Combined transconjunctival sutureless threeport vitrectomy and scleral fixation regarding intraocular lens

prevalence of dual-chamber pacing. The use of CRT-PM regards a very limited number of patients. The ICD Registry documented a large use of prophylactic and biventricular ICD, reflecting a favorable adherence to trials and guidelines in clinical practice. In order to increase and optimize the cooperation of Italian implanting centers, online data entry (http//www.aiac.it/riprid) should be adopted at large scale.Kawasaki disease is an acute febrile illness of childhood that affects usually children younger than 5 years of age. The diagnosis is based on typical clinical features. Atypical or incomplete forms of Kawasaki disease can be observed in almost 20% of patients and at onset is a clinical challenge leading to diagnostic and therapeutic delays with higher risk of coronary abnormalities. We report the case of a 13-year-old boy who presented with febrile cholestasis, abdominal pain and early coronary anomalies that was diagnosed with Kawasaki disease. Atypical findings of our case at onset were the age, the clinical presentation and the timing of appearance of coronary anomalies. A high index of suspicion of Kawasaki disease should be maintained in patients presenting with febrile cholestatic jaundice.The introduction of direct oral anticoagulants (DOACs) has been the main therapeutic revolution in the last 20 years. Four molecules have been approved for the thromboembolic prophylaxis in patients with non-valvular atrial fibrillation (AF). Darolutamide datasheet After the publication of phase 3 clinical trials, many studies evaluating DOAC safety and efficacy in daily clinical practice have been published. Edoxaban is the latest DOAC available on the market, based on the results of the ENGAGE AF-TIMI 48 trial. The phase 4 ETNA-AF (Edoxaban Treatment in Routine Clinical Practice for Patients With Non-Valvular Atrial Fibrillation) observational study was designed with the aim to confirm the results of the pivotal clinical trial in routine care in unselected patients with AF. This registry involved several sites and enrolled a large population in Europe and in Italy (13 980 and 3512 patients, respectively). The broad spectrum of patients will allow to have an overview of the characteristics of the AF population and to make a comparison with previous national registries and between different European realities.BACKGROUND Percutaneous ventricular assist devices (pVADs) are frequently used for the treatment of patients with cardiogenic shock (CS) due to acute myocardial infarction (AMI) and as a support in percutaneous coronary intervention (PCI) for high-risk patients. CS is a clinical condition characterized by inadequate tissue perfusion due to cardiac dysfunction and for 80% of cases it is caused by AMI with left ventricular insufficiency. CS is responsible for about 50% of deaths in patients with myocardial infarction. Usually, PCIs do not require hemodynamic support, which could be however necessary in patients undergoing high-risk PCI. Presently, available pVADs in Europe are Impella 2.5, Impella CP, HeartMate PHP, TandemHeart, PulseCath iVAC2L. The aim of this review is to evaluate the efficacy and safety of pVADs in patients with refractory CS complicating AMI or undergoing high-risk PCI. METHODS We systematically searched for randomized controlled trials (RCTs) and controlled observational studies in PubMedy results in a meta-analysis. One RCT reported no difference in 30- and 90-day mortality between patients randomized to Impella or IABP. Two non-randomized controlled studies reported no difference in terms of in-hospital all-cause mortality between the two groups. CONCLUSIONS Our meta-analysis suggests similar results in terms of efficacy and safety between pVADs and control (IABP and medical therapy) for the treatment of patients with CS complicating AMI or undergoing high-risk PCI.Heart failure with preserved ejection fraction (≥50%, HFpEF) has a high prevalence, affecting approximately 50% of patients with heart failure, for which no effective medication exists as yet, as no drug therapy was successful in improving survival. HFpEF is a syndrome that in its classical form is associated with multiple risk factors and comorbidities, which confer an extreme heterogeneity characterizing HFpEF. In addition to the clinical presentation, also the pathophysiological mechanisms are multiple. Altogether, these aspects largely account for the diagnostic challenges and the lack of a comprehensive treatment strategy in HFpEF patients. A more personalized medicine approach is therefore needed, aimed at treating specific patient subsets, with therapies that in several HFpEF phenotypes proved to be effective in reducing morbidity and improving surrogate outcomes, including quality of life.Clinical guidelines, while representing an objective reference to perform correct therapeutic choices, contain grey zones, where recommendations are not supported by solid evidence. In a conference held in Bergamo in October 2018, an attempt was made to highlight some of the main grey zones in Cardiology and, through a comparison between experts, to draw shared conclusions that can illuminate our clinical practice. This manuscript contains the statements of the symposium concerning the controversies in the percutaneous treatment of valvulopathies. The first topic concerns the durability of aortic bioprostheses, comparing percutaneous interventional with surgical experiences. The second issue examines the opportunity to extend percutaneous aortic replacement as standard care to low-risk patients. The last gap in evidence concerns the percutaneous treatment of functional mitral valve insufficiency, with the MitraClip system. The work has also been implemented with evidences deriving from important randomized studies published after the date of the Conference.Clinical guidelines, while representing an objective reference to perform appropriate treatment choices, contain grey zones, where recommendations are not supported by solid evidence. In a conference held in Bergamo in October 2018, an attempt was made to highlight some of the main grey zones in Cardiology and, through a comparison between experts, to draw shared conclusions that can illuminate our clinical practice. This manuscript contains the statements of the symposium concerning the controversies regarding new oral anticoagulants (NOACs) and atrial fibrillation (AF). The manuscript represents the organization of the meeting, with an initial review of current guidelines on this topic, followed by an expert presentation of pros (white) and cons (black) related to the identified "gaps of evidence". For every issue is then reported the response derived from the votes of the experts and the public, the discussion and, finally, the highlights, which are intended as practical "take home messages" to be used in everyday clinical practice.