iveness. However, the study showed the feasibility of such a program, and raised some elements of interest regarding hospital territory integration, the need to develop tools to support home care and the variability of the clinical manifestations of the CoViD-19 disease.The situation of uncertainty several people faced in Italy due to the SARS-CoV-2 epidemic suggested this contribution concerning the potential outcomes in some safety areas of the primary needs of the individual safety and security needs, love and belonging needs, esteem, and self-actualization. When uncertainty features one or more of them, the risk of health outcomes increases, specifically with respect to mental health. This contribution compares the experience of the severe earthquake that hit Emilia-Romagna region (North Italy) in May 2012 and the epidemic of CoViD-19 officially started in Italy in February 2020. Both experiences were lived by the authors, as citizens and mental health professionals. The considerations presented stemmed out from the clinical experience and are articulated around some key words surprise, length, places, society, work, welfare, feelings, economics. Similarities and differences are presented, suggesting that new therapeutic devices are necessary, to hold and treat patients during this specific epidemic, as well as during future ones. Up to the moment we have just been able to chase the shadow, by integrating medieval systems (quarantine) and hyper-technological systems (i.e., the most advanced resuscitation techniques).The target populations for new drugs, in particular when these are labelled for the treatment of chronic diseases, are a central point of health planning as regulatory agencies make their decisions on pharmacoeconomic analyses performed on real-world data, health institutions have the need to plan care pathways starting from the identification of subjects requiring a specific care process and research has recognized real world evidence (RWE) studies as a complementary approach to clinical trials. On the topic of target populations for new drugs for chronic diseases, the first working group of the MaCroScopio project (observatory on chronic diseases) was launched, in which various stakeholders participated, whose reflections have been collected in this consensus document. Starting from the entry of RWE into national and international regulatory procedures, as a strategy for identifying target populations, the document describes the advantages and limitations of administrative health databases as a data source to achieve this goal. In the document is highlighted the need to adapt the identifying algorithms according to the aim to be achieved exploratory aim, economic/organizational scope, planning/evaluation purpose in order to set up the health policy in relation to the positioning of a new drug in a given care path. Finally, the article points out the main methodological challenges that all those interested in this topic are called to face the complementarity between RWE and randomized controlled clinical trials, the need to measure and evaluate the complexity and variability of clinical reality, as well as the opportunity to carry out validation studies of the identification algorithms of the target populations. The resulting consensus document, therefore, intends to lay the foundations for the application of the epidemiological methodology and the use of its results in the area of planning/evaluation of care interventions, in order to identify their effectiveness, quality and sustainability.The classic anamnesis, oriented to the disease, tends to consider the patient as the object of the privileged attention of medical science. Especially in the context of general medicine, characterized by a patient-oriented approach, illness histories are used instead, which are more pertinent to a context characterized by subjectivity and objectivity, both biological and biographical paths. Digital technologies, which have so radically changed the doctor-patient relationship, can help to describe in a more exhaustive way the not strictly clinical needs of patients and doctors and provide the possibility of building a new way of interaction and sharing of the objectives of care.The CoViD-19 pandemic has pointed out the the need for an efficient, timely, ethically correct clinical research, in order to find rapid and reliable responses to health challenges. The guidelines published by the Agenzia Italiana del Farmaco during the pandemic have shown that some useful changes for simplifying and speeding-up clinical research in Italy are feasible, while maintaining high levels of quality. https://www.selleckchem.com/products/U0126.html In this perspective, a reflection is a must perhaps we are ready to detach ourselves from that image of a slow and bureaucratic country now widespread in Europe. Perhaps the pandemic has left us something good. Maybe we are really able of working much better, even in non-emergency conditions.Extracorporeal membrane oxygenation (ECMO) has been developed to provide hemodynamic support in patients with severe cardiac or respiratory failure. In the last few years, its use has become increasingly common in interventional cardiology rooms for high-risk coronary interventions and for transcatheter therapies for valvular disease, which are increasingly complex in subsets of fragile patients at high surgical risk and with multiple comorbidities.Here, we describe the treatment of an extremely critical patient for severe dual valvulopathy, severe impairment of post-infarct systolic function, advanced heart failure with prohibitive operative risk. In a single session, the double valvular volume defect was treated percutaneously, using ECMO with an additional drainage of the left ventricle, performing a transcatheter implantation of two aortic valve prostheses with the valve-in-valve technique and the implantation of two MitraClips with excellent final result. Neurological events after cardiac surgery or transcatheter aortic valve implantation (TAVI) have a dramatic effect on patients' prognosis. Recent development of transcatheter cerebral protection systems aims to reduce their incidence, even if their use is currently limited to TAVI. Here we report our initial experience with transcatheter cerebral protection devices used in patients at high brain embolic risk undergoing cardiac surgery. Between December 2018 and March 2020, at the Cardiac Surgery Unit of Lancisi Cardiovascular Center in Ancona, Italy, 9 patients (mean age 77 years; median EuroSCORE II 2.2%) underwent cardiac surgery using a transcatheter cerebral protection system (Sentinel, Claret Medical, Santa Rosa, CA, USA). In all cases, a preoperative computed tomography scan highlighted the presence of severely calcified ascending aorta. The brain protection system was successfully implanted in all patients. Total time for device implantation and removal was less than 10 min in all cases. Four patients underwent aortic valve replacement, 2 mitral surgery, whereas 3 received combined valve surgery.