Notes

Multicenter Western european real-world using VasQ anastomotic external assistance device with regard to arteriovenous fistulae.
This paper discusses the measures adopted by the Italian government to face the COVID-19 emergency after the first wave in March/April 2020. This study places these measures in light of the massive reform process based on the "managerialism" of healthcare, which started in the 1990s. These reforms, which were inspired by the ideas of 'New Public Management', introduced managerialism, regionalization and quasi-markets to the Italian National Health System. As a result, dramatic changes have been made in public healthcare, and the responsibility for healthcare was decentralized to regions, introducing a multi-level governance structure. The COVID-19 emergency has drawn the results of this approach into question. With the enactment of new decrees, the central government directly intervened in the management of the health system by introducing specific measures aiming to increase the number of hospital beds and personnel, which w previously downsized. Ivosidenib We describe the main content of the new measures adopted to face the COVID-19 emergency and discuss how key points of the managerialization process in Italy are being questioned as a result of these measures. The COVID-19 emergency will likely redesign the trajectory of health reforms in Italy and other countries in Europe.This study identifies gaps in universal health coverage in the European Union, using a questionnaire sent to the Health Systems and Policy Monitor network of the European Observatory on Health Systems and Policies. The questionnaire was based on a conceptual framework with four access dimensions population coverage, service coverage, cost coverage, and service access. With respect to population coverage, groups often excluded from statutory coverage include asylum seekers and irregular residents. Some countries exclude certain social-professional groups (e.g. civil servants) from statutory coverage but cover these groups under alternative schemes. In terms of service coverage, excluded or restricted services include optical treatments, dental care, physiotherapy, reproductive health services, and psychotherapy. Early access to new and expensive pharmaceuticals is a concern, especially for rare diseases and cancers. As to cost coverage, some countries introduced protective measures for vulnerable patients in the form of exemptions or ceilings from user chargers, especially for deprived groups or patients with accumulation of out-of-pocket spending. For service access, common issues are low perceived quality and long waiting times, which are exacerbated for rural residents who also face barriers from physical distance. Some groups may lack physical or mental ability to properly formulate their request for care. Currently, available indicators fail to capture the underlying causes of gaps in coverage and access.
Shoulder pain is a common symptom for non-traumatic shoulder pathologies and affects 4.7-66.7% of entire population. Even with the latest technological advantages, palpation still is a cost and time efficient tool to evaluate the shoulder pathologies. Our aim was to investigate and compare palpation findings in different shoulder pathologies.

We used first assessments of impingement syndrome (IS) (n=205), rotator cuff tear (RCT) (n=185) and frozen shoulder (FS) (n=210) patients who received treatment between 2010 and 2019 years. Two experienced physiotherapists palpated predefined points long head of biceps brachii, pectoralis minor, lateral intermuscular septum, proximal tendons of extensor group. These points categorized into "proximal", "mid-proximal", "mid-distal", "distal", "irregular". We also grouped patients by their BMIs.

We found RCT patients had higher BMI than IS and FS patients (p<0.001, p=0.001); more tender intermuscular septum points and night pain than IS patients (p=0.001, p=0.003) or muscles' proximal tendons.
Recurrence of hallux valgus deformity is a complication following surgical treatment of hallux valgus. This study was performed to identify risk factors for recurrence of hallux valgus deformity after minimally invasive distal linear metatarsal osteotomy (DLMO).

Sixty-seven patients (100 feet) with mild to severe hallux valgus who underwent DLMO from 2007 to 2018 were retrospectively investigated. Their average age at the time of surgery was 54 years (range, 18-88 years). The average follow-up duration was 46 months. The feet were divided into two groups with and without recurrence. A multivariate analysis was performed to identify the risk factors for recurrence of deformity based on preoperative and 3-month postoperative radiographic parameters.

Recurrence of deformity was found in 18 (18%) of the 100 feet at the final follow-up. The preoperative hallux valgus angle and 3-month postoperative hallux valgus angle, intermetatarsal angle, round sign positivity, and sesamoid position grade were significantly greater in the recurrence group than in the non-recurrence group. The logistic regression analysis revealed that a 3-month postoperative hallux valgus angle of ≥13.5°, positive round sign, and grade ≥2 sesamoid position were significantly associated with recurrence of deformity.

The present findings can help to identify patients at higher risk of recurrence of hallux valgus deformity after DLMO and to modify their surgical procedures.
The present findings can help to identify patients at higher risk of recurrence of hallux valgus deformity after DLMO and to modify their surgical procedures.
Inferior vena cava (IVC) agenesis is an uncommon congenital vascular anomaly stemming from aberrant development during embryogenesis. It results from the failure of one or more of the supracardinal veins, subcardinal veins, vitelline veins or postcardinal veins to connect. The symptomatology resulting from this vascular malformation can be either absent or extremely rich and varied.

Thoracoabdominal-pelvic CT scan projections following iodine-based contrast product injection were analyzed and a three-dimensional model of vascularization constructed.

Herein, an asymptomatic case of IVC agenesis with absence of the suprarenal and renal segments, with azygos continuation, presenting an accessory hepatorenal vein is reported. The presence of this type of accessory vein has never been described in the literature to date. The etiology of this case of IVC agenesis is explored in depth. We also analyzed the morphometric parameters of the IVC remnant segments and the azygos vein in order to quantify the dilatation of the collateral venous pathway overdeveloped to handle blood return.
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