902 results match your criteria: "Azienda Sanitaria Universitaria "Giuliano Isontina"[Affiliation]"

Targeted Prostate Biopsy: How, When, and Why? A Systematic Review.

Diagnostics (Basel)

August 2024

Urology Clinic, Department of Precision Medicine in Medical, Surgical and Critical Care, University of Palermo, 90127 Palermo, Italy.

Objective: Prostate cancer, the second most diagnosed cancer among men, requires precise diagnostic techniques to ensure effective treatment. This review explores the technological advancements, optimal application conditions, and benefits of targeted prostate biopsies facilitated by multiparametric magnetic resonance imaging (mpMRI).

Methods: A systematic literature review was conducted to compare traditional 12-core systematic biopsies guided by transrectal ultrasound with targeted biopsy techniques using mpMRI.

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Gaps in evidence in the treatment of prevalent patients with pulmonary arterial hypertension at intermediate risk: An expert consensus.

Vascul Pharmacol

December 2024

Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Policlinico Universitario Umberto I, Sapienza University of Rome, 00161 Rome, Italy.

Despite the innovations introduced in the 2022 European Society of Cardiology/European Respiratory Society Guidelines on Pulmonary Hypertension, risk discrimination and management of pulmonary arterial hypertension (PAH) patients at intermediate risk still represents a grey zone. Additionally, clinical evidence derived from currently available studies is limited. This expert panel survey intends to aid physicians in choosing the best therapeutic strategy for patients at intermediate risk despite ongoing oral therapy.

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Developing an ensemble machine learning study: Insights from a multi-center proof-of-concept study.

PLoS One

September 2024

Laboratorio Biostatistica e Bioinformatica, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Bari, Italy.

Background: To address the numerous unmeet clinical needs, in recent years several Machine Learning models applied to medical images and clinical data have been introduced and developed. Even when they achieve encouraging results, they lack evolutionary progression, thus perpetuating their status as autonomous entities. We postulated that different algorithms which have been proposed in the literature to address the same diagnostic task, can be aggregated to enhance classification performance.

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Article Synopsis
  • * Healthcare providers must be cautious about drug-drug interactions (DDIs) due to cardiovascular patients often taking multiple medications, requiring careful assessment and management.
  • * The review highlights the clinical pharmacology of nirmatrelvir/ritonavir and stresses avoiding potential DDIs, particularly with drugs metabolized by cytochrome P450 3A4 and those with a narrow therapeutic index.
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Objectives: Treatment of metastatic colorectal cancer (mCRC) includes resection of liver metastases (LM), however, no validated biomarker identifies patients most likely to benefit from this procedure. This meta-analysis aimed to assess the impact of the most relevant molecular alterations in cancer-related genes of CRC (i.e.

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MRI-based assessment of the mylohyoid muscle in oral squamous cell carcinoma, a 7-point scoring method.

Eur Radiol

August 2024

Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, University of Trieste, Trieste, Italy.

Objectives: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).

Materials And Methods: We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman's rank coefficient.

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Many years ago, asbestos fibers were banned and replaced by synthetic vitreous fibers because of their carcinogenicity. However, the toxicity of the latter fibers is still under debate, especially when it concerns the early fiber interactions with biological cell membranes. Here, we aimed to investigate the effects of a synthetic vitreous fiber named FAV173 on the oocyte membrane, the cell model we have already used to characterize the effect of crocidolite asbestos fiber exposure.

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Optimized use of prophylactic or therapeutic donor lymphocyte infusions (DLI) is aimed at improving clinical outcomes in patients with malignant and non-malignant hematological diseases who have undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT). Memory T-lymphocytes (CD45RA-/CD45RO+) play a crucial role in immune reconstitution post-HSCT. The infusion of memory T cells is proven to be safe and effective in improving outcomes due to the enhanced reconstitution of immunity and increased protection against viremia, without exacerbating graft-versus-host disease (GVHD) risks.

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Dynamic evolution of tricuspid regurgitation during hospitalization in patients with acute decompensated heart failure.

Eur J Heart Fail

November 2024

Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste (a member of the European Reference Network for rare, low-prevalence, or complex diseases of the Heart [ERN GUARD-Heart]), Trieste, Italy.

Article Synopsis
  • Secondary tricuspid regurgitation (TR) is linked to worse outcomes in patients with acute decompensated heart failure (ADHF), and this study investigates how TR changes during hospital treatment and its impact on patient prognosis.
  • The research included 1054 ADHF patients, finding that nearly half (49%) of those with severe TR at admission improved during their hospital stay, which correlated with better recovery and lower long-term risk of dying or being readmitted for heart failure.
  • Factors like atrial fibrillation and higher diuretic doses were associated with less likelihood of TR improvement, but better TR status was significantly tied to better 5-year survival rates and heart failure hospitalization outcomes.
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Article Synopsis
  • Type 1 diabetes is an autoimmune condition influenced by genetic factors, primarily related to class II genes, but there is growing interest in the role of class I genes in its development.
  • A study involving 115 children and young adults used advanced genetic typing to show that 13% had non-classical haplotypes that increase diabetes risk, differing significantly in immune response and clinical features compared to those with classical haplotypes.
  • Findings suggest that the genetic landscape of type 1 diabetes is more complex than previously understood, indicating potential new strategies for prevention and management of the disease.
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Redefining Cardiac Involvement and Targets of Treatment in Systemic Immunoglobulin AL Amyloidosis.

JAMA Cardiol

November 2024

National Amyloidosis Centre, Division of Medicine, University College London, Royal Free Hospital, London, United Kingdom.

Article Synopsis
  • Cardiac amyloid infiltration significantly impacts survival in systemic light-chain (AL) amyloidosis, with guidelines suggesting early therapy changes for patients not responding well, regardless of cardiac amyloid severity.
  • The study aimed to compare serum biomarkers, echocardiography, and cardiovascular magnetic resonance (CMR) with extracellular volume (ECV) mapping in understanding cardiac amyloid and its prognostic value.
  • Findings revealed that ECV is a strong independent predictor of mortality, showing different relationships between the depth of hematological response and survival based on specific ECV thresholds over 1- and 6-month periods.
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Efficacy and Safety of bimekizumab in elderly patients: real-world multicenter retrospective study - IL PSO (Italian Landscape Psoriasis).

J Dermatolog Treat

December 2024

Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy.

Article Synopsis
  • The study aimed to gather real-world data on the use of bimekizumab for treating moderate-to-severe plaque psoriasis in patients aged 65 and older, an age group often underrepresented in clinical trials.
  • Conducted in 33 dermatological clinics in Italy, 98 elderly patients were treated with bimekizumab while collecting clinical and demographic data to monitor their progress and any adverse events over 36 weeks.
  • Results showed significant improvements in psoriasis symptoms, with PASI scores dropping substantially after treatment, and a majority of patients achieving PASI75 or higher by weeks 16 and 36.
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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

January 2025

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; median age 42 years.

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Article Synopsis
  • LMNA-related dilated cardiomyopathy (DCM) is a rare condition, and the REALM-DCM trial aimed to test a new therapy, but it was halted for being ineffective without safety issues.
  • The trial included 77 patients with stable LMNA-related DCM who had specific heart devices and symptoms rated as Class II or III on the NYHA scale, with an average age of 53 years.
  • Results showed most patients had significant heart-related symptoms, with a notable percentage suffering from atrial fibrillation, and patients with NYHA Class III symptoms had worse heart function measurements compared to those with Class II symptoms.
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Optimizing Management of Stable Angina: A Patient-Centered Approach Integrating Revascularization, Medical Therapy, and Lifestyle Interventions.

J Am Coll Cardiol

August 2024

Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Center of Excellence of Cardiovascular Sciences, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy.

Article Synopsis
  • * Treatment for obstructive CAD focuses on reducing heart events and symptoms, while INOCA requires addressing functional changes in coronary circulation.
  • * A precise diagnosis in patients with INOCA is vital for personalized treatment, and the paper emphasizes combining coronary revascularization, medication, and lifestyle changes for effective angina management.
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Article Synopsis
  • * Even those who recover may deal with long-term health issues like hypertension and arrhythmias, affecting not just their health but also their families' well-being and quality of life.
  • * A collaborative, multidisciplinary approach is essential for managing PPCM, involving various healthcare professionals to address both medical and psychosocial needs, along with informing women about the risks of future pregnancies.
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Non-diphtheroid sepsis is rare and has affected only immunocompromised or particularly predisposed patients so far. We present the first case of urosepsis caused by in a 67-year-old woman, without any known immunodeficiencies and in absence of any immunosuppressive therapy, admitted to the hospital for fever and acute dyspnea. This work suggests a new approach in evaluating the isolation of , especially if isolated from blood.

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Central venous access devices are essential for the management of critically ill patients, but they are potentially associated with many complications, which may occur during or after insertion. Many evidence-based documents-consensus and guidelines-suggest practical recommendations for reducing catheter-related complications, but they have some limitations. Some documents are not focused on critically ill patients; other documents address only some special strategies, such as the use of ultrasound; other documents are biased by obsolete concepts, inappropriate terminology, and lack of considerations for new technologies and new methods.

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Imaging in Amyloidosis: 20 Years of Sustained Innovation.

JACC Cardiovasc Imaging

November 2024

National Amyloidosis Centre, Division of Medicine, University College London, Royal Free Hospital, London, United Kingdom; Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy; European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart, Trieste, Italy.

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Aims: We explored timing, settings and predictors of angiotensin receptor-neprilysin inhibitor (ARNI) initiation in a large, nationwide cohort of patients with heart failure (HF) with reduced ejection fraction (HFrEF).

Methods And Results: Patients with HFrEF (ejection fraction <40%) registered in the Swedish HF Registry in 2017-2021 and naïve to ARNI were evaluated for timing and location of, and their characteristics at ARNI initiation. ARNI use increased from 8.

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Article Synopsis
  • Primary percutaneous coronary intervention (PCI) is the preferred method for treating acute ST-elevation myocardial infarction (STEMI), helping to restore blood flow in blocked arteries.
  • Some patients, however, suffer from a 'no-reflow' phenomenon, where blood flow remains compromised despite the artery being opened, usually due to microvascular obstruction from thrombus or plaque.
  • There is no clear consensus on preventing or treating no-reflow, and while various medications are used, they only improve blood flow for certain patients; a new idea involving low-dose fibrinolysis during PCI shows promise for enhancing recovery.
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Article Synopsis
  • Heart failure with preserved ejection fraction (HFpEF) has been challenging to treat over the years, but recent therapies, including sodium-glucose cotransporter 2 inhibitors (SGLT2i), show promise in improving patient outcomes.
  • HFpEF is increasingly prevalent, influenced by longer life expectancies and rising health issues like diabetes and obesity, suggesting it's part of a wider cardio-nephro-metabolic syndrome.
  • The Cardiovascular Observatory of Friuli-Venezia Giulia plays a crucial role in identifying and managing HFpEF patients, highlighting the need for tailored therapeutic approaches, particularly with the emerging role of SGLT2i in treatment guidelines.
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[Substance abuse and cardiovascular risk: energy drinks].

G Ital Cardiol (Rome)

August 2024

U.O.C. Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda, Milano - Presidente, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze.

The consumption of energy drinks (ED) has become a growing public health issue, since potentially ED-related serious adverse cardiovascular events, including arrhythmias, myocardial infarction, cardiomyopathies, and sudden cardiac death, have been reported in recent years. The substances contained in ED include caffeine, taurine, sugars, B group vitamins and phyto-derivatives, which, especially if taken in large quantities and in a short amount of time, could cause serious side effects through various mechanisms of action, such as increased blood pressure and QT interval prolongation. Although there are still many open questions on ED that require further specific investigations, there is an urgent need for information and educational plans to the population, as well as for regulatory actions, particularly regarding transparency of substances and possible adverse effects.

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