237 results match your criteria: ""Regina Apostolorum" Hospital[Affiliation]"

A tracheoesophageal fistula (TEF) represents a condition characterized by abnormal communication between the gastrointestinal tract and the airways. Although the current gold-standard treatment is surgery, pre-existing clinical conditions may represent contraindications. We therefore propose a bronchoscopic approach through rigid bronchoscopy without tracheostomy for total repair in patients suffering from benign tracheoesophageal fistulas.

View Article and Find Full Text PDF

To date, the public health system has been impacted by the increasing costs of many diagnostic and therapeutic pathways due to limited resources. At the same time, we are constantly seeking to improve these paths through approaches aimed at personalized medicine. To achieve the required levels of diagnostic and therapeutic precision, it is necessary to integrate data from different sources and simulation platforms.

View Article and Find Full Text PDF

Obesity is a chronic disease associated with increased morbidity and mortality and reduced quality of life. Pharmacotherapy can be associated with life style changes in increasing and maintaining weight loss and ameliorating obesity-related complications and comorbidities. In patients affected by obesity and uncontrolled obesity-associated complications or high degrees of BMI (> 40 Kg/m), metabolic bariatric surgery can be a valid therapeutic option.

View Article and Find Full Text PDF

Objective: The ultrasound evaluation of thyroid nodules (TNs) in patient selection for fine needle aspiration (FNA) requires both uniformly accepted definitions of each nodule characteristic and extensive experience from the examiner. We hypothesized that nodule echogenicity alone may provide comparable performance to more complex approaches in patient selection for FNA.

Patients And Methods: Seven highly experienced investigators from four countries evaluated, online, the ultrasound (US) video recordings of 123 histologically verified TN by answering 17 nodule characteristics-related questions.

View Article and Find Full Text PDF

The prediction of liver-related events (LRE) after sustained virological response (SVR) in HCV-advanced chronic liver disease (ACLD) patients is crucial. We aimed to evaluate incidence and risk factors of LRE in HCV-cirrhotic patients after SVR and to assess dynamic changes of liver stiffness in participants without LRE at the end of follow-up. We enrolled 575 consecutive patients with HCV-ACLD treated with DAAs and followed up for 5 years after SVR12.

View Article and Find Full Text PDF

How histopathological diagnosis interacts with kidney ultrasound parameters and glomerular filtration rate.

Intern Emerg Med

November 2024

Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

The evaluation of estimated GFR (eGFR) is a pivotal staging step in patients with chronic kidney disease (CKD), and renal ultrasound plays an important role in diagnosis, prognosis and progression of CKD. The interaction between histopathological diagnosis and ultrasound parameters in eGFR determination has not been fully investigated yet. The study examined the results of native kidney biopsies performed in 48 Italian centers between 2012 and 2020.

View Article and Find Full Text PDF
Article Synopsis
  • An online survey of European thyroid specialists revealed that 28% believe thyroid hormone (TH) treatment may be appropriate for euthyroid patients with growing simple goiters, despite guidelines against this practice.
  • There were significant regional differences in support for TH treatment, with only 7% in The Netherlands compared to 78% in the Czech Republic.
  • Factors influencing the likelihood of recommending TH included the specialist's age and the historical iodine insufficiency of their region, while gender, country, and economic factors showed weak associations.
View Article and Find Full Text PDF

Poor diet is the top modifiable mortality risk factor globally, accounting for 11 million deaths annually with half being from diet-linked atherosclerotic cardiovascular disease (ASCVD). Yet, most of the world cannot afford a healthy diet-as the hidden costs of the inadequate global food system total over USD 13 trillion annually-let alone the much more clinically, financially, and ecologically costly and resource-intensive medical interventions required to address the disease progression and acute complications of ASCVD. Yet, AI is increasingly understood as a force multiplying revolutionary technology which may catalyze multi-sector efforts in medicine and public health to better address these significant health challenges.

View Article and Find Full Text PDF

Medically not yet explained symptoms in hypothyroidism.

Nat Rev Endocrinol

November 2024

Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.

Persistent symptoms are common in the general population and even more so in people with hypothyroidism. When symptoms are unexplained and brought to medical attention, they can be referred to as medically not yet explained symptoms (MNYES), a term preferred to other descriptors by patients, care-givers and experts. MNYES might be neglected by endocrinologists or misattributed to hypothyroidism.

View Article and Find Full Text PDF

Obesity/overweight and its complications are a growing problem in many countries. Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell'Obesità e delle Malattie Metaboliche-SICOB) decided to develop the first Italian guidelines for the endoscopic bariatric treatment of obesity. The creation of SICOB Guidelines is based on an extended work made by a panel of 44 members and a coordinator.

View Article and Find Full Text PDF

Purpose: The use of thyroid hormones (TH) to treat obesity is unsupported by evidence as reflected in international guidelines. We explored views about this practice, and associations with respondent characteristics among European thyroid specialists.

Methods: Specialists from 28 countries were invited to a survey via professional organisations.

View Article and Find Full Text PDF
Article Synopsis
  • - The study aimed to assess how European thyroid specialists view levothyroxine (LT4) treatment for euthyroid women with positive thyroid peroxidase antibodies (TPOAb) to improve fertility, as current evidence does not support this practice.
  • - An international survey (THESIS) revealed that 42.8% of over 2,316 respondents believe LT4 might be indicated for these patients, with significant variation across countries, highlighting a range from 22.9% to 83.7% of positive responses.
  • - Factors such as gender, age, and clinical experience influenced opinions; younger specialists and those who treat more thyroid patients were more likely to consider LT4, raising concerns about potential overtreatment risks in
View Article and Find Full Text PDF

Obesity and prediabetes affect a substantial part of the general population, but are largely underdiagnosed, underestimated, and undertreated. Prediabetes differs from diabetes only in the degree of hyperglycaemia consequent to the progressive decline in residual beta-cell function. Both prediabetes and diabetes occur as a consequence of insulin resistance that starts several years before the clinical onset of overt diabetes.

View Article and Find Full Text PDF

Background: Current management options for PTMC include lobo-isthmectomy and active surveillance (AS). Recently, ultrasound-guided minimally invasive procedures (MITs) are offered as a nonsurgical therapy for PTMC because they do not require hospitalization and general anaesthesia, and do not result in loss of thyroid function or cosmetic damage. MITs are reported to consistently provide, mostly in large retrospective series of patients, a rapid, safe, and cost-effective way to eradicate low-risk thyroid malignancies.

View Article and Find Full Text PDF
Article Synopsis
  • The guideline is designed to help healthcare professionals manage sporadic primary hyperparathyroidism (PHPT) in adults, excluding cases during pregnancy.
  • Developed through a systematic review process, the guideline focuses on identifying critical outcomes that impact treatment decisions, emphasizing pharmacological and surgical options.
  • Key recommendations include recommending parathyroidectomy for symptomatic patients or those with specific criteria, while also providing guidance for monitoring other related health issues.
View Article and Find Full Text PDF

Aim: This guideline (GL) is aimed at providing a clinical practice reference for the management of adult patients with overweight or obesity associated with metabolic complications who are resistant to lifestyle modification.

Methods: Surgeons, endocrinologists, gastroenterologists, psychologists, pharmacologists, a general practitioner, a nutritionist, a nurse and a patients' representative acted as multi-disciplinary panel. This GL has been developed following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

View Article and Find Full Text PDF

Context: Between 10% and 15% of people with hypothyroidism experience persistent symptoms, despite achieving biochemical euthyroidism. The underlying causes are unclear. Type D personality (a vulnerability factor for general psychological distress) is associated with poor health status and symptom burden but has not been studied in people with hypothyroidism.

View Article and Find Full Text PDF

Objective: Hypothyroidism is a common endocrine condition usually managed with levothyroxine (LT4). However, controversy remains around the use of liothyronine (LT3). We aimed to investigate the practices of Australian endocrinologists when managing patients with hypothyroidism, their use of LT3 + LT4 combination therapy and use of thyroid hormones in euthyroid patients.

View Article and Find Full Text PDF

Hypothyroidism is common, however, aspects of its treatment remain controversial. Our survey aimed at documenting treatment choices of European thyroid specialists and exploring how patients' persistent symptoms, clinician demographics, and geo-economic factors relate to treatment choices. Seventeen thousand two hundred forty-seven thyroid specialists from 28 countries were invited to participate in an online questionnaire survey.

View Article and Find Full Text PDF

Background: Prolactinoma, the most common pituitary adenoma, is usually treated with dopamine agonist (DA) therapy like cabergoline. Surgery is second-line therapy, and radiotherapy is used if surgical treatment fails or in relapsing macroprolactinoma.

Objective: This study aimed to provide economic evidence for the management of prolactinoma in Italy, using a cost-of-illness and cost-utility analysis that considered various treatment options, including cabergoline, bromocriptine, temozolomide, radiation therapy, and surgical strategies.

View Article and Find Full Text PDF

Background: In Italy, surgeons continue to drain the abdominal cavity in more than 50 per cent of patients after colorectal resection. The aim of this study was to evaluate the impact of abdominal drain placement on early adverse events in patients undergoing elective colorectal surgery.

Methods: A database was retrospectively analysed through a 1:1 propensity score-matching model including 21 covariates.

View Article and Find Full Text PDF

Despite the advances made by therapeutic technologies, healthcare-associated infections (HAIs) are currently still a worldwide problem. Central-line-associated bloodstream infections (CLABSIs) are one of the most common causes of HAIs. The cost of CLABSIs is considerable, both for the increase in morbidity and financial resources expenses.

View Article and Find Full Text PDF

Introduction: Thyroid specialists influence how hypothyroid patients are treated, including patients managed in primary care. Given that physician characteristics influence patient care, this study aimed to explore thyroid specialist profiles and associations with geo-economic factors.

Methods: Thyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS).

View Article and Find Full Text PDF

Objectives: Here we investigate Hepatitis D virus (HDV)-prevalence in Italy and its fluctuations over time and we provide an extensive characterization of HDV-infected patients.

Methods: The rate of HDV seroprevalence and HDV chronicity was assessed in 1579 hepatitis B surface antigen (HBsAg)+ patients collected from 2005 to 2022 in Central Italy.

Results: In total, 45.

View Article and Find Full Text PDF