AKI as center of target.
Central MessageNew studies are widening our knowledge of AKI after open surgery, but we are still powerless in applying effective treatments and prevention measures.
Background: Cognitive impairment is a staggering personal and societal burden; accordingly, there is a strong interest in potential strategies for its prevention and treatment. Nutritional supplements have been extensively investigated, and citicoline seems to be a promising agent; its role in clinical practice, however, has not been established. We systematically reviewed studies on the effect of citicoline on cognitive performance. Methods: We searched the PubMed and Cochrane Library databases for articles published between 2010 and 2022. Relevant information was extracted and presented following the PRISMA recommendations. Data were pooled using the inverse-variance method with random effects models. Results: We selected seven studies including patients with mild cognitive impairment, Alzheimer’s disease or post-stroke dementia. All the studies showed a positive effect of citicoline on cognitive functions. Six studies could be included in the meta-analysis. Overall, citicoline improved cognitive status, with pooled standardized mean differences ranging from 0.56 (95% CI: 0.37–0.75) to 1.57 (95% CI: 0.77–2.37) in different sensitivity analyses. The overall quality of the studies was poor. Discussion: Available data indicate that citicoline has positive effects on cognitive function. The general quality of the studies, however, is poor with significant risk of bias in favor of the intervention. Other: PubMed and the Cochrane Library.
La porzione oggetto di questo contributo ricade entro i confini amministrativi dei comuni di Monterotondo Marittimo e Massa Marittima, nel cuore delle Colline Metallifere grossetane. Su questo territorio da lungo tempo si sono appuntati gli interessi di ricerca dell’insegnamento di Archeologia Medievale dell’Università di Siena, e si è posta attenzione allo studio delle dinamiche insediative e di controllo del ciclo produttivo attraverso i secoli, con uno specifico focus sul periodo medievale. Le indagini hanno evidenziato il ruolo chiave giocato da queste aree in differenti periodi storici in relazione alla presenza di importanti materie prime quali il diaspro per la Preistoria, le mineralizzazioni a solfuri misti, i significativi fenomeni di carattere idrotermale e l’alunite dall’epoca etrusca fino alla metà del XVIII secolo. In relazione a quest’ultimo aspetto forniamo infine un rapporto preliminare sui dati emersi dalla prima campagna di scavo effettuata sul sito ove si conservano i resti della settecentesca allumiera di Monteleo (Monterotondo Marittimo). prima campagna di scavo effettuata sul sito ove si conservano i resti della settecentesca allumiera di Monteleo (Monterotondo Marittimo).
The apical approach, the length of neochordae, and the lack of a remodeling annuloplasty could have induced an increase of mechanical stress on the neochordae, causing a delayed rupture.
After a median full sternotomy, cardiopulmonary bypass is installed in the usual manner. Apical ventriculotomy is performed through the infarcted myocardium. Polypropylene pledgeted mattress sutures are passed from the right to the left ventricular side through the ventricular septal defect, with the pledgets remaining on the right ventricle. Great care must be taken to place the suture on healthy myocardium and away from the edge of the ventricular septal defect; otherwise the chances of a recurrent postoperative ventricular septal defect would increase. The sutures are subsequently positioned through a heterologous patch, previously prepared to be appropriate for the ventricular septal defect closure. A collar of 3 to 4 cm is left on the external side of the patch. A 4-0 polypropylene running suture is placed through this collar and the left ventricle to further reinforce the ventricular septal defect closure. The left ventricular incision is closed with polypropylene 3-0 continuous sutures. For each ventricular edge, the running suture is passed through 2 polytetrafluoroethylene felts: one on the endoventricular side and the other on the epicardial side. Finally, the suture line is reinforced with a continuous 2-0 polypropylene suture, which is passed through the polytetrafluoroethylene felts, the ventricular wall, and the heterologous patch used to close the ventricular septal defect.
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