Publications by authors named "Pugliese F"
The role of Heart Rate Variability (HRV) indices in predicting the outcome of the weaning process remains a subject of debate. The aim of this study is to investigate HRV analysis in critically ill adult patients undergoing weaning from invasive mechanical ventilation (IMV). The protocol of this systematic review was registered with PROSPERO (CRD42024485800).
View Article and Find Full Text PDFAssessing the respiratory system of a patient receiving mechanical ventilation is complex. We provide an overview of an approach at the bedside underpinned by physiology. We discuss the importance of distinguishing between extensive and intensive ventilatory variables.
View Article and Find Full Text PDFBackground: COVID-19 vaccines reduced mortality, hospitalizations and ICUs admissions. Conversely, the impact of vaccination on Long COVID-19 syndrome is still unclear. This study compared the prevalence of post-acute sequelae at short and long-term follow-up among hospitalized unvaccinated and vaccinated COVID-19 survivors through a multidisciplinary approach.
View Article and Find Full Text PDFArticle Synopsis
- Coronary computed tomography angiography (CCTA) was evaluated as an alternative to intravascular imaging techniques for assessing plaque pathology in patients with chronic coronary syndrome.
- The study involved 70 patients and compared CCTA with near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) to analyze atheroma burden and composition, focusing on the accuracy of detecting lipid-rich plaques.
- Results showed that CCTA had limitations in accurately measuring plaque dimensions and composition, leading to potential issues in planning for coronary interventions.
Article Synopsis
- The BYPASS-CTCA trial found that using computed tomography cardiac angiography (CTCA) prior to invasive coronary angiography (ICA) in patients with previous bypass surgery reduces procedure time and the risk of kidney injury, improving patient satisfaction.
- In this study, 688 patients were divided into two groups: one receiving CTCA before ICA and the other receiving ICA alone, with follow-up averaging 3 years.
- Results showed that although benefits like being angina-free and improved quality of life were seen at 3 months, long-term outcomes showed CTCA/ICA patients had lower imaging resource use and fewer major adverse cardiac events compared to those who only had ICA.
Hypophosphatasia (HPP) is a rare disorder of the bone metabolism, characterized by genetically determined low alkaline phosphatase (ALP) activity. Low ALP may also be observed in some common causes of bone fragility, such as in osteoporosis treated with antiresorptive drugs. This study aimed to verify whether differences in bone turnover markers (BTMs) could help differentiate adult patients with HPP from those with osteoporosis undergoing antiresorptive treatment.
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- Low-grade endotoxemia, caused by lipopolysaccharide (LPS), is detected in COVID-19 patients, potentially promoting thrombosis through a pro-inflammatory and pro-coagulant state.
- The study measured various biomarkers in 175 COVID-19 patients and 50 healthy controls, finding significantly elevated levels of markers like sNOX2-dp and D-dimer in COVID-19 patients, especially those with acute respiratory distress syndrome (ARDS).
- Results suggest that factors like impaired gut barrier function, high NOX2 activation, and low albumin may lead to low-grade endotoxemia, increasing the risk of thrombotic events in COVID-19 patients.
Article Synopsis
- Umberto I Teaching Hospital in Rome set up a temporary ICU in March 2021 to manage critical COVID-19 patients and studied healthcare-associated infections (HAIs) among them across different COVID-19 variants.
- Out of 355 patients admitted, 27.3% developed at least one HAI and the mortality rate was 49.6%, with older and more complex cases appearing over time, especially in the first year.
- The research found that patients admitted during the later Omicron variants had lower chances of developing HAIs compared to those admitted during the Alpha variant, suggesting improvements in clinical management and infection control measures played a role in reducing HAI rates despite increasing patient severity.
Article Synopsis
- Invasive aspergillosis (IA) can cause severe respiratory issues, sometimes requiring ECMO, but there is limited existing data on its effectiveness in these cases.
- This systematic review analyzed 32 patients with IA, finding that a majority of them had ARDS and that mortality was high at 78%, with numerous complications related to ECMO.
- While ECMO may enhance survival for critically ill patients with IA, associated risks like superinfections and altered medication effects need cautious management.
Article Synopsis
- The study investigates long-term symptoms of COVID-19, focusing on both hospitalized and home-isolated patients to detail persistent issues related to long COVID.
- Conducting a retrospective cohort study with 364 patients, researchers found that 82% experienced at least one symptom, primarily fatigue, and notable lung issues were detected in many patients.
- The findings highlight significant long-term effects of COVID-19, stressing the need for comprehensive healthcare approaches and multidisciplinary teams to manage and improve patient outcomes.
Objective: The aim of this study was to assess the risk of sleep-disordered breathing (SDB) in orthodontic patients and to evaluate the influence of sex, age, and orthodontic treatment in a cohort of subjects using the Pediatric Sleep Questionnaire (PSQ) screening tool.
Methods: Parents of 245 patients aged 5-18 years (11.4 ± 3.
Context: The risk of vertebral fractures (VFx) in patients with nonfunctioning adrenal incidentalomas (NFAI) is unknown.
Objective: This work aimed to assess in NFAI patients the prevalence and incidence of VFx and a hormonal marker to identify patients at risk.
Methods: A retrospective, cross-sectional, and longitudinal study of outpatients was conducted.
Article Synopsis
- - The study analyzed how calcific (Ca) burden affects the accuracy of coronary computed tomography angiography (CTA) in assessing plaque burden and composition, using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) as a comparison standard.
- - Involving 64 patients and 186 vessels, results indicated that while Ca did not significantly alter correlations between NIRS-IVUS and CTA at the segment and lesion levels, it did affect their agreement at the cross-sectional level, specifically regarding lipid and Ca components.
- - Ultimately, the presence of Ca burden influenced measurements and predictions of plaque volume and composition between NIRS-IVUS and CTA, highlighting the importance of considering coronary calcification in clinical evaluations.
Background CT-derived fractional flow reserve (CT-FFR) and dynamic CT myocardial perfusion imaging enhance the specificity of coronary CT angiography (CCTA) for ruling out coronary artery disease (CAD). However, evidence on comparative diagnostic value remains scarce. Purpose To compare the diagnostic accuracy of CCTA plus CT-FFR, CCTA plus CT perfusion, and sequential CCTA plus CT-FFR and CT perfusion for detecting hemodynamically relevant CAD with that of invasive angiography.
View Article and Find Full Text PDFIn this editorial, we explore the challenges of managing noncurative resections in early gastric cancer after endoscopic submucosal dissection (ESD), starting from the consideration recently made by Zhu . Specifically, we evaluate the management of eCura C1 lesions, where decisions regarding further interventions are pivotal yet contentious. Collaboration among endoscopists, surgeons, and pathologists is underscored to refine risk assessment and personalize therapeutic management.
View Article and Find Full Text PDFBackground: Coronary artery calcium score (CACS) is an established marker of coronary artery disease (CAD) and has been extensively used to stratify risk in asymptomatic individuals. However, the value of CACS in predicting plaque morphology in patients with advanced CAD is less established. The present analysis aims to assess the association between CACS and plaque characteristics detected by near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) imaging in patients with obstructive CAD.
View Article and Find Full Text PDFNeoadjuvant chemotherapy (NAT) plays a crucial role in breast cancer (BC) treatment, both in advanced BC and in early-stage BC, with different rates of pathological complete response (pCR) among the different BC molecular subtypes. Imaging monitoring is mandatory to evaluate the NAT efficacy. This study evaluates the diagnostic performance of Contrast-Enhanced Mammography (CEM) in BC patients undergoing NAT.
View Article and Find Full Text PDFBackground And Aim: In surgically altered anatomy (SAA), endoscopic retrograde cholangiopancreatography (ERCP) can be challenging, and it remains debatable the choice of the optimal endoscopic approach within this context. We aim to show our experience and evaluate the technical and clinical success of endoscopic treatment performed in the setting of adverse events (AE) after pancreaticoduodenectomy (PD).
Methods: This study was conducted on a retrospective cohort of patients presenting biliopancreatic complications after PD from 01/01/2012 to 31/12/2022.
Article Synopsis
- Early identification of high-risk elderly patients in the Emergency Department (ED) is essential for effective treatment and resource management, especially for those over 65 with acute medical conditions.
- A study involving 953 patients found that a Neutrophil to Lymphocyte Ratio (NLR) greater than 8 is a significant predictor for 30-day mortality, with patients in this group exhibiting more severe symptoms and poorer vital signs.
- The NLR was confirmed as an effective, low-cost tool for assessing mortality risk, but further validation in larger studies is necessary to strengthen these findings.
Background: The efficacy and safety of dupilumab in atopic dermatitis (AD) have been defined in clinical trials but limited real-world evidence on long-term treatment outcomes is currently available to inform clinical decisions.
Objectives: To describe the long-term effectiveness and safety of dupilumab up to 48 months in patients with moderate-to-severe AD.
Methods: A multicentre, retrospective, dynamic cohort study was conducted to assess long-term effectiveness and safety of dupilumab in patients with moderate-to-severe AD in a real-world setting.
Article Synopsis
- - The current clinical practice utilizes qualitative and semi-quantitative measures to assess coronary artery disease via cardiac CT, but advancements in technology are paving the way for more quantitative approaches.
- - Quantitative coronary CT angiography offers significant potential benefits for both patient management and research in the field of cardiology.
- - This document seeks to establish clear definitions and standards for how quantitative measures of coronary artery disease should be performed and reported using cardiac CT.