328 results match your criteria: ""Cardinal Massaia" Hospital[Affiliation]"

Development and Validation of a Scoring System to Predict Response to Obeticholic Acid in Primary Biliary Cholangitis.

Clin Gastroenterol Hepatol

October 2024

Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza, Italy. Electronic address:

Article Synopsis
  • The study focused on creating a scoring system called the OCA response score (ORS) to predict how individuals with primary biliary cholangitis (PBC) will respond to the treatment using obeticholic acid (OCA).
  • Data were collected from two large cohorts in Italy to derive and validate the score, which includes various clinical factors both before and after six months of treatment.
  • The scoring system demonstrated good predictive ability for treatment response, which could help healthcare providers customize therapies for patients with PBC more effectively.
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Treatment options in first-line metastatic renal carcinoma: A meta-analysis of 2556 patients treated with immune checkpoint inhibitors-based combinations in randomised controlled trials.

Cancer Treat Rev

June 2024

Department of Clinical Oncology, Medical Oncology Section, AULSS 9 Scaligera, 37045 Verona, Italy; Department of Clinical Oncology, Radiation Oncology and Nuclear Medicine Section, AULSS 9 Scaligera, 37045 Verona, Italy.

Background & Aims: The average five-year survival of metastatic renal cell carcinoma (mRCC) is 71%. However, there is significant variability in patient prognosis. Immune checkpoint inhibitors (ICIs) have been introduced into the treatment landscape of mRCC.

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Adjunctive immunotherapeutic agents in patients with sepsis and septic shock: a multidisciplinary consensus of 23.

J Anesth Analg Crit Care

April 2024

Department of Medical and Surgical Sciences Infectious Diseases Unit, IRCCS Azienda Ospedaliero Universitaria Di Bologna, Alma Mater Studiorum University of Bologna, Bologna, Italy.

Background: In the last decades, several adjunctive treatments have been proposed to reduce mortality in septic shock patients. Unfortunately, mortality due to sepsis and septic shock remains elevated and NO trials evaluating adjunctive therapies were able to demonstrate any clear benefit. In light of the lack of evidence and conflicting results from previous studies, in this multidisciplinary consensus, the authors considered the rational, recent investigations and potential clinical benefits of targeted adjunctive therapies.

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How to deal with renal toxicities from immune-based combination treatments in metastatic renal cell carcinoma. A nephrological consultation for Oncologists.

Cancer Treat Rev

April 2024

Division of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

We are witnessing a revolution in the treatment of metastatic renal cell carcinoma (mRCC). Indeed, several immune-based combinations (ICI [immune checkpoint inhibitor] + ICI, or ICI + antiangiogenic agents) have been approved as first-line therapy for mRCC after demonstrating superior efficacy over the previous standard. Despite all the improvements made, safety remains a critical issue, adverse events (AEs) being the main reason for drug discontinuations or dose reductions, ultimately resulting in an increased risk of losing efficacy.

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TROP-2, NECTIN-4 and predictive biomarkers in sarcomatoid and rhabdoid bladder urothelial carcinoma.

Pathologica

February 2024

Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera S. Maria, Terni, Italy.

Article Synopsis
  • This study investigates the expression of TROP-2 and NECTIN-4 in undifferentiated bladder urothelial carcinoma (BUC), specifically focusing on sarcomatoid and rhabdoid subtypes, which are less understood compared to common forms of BUC.
  • Out of 35 undifferentiated BUC cases, TROP-2 was expressed in 20% and NECTIN-4 in 29%, with various other biomarkers such as HER-2 and PD-L1 also evaluated, showing diverse expression rates across cases.
  • The findings suggest that while TROP-2 and NECTIN-4 can be present in some sarcomato
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Purpose: Cancer treatment-induced bone loss is a side effect of hormonal therapy that can severely affect patients' quality of life. The aim of this survey was to obtain an updated picture of management of bone health in patients with breast cancer undergoing adjuvant hormonal therapy and in patients with hormone sensitive prostate cancer according to Italian oncologists.

Methods: Our survey was made up of 21 multiple-choice questions: the first part dealt with the respondents' characteristics, while the second with management of bone health in the described setting.

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Toxocariasis is a zoonosis transmitted by the nematode spp. Immunocompromised hosts are more susceptible than general population to bacterial, viral, fungal and parasitic infections. In this population toxocariasis may present as exacerbation or reactivation and could have severe or atypical manifestations being a diagnostic challenge for healthcare providers.

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Article Synopsis
  • A 48-week study assessed the effectiveness and safety of fremanezumab in patients with high-frequency episodic migraine (HFEM) or chronic migraine (CM) who had experienced more than three treatment failures.* -
  • Results showed significant reductions in monthly migraine days (HFEM -6.4; CM -14.5) and monthly analgesic medication usage, along with improvements in pain and disability scores, across the majority of participants.* -
  • Response rates to treatment indicated that a substantial number of patients experienced significant reductions in migraine frequency, with 75.5% achieving at least a 50% reduction in HFEM and 71.6% in CM.*
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Purpose: Optimal use of bone-modifying agents (BMAs) in patients with bone metastases from solid tumors is uncertain in some aspects: the drug choice; the planned treatment duration and long-term therapy; the prevention and management of possible side effects, including renal toxicity, hypocalcaemia, and medication-related osteonecrosis of the jaw (MRONJ).

Methods: Italian oncologists were invited to fulfil a 24-question web survey about prescription of BMAs for bone metastases of breast cancer, prostate cancer, and other solid tumors. Prevention and management of side effects were also investigated.

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Situs viscerum inversus and abdominal aortic aneurysm: A systematic review of a rare association.

Intractable Rare Dis Res

February 2024

Department of Surgical Sciences, Policlinico Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.

Situs viscerum inversus (SVI) is a very rare condition in that abdominal and thoracic organs are located reversed. Abdominal aortic aneurysm (AAA) is a life-threatening pathology due to progressive aortic enlargement until the rupture. The association between SVI and AAA is very infrequent.

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Objectives: Early sepsis detection and diagnosis still constitutes an open issue since the accuracy of standard-of care parameters is biased by a series of perinatal factors including hypoxia. Therefore, we aimed at investigating the effect of fetal chronic hypoxia insult on urine levels of a promising new marker of sepsis, namely presepsin (P-SEP).

Methods: We conducted a prospective case-control study in 22 cases of early-intrauterine growth restriction (E-IUGR) compared with 22 small-for-gestational-age (SGA) newborns and 66 healthy controls.

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Objectives: Seizures (SZ) are one of the main complications occurring in infants undergoing therapeutic hypothermia (TH) due to perinatal asphyxia (PA) and hypoxic ischemic encephalopathy (HIE). Phenobarbital (PB) is the first-line therapeutic strategy, although data on its potential side-effects need elucidation. We investigated whether: i) PB administration in PA-HIE TH-treated infants affects S100B urine levels, and ii) S100B could be a reliable early predictor of SZ.

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The use of immune checkpoint inhibitors (ICIs) in combination with tyrosine kinase inhibitors or other ICIs has significantly improved the prognosis for patients with mccRCC. This marks a major milestone in the treatment of mccRCC. Nonetheless, most patients will discontinue first-line therapy.

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Article Synopsis
  • * The case series involved 10 patients with an average age of 67, most of whom had significant health issues and common blood disorders like acute myeloid leukaemia and non-Hodgkin's lymphoma.
  • * Despite a 90% improvement rate after starting treatment, the study reported high mortality rates of 30% within 30 days and 50% during hospital stays for these patients.
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Objective: Nearly 60% of migraine patients treated with monoclonal antibodies (mAbs) targeting the calcitonin gene-related peptide (CGRP) pathway experience a ≥ 50% reduction in monthly migraine days (MMD) at 12 weeks compared to baseline (responders). However, approximately half of the patients not responding to anti-CGRP mAbs ≤ 12 weeks do respond ≤ 24 weeks (late responders). We assessed frequency and characteristics of patients responding to anti-CGRP mAbs only > 24 weeks (ultra-late responders).

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Article Synopsis
  • The study aimed to analyze how dalbavancin was used to treat infections in diabetic patients across Italian and Spanish clinics.
  • The research involved 97 adults with diabetes and highlighted that most treatments were for Gram-positive infections, primarily cellulitis and Staphylococcus aureus.
  • The findings suggest dalbavancin was recommended for its simplicity in antibiotic regimens and resulted in a high rate of clinical improvements for patients.
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Androgen receptor pathway inhibitors (ARPI) and polyadenosine diphosphate-ribose inhibitors (PARPi) are part of the standard of care in patients with metastatic castration-resistant prostate cancer (mCRPC). There is biological evidence that the association of ARPI and PARPi could have a synergistic effect; therefore, several ongoing clinical trials are investigating the efficacy of this combination with preliminary results that are not perfectly concordant in identifying patients who can obtain the most benefit from this therapeutic option. The purpose of this review is to describe the PARPi mechanisms of action and to analyze the biological mechanisms behind the interplay between the androgen receptor and the PARPi system to better understand the rationale of the ARPI + PARPi combinations.

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Article Synopsis
  • - Graft-versus-host disease (GVHD) significantly impacts patient health post-allogeneic hematopoietic stem-cell transplantation, prompting new drug approvals and clinical practice changes in its management over the last three years.
  • - The European Society for Blood and Marrow Transplantation (EBMT) convened a panel of 23 experts to update clinical recommendations using the GRADE process and PICO questions to ensure standardized treatment approaches.
  • - Key updates include making ruxolitinib the standard care for steroid-refractory GVHD, using rabbit anti-T-cell globulin or post-transplantation cyclophosphamide for GVHD prevention, and adding belumosudil for treating steroid-refractory chronic GVHD.
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Article Synopsis
  • The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to investigate stress echocardiography (SE) practices across Italy, collecting data from 228 laboratories in November 2022.
  • The survey revealed that out of 179 centers performing SE, most were located in northern Italy, and the study categorized them into low, moderate, and high volume of activity based on the number of SE examinations.
  • Key findings indicated differences in the use of stressors, with a tendency for high-volume centers to employ multiple stress techniques and incorporate advanced evaluations like coronary flow velocity reserve (CFVR) more frequently than low and moderate volume centers.
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Article Synopsis
  • The study investigates bloodstream infections caused by uncommon Enterobacterales species over five years, revealing a low prevalence of 0.4% among Gram-negative isolates.
  • In adults, malignancy is a common comorbidity, while in pediatric cases, cerebrovascular disease linked to meconium aspiration is notable; primary infections in adults are often bloodstream-related whereas in children, catheter and respiratory tract sources are more frequent.
  • Antibiotic susceptibility varies, with high effectiveness against most drugs except for a few, and targeted treatments included monotherapy for adults and combination therapy for pediatric cases, resulting in a low overall mortality rate of 5.3%.
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Safety profile of darolutamide versus placebo: a systematic review and meta-analysis.

Prostate Cancer Prostatic Dis

September 2024

Istituto Oncologico della Svizzera Italiana, EOC, Bellinzona, Switzerland.

Article Synopsis
  • Darolutamide is an androgen receptor pathway inhibitor for prostate cancer, and its toxicity profile is a crucial factor for treatment selection, although efficacy among different ARPIs appears similar.
  • A systematic review and meta-analysis were conducted using data from clinical trials comparing darolutamide to placebo, focusing on adverse events (AEs) that could lead to treatment discontinuation.
  • The results showed that darolutamide did not significantly increase AEs compared to placebo, except for a notable higher incidence of bone fractures associated with placebo.
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Study Design: Qualitative descriptive.

Objectives: To describe the experiences of people with Spinal Cord Injury (SCI) re-admitted to the hospital due to continence-related complications.

Setting: Inpatient service of a large spinal unit in North-West of Italy.

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