262 results match your criteria: "Cardinal Massaia Hospital[Affiliation]"

How to deal with renal toxicities from immune-based combination treatments in metastatic renal cell carcinoma. A nephrological consultation for Oncologists.

Cancer Treat Rev

April 2024

Division of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

We are witnessing a revolution in the treatment of metastatic renal cell carcinoma (mRCC). Indeed, several immune-based combinations (ICI [immune checkpoint inhibitor] + ICI, or ICI + antiangiogenic agents) have been approved as first-line therapy for mRCC after demonstrating superior efficacy over the previous standard. Despite all the improvements made, safety remains a critical issue, adverse events (AEs) being the main reason for drug discontinuations or dose reductions, ultimately resulting in an increased risk of losing efficacy.

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TROP-2, NECTIN-4 and predictive biomarkers in sarcomatoid and rhabdoid bladder urothelial carcinoma.

Pathologica

February 2024

Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera S. Maria, Terni, Italy.

Article Synopsis
  • This study investigates the expression of TROP-2 and NECTIN-4 in undifferentiated bladder urothelial carcinoma (BUC), specifically focusing on sarcomatoid and rhabdoid subtypes, which are less understood compared to common forms of BUC.
  • Out of 35 undifferentiated BUC cases, TROP-2 was expressed in 20% and NECTIN-4 in 29%, with various other biomarkers such as HER-2 and PD-L1 also evaluated, showing diverse expression rates across cases.
  • The findings suggest that while TROP-2 and NECTIN-4 can be present in some sarcomato
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Purpose: Cancer treatment-induced bone loss is a side effect of hormonal therapy that can severely affect patients' quality of life. The aim of this survey was to obtain an updated picture of management of bone health in patients with breast cancer undergoing adjuvant hormonal therapy and in patients with hormone sensitive prostate cancer according to Italian oncologists.

Methods: Our survey was made up of 21 multiple-choice questions: the first part dealt with the respondents' characteristics, while the second with management of bone health in the described setting.

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Article Synopsis
  • A 48-week study assessed the effectiveness and safety of fremanezumab in patients with high-frequency episodic migraine (HFEM) or chronic migraine (CM) who had experienced more than three treatment failures.* -
  • Results showed significant reductions in monthly migraine days (HFEM -6.4; CM -14.5) and monthly analgesic medication usage, along with improvements in pain and disability scores, across the majority of participants.* -
  • Response rates to treatment indicated that a substantial number of patients experienced significant reductions in migraine frequency, with 75.5% achieving at least a 50% reduction in HFEM and 71.6% in CM.*
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Purpose: Optimal use of bone-modifying agents (BMAs) in patients with bone metastases from solid tumors is uncertain in some aspects: the drug choice; the planned treatment duration and long-term therapy; the prevention and management of possible side effects, including renal toxicity, hypocalcaemia, and medication-related osteonecrosis of the jaw (MRONJ).

Methods: Italian oncologists were invited to fulfil a 24-question web survey about prescription of BMAs for bone metastases of breast cancer, prostate cancer, and other solid tumors. Prevention and management of side effects were also investigated.

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Situs viscerum inversus and abdominal aortic aneurysm: A systematic review of a rare association.

Intractable Rare Dis Res

February 2024

Department of Surgical Sciences, Policlinico Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.

Situs viscerum inversus (SVI) is a very rare condition in that abdominal and thoracic organs are located reversed. Abdominal aortic aneurysm (AAA) is a life-threatening pathology due to progressive aortic enlargement until the rupture. The association between SVI and AAA is very infrequent.

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The use of immune checkpoint inhibitors (ICIs) in combination with tyrosine kinase inhibitors or other ICIs has significantly improved the prognosis for patients with mccRCC. This marks a major milestone in the treatment of mccRCC. Nonetheless, most patients will discontinue first-line therapy.

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Androgen receptor pathway inhibitors (ARPI) and polyadenosine diphosphate-ribose inhibitors (PARPi) are part of the standard of care in patients with metastatic castration-resistant prostate cancer (mCRPC). There is biological evidence that the association of ARPI and PARPi could have a synergistic effect; therefore, several ongoing clinical trials are investigating the efficacy of this combination with preliminary results that are not perfectly concordant in identifying patients who can obtain the most benefit from this therapeutic option. The purpose of this review is to describe the PARPi mechanisms of action and to analyze the biological mechanisms behind the interplay between the androgen receptor and the PARPi system to better understand the rationale of the ARPI + PARPi combinations.

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Article Synopsis
  • The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to investigate stress echocardiography (SE) practices across Italy, collecting data from 228 laboratories in November 2022.
  • The survey revealed that out of 179 centers performing SE, most were located in northern Italy, and the study categorized them into low, moderate, and high volume of activity based on the number of SE examinations.
  • Key findings indicated differences in the use of stressors, with a tendency for high-volume centers to employ multiple stress techniques and incorporate advanced evaluations like coronary flow velocity reserve (CFVR) more frequently than low and moderate volume centers.
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  • The study investigates bloodstream infections caused by uncommon Enterobacterales species over five years, revealing a low prevalence of 0.4% among Gram-negative isolates.
  • In adults, malignancy is a common comorbidity, while in pediatric cases, cerebrovascular disease linked to meconium aspiration is notable; primary infections in adults are often bloodstream-related whereas in children, catheter and respiratory tract sources are more frequent.
  • Antibiotic susceptibility varies, with high effectiveness against most drugs except for a few, and targeted treatments included monotherapy for adults and combination therapy for pediatric cases, resulting in a low overall mortality rate of 5.3%.
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Safety profile of darolutamide versus placebo: a systematic review and meta-analysis.

Prostate Cancer Prostatic Dis

September 2024

Istituto Oncologico della Svizzera Italiana, EOC, Bellinzona, Switzerland.

Article Synopsis
  • Darolutamide is an androgen receptor pathway inhibitor for prostate cancer, and its toxicity profile is a crucial factor for treatment selection, although efficacy among different ARPIs appears similar.
  • A systematic review and meta-analysis were conducted using data from clinical trials comparing darolutamide to placebo, focusing on adverse events (AEs) that could lead to treatment discontinuation.
  • The results showed that darolutamide did not significantly increase AEs compared to placebo, except for a notable higher incidence of bone fractures associated with placebo.
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Study Design: Qualitative descriptive.

Objectives: To describe the experiences of people with Spinal Cord Injury (SCI) re-admitted to the hospital due to continence-related complications.

Setting: Inpatient service of a large spinal unit in North-West of Italy.

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Managing repaired tetralogy of Fallot (TOF) patients is still challenging despite the fact that published studies identified prognostic clinical or imaging data with rather good negative predictive accuracy but weak positive predictive accuracy. Heterogeneity of the initial anatomy, the surgical approach, and the complexity of the mechanism leading to dilation and ventricular dysfunction explain the challenge of predicting the adverse event in this population. Therefore, risk stratification and management of this population remain poorly standardized.

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The Effect of Diet on Breast Cancer Recurrence: The DIANA-5 Randomized Trial.

Clin Cancer Res

March 2024

Department of Experimental Oncology, S.S.D. Nutrition Research and Metabolomics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.

Purpose: The DIANA-5 randomized controlled trial assessed the effectiveness of a diet based on Mediterranean and macrobiotic traditions (macro-Mediterranean diet) in reducing breast cancer recurrence.

Patients And Methods: The DIANA-5 study involved 1,542 patients with breast cancer at high risk of recurrence because of estrogen receptor-negative cancer, or metabolic syndrome, or high plasma levels of insulin or testosterone. Women were randomly assigned to an active dietary intervention (IG) or a control group (CG).

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Background: Treatment of metastatic hormone-sensitive prostate cancer (mHSPC) dramatically changed. PEACE-1 and ARASENS trials established triplet therapy efficacy. Identifying prognostic factors supporting treatment choice is pivotal.

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Article Synopsis
  • Prolonged SARS-CoV-2 infections are common in immunosuppressed patients, and current treatment options are limited, prompting a study on effective strategies.
  • The study involved 15 immunosuppressed patients treated between March 2022 and February 2023, using various combinations of antivirals and monoclonal antibodies, aiming for complete virological response.
  • Results showed that 93% of patients tested negative for SARS-CoV-2 within 16 days post-treatment, demonstrating that both sequential and combination therapies can be effective and safe for this high-risk group.
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Answer to comment on new strategy to lung/lobe isolation.

Ann Card Anaesth

November 2023

Department of Surgery, Valencia University Medical School, Blasco Ibáñez Av; Department of Anesthesia Critical Care and Pain Management, Valencia University General Hospital, Tres Creus Avenue, Valencia, Spain.

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We report the case of a 58-year-old male with a recent diagnosis of HIV infection admitted for progressive muscular weakness and psychomotor impairment. Cerebrospinal examination documented a mild hyperproteinorrachia, with normal cells count and reduced glycorrhachia. Brain gadolinium-enhanced MRI showed bilateral T2 and FLAIR hyperintensities in the nucleo-capsular region and irregular contrast-enhancement of the and the right putamen.

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Article Synopsis
  • The study analyzed the incidence of postoperative pulmonary complications (PPCs) in patients undergoing major elective abdominal surgery and their impact on mortality.
  • PPCs were found in 12.6% of patients, with a notably higher incidence in general surgery compared to gynecological and urological procedures.
  • Patients who experienced PPCs had increased hospital stays, higher readmission rates, and greater mortality risk within 30 days and one year after the surgery.
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Background: Highly localized impedance (LI) measurements during atrial fibrillation (AF) ablation have the potential to act as a reliable predictor of the durability of the lesions created.

Objective: We aimed to collect data on the procedural parameters affecting LI-guided ablation in a large multicenter registry.

Methods: A total of 212 consecutive patients enrolled in the CHARISMA registry and undergoing their first pulmonary vein (PV) isolation for paroxysmal and persistent AF were included.

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Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy.

Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website.

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Background: Evidence has shown that short courses of antibiotic therapy are at least as effective as long courses with better clinical outcomes. CAZ/AVI has demonstrated its clinical efficacy in treating -KPC infections.

Methods: We conducted an analysis based on the real-life data of our ten years retrospective cohort to assess the cost-effectiveness and cost-utility of a short course of CAZ/AVI plus source control compared to a long course plus source control.

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