Pulmonary Arterial Hypertension Incidence in Scleroderma Patients Treated with Bosentan for Digital Ulcers: Evidence from the Italian SPRING Registry.

Objective: Bosentan (BOS) is approved for treating pulmonary arterial hypertension (PAH) and preventing digital ulcers (DU) in systemic sclerosis (SSc). Our study aimed to evaluate whether BOS prescribed for DU could reduce the incidence of PAH in a large SSc cohort from the SPRING registry.

Methods: Patients with SSc from the SPRING registry, meeting ACR/EULAR 2013 classification criteria with data on PAH onset, DU status, BOS exposure, and at least a one-year follow-up between 2015 and 2020, and no known PAH at baseline were included.

Refining the clinical and therapeutic spectrum of granulomatous myositis from a large cohort of patients.

Objectives: Granulomatous myositis (GM) is a rare entity whose precise clinical features and therapeutic outcomes have not yet been well defined. Given the limited evidence, data from a large cohort of patients is needed to aid in the recognition and management of this condition.

Methods: We retrospectively analyzed our institutional databases to identify patients who had myositis and non-caseating granuloma on muscle biopsy (GM).

Expert Opinion on Multiple Myeloma Treatment in Brazil in the Bispecific Antibody Era.

Multiple myeloma treatment has evolved rapidly with the development of novel targeted therapies. The paper outlines multiple myeloma epidemiology, current treatments, and recent advances, highlighting the role of bispecific antibodies. Brazilian authorities have approved 3 bispecific antibodies (teclistamab, elranatamab, and talquetamab) for relapsed/refractory multiple myeloma patients who have received at least three prior therapies.

High Sensitivity of Fine-Needle Aspiration Calcitonin in Detecting Medullary Thyroid Carcinoma Is Independent of Predefined Decisional Thresholds.

The measurement of Calcitonin (Ctn) in fine-needle aspiration (FNA) washout fluids (FNA-Ctn) has demonstrated excellent sensitivity, significantly higher than FNA cytology, in detecting medullary thyroid carcinoma (MTC). However, the absence of a fixed cutoff value for FNA-Ctn poses a limitation. This study aimed to investigate whether the sensitivity of FNA-Ctn in detecting MTC varies with different cutoffs reported in the literature.

Inclisiran, Reasons for a Novel Agent in a Crowded Therapeutic Field.

Purpose Of The Review: A significant number of patients fail to achieve target LDL cholesterol (LDL-C) levels. This review aims to explore why inclisiran, a novel class of LLT, should be considered a valuable addition to the current treatment options.

Recent Findings: Inclisiran is a small interfering RNA (siRNA) that targets PCSK9 synthesis specifically in the hepatocytes.

Outcomes and prognostic indicators in daratumumab-refractory multiple myeloma: a multicenter real-world study of elotuzumab, pomalidomide, and dexamethasone in 247 patients.

Background: Daratumumab-refractory multiple myeloma (Dara-R MM) presents a significant treatment challenge. This study aimed to evaluate the efficacy and survival outcomes of elotuzumab, pomalidomide, and dexamethasone (EloPd) in a large, real-world cohort of patients with Dara-R MM, with particular focus on progression-free survival (PFS) and overall survival (OS).

Materials And Methods: This retrospective analysis included 247 Dara-R MM patients treated with EloPd.

Unusual anatomic variation: The posterior inferior cerebellar artery arising from the middle meningeal artery.

An adult patient was admitted to our emergency department for a first episode of generalized tonic-clonic seizure. Computed tomography scan and magnetic resonance imaging showed a temporal intracranial hemorrhage and parenchymal edema caused by a dural arteriovenous fistula (DAVF), whose angioarchitecture was better understood through the DSA which showed as intriguing and rare vascular anomaly the origin of the posterior inferior cerebellar artery (PICA) from the middle meningeal artery (MMA). The endovascular treatment of the DAVF was then successfully performed.

Effectiveness and Predictors of Long-Term Treatment Response to Tofacitinib in Rheumatoid Arthritis Cohort: General Analysis and Focus on High-Cardiovascular-Risk Subgroup-A Multicenter Study.

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.

Extracorporeal Membrane Oxygenation as Life Support in Neonatal Respiratory Failure: A Single-Center Cohort Study and a Systematic Review.

Background: Extracorporeal membrane oxygenation (ECMO) is a life support in newborns with severe respiratory failure. Our main objective was to evaluate the mortality of patients and define positive and negative predictive factors of survival.

Methods: We performed a Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)-conformed retrospective observational study and a systematic review, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Non-Invasive Ventilation Failure in Pediatric ICU: A Machine Learning Driven Prediction.

: Non-invasive ventilation (NIV) has emerged as a possible first-step treatment to avoid invasive intubation in pediatric intensive care units (PICUs) due to its advantages in reducing intubation-associated risks. However, the timely identification of NIV failure is crucial to prevent adverse outcomes. This study aims to identify predictors of first-attempt NIV failure in PICU patients by testing various machine learning techniques and comparing their predictive abilities.

Survival analysis of the non-metastatic cohort of the Italian Association for Medical Oncology (AIOM) Guideline Application in Real world: multi-Institutional Based survey of Adjuvant and first-Line pancreatic Ductal adenocarcinoma treatment in Italy (GARIBALDI).

Background: Non-metastatic pancreatic ductal adenocarcinoma (PDAC) presents a challenging scenario: the rarity of the disease, the limited number of completed prospective trials, and the shortcomings of comparability across series produce several controversial topics and unanswered questions. Guideline recommendations usually include all the different therapeutic options, de facto transferring to the multidisciplinary team the responsibility on the final decision. This secondary analysis of the GARIBALDI study was aimed to explore the correlation of center type, self-declared volume, and commitment with the overall survival (OS) in patients with non-metastatic PDAC.

Smoking-related complications in foot and ankle surgery: a systematic review.

Objective: The detrimental effects of cigarette smoking on overall health are well-documented, with nicotine and carbon monoxide contributing to peripheral vasoconstriction and impaired oxygen delivery to tissues. This study reviews the impact of smoking on wound and bone healing, specifically in foot and ankle surgery, given its significant role as a modifiable risk factor for complications in orthopedic procedures.

Materials And Methods: A systematic literature review was conducted in May 2024 following PRISMA guidelines.

Novel force feedback technology improves suturing in robotic-assisted surgery: a pre-clinical study.

Introduction: The inability to sense force applied to tissue is suggested as a limitation to robotic-assisted surgery (RAS). This pre-clinical study evaluated the impact of a novel force feedback (FFB) technology, integrated on a next-generation robotic system that allows surgeons to sense forces exerted at the instrument tips, on suturing performance by novice surgeons during RAS.

Methods: Twenty-nine novice surgeons (< 50 RAS cases in the last 5 years) were randomized into two groups with (n = 15) or without (n = 14) FFB sensing.

Addressing the Effect of Exercise on Glial Cells: Focus on Ependymal Cells.

A growing body of research highlights the positive impact of regular physical activity on improving physical and mental health. On the other hand, physical inactivity is one of the leading risk factors for noncommunicable diseases and death worldwide. Exercise profoundly impacts various body districts, including the central nervous system.

Intraoperative variations in intra-axial brain tumor size after craniotomy: a prospective study with histopathological and tumor tissue composition correlation, introducing concepts of tumor expansion and tumor surfacing.

Intraoperative assessment of tumor margins can be challenging; as neoplastic cells may extend beyond the margins seen on preoperative imaging. Real-time intraoperative ultrasonography (IOUS) has emerged as a valuable tool for delineating tumor boundaries during surgery. However, concerns remain regarding its ability to accurately distinguish between tumor margins, peritumoral edema, and normal brain tissue.

Fulminant Invasive Aspergillosis in a Previously Healthy Woman After Cesarean Section and a Review of the Literature.

Invasive aspergillosis is an extremely rare condition in healthy and immunocompetent individuals, and very few cases have been reported in previously healthy, pregnant, or postpartum women. We describe a case of invasive aspergillosis in a puerperal patient and present literature review results. We present a case of fulminant invasive pulmonary aspergillosis with cerebral, cardiac, and gastric involvement in a young woman, occurring a few days after an elective cesarean section.

Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches-A Systematic Review with an Institutional Case Illustration.

(1) Background: Testicular cancer, although accounting for only 0.5% to 1% of all solid male cancers, is the most common malignancy in males aged 15 to 35 years. Non-seminomatous germ cell tumors (NSGCT) represent nearly half of all testicular germ cell tumors and are associated with a more aggressive clinical course.

Impact of dyslipidemia and lipid-lowering therapy with statins in patients with neuroendocrine tumors.

Dyslipidemia is a potential unfavorable prognostic factor in neuroendocrine tumors (NETs); conversely, statins proved to have antiproliferative effects in NET cell lines and could be a helpful therapeutic strategy for these patients. The main objective of this observational cohort retrospective study is to explore the associations between dyslipidemia and NET progression and evaluate the potential influence of statins in this context. 393 patients with histologically confirmed gastroenteropancreatic or bronchopulmonary NETs from six Italian centres didicated to NET diagnosis and therapy were included.

Spinal Dumbbell Meningiomas: A Systematic Review.

Aim: This systematic review aims to synthesize the epidemiology, clinical presentation, diagnostic approaches, treatment strategies, and outcomes of spinal dumbbell meningiomas to enhance understanding and improve patient management.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four major databases (PubMed, Scopus, Web of Science, and Cochrane Library) were searched until June 2024. Studies included patients diagnosed with spinal dumbbell intradural-extradural meningiomas, focusing on patient demographics, tumor characteristics, diagnostic methods, treatment modalities, and clinical outcomes.

Casual detection of an abdominal aortic aneurysm thanks to a trainee-made ultrasound with two subsequent "domino" diagnoses: case report and insights on the role of ultrasound courses.

Early detection of abdominal aortic aneurysm (AAA) is crucial as untreated lesions can be life-threatening. We describe the case of a fortuitous ultrasound (US) detection of AAA by a trainee which allowed two subsequent "domino" diagnoses. A 69 y.

PEG Precipitation to Detect Macro-TSH in Clinical Practice: A Systematic Review.

Unlabelled: Macro-thyroid-stimulating hormone (macro-TSH) is a complex formed by monomeric TSH with anti-TSH antibodies, causing falsely elevated TSH levels and potential misdiagnosis of hypothyroidism. Identification of macro-TSH is essential for proper treatment and patient follow-up. Its diagnostic gold standard is gel filtration chromatography (GFC), which is very expensive, time-consuming, and rarely available.

The effect of phlebotomy and placement of an intravenous catheter on plasma catecholamine and serum copeptin concentrations.

Objectives: Limited data are available on the hormonal response of children to venepuncture or intravenous cannulation (IVC). Catecholamines [epinephrine (E) and norepinephrine (NE)] have been traditionally recognized as stress hormones. Copeptin, the carboxyl-terminus of the arginine vasopressin (AVP) precursor peptide, is also a known marker for stressful stimuli, including myocardial infarction, critical illness, and sepsis.

Long-Term Effectiveness and Safety of Ustekinumab in Crohn's Disease: Results from a Large Real-Life Cohort Study.

Ustekinumab (UST) is an interleukin-12/interleukin-23 receptor antagonist approved for the treatment of Crohn's disease (CD). Only limited real-life data on the long-term outcomes of CD patients treated with UST are available. This study assessed UST's long-term effectiveness and safety in a large population-based cohort of moderate to severe CD patients.

Noninvasive Assessment of portal Hypertension in Patients With Primary Biliary Cholangitis is Affected by Severity of Cholestasis.

Background & Aims: Noninvasive tests (NITs) for ruling-out clinical significant portal hypertension (CSPH) and high-risk varices (HRVs) in patients with primary biliary cholangitis (PBC) and compensated advanced chronic liver disease (cACLD) are lacking. We evaluated NITs in these patients and the influence of cholestasis on their performance.

Methods: Consecutive patients from the "Italian PBC registry" and 2 United Kingdom large-volume PBC referral centers with upper endoscopy within 6 months from biochemical evaluation and transient elastography were included.