Publications by authors named "Lucia F"

Multidrug-resistant is a significant healthcare challenge that particularly affects vulnerable patients through opportunistic nosocomial infections. Surveillance is crucial for monitoring the prevalence of these infections. Eighty-four KPC strains (2019-2022) were collected from patients admitted in Fondazione Policlinico Universitario Campus Bio-Medico.

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The treatment landscape for Rheumatoid Arthritis (RA) has evolved significantly with the introduction of Janus kinase inhibitors (JAKi), such as Tofacitinib (TOFA), which offer a new therapeutic option for patients who have failed or are intolerant to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). Safety concerns, particularly related to cardiovascular and cancer risks, prompted a need for additional investigation in real-world clinical settings. This study aimed to evaluate the long-term effectiveness and predictors of response to TOFA in two subpopulations of RA patients, categorized by differing cardiovascular risk profiles.

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Due to the recent advances in the systemic treatment of non-small cell lung cancer, the management of locoregional recurrences, especially after initial radiotherapy (with or without concurrent chemotherapy), is of increasing significance. The potential alternatives in this setting include: a salvage local strategy (based on surgery, radiotherapy or thermoablative treatment), promising approach, but sometimes difficult to implement in often frail patients, and whose modalities remain under-researched; or alternatively, the initiation of systemic treatment, where the prognosis aligns with that of de novo metastatic patients. This comprehensive literature review focused on salvage radiotherapy treatment of recurrent non-small cell lung carcinomas, after initial radiotherapy, with or without associated systemic treatment.

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Article Synopsis
  • Radiotherapy plays a crucial role in treating cancer but often struggles with effective local control, especially in advanced tumours that are resistant to radiation.
  • Surrounding healthy tissues often limit how much radiation can be safely used, which can lead to complications.
  • New agents like chemotherapies and targeted monoclonal antibodies have shown promise in improving treatment outcomes, and current research is exploring innovative radioenhancers, particularly nanoparticles like NBTXR3 and AGuIX®.
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Background: Upadacitinib (UPA) is a selective, reversible Janus kinase inhibitor (JAKi) approved for the treatment of RA. However, there is still no solid evidence on the long-term efficacy of UPA in treated patients. The purpose of this study was to determine the efficacy of UPA to obtain remission or low disease activity (LDA) in a series of UPA patients in patients with RA after 6 and 12 months of treatment in a real-world setting.

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  • Brain radiation necrosis (BRN) is a serious complication of stereotactic radiotherapy, making it crucial to differentiate it from tumor recurrence using advanced diagnostic techniques.
  • BRN often appears months to years after treatment, with symptoms and MRI changes, influenced by factors like the amount of brain tissue irradiated and radiation dose.
  • Management strategies vary; asymptomatic cases may require monitoring, while symptomatic BRN typically responds to corticosteroids, and emerging treatments like bevacizumab show promise; ongoing research aims to improve outcomes for patients.
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Article Synopsis
  • * Recent advancements in immunotherapy have improved treatment options for non-small-cell lung cancer (NSCLC), but SCLC still poses significant challenges due to its aggressive nature and high chances of recurrence or metastasis.
  • * The article discusses the emerging role of stereotactic radiotherapy in managing small-cell lung cancer, similar to its established use in treating early-stage NSCLC and metastatic diseases.
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  • The Janus kinase inhibitors (JAKi) like tofacitinib, baricitinib, upadacitinib, and filgotinib are effective in treating rheumatoid arthritis but faced safety concerns from the FDA and EMA, particularly about serious adverse events (SAEs) such as thrombosis and cancer.
  • The study aimed to analyze the impact of the EMA's first two safety warnings on how rheumatologists in Italy prescribed JAKi from July 2019 to June 2022, using data from 29 rheumatology centers.
  • Results showed a significant reduction (32%) in JAKi prescriptions after the first warning, with a smaller decrease (16%) observed after the second warning, although there
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Background: exon 14 (ex14) skipping mutations are oncogenic drivers observed in approximately 3-4% of non-small cell lung cancers (NSCLC). Several distinct genetic alterations leading to METex14 have been reported but clinical significances of rare mutations are not well defined as well as outcomes of patients upon MET inhibitors (METi).

Case Presentation: This report presents the case of a patient with metastatic NSCLC harboring an uncommon mutational landscape including notably a novel ex14 mutation (R1022L).

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Article Synopsis
  • Functional imaging techniques like PET/CT are beneficial in evaluating various biological properties crucial for managing patients undergoing radiotherapy.
  • They enhance initial disease staging, help identify predictive biomarkers for treatment response, and improve patient selection for radiotherapy.
  • Additionally, these imaging methods aid in precise targeting for dose escalations and are useful for monitoring treatment effectiveness during follow-ups.
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Purpose: The accuracy of target delineation in radiation treatment planning of high-grade gliomas (HGGs) is crucial to achieve high tumor control, while minimizing treatment-related toxicity. Magnetic resonance imaging (MRI) represents the standard imaging modality for delineation of gliomas with inherent limitations in accurately determining the microscopic extent of tumors. The purpose of this study was to assess the survival impact of multi-observer delineation variability of multiparametric MRI (mpMRI) and [F]-FET PET/CT.

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The primary objective of the present study was to identify a subset of radiomic features extracted from primary tumor imaged by computed tomography of early-stage non-small cell lung cancer patients, which remain unaffected by variations in segmentation quality and in computed tomography image acquisition protocol. The robustness of these features to segmentation variations was assessed by analyzing the correlation of feature values extracted from lesion volumes delineated by two annotators. The robustness to variations in acquisition protocol was evaluated by examining the correlation of features extracted from high-dose and low-dose computed tomography scans, both of which were acquired for each patient as part of the stereotactic body radiotherapy planning process.

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Four-dimensional computed tomography (4DCT) imaging consists in reconstructing a CT acquisition into multiple phases to track internal organ and tumor motion. It is commonly used in radiotherapy treatment planning to establish planning target volumes. However, 4DCT increases protocol complexity, may not align with patient breathing during treatment, and lead to higher radiation delivery.

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Background And Aims: Measuring 1,25-dihydroxyvitamin D (1,25(OH)D), parathyroid hormone 1-84 (PTH 1-84) and intact FGF23 (iFGF23) is crucial for diagnosing a variety of diseases affecting bone and mineral homeostasis. Biological variability (BV) data are important for defining analytical quality specifications (APS), the usefulness of reference intervals, and the significance of variations in serial measurements in the same subject. The aim of this study was to pioneer the provision of BV estimates for 1,25(OH)2D and to improve existing BV estimates for iFGF23 and PTH 1-84.

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Objectives: Stereotactic radiotherapy (SRT) for brain metastases (BM) allows very good local control (LC). However, approximately 20%-30% of these lesions will recur. The objective of this retrospective study was to evaluate the impact of dosimetric parameters on LC in cerebral SRT.

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In lung cancer patients, radiotherapy is associated with a increased risk of local relapse (LR) when compared with surgery but with a preferable toxicity profile. The KEAP1/NFE2L2 mutational status (Mut) is significantly correlated with LR in patients treated with radiotherapy but is rarely available. Prediction of Mut with noninvasive modalities could help to further personalize each therapeutic strategy.

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Purpose: To evaluate the impact of dosimetric parameters on efficacy of stereotactic body radiation therapy (SBRT) in early-stage non-small cell lung cancer (ES-NSCLC), using Hypofractionated Treatment Effects in the Clinic (HyTEC) reporting standards.

Methods: From April 2010 to December 2020, 497 patients who received SBRT for ES-NSCLC at the University Hospital of Liège were retrospectively enrolled. A total dose of 40 to 60 Gy in 3-5 fractions (72-180 Gy biologically effective dose with an α/β ratio of 10 (BED)) was prescribed to the 80 % isodose line of the PTV.

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There are currently no accurate rules for manually delineating the subregions of the heart (cavities, vessels, aortic/mitral valves, Planning organ at Risk Volumes for coronary arteries) with the perspective of deep-learning based modeling. Our objective was to present a practical pictorial view for radiation oncologists, based on the RTOG atlas and anatomical complementary considerations for the cases where the RTOG guidelines are missing.

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Article Synopsis
  • * Researchers analyzed data from 464 patients, focusing on various radiomic features extracted from imaging studies, and applied machine learning techniques to evaluate the performance of clinical, radiomic, and combined prediction models.
  • * The findings revealed that radiomic models significantly outperformed traditional clinical models in predicting recurrence, suggesting the potential benefit of using these advanced techniques for discussing follow-up treatments in ES-NSCLC patients.
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Purpose: The aim of this work was to compare anatomic and functional dose-volume parameters as predictors of acute radiation-induced lung toxicity (RILT) in patients with lung tumors treated with stereotactic body radiation therapy.

Methods And Materials: Fifty-nine patients treated with stereotactic body radiation therapy were prospectively included. All patients underwent gallium 68 lung perfusion positron emission tomography (PET)/computed tomography (CT) imaging before treatment.

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We reported imaging findings of arterio-venous malformation complicated by hemorrhage and venous pseudoaneurysm in a young child consulting for headache and emesis: to our knowledge venous pseudoaneurysm in association with ruptured arteriovenous malformation is a rare complication reported in the literature. We present the indications for endovascular treatment, especially with NBCA (N-butyl cyanoacrylate).

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: Tofacitinib (TOFA) was the first Janus kinase inhibitor (JAKi) to be approved for the treatment of rheumatoid arthritis (RA). However, data on the retention rate of TOFA therapy are still far from definitive. : The goal of this study is to add new real-world data on the TOFA retention rate in a cohort of RA patients followed for a long period of time.

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Purpose: To investigate the role of chest computed tomography (CT) scan in the prediction of admission of pregnant women with COVID-19 into intensive care unit (ICU).

Methods: This was a single-center retrospective case-control study. We included pregnant women diagnosed with COVID-19 by reverse transcriptase polymerase chain reaction between February 2020 and July 2021, requiring hospital admission due to symptoms, who also had a CT chest scan at presentation.

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Article Synopsis
  • Despite advancements in HPV vaccination and screening, about 5% of cervical cancer cases are initially diagnosed at a metastatic stage, with many patients experiencing recurrence after treatment.
  • Treatment options for recurrent or metastatic cervical cancer are currently limited, with traditional therapies primarily involving platinum-based drugs, paclitaxel, and newer immune checkpoint inhibitors showing promise for longer survival.
  • The potential for radiation therapy to induce an abscopal effect—where treatment at one site impacts tumors beyond that area—may enhance therapeutic outcomes when combined with immune therapies, suggesting a new direction in managing metastatic cervical cancer.
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