111 results match your criteria: "Humanitas Clinical and Research Hospital-IRCCS[Affiliation]"

Atrial fibrillation versus. atrial myopathy in thrombogenesis: Two sides of the same coin?

Trends Cardiovasc Med

January 2025

Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Medical University of Bialystok, Bialystok, Poland.

Atrial fibrillation (AF) and atrial myopathy are recognized contributors to cardiovascular morbidity, particularly ischemic stroke. AF poses an elevated risk of thrombogenesis due to irregular heart rhythm leading to blood stasis and clot formation. Atrial myopathy, marked by structural and functional alterations in the atria, is emerging as a crucial factor influencing thromboembolic events, independently of AF.

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  • As cancer patients with brain metastases live longer, managing recurring brain lesions becomes more complex and requires careful assessment of various factors.
  • Clinicians must distinguish between actual disease progression and side effects from previous radiation, and classify the recurrence based on its location and characteristics.
  • Treatment options range from surgeries and various forms of radiotherapy to investigating systemic therapies, requiring a thorough, interdisciplinary approach tailored to individual patient factors.
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The #HOPE4LIVER Single-Arm Pivotal Trial for Histotripsy of Primary and Metastatic Liver Tumors.

Radiology

September 2024

From the Department of Radiology, University of Michigan Medicine, Ann Arbor, Mich (M.M.L., N.D.P., C.C.); Institut für Röntgendiagnostik und Nuklearmedizin, Städtisches Klinikum Braunschweig, Braunschweig, Germany (P.W., M.P.); Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg, Magdeburg, Germany (M.P., M.T.); Department of Radiology, Vall d'Hebrón University Hospital, Barcelona, Spain (X.S.C.); Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (S.B.W.); Department of Radiology, Tampa General Hospital, Tampa, Fla (C.D.); Department of Interventional Radiology, University of Chicago Pritzker School of Medicine, Chicago, Ill (O.A.); Departments of Biomedical Engineering, Radiology, and Neurosurgery, University of Michigan, Ann Arbor, Mich (Z.X.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (Z.C.); Department of Interventional Radiology, Baptist Hospital of Miami, Miami, Fla (G.N.); Department of Biomedical Science, Humanitas University & Humanitas Clinical and Research Hospital IRCCS, Rozzano, Italy (G.T., L.S.); Department of Radiology, Freeman Hospital, Newcastle, United Kingdom (P.L.); Department of Diagnostic and Interventional Radiology, Leeds Teaching Hospital and Trust, West Yorkshire, United Kingdom (T.M.W.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (T.J.Z.).

Background Histotripsy is a nonthermal, nonionizing, noninvasive, focused US technique that relies on cavitation for mechanical tissue breakdown at the focal point. Preclinical data have shown its safety and technical success in the ablation of liver tumors. Purpose To evaluate the safety and technical success of histotripsy in destroying primary or metastatic liver tumors.

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  • Atrial fibrillation (AF) is the most common arrhythmia after surgery, and this study aimed to find out how often it occurs (postoperative AF or POAF) and what factors predict it, especially focusing on inflammation markers like C-reactive protein (CRP).
  • In a study with over 53,000 patients, POAF happened in 570 patients (1.1%), primarily occurring around 3.4 days post-surgery, with a notable link between higher CRP levels and the likelihood of developing POAF.
  • The research found that patients undergoing lung and cardiovascular surgeries had the highest risk of POAF, indicating that surgery type and levels of inflammation are key predictors of this condition.
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  • - Percutaneous left atrial appendage closure (LAAC) is being explored as a non-drug option for preventing strokes in patients with atrial fibrillation, but there’s still limited comparative data on its effectiveness versus traditional anticoagulants like vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs).
  • - A meta-analysis of seven trials involving over 73,000 patients found that LAAC has similar rates of stroke or systemic embolism compared to VKAs and DOACs, and while bleeding risks were similar, LAAC was linked to lower bleeding risk after excluding procedural complications.
  • - Ultimately, both LAAC and DOACs showed lower all-cause mortality compared to VK
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OPTImal PHARMacological therapy for patients with heart failure: Rationale and design of the OPTIPHARM-HF registry.

Eur J Heart Fail

August 2024

Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Aims: Patients with heart failure (HF) remain often undertreated for multiple reasons, including treatment inertia, contraindications, and intolerance. The OPTIimal PHARMacological therapy for patients with Heart Failure (OPTIPHARM-HF) registry is designed to evaluate the prevalence of evidence-based medical treatment prescription and titration, as well as the causes of its underuse, in a broad real-world population of consecutive patients with HF across the whole ejection fraction spectrum and among different clinical phenotypes.

Methods: The OPTIPHARM-HF registry (NCT06192524) is a prospective, multicenter, observational, national study of adult patients with symptomatic HF, as defined by current international guidelines, regardless of ejection fraction.

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  • * In a study involving 93 patients, those who achieved ultrasound remission at week 12 had a significantly higher chance of long-term endoscopic remission (59%) compared to those without ultrasound remission (41%).
  • * The findings suggest that achieving ultrasound remission early in treatment is important, indicating it should be considered a key treatment goal; further larger studies are needed for validation.
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  • Patients with atrial fibrillation on chronic anticoagulation often need coronary procedures, and managing their OAC is challenging due to bleeding and clotting risks.
  • Current guidelines suggest keeping Vitamin-K Antagonists uninterrupted but recommend stopping direct oral anticoagulants (DOACs) 12-24 hours before procedures.
  • The DOAC-NOSTOP study aims to evaluate the safety of continuing DOACs in 200 patients during trans-radial coronary procedures, with a focus on bleeding complications within 30 days.
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Clinical usefulness of routinely performed drain fluid cultures after pancreaticoduodenectomy. A new ally to predict patients' outcomes?

Pancreatology

February 2024

Pancreatic Surgery Unit, Humanitas Clinical and Research Hospital - IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. Electronic address:

Background: Previous studies showed that bacterial contamination of surgical drains was associated with higher morbidity and mortality following pancreaticoduodenectomy (PD). However, there is still no agreement on the routine use of fluid drainage cultures in the management of patients underwent PD. Therefore, we aimed to clarify the role of surgical drain bacterial contamination in predicting patients' postoperative course.

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Regular assessment of serum vascular endothelial growth factor levels to monitor POEMS syndrome.

Neurol Sci

February 2024

Neuromuscular and Neuroimmunology Unit, Department of Medical Biotechnology and Translational Medicine, IRCCS Humanitas Research Hospital, Milan University, Via Manzoni 56, 20089, Rozzano, Italy.

Background: To investigate the utility of regular serum VEGF (sVEGF) levels assessment in the monitoring of POEMS syndrome.

Methods: We retrospectively reviewed data of 30 patients with POEMS syndrome whose sVEGF was tested regularly every 6 months. sVEGF levels after treatment were measured and correlated with disability (Overall Neuropathy Limitations Scale, ONLS), clinical impairment (measured with the modified Clinical Response Evaluation Scale, mCRES), and relapse-free survival.

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Thrombotic risk in patients with acute coronary syndromes discharged on prasugrel or clopidogrel: results from the PROMETHEUS study.

Eur Heart J Acute Cardiovasc Care

September 2023

The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.

Aims: Based on recent clinical data, the 2020 ESC guidelines on non-ST-elevation acute coronary syndrome (NSTE-ACS) suggest to tailor antithrombotic strategy on individual thrombotic risk. Nonetheless, prevalence and prognostic impact of the high thrombotic risk (HTR) criteria proposed are yet to be described. In this analysis from the PROMETHEUS registry, we assessed prevalence and prognostic impact of HTR, defined according to the 2020 ESC NSTE-ACS guidelines, and if the benefits associated with prasugrel vs.

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Since the publication of the 2015 EAPCI consensus on rotational atherectomy, the number of percutaneous coronary interventions (PCI) performed in patients with severely calcified coronary artery disease has grown substantially. This has been prompted on one side by the clinical demand for the continuous increase in life expectancy, the sustained expansion of the primary PCI networks worldwide, and the routine performance of revascularization procedures in elderly patients; on the other side, the availability of new and dedicated technologies such as orbital atherectomy and intravascular lithotripsy, as well as the optimization of the rotational atherectomy system, has increased operators' confidence in attempting more challenging PCI. This current EAPCI clinical consensus statement prepared in collaboration with the EURO4C-PCR group describes the comprehensive management of patients with heavily calcified coronary stenoses, starting with how to use non-invasive and invasive imaging to assess calcium burden and inform procedural planning.

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  • The Milan ultrasound criteria (MUC) is a scoring system that evaluates endoscopic activity in ulcerative colitis (UC) and helps predict response to biologic treatments.
  • In a study involving 49 UC patients starting biologic therapy, a MUC score of ≤ 6.2 at 12 weeks was found to be a strong predictor of endoscopic improvement, signifying successful treatment response.
  • The study concludes that MUC is a reliable tool for monitoring treatment effectiveness and can be applied in both clinical trials and everyday medical practice.
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Artificial intelligence (AI) is set to impact several fields within gastroenterology. In gastrointestinal endoscopy, AI-based tools have translated into clinical practice faster than expected. We aimed to evaluate the status of research for AI in gastroenterology while predicting its future applications.

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Stereotactic radiosurgery for the treatment of brainstem metastases: a multicenter retrospective study.

Radiat Oncol

August 2022

Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, 53100, Siena, Italy.

Background: Brainstem metastases (BSM) are associated with a poor prognosis and their management represents a therapeutic challenge. BSM are often inoperable and, in absence of randomized trials, the optimal radiation treatment of BSM remains to be defined. We evaluated the efficacy and toxicity of linear accelerator (linac)-based stereotactic radiosurgery (SRS) and hypofractionated steretotactic radiotherapy (HSRT) in the treatment of BSM in a series of patients treated in different clinical centers.

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  • * Out of 249 patients, 25.3% tested positive for SE-IgE, showing a connection between this sensitization and factors such as female gender and comorbidities like chronic rhinosinusitis with nasal polyps.
  • * Findings suggest that identifying SE-IgE sensitization can help refine asthma patient profiles and predict the development of related health issues, emphasizing its role in targeted therapeutic choices.
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Objective: The objective of this study was to test the superiority of multidisciplinary approach, that is, Short-Term Psychodynamic Psychotherapy (STPP) plus drug of choice, versus monotherapy, that is, OnabotulinumtoxinA (OnaBoNT-A).

Method: We consecutively recorded data from chronic migraine (CM) patients, with or without medication overuse headache (MOH), who underwent STPP or OnaBoNT-A, with a 3-month follow-up schedule. Headache days and analgesics intake were monitored as primary outcome measures.

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The liver is the first metastatic site in 15-25% of colorectal cancer patients and one of the first metastatic sites for lung and breast cancer patients. A computed tomography (CT ) scan with contrast medium is a standard procedure for assessing liver lesions but magnetic resonance imaging (MRI) characterizes small lesions better thanks to its high soft-tissue contrast. Positron emission tomography with computed tomography (PET-CT ) plays a complementary role in the diagnosis of liver metastases.

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Background: The COVID-19 pandemic has affected health care systems unexpectedly. However, data focusing on practical considerations experienced by health care professionals (HCPs) providing care to allergic patients is scarce.

Methods: Under the framework of the European Academy of Allergy and Clinical Immunology (EAACI), a panel of experts in the field of immunotherapy developed a 42-question online survey, to evaluate real-life consequences of the COVID-19 pandemic in allergy practice.

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Ticagrelor Monotherapy After PCI in High-Risk Patients With Prior MI: A Prespecified TWILIGHT Substudy.

JACC Cardiovasc Interv

February 2022

Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address:

Objectives: The aim of this study was to evaluate if patients with prior myocardial infarction (MI) could benefit from ticagrelor monotherapy in terms of bleeding reduction without any compromise in ischemic event prevention.

Background: Patients with history of MI who undergo percutaneous coronary intervention (PCI) remain at risk for recurrent ischemic events. The optimal antithrombotic strategy for this cohort remains debated.

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The diagnosis and therapy of squamous cell carcinoma of the anus may vary significantly in daily clinical practice, even if international guidelines are available. We conducted a pattern of care survey to assess the management of patients with anal cancer in Italy (38 questions). We analyzed 58 questionnaires.

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