Videoscopic and Robotic Inguinal-Iliac-Obturator Lymphadenectomy in Patients with Cutaneous Melanoma.

Inguinal-iliac-obturator lymph node dissection is essential in the treatment of patients with cutaneous melanoma exhibiting the clinical or radiological involvement of pelvic lymph nodes. The open procedure is associated with elevated mortality rates. Numerous minimally invasive approaches have been suggested to mitigate the impact of this surgery on the patient's quality of life.

Rouvière's Sulcus as a Landmark for a Safe Laparoscopic Cholecystectomy: An Interim Analysis of a Multicenter Cross-sectional Study on the Prevalence and Morphologic Type of Rouvière's Sulcus in the Italian Population.

Background: Laparoscopic cholecystectomy is the gold standard in the treatment of symptomatic gallstones. The large number of gallbladders removed every year is not fully consistent with the excessively high incidence of iatrogenic bile duct injury (IBDI). Several strategies have been suggested to reduce this risk.

Local Recurrence and Survival in Patients With Melanoma >2 mm in Thickness at Difficult Sites Treated With 1-cm Versus 2-cm Margins.

Background: Melanoma guidelines recommend surgical excision with 2-cm margins for melanomas >2 mm in thickness. However, this procedure may be problematic at critical anatomic sites. We aimed to compare the outcomes of wide (2 cm) versus narrow (1 cm) excision margins in patients with melanoma >2 mm in thickness near critical structures.

Anatomical Variants of the Jejunal Veins and Their Technical Implications in Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis.

Introduction: One of the most common causes of bleeding during pancreaticoduodenectomy is a dissection of the pancreatic head from the superior mesenteric vein and superior mesenteric artery. Knowledge of the anatomical variants of the veins draining the proximal jejunum may allow better control of bleeding during detachment of the uncinate process and pancreatic head from the mesenteric pedicle and division of the mesopancreas. The aim of this systematic review and meta-analysis was to evaluate the anatomical variations of the first jejunal vein (FJV) and jejunal trunk (FJT).

Effectiveness of cardiopulmonary bypass for radical resection of giant middle mediastinal paraganglioma.

A non-functional middle mediastinal paraganglioma is a rare entity. We describe a case of a 67-year-old woman with a diagnosis of a big mediastinal paraganglioma by endobronchial ultrasound transbronchial needle aspiration after chest CT and 18F-fluorodeoxyglucose positron-emission tomography. The nine centimeter in length tumor was located between the superior vena cava and the posterior portion of the ascending aorta, compressing the left atrium and the trachea and main left bronchus, posteriorly, surrounding the right pulmonary artery.

[Percutaneous treatment of post-acute myocardial infarction mechanical complications: state of the art].

Left ventricular free wall rupture, ventricular pseudoaneurysm, papillary muscle rupture and ventricular septal rupture are life-threatening mechanical complications of acute myocardial infarction. Despite significant improvements over the last decades in overall mortality for patients with myocardial infarction, the outcome of subjects who develop post-infarction mechanical complications remains poor. Surgical treatment is considered the standard of care.

Age Group Discrimination via Free Handwriting Indicators.

Ageing is associated with cognitive and functional decline, which can hamper daily activities and independent living. Chronic diseases may intensify this process. Early detection of unhealthy decline is key but hindered by similarity to normal ageing.

[Surgical treatment of isolated tricuspid valve disease: indications, new evidence, and risk stratification].

The tricuspid valve, long neglected as a passive structure and often termed the "forgotten valve", has recently gained attention from the international medical and cardiological community due to the association of tricuspid regurgitation with an unfavorable prognosis. Isolated tricuspid regurgitation represents a relatively unknown and variable condition, closely linked to the shape and function of the right ventricle and the state of the pulmonary circulation. Currently, guidelines are not clear regarding the optimal treatment strategy, the process of patient selection, and the surgical or transcatheter procedural timing, nor for predicting patient outcomes.