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Purpose: We hypothesized that inducibility of the VT responsible for ICD therapies at the end of RFCA, would also be associated with a differential risk, depending on left ventricular function.Methods: We retrospectively studied 66 patients with previous myocardial infarction and with ICD who also underwent RFCA for recurrent refractory VTs.Results: During the follow-up only 19 patients (29%) showed VTs. Among patients with ejection fraction (EF) 35% and <50%, no recurrent VT was any longer detected in the nine patients in whom the VT was not inducible, while VT recurrences still continued only in the eight patients in whom it was. Finally, all the 24 patients with EF >or=50% did not show any recurrent VT.Conclusions: Our findings confirm the role of RFCA in reducing ICD therapies and also place RFCA in the overall clinical management of recurrent post infarction VTs according to the left ventricular function. [ABSTRACT FROM AUTHOR]

Background: Recent data published by the Special Operations community suggest the Lethal Triad of Trauma should be changed to the Lethal Diamond, to include coagulopathy, acidosis, hypothermia, and hypocalcemia. The purpose of this study is to determine the prevalence of trauma-induced hypocalcemia in level I and II trauma patients., Methods: This is a retrospective cohort study conducted at a level I trauma center and Special Operations Combat Medic (SOCM) training site. Adult patients were identified via trauma services registry from September 2021 to April 2022. Patients who received blood products prior to emergency department (ED) arrival were excluded from the study. Ionized calcium levels were utilized in this study., Results: Of the 408 patients screened, 370 were included in the final analysis of this cohort. Hypocalcemia was noted in 189 (51%) patients, with severe hypocalcemia identified in two (<1%) patients. Thirty-two (11.2%) patients had elevated international normalized ratio (INR), 34 (23%) patients had pH <7.36, 21 (8%) patients had elevated lactic acid, and 9 (2.5%) patients had a temperature of <35°C., Conclusion: Hypocalcemia was prevalent in half of the trauma patients in this cohort. The administration of a calcium supplement empirically in trauma patients from the prehospital environment and prior to blood transfusion is not recommended until further data prove it beneficial., (2023.)

Extensive molecular characterization of human colorectal cancer (CRC) via Next Generation Sequencing (NGS) indicated that genetic or epigenetic dysregulation of a relevant, but limited, number of molecular pathways typically occurs in this tumor. The molecular picture of the disease is significantly complicated by the frequent occurrence of individually rare genetic aberrations, which expand tumor heterogeneity. Inter- and intratumor molecular heterogeneity is very likely responsible for the remarkable individual variability in the response to conventional and target-driven first-line therapies, in metastatic CRC (mCRC) patients, whose median overall survival remains unsatisfactory. Implementation of an extensive molecular characterization of mCRC in the clinical routine does not yet appear feasible on a large scale, while multigene panel sequencing of most commonly mutated oncogene/oncosuppressor hotspots is more easily achievable. Here, we report that clinical multigene panel sequencing performed for anti-EGFR therapy predictive purposes in 639 formalin-fixed paraffin-embedded (FFPE) mCRC specimens revealed previously unknown pairwise mutation associations and a high proportion of cases carrying actionable gene mutations. Most importantly, a simple principal component analysis directed the delineation of a new molecular stratification of mCRC patients in eight groups characterized by non-random, specific mutational association patterns (MAPs), aggregating samples with similar biology. These data were validated on a The Cancer Genome Atlas (TCGA) CRC dataset. The proposed stratification may provide great opportunities to direct more informed therapeutic decisions in the majority of mCRC cases., (Copyright © 2020 Belardinilli, Capalbo, Malapelle, Pisapia, Raimondo, Milanetti, Yasaman, Liccardi, Paci, Sibilio, Pepe, Bonfiglio, Mezi, Magri, Coppa, Nicolussi, Gradilone, Petroni, Di Giulio, Fabretti, Infante, Coni, Canettieri, Troncone and Giannini.)