192 results match your criteria: "ASL Roma 1 "San Filippo Neri" Hospital[Affiliation]"

Advancements and applications of artificial intelligence in cardiovascular imaging: a comprehensive review.

Eur Heart J Imaging Methods Pract

October 2024

Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare 'A. De Gasperis', ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.

Artificial intelligence (AI) is transforming cardiovascular imaging by offering advancements across multiple modalities, including echocardiography, cardiac computed tomography (CCT), cardiovascular magnetic resonance (CMR), interventional cardiology, nuclear medicine, and electrophysiology. This review explores the clinical applications of AI within each of these areas, highlighting its ability to improve patient selection, reduce image acquisition time, enhance image optimization, facilitate the integration of data from different imaging modality and clinical sources, improve diagnosis and risk stratification. Moreover, we illustrate both the advantages and the limitations of AI across these modalities, acknowledging that while AI can significantly aid in diagnosis, risk stratification, and workflow efficiency, it cannot replace the expertise of cardiologists.

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Article Synopsis
  • * This review analyzes factors influencing the choice between active (Osia System) and passive (Baha Connect System) bone-conduction devices based on expert feedback from surveys and discussions.
  • * Key decision-making factors include surgical requirements, bone thickness, MRI compatibility, patient preferences, and risks like skin infections, emphasizing the need for personalized consultations in multidisciplinary settings.
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  • * They are less likely to receive crucial procedures and effective medications, so assessing factors like frailty and other health conditions is vital for tailoring their care.
  • * There is a lack of research on elderly individuals with ACS, making it critical for clinicians to develop targeted strategies to improve these patients' treatment and quality of life as the population ages.
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  • * The meeting involves discussion of pre-selected topics by working groups, which are informed by systematic reviews and surveys reflecting current clinical practices.
  • * The Assisi Working Group specifically examines lobular carcinoma, offering recommendations for locoregional therapy, especially radiation therapy for non-metastatic cases.
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Role of polypill in cardiovascular prevention and treatment.

Minerva Cardiol Angiol

October 2024

Division of Cardiology, Department of Cardio-Thoraco-Vascular Sciences, A.O. San Camillo-Forlanini, Rome, Italy.

Article Synopsis
  • - Cardiovascular diseases (CVD) are the top cause of death worldwide, prompting the need for innovative prevention and treatment solutions, like the polypill, which combines multiple heart-healthy medications into one pill to enhance adherence and management.
  • - Clinical studies show that the polypill can reduce major cardiovascular events, improve medication adherence, and possibly help address treatment gaps in various populations, particularly in low- and middle-income countries where CVD rates are rising.
  • - Despite its potential benefits, there are ongoing debates about the polypill's effectiveness compared to personalized treatment plans, and challenges remain in customizing it for individual patient needs and gathering more extensive evidence from large trials.
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Background: The clinical governance of patients with acute myocardial infarction (AMI) has markedly changed in the last few years. We sought to assess the contemporary in-hospital management patterns of patients with AMI at a country level.

Methods: EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units)-2 was a nationwide, prospective registry aimed to evaluate the current management of patients admitted to intensive cardiac care units (CCUs) for an AMI in Italy.

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[Ten questions about infective endocarditis].

G Ital Cardiol (Rome)

October 2024

Unità di Cure Intensive Cardiologiche, Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano.

Infective endocarditis (IE) is an infective process involving the endocardium and, more frequently, the native heart valves, valvular prostheses and cardiac implantable electronic devices. IE can manifest with various non-specific symptoms making the diagnosis challenging. This condition is associated with high in-hospital and long-term mortality.

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[Registers as central real world data source: the experience of the Italian Multiple Sclerosis and Related Disorders Register].

Epidemiol Prev

September 2024

Struttura Tecnico Operativa, Laboratorio di Ricerca per il Coinvolgimento dei Cittadini in Sanità, Dipartimento di Epidemiologia Medica, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano.

Registers collecting data from clinical practice (real world data) have gained increasing interest in recent years in the scientific, administrative, and regulatory fields. The value of longitudinal data collection in deepening knowledge about a specific pathology and its healthcare complexity is increasingly recognized. This article describes the development, organizational structure, and technical characteristics of the Italian Multiple Sclerosis and Related Disorders Register (RISM).

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Takotsubo Syndrome and Gender Differences: Exploring Pathophysiological Mechanisms and Clinical Differences for a Personalized Approach in Patient Management.

J Clin Med

August 2024

"A. De Gasperis" Cardiovascular Department, Division of Cardiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore 3, 20162 Milan, Italy.

Takotsubo syndrome (TTS), also known as the broken-heart syndrome, is a reversible condition typically observed in female patients presenting for acute coronary syndromes (ACS). Despite its increasing incidence, TTS often remains undiagnosed due to its overlap with ACS. The pathophysiology of TTS is complex and involves factors such as coronary vasospasm, microcirculatory dysfunction, increased catecholamine levels, and overactivity of the sympathetic nervous system.

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  • Lithium during pregnancy has been linked to potential foetal malformations, but treatment for maternal psychiatric conditions is often deemed more critical by clinicians.
  • A systematic review analyzed 28 studies, with meta-analysis including data from 1402 newborns and 2595 women, revealing increased risks of cardiac malformations, preterm birth, and being large for gestational age among those taking lithium.
  • Women with bipolar disorder should consider stopping lithium before pregnancy if stable, but if they continue during pregnancy, they should have close monitoring to manage potential risks.
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  • * Managing AF effectively involves a multidisciplinary team (MDT), working closely with cardiologists and other healthcare providers to create a tailored care plan that addresses the complex nature of the disorder.
  • * Ongoing evaluation and adjustment of treatment are essential, as new risk factors, symptoms, and advancements in therapies can change the approach to AF management over time.
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The Challenge of Managing Atrial Fibrillation during Pregnancy.

Rev Cardiovasc Med

October 2023

Cardiology Department, Grande Ospedale Metropolitano, GOM, AO Bianchi Melacrino Morelli, 89124 Reggio Calabria, Italy.

Article Synopsis
  • * Treating AF in pregnant women is tricky since medications can pose risks to both mother and baby; thus, strategies like electrical cardioversion and beta-blockers are preferred for safety and effectiveness.
  • * Collaboration among healthcare professionals in a "Pregnancy-Heart Team" enhances patient care, but more research is necessary to establish the best treatment approaches for managing AF in pregnancy.
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  • The study focused on the effectiveness of tixagevimab/cilgavimab (T/C) as pre-exposure prophylaxis (PrEP) in immunocompromised individuals, categorizing them into groups based on their COVID-19 history.
  • A total of 231 participants were included, with a significant portion having hematological diseases and receiving multiple vaccine doses; breakthrough infections (BTIs) occurred in 56 participants (24%) but were mostly mild to moderate.
  • Immune markers were measured over time, showing an initial increase in anti-RBD IgG antibodies at 3 months, a decline at 6 months, and low neutralizing antibodies, reinforcing T/C's clinical efficacy in reducing severe COVID-19
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Aspirin in Primary Prevention: Looking for Those Who Enjoy It.

J Clin Med

July 2024

"A. De Gasperis" Cardiovascular Department, Division of Cardiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore 3, 20162 Milan, Italy.

Based on a wealth of evidence, aspirin is one of the cornerstones of secondary prevention of cardiovascular disease. However, despite several studies showing efficacy also in primary prevention, an unopposed excess risk of bleeding leading to a very thin safety margin is evident in subjects without a clear acute cardiovascular event. Overall, the variability in recommendations from different scientific societies for aspirin use in primary prevention is a classic example of failure of simple risk stratification models based on competing risks (atherothrombosis vs.

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Purpose: Intraoperative radiation therapy with electrons (IOERT) may represent a viable choice for partial breast reirradiation after repeat quadrantectomy for local recurrence (LR) for primary breast cancer (BC) in lieu of mastectomy.

Methods And Materials: A database collecting data on partial breast reirradiation with IOERT from 8 Italian centers was set up in 2016 to 2018, providing data on cumulative incidence (CumI) of second LR and survival with a long follow-up.

Results: From 2002 to 2015, 109 patients underwent the conservative retreatment.

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Background: Myostatin is a protein compound, structurally related to the transforming growth factor-beta protein, which plays a pivotal role in regulating muscle growth and extracellular matrix production. It exerts both profibrotic and antihypertrophic effects on vascular smooth muscle cells. Aim of the study was to explore the potential association between serum myostatin levels (sMSTN) and carotid-femoral pulse wave velocity (cf-PWV), carotid-radial pulse wave velocity (cr-PWV), and their ratio (PWVr), in a cohort of healthy adolescents.

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Management of severe thrombocytopenia poses significant challenges in patients with chronic liver disease. Here, we aimed to evaluate the first real-world European post-marketing cohort of cirrhotic patients treated with lusutrombopag, a thrombopoietin receptor agonist, verifying the efficacy and safety of the drug. In the REAl-world Lusutrombopag treatment in ITalY (REALITY) study, we collected data from consecutive cirrhotic patients treated with lusutrombopag in 19 Italian hepatology centers, mostly joined to the "Club Epatologi Ospedalieri" (CLEO).

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Inotropes are prescribed to enhance myocardial contractility while vasopressors serve to improve vascular tone. Although these medications remain a life-saving therapy in cardiovascular clinical scenarios with hemodynamic impairment, the paucity of evidence on these drugs makes the choice of the most appropriate vasoactive agent challenging. As such, deep knowledge of their pharmacological and hemodynamic effects becomes crucial to optimizing hemodynamic profile while reducing the potential adverse effects.

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Radiation Therapy in Non-Melanoma Skin Cancers: An Italian Survey on Behalf of the Italian Association of Radiotherapy and Clinical Oncology.

Clin Oncol (R Coll Radiol)

December 2024

Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Italy.

Aims: The National Palliative Care and Interventional Radiotherapy Study Groups of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) carried out a survey whose aim was to obtain a "snapshot" of the real-world practice of nonmelanoma skin cancer (NMSC) treatments in Italy.

Materials And Methods: The survey was conducted on SurveyMonkey's online interface and was sent via e-mail to our society Radiation Oncologists.

Results: Fifty-eight Italian radiation oncologists (ROs), representing 54 centers, answered the survey.

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Multidisciplinary care use in neurodegenerative complex diseases: The example of progressive supranuclear palsy and advanced Parkinson's disease in real-life.

Parkinsonism Relat Disord

August 2024

Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, Baronissi, SA, 84081, Italy. Electronic address:

Background: In spite of being considered the gold-standard of care, little is known about the real-life use of in-home and multidisciplinary care in atypical parkinsonism.

Objective: Primary: Examine real-life multidisciplinary care use for Progressive Supranuclear Palsy (PSP). Secondary: a) Compare PSP care to advanced Parkinson's disease (APD) care; (b) Explore demographic and clinical variables associated with care needs in both groups.

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Perampanel in post-stroke epilepsy: Clinical practice data from the PERampanel as Only Concomitant antiseizure medication (PEROC) study.

J Neurol Sci

July 2024

Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan "Bianchi-Melacrino-Morelli" Hospital, Reggio Calabria, Italy. Electronic address:

Introduction: Post-stroke epilepsy (PSE) is one of the most common causes of acquired epilepsy. Nevertheless, there is limited evidence regarding the clinical profile of antiseizure medications (ASMs) in PSE. This study aims to evaluate the 12-month effectiveness and tolerability of perampanel (PER) used as only add-on treatment in patients with PSE in a real-world setting.

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Article Synopsis
  • There has been a significant rise in the use of direct oral anticoagulants (DOACs) over the past ten years, surpassing vitamin K antagonists (VKAs) due to easier management and better safety profiles.
  • Managing anticoagulation for patients on DOACs during surgical or interventional procedures is complex, as some surgeries require stopping DOACs while others can proceed uninterrupted.
  • A thorough assessment of patient factors (like age, bleeding history, and organ function) and surgical details is crucial for determining the best timing for stopping and resuming DOACs, necessitating a collaborative approach among healthcare providers.
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Introduction ChatGPT (OpenAI Incorporated, Mission District, San Francisco, United States) is an artificial intelligence (AI) chatbot with advanced communication skills and a massive knowledge database. However, its application in medicine, specifically in neurolocalization, necessitates clinical reasoning in addition to deep neuroanatomical knowledge. This article examines ChatGPT's capabilities in neurolocalization.

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ANMCO/SIMEU consensus document on the use of reversal agents for antithrombotic therapies in patients with ongoing bleeding or at high risk of haemorrhagic events.

Eur Heart J Suppl

April 2024

Unità di Cure Intensive Cardiologiche, Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare 'A. De Gasperis', ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

In recent decades, an incredible evolution in antithrombotic therapies used for treating patients with atherosclerosis, atrial fibrillation, and venous thromboembolism has been observed, leading to the availability of increasingly safe drugs. Nonetheless, bleeding complications remain a significant concern, with considerable health, social, and economic implications. To improve the acute management of patients experiencing or at risk for major bleeding events, specific reversal agents for antithrombotic drugs have been recently developed.

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Italian Association of Hospital Cardiologists Position Paper 'Gender discrepancy: time to implement gender-based clinical management'.

Eur Heart J Suppl

April 2024

Cardiology Unit, Cariovascular Department, 'A. De Gasperis', ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy.

Article Synopsis
  • * Differences in how drugs are metabolized by sex highlight the need for sex-specific medical approaches, yet awareness of this issue is still limited.
  • * The paper focuses on evaluating therapeutic strategies for managing common diseases affecting women, emphasizing the importance of individualized treatment guidelines based on gender.
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