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LETTERS TO EDITOR

Fontan circulation: beyond cardiopulmonary assessment

Efrén Martínez-Quintana, Fayna Rodríguez-González
Fontan circulation: beyond cardiopulmonary assessment

Dear Editor


The Fontan procedure is today the last staged operation for children with congenital heart disease who cannot be offered a 2-ventricle repair, and it refers to any operation that results in the flow of systemic venous blood to the lungs without passing through a ventricle(1). Therefore, pathophysiology of the Fontan circulation leads to an obligatory systemic venous hypertension in which the superior and inferior vena cava and the pulmonary artery pressure are equal and generally in the
range of 10 to 20 mmHg, 2 to 4 times that of normal.

Cytisine: a good example for hospitals

Fabio Lugoboni, Stefania Schiroli, Sara Pigozzo, Paola Marini
Cytisine: a good example for hospitals
Dear Editor


Effective tobacco smoking cessation drugs are most needed in low- and middle-income countries, where tobacco consumption is very prevalent, and the access to first line medicines is more problematic than in high income ones. A very recent editorial, authored by some of the leading world experts in the treatment of tobacco addiction(1), clearly describes cytisine (CY), an alpha4 beta2 nicotinic partial agonist receptor with the same
mechanism of action as varenicline, as one of the most efficient drugs used for smoking cessation. CY widespread use in clinical practice is indicated as a priority, even more than the conduction of further clinical trials(1).

Cytisine: a good example for hospitals