Publications by authors named "Gerardo Lorusso"

Background: We aimed to estimate the effect of extracorporeal cardiopulmonary resuscitation (ECPR) on neurological outcome and mortality, when compared to conventional cardiopulmonary resuscitation (CCPR), using an individual patient data meta-analysis (IPDMA).

Methods: A systematic literature search was performed up to the 20th of October 2022 in the PubMed, EMBASE and CENTRAL databases. For observational studies with unmatched populations, a propensity score including age, location of arrest and initial rhythm was used to match ECPR and CCPR patients in a 1:1 ratio.

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  • The study looks at how the location where doctors put tubes in the arteries for heart support affects brain health after surgery.
  • They compared three methods: using the aorta, subclavian/axillary arteries, and femoral artery to see which had the least brain problems.
  • Results showed that patients using the subclavian/axillary method had more major brain issues compared to the others, and also had more seizures after the surgery.
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  • ECLS cannulation in post-cardiotomy patients is uncommon in general wards, with only 39 out of 2058 patients studied undergoing the procedure while at the hospital.
  • The majority of these patients faced complications like acute kidney injury and arrhythmias, with a high in-hospital mortality rate of 84.6%, predominantly due to persistent heart failure.
  • Findings suggest that ECLS cannulation mainly affects low-risk patients who experience cardiac arrest post-surgery, indicating a need for further research into improving outcomes.
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Merkel cell carcinoma (MCC) is a rare, highly aggressive, primitive neuroendocrine carcinoma of the skin, the origin of which is not yet fully understood. Numerous independent prognostic factors have been investigated in an attempt to understand which are the most important parameters to indicate in the histological diagnostic report of MCC. Of these, mast cells have only been studied in one paper before this one.

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  • * Conducted across 34 centers globally from 2000 to 2020, the study included over 2,000 adult patients split into different ECMO duration groups, revealing higher complications and mortality rates associated with longer ECMO durations.
  • * The findings suggest that while most in-hospital complications increase with ECMO duration, post-discharge survival rates remain similar across groups, with specific risk factors like age and pre-existing conditions affecting long-term survival for those on ECMO longer than 7 days.
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Objectives: Although cardiogenic shock requiring extracorporeal life support after cardiac surgery is associated with high mortality, the impact of sex on outcomes of postcardiotomy extracorporeal life support remains unclear with conflicting results in the literature. We compare patient characteristics, in-hospital outcomes, and overall survival between females and males requiring postcardiotomy extracorporeal life support.

Methods: This retrospective, multicenter (34 centers), observational study included adults requiring postcardiotomy extracorporeal life support between 2000 and 2020.

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Limb ischaemia is a clinically relevant complication of venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. No selective distal perfusion or other advanced techniques were used in the past to maintain adequate distal limb perfusion. A more recent trend is the shift from the reactive or emergency management to the pro-active or prophylactic placement of a distal perfusion cannula to avoid or reduce limb ischaemia-related complications.

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  • Recurrent gynecological tumors like endometrial and ovarian cancers lack effective treatments, prompting research into the PTEN-AKT-PI3K pathway as a target, with alpelisib being a notable PI3K inhibitor.
  • A study involving 36 patients with PIK3CA-mutated advanced gynecological cancers showed an overall objective response rate (ORR) of 28% and a disease control rate (DCR) of 61%, with the best results in endometrial cancer patients.
  • The findings suggest that alpelisib could be a promising treatment option for these patients and highlight the importance of further clinical trials focusing on biomarker-driven approaches for PI3K inhibitors in gynecological cancers
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Background: In 2022 the total world migrant population was 281 million (an increase of approximately 62% compared to year 2000), of whom 169 million were migrant workers. The number of refugees, asylum seekers and others in need of international protection increased by 22% compared to 2021. Research has shown that the forcibly displaced have high rates of mental disorders (including depression, post-traumatic stress disorder (PTSD) and anxiety), with an estimated prevalence almost 6 to 7 times higher than the general population.

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Objectives: to evaluate long-term effectiveness and safety of fluocinolone acetonide (FAc) implant used as second-line treatment in patients with persistent diabetic macular edema (DME).

Methods: retrospective data chart review of 241 pseudophakic eyes of 178 patients treated with FAc from July 2017 to December 2021 in 10 medical retinal units in Italy. The primary endpoint was the change of best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 2 years.

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Late diagnosis and the lack of screening methods for early detection define high-grade serous ovarian cancer (HGSOC) as the gynecological malignancy with the highest mortality rate. In the work presented here, we investigated a retrospective and multicentric cohort of 250 archival Papanicolaou (Pap) test smears collected during routine gynecological screening. Samples were taken at different time points (from 1 month to 13.

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  • Anticoagulation management during veno-venous extracorporeal membrane oxygenation (VV ECMO) is challenging due to a lack of definitive guidelines, leading to significant bleeding complications.
  • A study involving 652 adult patients across 41 centers analyzed anticoagulation practices and bleeding events, finding that unfractionated heparin was the most commonly used anticoagulant and that bleeding occurred in 52.5% of patients.
  • Results showed that higher activated partial thromboplastin time (aPTT) levels were linked to an increased risk of bleeding, suggesting that future research could investigate whether lower aPTT targets might help minimize these complications.
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Introduction: COVID-19 pandemic had a great impact on outcome in SARS-CoV-2 positive patients with ischemic stroke during the first wave in Italy. Few data are available on outcome stratified by sex.

Methods: The Italian Society of Hospital Neuroscience conducted a multi-center, retrospective, observational study on neurological complications in COVID-19 patients with ischemic stroke.

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The aim of the "Diogene Project" is to recruit, evaluate, and treat homeless people affected by psychiatric disorders. Three multidisciplinary street units patrolled the streets in Milan, Italy, two/three evenings per week to recruit participants. A sociodemographic questionnaire, the HoNOS, and the GAF were administered at recruitment (T0), 1 year (T1), and 2 years (T2) after the first evaluation.

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  • The study examines the use of extracorporeal membrane oxygenation (ECMO) in adults experiencing cardiogenic shock after heart surgery, noting significant in-hospital mortality rates (60.5%).
  • Conducted across 34 centers from 2000 to 2020, the research analyzes patient characteristics and factors affecting both in-hospital and long-term survival.
  • Despite high initial mortality, approximately 66% of hospital survivors can expect to live for a decade post-discharge, with age and certain postoperative complications influencing long-term outcomes.
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  • Postcardiotomy venoarterial extracorporeal membrane oxygenation (VA ECMO) shows a gap between the rates of successful weaning from the device and actual survival after discharge, prompting an analysis of patient outcomes.
  • A study of 2058 adult patients revealed that 62.7% could be weaned off VA ECMO, but only 39.6% survived to be discharged; major causes of death included multiorgan failure and persistent heart failure, with significant differences in mortality rates during and after ECMO support.
  • Key risk factors for on-ECMO mortality included emergency surgery and preoperative cardiac issues, while postweaning mortality was linked to complications like diabetes and septic shock.
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Introduction: Standard treatment of newly diagnosed, advanced ovarian carcinoma (OC) consists of cytoreductive surgery followed by platinum-based chemotherapy with or without bevacizumab. Maintenance therapy with PARP inhibitors and olaparib-bevacizumab has recently shown to significantly improve progression-free survival in the first-line setting. Some practical aspects of maintenance therapy, however, are still poorly defined.

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Pharmacogenomics studies how genes influence a person's response to treatment. When complex phenotypes are influenced by multiple genetic variations with little effect, a single piece of genetic information is often insufficient to explain this variability. The application of machine learning (ML) in pharmacogenomics holds great potential - namely, it can be used to unravel complicated genetic relationships that could explain response to therapy.

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Objectives: Postcardiotomy extracorporeal membrane oxygenation (ECMO) can be initiated intraoperatively or postoperatively based on indications, settings, patient profile, and conditions. The topic of implantation timing only recently gained attention from the clinical community. We compare patient characteristics as well as in-hospital and long-term survival between intraoperative and postoperative ECMO.

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Narcissistic personality disorder is characterized by self-absorption, grandiosity, exploitation of others and lack of empathy. People with that disorder may switch from an overt form, mainly with grandiosity, to a covert presentation, with fears, hypersensitivity and dependence from others. Empathy represents a key point in detecting people affected by narcissistic personality disorder because, even if it is described as reduced, it plays a fundamental role in exploitation and manipulation.

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Background: Post-acute myocardial infarction papillary muscle rupture (post-AMI PMR) may present variable clinical scenarios and degree of emergency due to result of cardiogenic shock. Veno-arterial extracorporeal life support (V-A ECLS) has been proposed to improve extremely poor pre- or postoperative conditions. Information in this respect is scarce.

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  • Obesity is a significant concern in cardiac surgery, particularly for patients needing postcardiotomy V-A ECMO, but its impact on their outcomes is uncertain.
  • The PELS-1 study analyzed data from 2046 patients across 36 centers over 20 years, categorizing them by BMI and measuring in-hospital mortality and other major adverse events.
  • Findings revealed no significant difference in in-hospital mortality rates among different BMI categories, suggesting BMI should not be used to assess risk in these patients undergoing V-A ECMO.
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