3,255 results match your criteria: "Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS[Affiliation]"

Background And Objective: The introduction of the Hugo RAS system represents a recent innovation in robotic surgery. The potential benefits and limitations of this system and its integration into clinical practice in urology have yet to be fully delineated. Our objective was to assess surgical, early oncological, and functional outcomes in studies comparing robot-assisted radical prostatectomy (RARP) performed with the new Hugo RAS system and the well-established da Vinci surgical system.

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Is desmoplastic stromal reaction useful to modulate lymph node dissection in sporadic medullary thyroid carcinoma?

Surgery

January 2025

UOC Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell'Obesità, Università Cattolica del Sacro Cuore, Rome, Italy.

Article Synopsis
  • The study explores the effectiveness of desmoplastic stromal reaction as a marker for nodal metastases in sporadic medullary thyroid carcinoma, questioning the reliance on basal calcitonin levels for surgical decisions.
  • Researchers analyzed data from 246 cases of medullary thyroid carcinoma, finding that both desmoplastic stromal reaction positivity and high basal calcitonin levels (>113 pg/mL) were significant independent risk factors for nodal metastases.
  • The results indicate that patients with minimal desmoplastic stromal reaction might not need extensive neck surgeries, while those with significant markers should strongly consider undergoing lateral neck dissection.
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  • The study investigates the relationship between depressive symptoms, affective temperaments, and emotional dysregulation in adults with ADHD.
  • It involved 164 participants, revealing that emotional dysregulation and dysthymic temperament significantly influence depressive symptoms, even when considering ADHD severity and treatment.
  • The findings suggest the importance of assessing temperament in ADHD patients to improve treatment approaches and patient care.
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Growing scientific evidence suggests a link between the expression of toll-like receptor 4 (TLR4) and cervical cancer carcinogenesis. Specifically, a close relation between TLR4 expression and FIGO stage, lymph node metastases, and tumor size has been reported in cervical cancer. In the present study, we aimed to evaluate the relationship between TLR4 expression levels and human papillomavirus (HPV) infection and/or high-risk (hr) HPV integration status in patients with a histological diagnosis of high-grade squamous intraepithelial lesion (H-SIL), and squamous cell carcinoma (SCC) of the uterine cervix.

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Background: While immune checkpoint inhibitors (ICIs) are increasingly reshaping the therapeutic landscape of non-small-cell lung cancer (NSCLC), only a limited proportion of patients achieve a relevant and long-lasting benefit with these treatments, calling for the identification of clinical and, ideally modifiable, predictors of efficacy. Body composition phenotypes may reflect aspects of patients' immunology and thereby their ability to respond to ICIs. This study aims to explore the possible association between pre-treatment body composition phenotypes, tumour response, and clinical outcomes in patients receiving first-line pembrolizumab monotherapy for advanced NSCLC.

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In recent years, it has become clear that artificial intelligence (AI) models can achieve high accuracy in specific pathology-related tasks. An example is our deep-learning model, designed to automatically detect serous tubal intraepithelial carcinoma (STIC), the precursor lesion to high-grade serous ovarian carcinoma, found in the fallopian tube. However, the standalone performance of a model is insufficient to determine its value in the diagnostic setting.

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  • FSHD is a myopathy linked to changes in DNA methylation at the D4Z4 locus, and this study evaluates the effectiveness of a methylation assay as a diagnostic tool.
  • The research involved 218 individuals suspected of having FSHD, comparing traditional molecular testing with the new methylation assay to assess accuracy and consistency.
  • The refined methylation assay showed high sensitivity (90%), specificity (100%), and accuracy (93%), indicating its potential for early detection, even in asymptomatic individuals with a family history of FSHD.
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Breast cancer stands as the most frequently diagnosed cancer and the primary cause of cancer-related mortality among women worldwide, including Italy. With the increasing number of survivors, many are enrolled in regular follow-up programs. However, adherence to recommendations from scientific societies (such as ASCO, ESMO, AIOM) for breast cancer follow-up management varies in daily clinical practice across different cancer centers, potentially resulting in unequal management and escalating costs.

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Rehabilitation is the only current intervention that improves sensorimotor function in ischemic stroke patients, similar to task-specific intensive training in animal models of stroke. Bone marrow mesenchymal stem cells (BM-MSCs)-derived extracellular vesicles (EVs) are promising in restoring brain damage and function in stroke models. Additionally, the non-invasive intranasal route allows EVs to reach the brain and target specific ischemic regions.

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Mitochondrial pathways and sarcopenia in the geroscience era.

J Nutr Health Aging

December 2024

Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Department of Medicine and Surgery, LUM University, Casamassima, Italy. Electronic address:

Sarcopenia is associated with structural, ultrastructural, and molecular abnormalities of skeletal muscle. Mitochondrial dysfunction is a pivotal factor involved in muscle aging and sarcopenia. Mitochondrial bioenergetics are significantly reduced in muscles of older adults which is associated with whole-body aerobic capacity, muscle strength, and physical performance.

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Article Synopsis
  • The study aimed to analyze attrition rates from first-line to third-line therapies in patients with HER2-positive metastatic breast cancer across several European countries.
  • It found that 29.6% of patients discontinued treatment after first-line therapy and 34.2% after second-line therapy, often due to death or transition to palliative care.
  • Additionally, the time patients remained on treatment decreased with each line of therapy, indicating diminishing effectiveness of subsequent treatments.
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Background: Genomic profiling-based model (GP-M) is the gold-standard for endometrial cancer (EC) molecular classification, but several issues related to the availability of genomic sequencing in low-income settings remain and health disparities in the management are increasing. This study aims to investigate the non-inferiority of the immunohistochemistry-alone model in classifying ECs compared to the standard genomic profiling-based model in terms of oncologic outcomes.

Methods: All preoperative uterine-confined ECs undergoing surgical staging were retrospectively included.

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Introduction: To evaluate the prognostic impact of substantial lymph vascular space invasion (LVSI) on the sentinel lymph node involvement and recurrence rate of patients with apparent uterine-confined endometrial cancer.

Materials And Methods: We enrolled consecutive patients with apparent confined endometrial cancer who underwent surgical staging with sentinel node mapping from 14 European reference centers. LVSI was analyzed semi-quantitatively, according to a 3-tiered scoring system classified as absent, focal, and substantial.

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  • * The meta-analysis included data from 17 studies, revealing that VEIL had significantly lower rates of major complications compared to OIL (12.6% vs. 41.1%), though other factors like blood loss and hospital stay were similar between the two methods.
  • * While VEIL appears to be a safer option, OIL is quicker, making it a valid alternative; further randomized trials are needed to better assess these outcomes.
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  • Sentinel lymph node (SLN) mapping in epithelial ovarian cancer may lower risks from lymphadenectomy while still providing reliable diagnostic results; ongoing research aims to evaluate its effectiveness.
  • A systematic review of four studies involving 239 patients found SLN detection rates of 59.5% for pelvic and 64.4% for para-aortic regions, with technetium-99 showing better detection rates compared to indocyanine green.
  • Diagnostic accuracy for identifying lymph node metastasis was high, reaching 100% in the pelvic field and 98.1% for the para-aortic field, suggesting SLN mapping could be a valuable tool in this context.
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Surgery after upfront chemoradiation in locally advanced squamous cell vulvar cancer: Analysis of postoperative outcomes and survival.

Gynecol Oncol

December 2024

Unità Operativa di Chirurgia dei Genitali Esterni Femminili, Divisione di Ginecologia Oncologica, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Gemelli Women Health Center for Digital and Personalized Medicine, Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.

Objective: The aim of the study was to assess the survival rates and surgery-related toxicity in patients with locally advanced squamous cell vulvar cancer (LAVC) managed by upfront chemoradiation (CRT) with/without following by surgery. CRT is the primary treatment for patients with unresectable locally advanced squamous cell vulvar carcinoma (LAVC), followed by surgery in case of residual tumor.

Methods: Patients with AJCC stage II-IV squamous cell vulvar carcinoma referred to Gynecologic Oncology Unit at Fondazione Policlinico Universitario Agostino Gemelli I.

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The Molecular Mechanisms of Portal Vein Thrombosis in Hepatocellular Carcinoma.

Cancers (Basel)

September 2024

Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy.

Hepatocellular carcinoma (HCC) represents the sixth most diagnosed cancer worldwide and is the second leading cause of cancer-related death in the world. The association of HCC and portal vein thrombosis (PVT) represents an advanced stage of the tumor. PVT has a prevalence of about 25-50% in HCC, determining poor prognosis and a remarkable reduction in therapeutic perspectives in these patients, leading to severe complications such as ascites, metastasis, an increase in portal hypertension and potentially fatal gastrointestinal bleeding.

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The introduction of new sequencing approaches into clinical practice has radically changed the diagnostic approach to mitochondrial diseases, significantly improving the molecular definition rate in this group of neurogenetic disorders. At the same time, there have been no equal successes in the area of in-depth understanding of disease mechanisms and few innovative therapeutic approaches have been proposed recently. In this regard, the identification of the molecular basis of phenotypic variability in primary mitochondrial disorders represents a key aspect for deciphering disease mechanisms with important therapeutic implications.

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Emerging Targets and Treatments for Sarcopenia: A Narrative Review.

Nutrients

September 2024

Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy.

Background: Sarcopenia is characterized by the progressive loss of skeletal muscle mass, strength, and function, significantly impacting overall health and quality of life in older adults. This narrative review explores emerging targets and potential treatments for sarcopenia, aiming to provide a comprehensive overview of current and prospective interventions.

Methods: The review synthesizes current literature on sarcopenia treatment, focusing on recent advancements in muscle regeneration, mitochondrial function, nutritional strategies, and the muscle-microbiome axis.

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Article Synopsis
  • The study evaluates the recovery of cardiac diagnostic procedures in Italy one year after the COVID-19 outbreak, focusing on procedure volumes, practices, and staff well-being.
  • A global survey revealed a 72% drop in cardiac diagnostic procedures in April 2020 compared to March 2019, with only a slight recovery (3% increase) by April 2021, though some specific tests showed increased volumes.
  • Many healthcare centers adopted measures like physical distancing and COVID-19 screening, but 25% of physicians reported high psychological stress levels, highlighting ongoing challenges within the healthcare system.
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The evolution in microsurgery using high-definition three-dimensional (3D) cameras has provided the opportunity to replace conventional operating microscopes (OM), improving ergonomics for microsurgeons. Several 3D exoscope systems have already demonstrated good surgical field visualization in a 3D space in performing microvascular anastomosis with favorable maneuverability and non-inferiority compared to OM. We present the application of the 4K-3D ORBEYE system (Olympus Inc.

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  • Multicentric studies face challenges with patient privacy and data security, prompting an exploration of federated analysis through secure multiparty computation.
  • A pilot study involving 48 cancer patients demonstrated a successful architecture for secure data analysis that complies with stringent European regulations on patient privacy.
  • The treatment led to high local control rates and low toxicity, with a median overall survival of 19 months, showcasing the benefits of privacy-friendly evaluation in clinical research.
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Introduction: A proper sample size calculation enables to conduct adequately powered randomized controlled trials (RCTs) and to provide a valid assessment of a specific clinical question.

Areas Covered: In the current manuscript, we tried to provide the reader with an easy guide on the principles of sample size calculation in RCTs, tailored specifically to the context of gastroenterology and hepatology. The basics of sample size calculation were commented with a description of some of the main methods, including the calculation of the non-inferiority margin for non-inferiority RCTs and the calculation of the minimum clinically important difference (MCID).

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  • Spinal muscular atrophy (SMA) is a genetic disorder resulting from mutations in the SMN1 gene, with a study aiming to track changes in motor function over 4 years using the Hammersmith Functional Motor Scale Expanded (HFMSE).
  • The research involved analyzing data from multiple countries, focusing on factors like age, functional status, and the number of SMN2 gene copies in SMA types II and III.
  • Results showed SMA type II patients had a mean decline of -2.20 points, while type III experienced a -2.75 point decline over 4 years, with age and baseline scores being significant predictors of these changes, suggesting the need for detailed assessment in specific SMA subgroups.
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