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Tamara Zec,1 Raffaela Di Napoli,1 Lydwine Fievez,1 Mohamed Ben Aziz,1 Alessandro Ottaiano,2 Alessandro Vittori,3 Francesco Perri,4 Marco Cascella5 1Department of Anesthesiology, Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, 1000, Belgium; 2SSD Innovative Therapies for Abdominal Metastases, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, 80100, Italy; 3Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Piazza S. Onofrio 4, Rome, 00165, Italy; 4Medical and Experimental Head and Neck Oncology Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, 80100, Italy; 5Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, 80100, ItalyCorrespondence: Francesco Perri, Email f.perri@istitutotumori.na.itAbstract: In cancer patients undergoing surgery, tumor biology and anticancer treatments can increase the risk of perioperative bleeding and blood transfusions. Notably, blood transfusions can be potentially associated with an increased risk of life-threatening immune responses, acute lung injury, postoperative infections, and thromboembolism. Moreover, the link between perioperative transfusion and increased risk of cancer recurrence cannot be excluded. On the other hand, cancer patients have an increased risk of thromboembolism due to cancer itself and antineoplastic systemic treatments including chemotherapy and anti-angiogenic drugs. In this complex scenario, effective and safe strategies aimed at the prevention of blood transfusions are warranted. This narrative review addresses the efficacy, and the safety of the synthetic antifibrinolytic agent tranexamic acid (TXA) when used perioperatively in cancer surgery. Although in not oncologic surgery the use of TXA has been extensively studied, in the setting of cancer patients requiring surgery, the evidence is scarce. An overview of the ongoing clinical research is also provided.Keywords: tranexamic acid, cancer surgery, oncology, anemia, blood transfusion, anti-fibrinolytic

Marco Cascella,1 Sabrina Bimonte,1 Raffaela Di Napoli2 1Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori – IRCCS – “Fondazione G. Pascale, Naples, Italy; 2Department of Anesthesiology, Institut Jules Bordet, Université Libre De Bruxelles, Bruxelles 1000, BelgiumCorrespondence: Marco CascellaDivision of Anesthesia and Pain Medicine, Istituto Nazionale Tumori – IRCCS – “Fondazione G. Pascale, Via Semmola 1. 80100, Naples, ItalyTel +39 0815903221Fax +39 0815903778Email m.cascella@istitutotumori.na.itAbstract: The emergence from anesthesia is the stage of general anesthesia featuring the patient’s progression from the unconsciousness status to wakefulness and restoration of consciousness. This complex process has precise neurobiology which differs from that of induction. Despite the medications commonly used in anesthesia allow recovery in a few minutes, a delay in waking up from anesthesia, called delayed emergence, may occur. This phenomenon is associated with delays in the operating room, and an overall increase in costs. Together with the emergence delirium, the phenomenon represents a manifestation of inadequate emergence. Nevertheless, in delayed emergence, the transition from unconsciousness to complete wakefulness usually occurs along a normal trajectory, although slowed down. On the other hand, this awakening trajectory could proceed abnormally, possibly culminating in the manifestation of emergence delirium. Clinically, delayed emergence often represents a challenge for clinicians who must make an accurate diagnosis of the underlying cause to quickly establish appropriate therapy. This paper aimed at presenting an update on the phenomenon, analyzing its causes. Diagnostic and therapeutic strategies are addressed. Finally, therapeutic perspectives on the “active awakening” are reported.Keywords: general anesthesia, anesthesia emergence, delayed emergence, emergence delirium

Ground Penetrating Radar (GPR) is an electromagnetic technique very appreciated by the community of the archaeologist and cultural heritage end-users community thanks to its appealing features in terms of non invasivity and rapidity of measurement and diagnostics. However, GPR data requires a high operator expertise in the data processing and interpretation. In the archaeological investigation, this drawback can be mitigated by the availability of a priori information about the archaeological scenario. On the other hand, in the case of the historical heritage, when the knowledge of constructive modalities and material of the structure may be completely missed, it is necessary to undertake other strategies of processing and interpretation. One of these can be provided by the use of novel inversion algorithms such as the Microwave Tomography (MT) which allows to reduce the subjectivity and the time consuming during the data processing. In this paper the MT was applied on raw data collected at two historical buildings of Chania (Crete, Greece). The first edifice is the Venizelo's House affected by visible fractures in its walls made up of cemented irregular stones. The second one is the headquarters of Prefecture of Chania showing some fractures along the floors. For these raw data, microwave tomography provided well detailed images which allowed to infer the fracture geometry and their extension in the host medium. This suggests microwave tomography can be a reliable complete processing tool requiring only the definition of the background scenario in terms of the dielectric permittivity and the conductivity of the host medium. [ABSTRACT FROM AUTHOR]