Search

In the first part of this paper, the Author describes the complexity of the virtual treatments in which telephones and other IT tools or platforms are used to simulate the analytical work which until recently took place almost exclusively in a corporeal co-presence in the analytical study. He also hypothesizes the loss of differentiation between the different psychodynamic therapies as the effect of an imitative defense. In the second clinical part he highlights how psychoanalytic treatment in presence is essential to grasp the unconscious communications of early levels of the mind which are expressed, within the transference/countertransference relationship, through unconscious bodily communications. [ABSTRACT FROM AUTHOR]

The author reflects on the bidirectional unconscious manners of communication in the analytic relationship that allow the patient to "know" elements of reality of the analyst. By reconstructing some of these "elements of reality", the author emotionally draw a remembrance of the analytical and institutional thinking of prof. Todesco. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the potential cross-talk between implantable cardioverter defibrillator device (ICD) and implantable neuromodulation device (IND) during the implantation procedure and the ventricular fibrillation induction test and in daily life. We present two cases of patients with an IND who underwent ICD implantation and one case of a patient implanted with a biventricular ICD who received an IND 6 months later. Two of these patients had a spinal cord stimulator (SCS), while the other had a sacral neuromodulator. No cross-talk was recorded in the patient with the sacral neuromodulator and the ICD. Temporary damage to one of the SCSs was observed after multiple ICD shocks. When implanted contemporarily with sacral or spinal neurostimulators, cardiac devices appear to be safe, as confirmed by the appropriate detection and interruption of arrhythmic episodes. On the other hand, neuromodulation devices could be temporarily or permanently damaged by multiple ICD discharges. It is recommended that the neurostimulator be interrogated after an ICD shock, in order to check the state of the device. (PACE 2011; 1-4) [ABSTRACT FROM AUTHOR]

The main objectives of the treatment of heart failure (HF) are to improve patient clinical status, functional capacity and quality of life, as well as reducing re-hospitalization rate and mortality. A new compound, consisting of an angiotensin-receptor blocker (ARB) (valsartan) and a neprilysin (NEP) inhibitor (sacubitril), belonging to the newly established class of angiotensin receptor-neprilysin inhibitors (ARNIs) showed marked efficacy, without any relevant safety issue, in the treatment of patients with HF. We report a case of a 48 year old male with HF with reduced ejection fraction (HFrEF) due to hypertensive cardiomyopathy (New York Heart Association [NYHA] class III). Therapy with sacubitril/valsartan was initiated after some years of other treatments, which did not lead to any positive outcome in HF, quality of life and clinical functions. After only 1 month of sacubitril/valsartan therapy, the patient reported a significant improvement in quality of life, and in 6 months his NYHA class switched from III to I. [ABSTRACT FROM AUTHOR]

The main objectives of the treatment of heart failure (HF) are to improve patient clinical status, functional capacity and quality of life, as well as reducing re-hospitalization rate and mortality. A new compound, consisting of an angiotensin-receptor blocker (ARB) (valsartan) and a neprilysin (NEP) inhibitor (sacubitril), belonging to the newly established class of angiotensin receptor-neprilysin inhibitors (ARNIs) showed marked efficacy, without any relevant safety issue, in the treatment of patients with HF. We report a case of a 48 year old male with HF with reduced ejection fraction (HFrEF) due to hypertensive cardiomyopathy (New York Heart Association [NYHA] class III). Therapy with sacubitril/valsartan was initiated after some years of other treatments, which did not lead to any positive outcome in HF, quality of life and clinical functions. After only 1 month of sacubitril/valsartan therapy, the patient reported a significant improvement in quality of life, and in 6 months his NYHA class switched from III to I. [ABSTRACT FROM AUTHOR]

We present a paradigmatic example of "cardiac memory," characterized by deep, giant, and negative T-waves in the inferior leads, after a successful ablation of a right-sided posteroseptal accessory pathway. [ABSTRACT FROM AUTHOR]

Primary school students (817 apparently healthy 10-year olds) were screened by transthoracic 2-dimensional echocardiography to assess for the prevalence of bicuspid aortic valve. Bicuspid aortic valve was found in 0.5% of cases, with a higher prevalence in males than females (0.75% vs 0.24%), and was significantly associated with aortic root enlargement compared with children who had tricuspid aortic valves. [Copyright &y& Elsevier]

Increased plasma levels of amino-terminal fraction of brain natriuretic peptide (NT-proBNP) and alterations of diastolic filling as described by Doppler transmitral flow pattern are well-known markers of decompensated heart failure (HF). Recently, some implantable defibrillators have allowed monitoring of intrathoracic impedance, which is related to lung water content, potentially indicating HF deterioration. The aim of this study was to assess the correlation between intrathoracic impedance and NT-proBNP and echo-Doppler transmitral flow indexes. Data were collected from 111 HF patients, in six Italian centers. All patients were on optimal medical therapy. Device diagnostics, echographic data, NT-proBNP determination, and clinical status as assessed by the Heart Failure Score (HFS) were registered at baseline, at bimonthly visits, and at unscheduled examinations due to HF decompensation or device alerts. Over a median follow-up of 413 days, 955 examinations were performed. Intrathoracic impedance was significantly correlated with NT-proBNP (P = 0.013) and with mitral E-wave deceleration time (DtE) (P = 0.017), but not with HFS. At the time of confirmed alert events, NT-proBNP was significantly higher than during confirmed nonalert event examinations; DtE did not differ, whereas impedance was significantly lower. A decrease in intrathoracic impedance is inversely correlated with NT-proBNP and directly correlated with DtE. Intrathoracic impedance monitoring therefore has the physiologic basis for being a useful tool to identify early HF decompensation. (PACE 2011; 34:407-413) [ABSTRACT FROM AUTHOR]