Publications by authors named "Alberto Milanese"

Background: Heart failure (HF), affecting 1-4% of adults in industrialized countries, is a major public health priority. Several algorithms based on administrative health data (HAD) have been developed to detect patients with HF in a timely and inexpensive manner, in order to perform real-world studies at the population level. However, their reported diagnostic accuracy is highly variable.

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Background: after the recent reform of territorial healthcare, districts have been designated within the Lombardy Regional Health System to coordinate and deliver territorial care. This entails the need of readily available information to measure the quality of provided healthcare, identify critical areas for improvement, monitor the balance between demand and supply of healthcare services.

Objectives: to present the development of a dynamic evaluation system of processes and outcomes resulting from the integration of territorial and hospital care, based on a set of composite indicators, called 'health profiles', and their visualization and release through a dedicated web platform.

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Objectives: The aim of this study was to investigate the retinal morpho-functional characteristics of patients with neovascular wet age-related macular degeneration (nAMD) treated with intravitreal injection (IV) of aflibercept (AFL).

Methods: The study was conducted on 35 patients previously diagnosed with type 1 nAMD who received a fixed-dosing regimen of aflibercept injections over 12 months. The goal was to assess trends in visual abilities over time by measuring visual acuity (VA), contrast sensitivity (CS), visual evoked potentials (VEPs), and spectral domain-optical coherence tomography (SD-OCT).

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Article Synopsis
  • Lipoid proteinosis (LP), also known as Urbach-Wiethe disease, is a rare condition marked by hoarseness and involvement of multiple organs, often going unrecognized, especially by otolaryngologists.
  • The study systematically reviewed literature, analyzing 154 cases to highlight that hoarseness was a common early symptom, typically identified around 19 months but was often diagnosed much later, around 15 years of age, resulting in significant diagnostic delays.
  • The findings indicate that while hoarseness is crucial for diagnosing LP, it is frequently missed, with genetic testing of the ECM1 gene being relevant for confirming the diagnosis in many cases.
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Aims: The multi-systemic effects of heart failure (HF) resemble the spread observed during cancer. We propose a new score, named HLM, analogous to the TNM classification used in oncology, to assess the prognosis of HF. HLM refers to H: heart damage, L: lung involvement, and M: systemic multiorgan involvement.

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Introduction: We presented a four-case series of COVID-19 related deaths occurred in patients with Guillain-Barré syndrome (GBS) between February 2020 and January 2022 in Italy.

Methods: They were extracted from 8,436 medical charts of COVID-19 patients dying. All cases, ranged 48-73 years, showed classical GBS clinical onset - limb weakness, sensory deficits, hypoareflexia - and three of them were admitted in intensive care unit (ICU) for ventilator support.

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Objectives: Acute gastrointestinal graft-versus-host disease (GI-aGVHD) is a severe complication of allogeneic hematopoietic stem cell transplantation (HSCT). Diagnosis relies on clinical, endoscopic, and pathological investigations. Our purpose is to assess the value of magnetic resonance imaging (MRI) in the diagnosis, staging, and prediction of GI-aGVHD-related mortality.

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Background: A severe multisystem inflammatory syndrome in children (MIS-C) related to SARS-CoV-2 has been described after infection. A limited number of reports have analyzed the long-term complications related to pro-inflammatory status in MIS-C. We evaluated multiorgan impairment at the 6-month follow-up in MIS-C.

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Background: Glut1 deficiency syndrome (Glut1-DS) is a rare metabolic encephalopathy. Familial forms are poorly investigated, and no previous studies have explored aspects of Glut1-DS over the course of life: clinical pictures, intelligence, life achievements, and quality of life in adulthood. Clinical, biochemical and genetic data in a cohort of familial Glut1-DS cases were collected from medical records.

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The struggle for information and the hasty search for answers caused by the COVID-19 pandemic threatened the possibility of lowering study quality, as well as ethical committees' review standards during the outbreak. Our investigation aimed to assess the impact of COVID-19 on the quality of clinical research studies submitted to Italian Ethics Committees in the period between April and July 2020. All 91 Italian ethics committees were contacted via email in order to collect anonymized information on the type and quality of COVID-19-related studies submitted to each committee during the study period.

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Insomnia is a widespread sleep disorder associated with physical and mental health conditions. Although the heterogeneity of insomnia presentations has been acknowledged, research investigating clinically meaningful insomnia subtypes is still ongoing. This study aimed at exploring insomnia subtypes according to widely-used measures of symptoms severity and sleep quality among Italian university students using a latent profile analysis.

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Patients with atrial fibrillation (AF) still experience a high mortality rate despite optimal antithrombotic treatment. We aimed to identify clinical phenotypes of patients to stratify mortality risk in AF. Cluster analysis was performed on 5171 AF patients from the nationwide START registry.

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Background:  Statins are guidelines recommended in patients with peripheral artery disease (PAD) for the prevention of cardiovascular (CV) events. Comprehensive meta-data on the impact of statins on major adverse limb events (MALE) in PAD patients are lacking. We examined the association of statin use with MALE in patients with PAD.

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Article Synopsis
  • Adapalene® is a synthetic retinoid designed to interact specifically with RARβ and RARγ receptors, synthesized through a process that involves Suzuki coupling and the addition of an adamantyl group.
  • The compound was studied for its interaction with DNA using UV-vis spectroscopy, revealing binding constants that ranged from 1.1×10^4 to 1.1×10^5 M(-1), with the highest values linked to the derivatives containing the adamantyl group.
  • Molecular modeling indicated that the main factor stabilizing the binding to DNA is hydrophobic interactions, which are influenced by the presence of the adamantyl group in the molecule.
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Article Synopsis
  • - An unknown by-product was discovered in the synthesis of Simvastatin from Lovastatin, specifically during a step where butylamine was replaced with benzylamine in Merck Sharp and Dhome's process.
  • - The molecular structure of the by-product was determined using various analytical techniques, including NMR spectroscopy, HPLC/MS, MS/MS, and FT-IR.
  • - The isolated compound was identified as alpha,beta,gamma,delta unsaturated Simvastatin N-benzylamide, with the molecular formula C(32)H(43)NO(3) and notable features in its heptanoic acid amide residue.
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