Publications by authors named "Silvia Martini"

Patients with HDV/HBV-related end-stage liver disease candidates for liver transplantation(LT) have traditionally been regarded as a special population, although their outcomes are controversial. A intention-to-treat(ITT) analysis of long-term outcomes of HDV/HBV-coinfected patients waitlisted for LT in Italy, between 2011-2020, was performed and compared to HBV-monoinfected LT candidates. Out of 1,731 HBV-infected LT candidates, 1,237(71.

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Background & Aims: Conflicting data exist regarding optimal prophylaxis for HBV recurrence (HBV-R) after liver transplantation (LT), particularly in patients with hepatocellular carcinoma (HCC). We assessed current practices for HBV-R prophylaxis in Italy, evaluating rates, risk factors, and the clinical impact of HBV-R and HCC-R.

Methods: We performed a multicentric, retrospective study involving 20 Italian LT centers.

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Hepatitis C virus (HCV) infection is a significant risk factor for liver cirrhosis and hepatocellular carcinoma (HCC). Traditionally, the primary prevention strategy for HCV-associated HCC has focused on removing infection through antiviral regimes. Currently, highly effective direct-acting antivirals (DAAs) offer extraordinary success across all patient categories, including cirrhotics.

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Hypoalbuminemia is a risk factor for mortality in patients with end-stage liver disease (ESLD) and in those undergoing orthotopic liver transplantation (OLT), since it represents a biomarker of post-operative delayed functional recovery of the graft. Despite albumin infusion during and after OLT is frequently adopted in recipients with hypoalbuminemia, it remains unclear whether this procedure could improve post OLT clinical outcomes. Observational studies indicated that treatment with albumin after OLT might be beneficial in reducing ascites and acute kidney injury (AKI) development.

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Postural balance is crucial for daily activities, relying on the coordination of sensory systems. Balance impairment, common in the elderly, is a leading cause of mortality in this population. To analyze balance, methods like postural adjustment analysis using electromyography (EMG) have been developed.

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Objective: To develop a mobile health application (mHealth) accessible to deaf adolescents, based on their health card, promoting autonomy to the access to the user's health information.

Method: This was a methodological study, divided into three stages: a questionnaire to understand the knowledge of deaf adolescents about the health card, and development of the application using videos in Brazilian Sign Language Libras, Android Studio platform with Java language, and evaluation of the application.

Results: Most deaf adolescents were not aware of the health card.

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Article Synopsis
  • Epithelioid hemangioendothelioma (EHE) is difficult to treat with traditional chemotherapy, prompting researchers to explore new therapies such as sirolimus and identify biomarkers for tumor aggressiveness.
  • Scientists created a patient-derived xenograft (PDX) model from an advanced EHE patient to test sirolimus and to study serum levels of Growth/Differentiation Factor 15 (GDF-15) as a potential biomarker.
  • The results indicated sirolimus was more effective than doxorubicin in reducing tumor growth and GDF-15 levels, establishing GDF-15 as a promising biomarker for EHE aggressiveness and potentially indicating the effectiveness of sirolimus in patients.
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  • Recent international guidelines have defined metabolic dysfunction-associated steatotic liver disease (MASLD), leading to a rise in its prevalence as a reason for liver transplantation (LT) in Italy between 2012 and 2022.
  • * An analysis of 1,941 patients with MASLD and 11,201 without MASLD revealed that while the prevalence of MASLD patients waiting for LT increased significantly, it did not independently affect patient survival post-transplant.
  • * Patients with non-HCC MASLD faced higher mortality rates on the waiting list but projected better 5-year transplant survival benefits than those without MASLD or HCC.
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Unlabelled: A stepwise approach is currently considered the best choice to manage gastroesophageal reflux (GER) in preterm infants. This study aimed to evaluate the effect of different tube feeding techniques on GER frequency and features in symptomatic tube-fed preterm neonates. Tube-fed infants < 34 weeks' gestation were eligible for this prospective, bicentric, cross-over study if, due to GER symptoms, they underwent a diagnostic 24-h combined pH and multiple intraluminal impedance (pH-MII) monitoring.

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Background: Prematurity is the strongest predictor of bronchopulmonary dysplasia (BPD). Most previous studies investigated additional risk factors by conventional statistics, while the few studies applying artificial intelligence, and specifically machine learning (ML), for this purpose were mainly targeted to the predictive ability of specific interventions. This study aimed to apply ML to identify, among routinely collected data, variables predictive of BPD, and to compare these variables with those identified through conventional statistics.

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Deranged cerebral autoregulation (CA) is associated with worse outcome in adult brain injury. Strategies for monitoring CA and maintaining the brain at its 'best CA status' have been implemented, however, this approach has not yet developed for the paediatric population. This scoping review aims to find up-to-date evidence on CA assessment in children and neonates with a view to identify patient categories in which CA has been measured so far, CA monitoring methods and its relationship with clinical outcome if any.

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Article Synopsis
  • The study examines muscle changes, specifically sarcopenia and myosteatosis, in cirrhosis patients to understand their prevalence and impact on health over a year.
  • In a group of 433 patients, different combinations of these muscle changes were found, with notable increases in mortality and hospitalization rates linked to isolated myosteatosis and combined muscle changes.
  • Findings indicate that both myosteatosis and sarcopenia are common in cirrhosis, leading to worse health outcomes, emphasizing the need for better prognostic evaluations in these patients.
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  • Caffeine is commonly used to prevent apnea in premature infants, and this study aims to assess its effects on cardiovascular and cerebrovascular health during critical transitional periods.
  • The research involved 77 preterm infants under 32 weeks of gestational age, measuring various heart and blood flow metrics before and after administering caffeine.
  • Results showed that caffeine increased systemic vascular resistance and improved cerebrovascular reactivity, suggesting its potential benefits in enhancing blood flow dynamics in these vulnerable infants.
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Background: Pallister-Killian syndrome (PKS) is a rare genetic disorder caused by mosaic tetrasomy of 12p with wide neurological involvement. Intellectual disability, developmental delay, behavioral problems, epilepsy, sleep disturbances, and brain malformations have been described in most individuals, with a broad phenotypic spectrum. This observational study, conducted through brain MRI scan analysis on a cohort of patients with genetically confirmed PKS, aims to systematically investigate the neuroradiological features of this syndrome and identify the possible existence of a typical pattern.

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Background: Primary sclerosing cholangitis is a cholestatic disease with a low prevalence in Italy. Indications for liver transplantation and the time of listing are not stated.

Aim: We performed a national survey to investigate the listing criteria, comorbidities, and outcomes.

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Background: The management of respiratory distress syndrome (RDS) in premature newborns is based on different types of non-invasive respiratory support and on surfactant replacement therapy (SRT) to avoid mechanical ventilation as it may eventually result in lung damage. European guidelines currently recommend SRT only when the fraction of inspired oxygen (FiO) exceeds 0.30.

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Background & Aims: Nephrotoxicity of intravenous iodinated contrast media (ICM) in cirrhosis is still a debated issue, due to scarce, low-quality and conflicting evidence. This study aims to evaluate the incidence and predisposing factors of acute kidney injury (AKI) in patients with cirrhosis undergoing contrast-enhanced computed tomography (CECT).

Methods: We performed a prospective, multicenter, cohort study including 444 inpatients, 148 with cirrhosis (cohort 1) and 163 without cirrhosis (cohort 3) undergoing CECT and 133 with cirrhosis (cohort 2) unexposed to ICM.

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Extracellular vesicles (EVs) are emerging as a promising field of research in liver disease. EVs are small, membrane-bound vesicles that contain various bioactive molecules, such as proteins, lipids, and nucleic acids and are involved in intercellular communication. They have been implicated in numerous physiological and pathological processes, including immune modulation and tissue repair, which make their use appealing in liver transplantation (LT).

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Background: Since November 2020, Italy was the first country to carry out a protocol and use liver from COVID-19 donors. We aimed to evaluate the medium-term outcome of patients who underwent liver transplant (LT) with those grafts.

Methods: We consecutively enrolled 283 patients who underwent first LT from November 2020 to December 2022 in our Center (follow-up 468 days).

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Objective: To evaluate the relationship between impaired brain growth and structural brain abnormalities at term-equivalent age (TEA) and neurodevelopment in extremely low-birth-weight (ELBW) infants over the first 2 years.

Methods: ELBW infants born from 2009 through 2018 and undergoing brain magnetic resonance imaging (MRI) at TEA were enrolled in this retrospective cohort study. MRI scans were reviewed using a validated quali-quantitative score, including several white and gray matter items.

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This study aims to assess the impact of time of onset and features of early foetal growth restriction (FGR) with absent end-diastolic flow (AEDF) on pregnancy outcomes and on preterm infants' clinical and neurodevelopmental outcomes up to 2 years corrected age. This is a retrospective, cohort study led at a level IV Obstetric and Neonatal Unit in Bologna, Italy. Pregnant women were eligible if having singleton pregnancies, with no major foetal anomaly detected, and diagnosed with early FGR + AEDF (defined as FGR + AEDF detected before 32 weeks gestation).

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Introduction: The study of immune response to SARSCoV-2 infection in different solid organ transplant settings represents an opportunity for clarifying the interplay between SARS-CoV-2 and the immune system. In our nationwide registry study from Italy, we specifically evaluated, during the first wave pandemic, i.e.

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This prospective observational study aimed to evaluate whether lung fluids, assessed by lung ultrasonography and transthoracic electrical bioimpedance (TEB), may be influenced by the presence of a haemodynamically significant patent ductus arteriosus (hsPDA) in very preterm infants during the transitional period. Infants < 32 weeks of gestational age (GA) admitted to the neonatal intensive care units of IRCCS AOU Bologna and Niguarda Metropolitan Hospital of Milan (Italy) underwent a daily assessment of a lung ultrasound score (LUS) and of a TEB-derived index of thoracic fluid contents (TFC) during the first 72 h after birth. Echocardiographic scans were simultaneously performed to evaluate the concomitant ductal status (hsPDA vs.

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