168 results match your criteria: "Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari[Affiliation]"

Bacteremic nosocomial pneumonia caused by Gram-negative bacilli: results from the nationwide ALARICO study in Italy.

Infection

December 2024

Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy.

Purpose: To describe the clinical characteristics and outcomes of patients with nosocomial pneumonia (NP) caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) and to compare them to patients with NP caused by carbapenem-susceptible (CS)-GNB.

Methods: Prospective observational multicenter study including patients with bacteremic NP caused by GNB from the ALARICO Network (June 2018-January 2020). The primary outcome measure was 30-day mortality.

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Mismatch negativity (MMN) is widely considered a candidate diagnostic biomarker for schizophrenia (SCZ). Although blunted MMN responses have been reliably observed in psychosis, the evidence for MMN deficits in other disorders, such as major depressive disorder (MDD), is mixed. This study explores whether MMN alterations in amplitude or latency are unique to SCZ or extend to non-psychotic MDD patients.

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  • Acute myocarditis cases in kids are increasing in Italy, with 65 suspected cases reported in 2024, largely linked to parvovirus B19 infection.
  • Among these cases, 29 children needed intensive care and there were eight fatalities, emphasizing the severity of the situation.
  • The study suggests a need for better diagnosis, enhanced monitoring, and standardized treatment strategies, as only about one-third of affected children received effective intravenous immunoglobulins.
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  • A study was conducted to evaluate preoperative platelet function in patients receiving antiplatelet drugs before coronary artery bypass grafting (CABG), aiming to shorten surgical wait times.* -
  • The research involved 48 patients on various P2Y12 receptor blockers and assessed their platelet response using thromboelastography-platelet mapping, revealing resistance rates of 25% for clopidogrel, 33% for ticagrelor, and 33% for prasugrel.* -
  • Findings suggested that identifying resistance to these medications can significantly reduce CABG waiting times compared to existing guidelines, thereby minimizing potential life-threatening delays.*
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The addition of metastasis-directed radiotherapy (MDRT) to immunotherapy in patients with advanced urothelial carcinoma (aUC) has shown promising results. We report the real-world data from the ARON-2 study (NCT05290038) on the impact of conventional (CRT) or stereotactic body radiotherapy (SBRT) on the outcome of aUC patients receiving pembrolizumab after platinum-based-chemotherapy. Medical records of 837 patients were reviewed from 60 institutions in 20 countries.

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Differential effect of asparagine and glutamine removal on three adenocarcinoma cell lines.

Heliyon

August 2024

Unit of Immunology and General Pathology, Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy.

Article Synopsis
  • Asparaginase (ASNase) significantly improves treatment outcomes for pediatric Acute Lymphoblastic Leukemia (ALL), achieving remissions in about 90% of cases, but its effects on adult solid tumors are not well understood.
  • In a study on three adenocarcinoma cell lines (A549, MCF-7, and 786-O), it was found that A549 and 786-O cells responded differently to ASNase treatment, with A549 showing a typical response while 786-O displayed alterations in cell cycle phases and dysfunctional DNA synthesis.
  • The findings suggest unique mechanisms of ASNase action in solid tumors, particularly in the 786-O cells, indicating a different response than what is seen in leukemic
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Outcome of 421 adult patients with Philadelphia-negative acute lymphoblastic leukemia treated under an intensive program inspired by the GIMEMA LAL1913 clinical trial: a Campus ALL study.

Haematologica

August 2024

Clinica Ematologica - Centro Trapianti e Terapie Cellulari, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Clinica Ematologica, Azienda Ospedaliero Universitaria di Modena, Dip. Scienze Mediche e Chirurgiche, UNIMORE, Modena, Italy.

The introduction of pediatric-inspired regimens in adult Philadelphia-negative acute lymphoblastic leukemia (Ph-ALL) has significantly improved patients' prognosis. Within the Campus ALL network we analyzed the outcome of adult Ph-ALL patients treated according to the GIMEMA LAL1913 protocol outside the clinical trial, to compare the real-life data with the study results. We included 421 consecutive patients, with a median age of 42 years.

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Despite the inevitable shift in medical practice towards a deeper understanding of disease etiology and progression through multigenic analysis, the profound historical impact of Mendelian diseases cannot be overlooked. These diseases, such as cystic fibrosis and thalassemia, are characterized by a single variant in a single gene leading to clinical conditions, and have significantly shaped our medical knowledge and treatments. In this respect, the monogenic approach inevitably results in the underutilization of Next-Generation Sequencing (NGS) data.

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A randomized phase II trial of Captem or Folfiri as second-line therapy in neuroendocrine carcinomas.

Eur J Cancer

September 2024

Osteoncology and Rare Tumor Center (CDO-TR), IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy; Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Background: Neuroendocrine Carcinomas (NECs) prognosis is poor.No standard second-line therapy is currently recognized after failure of platinum-based first-line treatment. FOLFIRI and CAPTEM regimens have shown promising activity in preliminary studies.

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RSV infection causes severe respiratory illness and mortality in the elderly, especially in the presence of comorbidities. Early identification of infection would result in appropriate clinical-therapeutic management, avoiding hospitalizations, the risk of healthcare-associated infections, and inappropriate antibiotic prescriptions, thus reducing healthcare costs and fighting antimicrobial resistance. The aim of this study was to assess RSV hospitalizations in subjects >64 years hospitalized in a large tertiary care hospital in Southern Italy, in order to assess their usefulness as a proxy for targeting a potential vaccination strategy.

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  • Older people often have a condition called anemia, which can make surgeries riskier and may lead to needing blood transfusions during major operations.
  • Taking medications like blood thinners (OAC) for heart conditions can increase the chances of bleeding during these surgeries.
  • Doctors are looking into better ways to manage anemia and bleeding risks for elderly patients having surgery, suggesting treatments like iron therapy and tranexamic acid to help improve their health outcomes.
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Background: Recent enhancements in Large Language Models (LLMs) such as ChatGPT have exponentially increased user adoption. These models are accessible on mobile devices and support multimodal interactions, including conversations, code generation, and patient image uploads, broadening their utility in providing healthcare professionals with real-time support for clinical decision-making. Nevertheless, many authors have highlighted serious risks that may arise from the adoption of LLMs, principally related to safety and alignment with ethical guidelines.

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Objectives: A new variant of echovirus 11 (E11) infection is a major health concern in neonates. Here, we describe the clinical and virological characteristics of enterovirus (EV) infections in children hospitalized with acute respiratory infection in Southern Italy.

Methods: Between July 2022 and August 2023, 173 EV infections were identified.

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Introduction: There are several treatment options for plaque psoriasis (PsO), but uncertainty remains around the optimal sequencing of treatments. The aims of this study were to investigate how adopting a best-treatment-first treatment sequence impacts patient outcomes and healthcare systems and to quantify the cost of treatment failure to the healthcare system.

Methods: A 3-year state-transition treatment-sequencing model which identifies all possible treatment sequences in PsO was adapted to the Italian healthcare setting.

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  • This study compares two surgical methods, Hartmann's procedure (HP) and resection with primary anastomosis (RPA), for treating acute left-sided colonic emergencies among 1215 patients from 204 centers globally.
  • Results showed that while HP was the more common treatment (57.3%), RPA was favored for younger patients with fewer health issues and those needing surgery sooner.
  • The study concluded that although HP is still widely used, RPA might be the better option, emphasizing the importance of patient characteristics and surgeon experience in determining treatment choice.
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  • Minimally invasive liver surgery (MILS) is becoming a big deal in treating liver cancer over the last 20 years.
  • More patients who are not able to have traditional surgery can now get MILS because new treatments are making it possible.
  • MILS is generally better than open surgery for recovery and has also opened up options for more people needing liver surgery.
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Awake Craniotomy in Conscious Sedation: The Role of A2 Agonists.

Brain Sci

January 2024

UOC of Anesthesia and Resuscitation II, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, 71013 Foggia, Italy.

Background: In Awake Craniotomy (AC), α2-agonists and remifentanil (clonidine and dexmedetomidine) are used in the preoperative phase and throughout the procedure to combine monitored anesthesia care and local anesthesia. The study aims were to specify the key role of α2-agonists administered and to evaluate complication presence/absence in anesthesiologic management.

Methods: 42 patients undergoing AC in 3 different centers in the south of Italy (Foggia, San Giovanni Rotondo, and Bari) were recruited.

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This multicenter study in Italian hospitals highlights the epidemiologic disruptions in the circulation of the 5 main respiratory viruses from 2019 to 2023. Our data reveal a resurgence of respiratory syncytial virus and influenza during the 2022-2023 winter season, with an earlier peak in cases for both viruses, emphasizing the importance of timely monitoring.

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  • A study investigated an outbreak of extensively drug-resistant Klebsiella pneumoniae (NDM-KP) in Southern Italy from 2020 to 2022, focusing on genomic surveillance of the bacteria.
  • Out of 459 carbapenem-resistant isolates tested, 22.6% carried the NDM gene, with high genetic similarity found in a subgroup of 27 isolates, all showing resistance to first-line antibiotics.
  • The findings highlight the urgent need for genomic surveillance and infection control measures in healthcare settings to manage the risks posed by these hypervirulent strains.
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[Pulmonary hypertension associated with left heart diseases: pathophysiology, diagnosis, treatment].

G Ital Cardiol (Rome)

February 2024

U.O.S. UTIC, U.O.C. Cardiologia, Ospedale Santa Maria della Misericordia Rovigo - ULSS 5 Polesana, Rovigo.

Pulmonary hypertension (PH) is a common complication of diseases affecting the left heart, mostly found in patients suffering from heart failure. Left atrial hypertension is the initial driver of post-capillary PH. However, several mechanisms may lead in a subset of patients to structural changes in the pulmonary vessels with development of a pre-capillary component.

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West Nile virus (WNV) is a public health concern in Europe. Rising temperatures and the migration of potential vectors promote the spread of viruses to previously unaffected areas. In 2023, the Apulia region of Southern Italy experienced an unexpected increase in West Nile neuroinvasive disease (WNND); no such cases had been reported in the previous 10 years.

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Acute bacterial skin and skin structure infections (ABSSSI) and osteoarticular infections compound the burden of morbidity, mortality and prolonged hospitalizations among gram-positive infections. Dalbavancin, a second-generation, intravenous lipoglycopeptide, due to its prolonged half-life, can be a valuable alternative in their treatment when administered as inpatient treatment at the price of an extended hospital stay. Between October 2019 and September 2023, 31 children and adolescents were treated with dalbavancin because of bone and joint infections (n = 12 patients, 39%), ABSSSI (n = 13 patients, 42%), mainly for the limbs, facial cellulitis or complicated ABSSSI (n = 6 patients, 19%), at five Italian pediatric centers.

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Background: The transition from in-hospital intravenous administration to subcutaneous therapies to treat inflammatory bowel disease (IBD) can raise some concerns among patients due to the self-administration concerns, the management of potential side effects and the overall worries related to a change of treatment. This study aimed at evaluating patients' opinion about the switch from intravenous to subcutaneous formulations and their knowledge on new available therapeutic options.

Methods: We conducted a survey using a questionnaire prepared by a team of gastroenterologists and nurses working at the IBD unit.

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A nationwide cross-sectional online survey was administered to dermatologists managing patients with moderate-to-severe plaque psoriasis across Italy to obtain real-world dermatologists' perspectives on the impact of psoriasis and its treatment on patients' daily lives and quality of life (QoL). A total of 91 dermatologists (aged 39.1 ± 11.

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Perturbations of the T-cell receptor repertoire in response to SARS-CoV-2 in immunocompetent and immunocompromised individuals.

J Allergy Clin Immunol

June 2024

Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md. Electronic address:

Article Synopsis
  • Elderly patients with severe COVID-19 showed reduced T-cell diversity and weaker immune responses compared to younger patients, highlighting age-related vulnerabilities in fighting the virus.
  • The study used advanced sequencing techniques to analyze T-cell responses in both COVID-19 patients and individuals with inborn errors of immunity who received an mRNA vaccine, revealing specific genetic associations affecting these responses.
  • Findings indicated that mRNA vaccines successfully enhanced the T-cell responses in individuals with immune deficiencies, suggesting their effectiveness even in populations that struggle to develop strong immune responses on their own.
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