Biologics as well as inhaled anti-asthmatic therapy achieve clinical remission: Evidence from the Severe Asthma Network in Italy (SANI).

Background: This study aimed to evaluate the impact of severe asthma (SA) treatments after 12 months in achieving clinical remission (CR) within the context of the Severe Asthma Network in Italy (SANI) using the recent SANI definition of CR on treatment.

Methods: CR has been defined by SANI as complete, partial, and no CR. Complete CR is defined by the absence of oral corticosteroids (OCS), no symptoms, no exacerbations, and stable lung function, and partial CR requires the absence of OCS and the fulfillment of 2 out of the other 3 criteria.

Deep learning helps discriminate between autoimmune hepatitis and primary biliary cholangitis.

Background & Aims: Biliary abnormalities in autoimmune hepatitis (AIH) and interface hepatitis in primary biliary cholangitis (PBC) occur frequently, and misinterpretation may lead to therapeutic mistakes with a negative impact on patients. This study investigates the use of a deep learning (DL)-based pipeline for the diagnosis of AIH and PBC to aid differential diagnosis.

Methods: We conducted a multicenter study across six European referral centers, and built a library of digitized liver biopsy slides dating from 1997 to 2023.

Large-bore rotational thrombectomy and balloon angioplasty for thrombus fragmentation and removal from occluded iliofemoral or inferior vena cava stents.

Although venous stent placement is an established treatment for patients with deep vein thrombosis (DVT) and post-thrombotic syndrome (PTS), stent patency rate may be as low as 80% at 12 months. Treatment of stent occlusion requires the removal of a large amount of fresh or organized thrombus from stents with a diameter of 12-20 mm. The feasibility of large-bore rotational thrombectomy in combination with angioplasty to treat thrombosed venous iliofemoral or inferior vena cava stents has not been investigated yet.

Bile acid diarrhea in patients with chronic diarrhea. Current appraisal and recommendations for clinical practice.

Bile Acid Diarrhea (BAD) is a common cause of chronic diarrhea, often accompanied by urgency, occasional fecal incontinence, abdominal pain, and fatigue. A nationwide survey has shown limited awareness of BAD within the Italian medical community, prompting a panel of experts to develop a Position Paper that outlines the most practical and cost-saving diagnostic investigations and treatments for this frequently overlooked condition. The document provides an overview of the epidemiology, pathophysiology, clinical manifestations, and classification of the different types of Bile Acid Diarrhea (BAD).

International Expert-Based Consensus Definition, Classification Criteria, and Minimum Data Elements for Osteoradionecrosis of the Jaw: An Inter-Disciplinary Modified Delphi Study.

Purpose: Osteoradionecrosis of the jaw (ORNJ) is a severe iatrogenic disease characterized by bone death after radiation therapy (RT) to the head and neck. With over 9 published definitions and at least 16 classification systems, the true incidence and severity of ORNJ are obscured by lack of a standard for disease definition and severity assessment, leading to inaccurate estimation of incidence, reporting ambiguity, and likely under-diagnosis worldwide. This study aimed to achieve consensus on an explicit definition and phenotype of ORNJ and related precursor states through data standardization to facilitate effective diagnosis, monitoring, and multidisciplinary management of ORNJ.

Immunosuppressive therapy to treat newly diagnosed primary heart involvement in patients with systemic sclerosis: An Italian cardiac magnetic resonance based study.

Background: Primary heart involvement (pHI) is frequent in systemic sclerosis (SSc), and is associated with a poor prognosis. Therapeutic strategies to treat SSc-pHI are not yet defined.

Objectives: To evaluate the efficacy of immunosuppressive therapy on cardiac magnetic resonance (CMR) features in patients with CMR-proven SSc-pHI.

Inter-Rater Disagreements in Applying the Montreal Classification for Crohn's Disease: The Five-Nations Survey Study.

Background: The Montreal classification has been widely used in Crohn's disease since 2005 to categorize patients by the age of onset (A), disease location (L), behavior (B), and upper gastrointestinal tract and perianal involvement. With evolving management paradigms in Crohn's disease, we aimed to assess the performance of gastroenterologists in applying the Montreal classification.

Methods: An online survey was conducted among participants at an international educational conference on inflammatory bowel diseases.

Incidence of hospital-acquired infections due to carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa in critically ill patients in Italy: a multicentre prospective cohort study.

Background: Carbapenem-Resistant Gram-Negative Bacteria, including Carbapenem-Resistant Enterobacterales (CRE) and Carbapenem-Resistant Pseudomonas aeruginosa (CRPA), are common causes of infections in intensive care units (ICUs) in Italy.

Objective: This prospective observational study evaluated the epidemiology, management, microbiological characterization, and outcomes of hospital-acquired CRE or CRPA infections treated in selected ICUs in Italy.

Methods: The study included patients with hospital-acquired infections due to CRE and CRPA treated in 20 ICUs from June 2021 to February 2023.

Individualized PEEP titration by lung compliance during one-lung ventilation: a meta-analysis.

Background: Despite the physiological advantages of positive end-expiratory pressure (PEEP), its optimal utilization during one-lung ventilation (OLV) remains uncertain. We aimed to investigate whether individualized PEEP titration by lung compliance is associated with a reduced risk of postoperative pulmonary complications during OLV.

Methods: We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials until April 1, 2024, to identify published randomized controlled trials that compared individualized PEEP titration by lung compliance with fixed PEEP during OLV.

Billing models for measuring nursing care in inpatient and outpatient settings: a scoping review.

Background: The rising cost of healthcare is a concerning issue for healthcare systems. The Diagnosis Related Group (DRG) system lacks direct consideration for costs related to nursing care. Therefore, to date there is no clear picture of billing models that consider also nursing activity when evaluating healthcare service costs or what factors related to nursing care affect the costs of healthcare services and would therefore need to be considered in billing models.

Impact of papillary muscle infarction on atrial and ventricular myocardial deformation in non-anterior STEMI patients.

The purpose of this study was to explore the impact of papillary muscle (PPM) infarction on left atrial and ventricular strain parameters in patients with non-anterior ST-segment elevation myocardial infarction (NA-STEMI) using cardiovascular magnetic resonance (CMR). This retrospective study performed CMR scans on 88 consecutive patients with NA-STEMI (68 males, 65 ± 10.05 years).

Prognostic value of manual versus automatic methods for assessing extents of resection and residual tumor volume in glioblastoma.

Objective: The extent of resection (EOR) and postoperative residual tumor (RT) volume are prognostic factors in glioblastoma. Calculations of EOR and RT rely on accurate tumor segmentations. Raidionics is an open-access software that enables automatic segmentation of preoperative and early postoperative glioblastoma using pretrained deep learning models.

Incidence and predictors of weaning failure from veno-arterial extracorporeal membrane oxygenation therapy in patients with cardiogenic shock.

Aims: This study aimed to investigate incidence and predictors of weaning failure and in-hospital death after successful weaning from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock (CS).

Methods And Results: Overall, 685 patients with CS treated with VA-ECMO from 23 tertiary care centres in 7 countries were analysed (median age 57 [interquartile range 49-66] years, 542 [79.1%] male, median lactate 7.

DAA-PASS: A Prospective Evaluation of HCC Recurrence After Direct Acting Antiviral Therapy.

Direct-acting antiviral (DAA) therapy is associated with a significant reduction in hepatocellular carcinoma (HCC) incidence among patients with cirrhosis, but data are conflicting about the risk of recurrence following DAA therapy. DAA-PASS was a prospective, pragmatic, observational study designed to estimate the risk of HCC recurrence associated with DAA therapy exposure during routine clinical care. Eligible patients were DAA treatment naive with Barcelona Clinic Liver Cancer (BCLC) stage A.

Is there a role for neoadjuvant therapies followed by radical cystectomy in oligometastatic bladder cancer?

Purpose Of Review: This review explores the potential role of neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) for oligometastatic bladder cancer (OMBC) treatment. We focused on extrapolating evidence from studies including lymph node-positive only and metastatic bladder cancer to address the key challenges and therapeutic strategies for OMBC.

Recent Findings: Current evidence for NAC and RC in OMBC is limited, with most data derived from studies in locally advanced bladder cancer.

Patient preferences for drug therapy in inflammatory arthritis: protocol for a living systematic review and evidence map to inform clinical practice guidelines.

Introduction: The pharmacological management of inflammatory arthritis often requires choices that involve trade-offs between benefits, risks and other attributes such as administration route, frequency and cost. This living systematic review aims to inform international clinical guidelines on inflammatory arthritis by creating an evidence map of patient preference studies concerning the trade-offs in pharmacological management of inflammatory arthritis.

Methods And Analysis: We will include published and peer-reviewed full-text studies in any language that quantitatively assess preferences of patients for the pharmacological management of inflammatory arthritis (rheumatoid arthritis, spondyloarthritis and juvenile idiopathic arthritis).

Paramagnetic rim lesion formation is predicted by the initial gadolinium-enhancing lesion diameter.

Background: Paramagnetic rim lesions (PRLs) are a magnetic resonance imaging (MRI) marker of compartmentalized intraparenchymal inflammation.

Objectives: The primary objective was to investigate clinical, demographic, and MRI factors that may be predictive of the future formation of PRL.

Methods: This is a retrospective analysis of longitudinal data.

Bacillary layer detachment: Updates on its clinical and prognostic significance in retinal disease.

Bacillary layer detachment (BALAD) refers to the distinctive splitting at the level of the photoreceptor inner segment myoid and accumulation of intraretinal fluid, as seen on optical coherence tomography (OCT). BALAD is an increasingly recognized OCT biomarker of numerous heterogeneous chorioretinal diseases, including posterior uveitis, age-related macular degeneration and macular neovascularization, neoplastic and paraneoplastic retinal disorders, rhegmatogenous retinal detachment, blunt ocular trauma, and miscellaneous conditions. The recognition of BALAD is clinically relevant because, based on the specific etiology, BALAD may require simple observation, ocular or systemic medical treatment, or even surgical intervention, with subsequent different prognosis.

Automatic base-dose planning for a robust field junction in total marrow irradiation.

Purpose: Total marrow (lymph-node) irradiation (TMI/TMLI) is a radiotherapy technique irradiating the whole body of a patient. The limited couch travel range in modern linacs (130-150 cm) forces to split the TMI/TMLI delivery into two plans with opposite orientation. A dedicated field junction is necessary to achieve satisfactory target coverage in the overlapping region of the two plans.

A comprehensive RCT in screening, surveillance, and diagnostic AI-assisted colonoscopies (ACCENDO-Colo study).

Background And Aims: Adenoma detection rate (ADR) serves as a primary quality metric in colonoscopy. Various computer-aided detection (CADe) tools have emerged, yielding diverse impacts on ADR across different demographic cohorts. This study aims to evaluate a new CADe system in patients undergoing colonoscopy.

Girentuximab imaging in renal cancer: diamond in the rough or just ZIRCON?

Small renal masses (SRM), especially those under 7 cm pose significant diagnostic challenges when using conventional imaging (CT/MRI). PET/CT with [Zr]Zr-girentuximab offers a promising alternative in this setting by enabling molecular-level imaging. The ZIRCON trial, a phase 3 multicenter study, evaluated the diagnostic accuracy of [Zr]Zr-girentuximab PET/CT in detecting clear cell renal cell carcinoma (ccRCC) in SRM.

Pulmonary Arterial Hypertension Incidence in Scleroderma Patients Treated with Bosentan for Digital Ulcers: Evidence from the Italian SPRING Registry.

Objective: Bosentan (BOS) is approved for treating pulmonary arterial hypertension (PAH) and preventing digital ulcers (DU) in systemic sclerosis (SSc). Our study aimed to evaluate whether BOS prescribed for DU could reduce the incidence of PAH in a large SSc cohort from the SPRING registry.

Methods: Patients with SSc from the SPRING registry, meeting ACR/EULAR 2013 classification criteria with data on PAH onset, DU status, BOS exposure, and at least a one-year follow-up between 2015 and 2020, and no known PAH at baseline were included.

The structural organisation of pentraxin-3 and its interactions with heavy chains of inter-α-inhibitor regulate crosslinking of the hyaluronan matrix.

Pentraxin-3 (PTX3) is an octameric protein, comprised of eight identical protomers, that has diverse functions in reproductive biology, innate immunity and cancer. PTX3 interacts with the large polysaccharide hyaluronan (HA) to which heavy chains (HCs) of the inter-α-inhibitor (IαI) family of proteoglycans are covalently attached, playing a key role in the (non-covalent) crosslinking of HC•HA complexes. These interactions stabilise the cumulus matrix, essential for ovulation and fertilisation in mammals, and are also implicated in the formation of pathogenic matrices in the context of viral lung infections.