A Rare Cause of Deep Vein Thrombosis in a Young Orchestra Conductor.

Upper extremity deep vein thrombosis (DVT) of the axillary/subclavian veins is rare (5-10% of DVT). After clinical suspicion and duplex ultrasound, anticoagulation, surgical decompression and sometimes thrombolysis are mandatory due to complications. We discuss the case of a young healthy orchestra conductor with primary DVT of the left upper extremity and concomitant left shoulder musculo-tendinous traumatic injury. Symptoms of both conditions and subtle signs of upper extremity DVT delayed the diagnosis until full-blown DVT occurred. After successful anticoagulation and surgical TOS (thoracic outlet syndrome) decompression, evolution was favorable, without recurrent thrombosis.

SGLT2 Inhibitor: an Emerging Pillar in Heart Failure Therapeutics?

Heart failure (HF) is a worldwide pandemic that affects at least 26 million people and is becoming more prevalent. Heart failure health expenditures are substantial and will considerably increase with population aging. Newer medications for treating type 2 diabetes include sodium-glucose cotransporter-2 inhibitors (SGLT2). Recent clinical studies and research have shown the efficacy of this class in treating heart failure by lowering the risk of cardiovascular events, hospitalization, and mortality. In addition, there is undeniable evidence that SGLT2 inhibitors have a beneficial effect on metabolic function, even though the mechanisms responsible for these drugs' practical consequences have not been completely elucidated. In this narrative review, we discuss the effects of SGLT2 inhibitors on the provision of cardiac energy by ketone bodies, pathological remodeling of the ventricle, arterial stiffness, and inflammation in patients with HF.

Managing Efficiency in Digital Transformation - EU Member States Performance during the COVID-19 Pandemic.

The COVID-19 pandemic context asserted the digitalization process in the European Union member countries five years forward (at least). The digital divide, a frequent debated issue was brought to the fore, and, under these circumstances, the proposed aim of the paper is to analyze the digitalization process, considering the data provided by Digital Economy and Society Index (DESI) and, additionally, the Stringency Index, that measure the governmental restrictions during the pandemic for 2020. From a methodological perspective, the empirical study focused on performing the Data Envelopment Analysis (DEA) non-parametric test. Measuring the digitalization efficiency or inefficiency of the European member states was conducted by using an output-oriented model, focused on output maximization for a given level of input, assuming Constant Returns to Scale (CRS). The results highlighted major discrepancies between the European countries. Solely eight countries out of 27 can be considered efficient in the digitalization processes during the COVID-19 pandemic. Based on the model, the most efficient EU countries could be considered peers/benchmarks for the inefficient ones, which should examine the best practices in order to improve their current situation.