27 results match your criteria: "Ospedale Universitario Careggi[Affiliation]"

Carbapenem-resistant Enterobacterales (CREs) are globally considered to be a major threat to public health. National and international guidelines emphasize the importance of routine active surveillance policies to prevent their transmission. Consequently, screening for the evaluation of the status of colonization by CREs in hospitalized patients in Italy is considered essential to contain and control the spread of these microorganisms and their evolution towards infection.

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Outcomes of Mechanical Thrombectomy in Patients With Acute Basilar Artery Occlusion With Mild to Moderate Symptoms.

Neurology

December 2024

From the Department of Human Neuroscience (E.N., S.L., D.T.), Sapienza University of Rome; Stroke Unit (E.N., F.S.), Ospedale dei Castelli, Ariccia (RM); Department of NEUROFARBA (G.P.), Neuroscience Section, University of Florence; Stroke Unit (A.C., M.D.M.), Policlinico Umberto I, Sapienza University of Rome; Neurology and Stroke Unit (V.S., T.T.), S. Corona Hospital, Pietra Ligure, Italy; Interventional Neurovascular Unit (N. Limbucci), Careggi University Hospital; Careggi University Hospital (P.N.), Florence; AUSL Romagna Cesena (M.R.); Neurologia e Stroke Unit Ospedale Bufalini Cesena (M.L.); UO Neuroradiologia (M. Cosottini); Neurological Institute (G.O.), Azienda Ospedaliero Universitaria Pisana; Dipartimento di Neuroscienze (M.B.), Universitá di Torino; A.O. Cittá della Salute (P.C.), Torino; UO Neuroradiologia (S.V.); Neurologia-Stroke Unit (G. Bigliardi), Ospedale Civile di Baggiovara - AOU di Modena; UOC Neuroradiologia diagnostica e terapeutica AOU Senese (S.C.); UOC Stroke Unit AOU Senese (R.T.), Siena; Dipartimento di Biomedicina e Prevenzione - UOSD radiologia interventistica (V.D.R.); Department of Systems Medicine (M.D.), University of Rome Tor Vergata; IRCCS Istituto di Scienze Neurologiche di Bologna - UOC Neuroradiologia Ospedale Bellaria (L.S.); IRCCS Istituto di Scienze Neurologiche di Bologna (A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital; UOC Neuroradiologia AOU "G. Martino" Messina (M.V.); UOSD Stroke Unit AOU "G. Martino"-Messina (P.L.L.S.); UO Neuroradiologia Ospedale Policlinico San Martino (L.C.); UO Neurologia Ospedale Policlinico San Martino (M.D.S.), Genova, Italy; Neurology Unit (I.C.), University Hospital Arcispedale S. Anna, Ferrara; Dipartimento di Scienze Biomediche (E.F.), Sperimentali e Cliniche, Neuroradiologia, Università degli Studi di Firenze, Ospedale Universitario Careggi; Unità Complessa di Neuroradiologia (R.M.), Azienda Ospedaliero-Universitaria; Dipartimento di Medicina e Chirurgia (A.P.), Università degli Studi di Parma - Programma Stroke Care, Dipartimento di Emergenza-Urgenza, Azienda Ospedaliero-Universitaria, Parma; UOSD Interventistica AOU Salerno (D.G.R.); UOC Neuroradiologia AOU Salerno (G.F.); Radiologia e Neuroradiologia diagnostica e interventistica (S.N.), IRCCS Policlinico San Matteo; UO Neurologia d'Urgenza e Stroke Unit (N. Loizzo), IRCCS Fondazione Mondino, Pavia; UO Neuroradiologia Dip Neuroscienze AZOU Ferrara (A.S.); UO Neurologia Dip Neuroscienze AZOU Ferrara (A.D.V.); Neuroradiology department ospedale di circolo- ASST Settelaghi Varese (R.A.); Stroke Unit - Azienda Ospedaliera Universitaria Integrata Verona (M. Cappellari); UO Neuroradiologia AOU Consorziale Policlinico Bari (D.S.Z.); UOC Neurologia e Stroke Unit "Puca" AOU Consorziale Policlinico Bari (M.P.); SC Neuroradiologia Diagnostica e Interventistica (L.A.), S. Corona Hospital, Pietra Ligure; UO Neuroradiologia interventistica (D.A.); Neurologia d'urgenza e Stroke Unit (S. Marcheselli), IRCCS Humanitas Research Hospital, Rozzano; UOC Neuroradiologia (M.P.G.); UOC Neurologia (G. Boero), Ospedale "SS. Annunziata", Taranto; IRCCS Neuromed (S. Mangiafico), Pozzilli (IS), Italy; Department of Clinical Neuroscience (N.A.), Karolinska Institutet, Stockholm, Sweden; Stroke Center EOC (C.W.C.), Neurocentre of Southern Switzerland; and Faculty of Biomedical Sciences (C.W.C.), Università della Svizzera Italiana, Lugano, Switzerland.

Background And Objectives: The benefit of mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS) with basilar artery occlusion (BAO) and a baseline National Institute of Health Stroke Scale (NIHSS) score <10 is unclear because this subpopulation has been substantially excluded from large clinical trials. The aim of our study was to determine whether MT ± IV thrombolysis (IVT) improves functional outcomes compared with IVT alone in patients with BAO and a NIHSS score <10.

Methods: We emulated a hypothetical trial including adult patients with BAO, a baseline NIHSS score <10, and prestroke modified Rankin scale (mRS) scores 0-2, comparing MT (±IVT) with IVT alone.

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Stroke thrombectomy in the elderly: A propensity score matched study on a nationwide real-world registry.

Eur Stroke J

November 2024

IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurologia e Rete Stroke Metropolitana, Bologna, Italy.

Introduction: Data on safety and efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke in older patients are limited and controversial, and people aged 80 or older were under-represented in randomized trials. Our aim was to assess EVT effect for ischemic stroke patients aged ⩾80 at a nationwide level.

Patients And Methods: The cohort included stroke patients undergoing EVT from the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS).

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Background: Collaterals are a strong determinant of clinical outcome in acute ischemic stroke (AIS) patients undergoing Endovascular Treatment (EVT). Careggi Collateral Score (CCS) is an angiographic score that demonstrated to be superior to the widely suggested ASITN/SIR score. Multi-phase CT-Angiography (mCTA) could be alternatively adopted for collateral assessment.

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Background: Mechanical thrombectomy (MT) was found to be beneficial in acute ischemic stroke patients with anterior tandem occlusion (a-TO). Instead, little is known about the effectiveness of MT in stroke patients with posterior tandem occlusion (p-TO). We aimed to compare MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO.

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Background: We aim to assess the association between procedural time and outcomes in patients in unsuccessful mechanical thrombectomy (MT) for anterior circulation acute stroke.

Methods: We conducted a cohort study on prospectively collected data from patients with M1 and/or M2 segment of middle cerebral artery occlusion with a thrombolysis in cerebral infarction 0-1 at the end of procedure. Primary outcome was 90-day poor outcome.

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Article Synopsis
  • This study looked at how patients with a minor stroke are treated, comparing two methods: one using a drug called IVT and another method called MT, versus just IVT alone.
  • They analyzed data from patients treated in Italy to see which method led to better health outcomes after a stroke.
  • The results showed that while IVT plus MT had more complications in the short term, both treatment methods had similar long-term recovery outcomes.
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Efficacy and safety of mechanical thrombectomy (MT) for stroke with posterior circulation large vessel occlusion (LVO) is still under debate. We aimed to compare the outcomes of stroke patients with posterior circulation LVO treated with intravenous thrombolysis (IVT) (< 4.5 h after symptom onset) plus MT < 6 h after symptom onset with those treated with IVT alone (< 4.

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Article Synopsis
  • - The study discusses cerebral collateral circulation, which helps keep at-risk brain tissue alive during strokes and can be improved with reperfusion therapies if blood flow is restored.
  • - It compares two techniques used in clinical practice to assess collateral vessels in patients with acute ischemic stroke: single-phase CTA (sCTA) and multi-phase CTA (mCTA), noting that mCTA has a higher predictive value for better outcomes.
  • - The review highlights the advantages and disadvantages of both methods, suggesting that mCTA could become the preferred method for evaluating collateral circulation and selecting patients for endovascular treatments.
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Article Synopsis
  • The study investigates predictors of hemorrhagic transformation (HT) and cerebral edema (CED) in stroke patients undergoing endovascular treatment after experiencing large vessel occlusion (LVO).
  • It analyzes data from 1,400 patients to find clinical and procedural factors associated with these complications, identifying variables like diabetes, NIHSS scores, and ASPECTS ratings as significant predictors.
  • Results show that HT occurred in 18% of patients and CED in 19.2%, with general anesthesia linked to a lower risk of HT, while factors like longer onset-to-groin times and invasive procedures raised the risk for both complications.
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Background: Heart failure (HF) is the second most important cardiac risk factor for stroke after atrial fibrillation (AF). Few data are available on mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients with HF.

Methods: The source of data is the multicentre Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS).

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Predictors for clinical and functional outcomes in stroke patients with first-pass complete recanalization after thrombectomy.

Eur J Neurol

August 2023

Interventional Neuroradiology Consultant at IRCCS Neuromed, Pozzilli (IS), and Adjunct Professor of Interventional Neuroradiology at Tor Vergata University, Sapienza University and S. Andrea Hospital, Rome, Italy.

Background And Purpose: The aim was to identify baseline clinical and radiological/procedural predictors and 24-h radiological predictors for clinical and functional outcomes in stroke patients obtaining complete recanalization in one pass of mechanical thrombectomy (MT) in an optimal baseline and procedural setting.

Methods: A retrospective analysis was conducted of prospectively collected data from 924 stroke patients with anterior large vessel occlusion, Alberta Stroke Program Early Computed Tomography (ASPECT) score ≥6 and pre-stroke modified Rankin Scale score 0, who started MT ≤6 h from symptom onset and obtained first-pass complete recanalization. A first logistic regression model was performed to identify baseline clinical predictors and a second model to identify baseline radiological/procedural predictors.

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Background: The benefit, safety, and time intervals of mechanical thrombectomy (MT) in patients with in-hospital stroke (IHS) are unclear. We sought to evaluate the outcomes and treatment times for IHS patients compared with out-of-hospital stroke (OHS) patients receiving MT.

Methods: We analyzed data from the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) between 2015 and 2019.

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Article Synopsis
  • - Breast IRRADIATA is a nationwide project in Italy, aimed at creating a registry for breast cancer patients treated with radiotherapy and defining care patterns, backed by the Italian Society of Radiotherapy and Clinical Oncology and the Italian League Against Cancer.
  • - A feasibility study conducted from July to October 2021 involved 17 Italian Radiation Oncology Centers and collected data from 335 breast cancer patients, demonstrating the effectiveness of a user-friendly data collection tool.
  • - Results showed that participants found the project overwhelmingly satisfactory, with 82.3% of centers rating it as excellent, supporting its potential for broader implementation and use in assessing radiotherapy care for other cancers in Italy.
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Background: The index case is a 21-year-old Italian woman with a mild hemorrhagic syndrome and von Willebrand factor antigen (VWF:Ag) = 34.3 U/dl, VWF recombinant glycoprotein Ib (VWF:GpIbR) = 32.8 U/dl, and factor VIII (FVIII) = 55.

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Purpose: To investigate the association and agreement between magnetic resonance dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) and computed tomography perfusion (CTP) in determining vascularity and permeability of primary and secondary brain tumors.

Material And Methods: DSC-PWI and CTP studies from 97 patients with high-grade glioma, low-grade glioma and solitary brain metastasis were retrospectively reviewed. Normalized cerebral blood flow (nCBF), cerebral blood volume (nCBV), capillary transfer constant (nK2) and permeability surface area product (nPS) values were obtained.

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Article Synopsis
  • The study analyzed the relationship between the Careggi Collateral Score (CCS) and radiological outcomes in 1,785 patients who underwent thrombectomy for middle cerebral artery (MCA) occlusions, revealing significant findings.* -
  • CCS scores range from 0 (no retrograde filling) to 4 (extensive collateral flow), with higher scores indicating better radiological outcomes related to infarct growth, cerebral bleeding, and edema at 24 hours post-treatment.* -
  • Ordinal regression analysis showed that lower CCS scores (0-4) were associated with worse outcomes, suggesting that CCS may serve as a useful predictor in assessing the effectiveness of thrombectomy treatments in stroke patients.*
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The Italian Society of Rheumatology clinical practice guidelines for the management of large vessel vasculitis.

Reumatismo

February 2022

Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, Università di Genova, Genoa.

Objective: Since of the last publication of last recommendations on primary large-vessel vasculitis (LVV) endorsed by the Italian Society of Rheumatology (SIR) in 2012, new evidence emerged regarding the diagnosis and the treatment with conventional and biologic immunosuppressive drugs. The associated potential change of clinical care supported the need to update the original recommendations.

Methods: Using the grading of recommendations assessment, development and evaluation (GRADE)-ADOLOPMENT framework, a systematic literature review was performed to update the evidence supporting the European Alliance of Associations for Rheumatology (EULAR) guidelines on LVV as reference.

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Background: The Careggi Collateral Score (CCS) (qualitative-quantitative evaluation) was developed from a single-centre cohort as an angiographic score to describe both the extension and effectiveness of the pial collateral circulation in stroke patients with occlusion of the anterior circulation. We aimed to examine the association between CCS (quantitative evaluation) and 3-month modified Rankin Scale (mRS) score in a large multi-center cohort of patients receiving thrombectomy for stroke with occlusion of middle cerebral artery (MCA).

Methods: We conducted a study on prospectively collected data from 1284 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke.

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Hematoma Expansion in Intracerebral Hemorrhage With Unclear Onset.

Neurology

May 2021

From UO Neurologia (A.M.), Azienda Socio-Sanitaria Territoriale (ASST) Valcamonica, Esine, Italy; Neuroradiology Department (G. Boulouis), Centre Hospitalier Sainte-Anne, Paris, France; J.P. Kistler Stroke Research Center, Department of Neurology (A. Charidimou, Q.L., A.D.W., C.D.A., M.E.G., A.B., A.V., S.M.G., J.R., J.N.G.), Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston; Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica (L.P., A. Pezzini, A. Padovani), Università degli Studi di Brescia; UO di Neurologia (P.C.), Istituto Clinico Fondazione Poliambulanza, Brescia; UOC Neurologia (V.D.G.), ASST Cremona; UC Malattie Cerebrovascolari e Stroke Unit (E.L., F.M., A. Cavallini) and UC Neurologia d'Urgenza (E.L., F.M., G.M.), IRCCS Fondazione Mondino, Pavia; Dipartimento di Dipartimento di Scienze Biomediche, Sperimentali e Cliniche, Neuroradiologia, Università degliStudi di Firenze (G. Busto, E.F.), and Stroke Unit (F.A., A.Z.), Ospedale Universitario Careggi, Firenze; UOC Neurologia e Rete Stroke, Metropolitana (L.B., S.G.), and Unità di Neuroradiologia (L.S.), IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Maggiore; Clinica Neurologica, Dipartimento di Scienze Biomediche e Chirurgico Specialistiche (M.L., I.C.), Università degli studi diFerrara, Ospedale Universitario S. Anna, Ferrara; Neurologia e Stroke Unit (E.C.), Ospedale di Circolo, ASST Settelaghi, Varese; Stroke Unit (M.G., M.M.), Neurologia Vascolare, ASST Spedali Civili, Brescia, Italy; Division of Neurocritical Care and Emergency Neurology, Department of Neurology (C.D.A., J.R., J.N.G.), Harvard Medical School, Henry and Allison McCance Center for Brain Health (C.D.A., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston.

Objective: To investigate the prevalence, predictors, and prognostic effect of hematoma expansion (HE) in patients with intracerebral hemorrhage (ICH) with unclear symptom onset (USO).

Methods: We performed a retrospective analysis of patients with primary spontaneous ICH admitted at 5 academic medical centers in the United States and Italy. HE (volume increase >6 mL or >33% from baseline to follow-up noncontrast CT [NCCT]) and mortality at 30 days were the outcomes of interest.

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Noncanonical type 2B von Willebrand disease associated with mutations in the VWF D'D3 and D4 domains.

Blood Adv

July 2020

Dipartimento di Medicina e Chirurgia Traslazionale, Facoltà di Medicina e Chirurgia Agostino Gemelli, Università Cattolica S. Cuore, Rome, Italy.

We observed a 55-year-old Italian man who presented with mucosal and cutaneous bleeding. Results of his blood analysis showed low levels of von Willebrand factor (VWF) antigen and VWF activity (both VWF ristocetin cofactor and VWF collagen binding), mild thrombocytopenia, increased ristocetin-induced platelet aggregation, and a deficiency of high-molecular-weight multimers, all typical phenotypic hallmarks of type 2B von Willebrand disease (VWD). The analysis of the VWF gene sequence revealed heterozygous in cis mutations: (1) c.

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Response by Morotti and Fainardi to Letter Regarding Article, "Subarachnoid Extension Predicts Lobar Intracerebral Hemorrhage Expansion".

Stroke

August 2020

Dipartimento di Dipartimento di Scienze Biomediche, Sperimentali e Cliniche, Neuroradiologia, Università degli Studi di Firenze, Ospedale Universitario Careggi, Italia (E.F.).

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Subarachnoid Extension Predicts Lobar Intracerebral Hemorrhage Expansion.

Stroke

May 2020

Dipartimento di Dipartimento di Scienze Biomediche, Sperimentali e Cliniche, Neuroradiologia, Università degli Studi di Firenze, Ospedale Universitario Careggi, Firenze, Italia (G.B., E.F.).

Background and Purpose- We investigated whether subarachnoid extension (SAHE) of intracerebral hemorrhage (ICH) is associated with hematoma expansion (HE). Methods- Retrospective analysis of patients with primary spontaneous ICH admitted at 3 academic hospitals in Italy. The study population was divided into a development and a replication cohort.

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