Immunonutrition to improve the quality of life of upper gastrointestinal cancer patients undergoing neoadjuvant treatment prior to surgery (NEOIMMUNE): double-blind randomized controlled multicenter clinical trial.

Background: Malnutrition is common with esophagogastric cancers and is associated with negative outcomes. We aimed to evaluate if immunonutrition during neoadjuvant treatment improves patient's health-related quality of life (HRQOL) and reduces postoperative morbidity and toxicities during neoadjuvant treatment.

Methods: A multicenter double-blind randomized controlled trial (RCT) was undertaken.

Leveraging Epigenetic Alterations in Pancreatic Ductal Adenocarcinoma for Clinical Applications.

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy characterized by late detection and poor prognosis. Recent research highlights the pivotal role of epigenetic alter- ations in driving PDAC development and progression. These changes, in conjunction with genetic mutations, contribute to the intricate molecular landscape of the disease.

Real-World Impact of Olaparib Exposure in Advanced Pancreatic Cancer Patients Harboring Germline BRCA1-2 Pathogenic Variants.

Introduction: Pancreatic cancer arising in the context of BRCA predisposition may benefit from poly(ADP-ribose) polymerase inhibitors. We analyzed real-world data on the impact of olaparib on survival in metastatic pancreatic cancer patients harboring germline BRCA mutations in Italy, where olaparib is not reimbursed for this indication.

Methods: Clinico/pathological data of pancreatic cancer patients with documented BRCA1-2 germline pathogenic variants who had received first-line chemotherapy for metastatic disease were collected from 23 Italian oncology departments and the impact of olaparib exposure on overall survival (OS) was analyzed.

The Interplay Between Gut Microbiota, Adipose Tissue, and Migraine: A Narrative Review.

Background: Migraine, a prevalent neurovascular disorder, affects millions globally and is associated with significant morbidity. Emerging evidence suggests a crucial role of the gut microbiota and adipose tissue in the modulation of migraine pathophysiology, particularly through mechanisms involving neuroinflammation and metabolic regulation.

Material And Methods: A narrative review of the literature from 2000 to 2024 was conducted using the PubMed database.

Hormonal Contraception and Bone Metabolism: Emerging Evidence from a Systematic Review and Meta-Analysis of Studies on Post-Pubertal and Reproductive-Age Women.

Background/objectives: This study aims to assess the effects of combined hormonal contraceptives (CHCs) on bone metabolism markers. It primarily measures osteocalcin and additionally examines other bone health markers, seeking to determine their responses to estrogen-progestogen treatments.

Methods: This study involved a comprehensive evaluation of the pertinent literature and a meta-analysis explicitly conducted on data describing women of reproductive age.

EEG Abnormalities and Phenotypic Correlates in Preschoolers with Autism Spectrum Disorder: A Single-Center Study.

The literature suggests the existence of an association between autism spectrum disorders (ASDs) and subclinical electroencephalographic abnormalities (SEAs), which show a heterogeneous prevalence rate (12.5-60.7%) within the pediatric ASD population.

Pelvic Floor Muscle Training vs. Vaginal Vibration Cone Therapy for Postpartum Dyspareunia and Vaginal Laxity.

Pelvic floor dysfunction and sexual health issues are common postpartum due to weakened pelvic muscles, significantly impacting women's quality of life (QoL). Pelvic floor muscle training (PFMT) is a widely used approach to address these issues. This study aimed to compare the effectiveness of two rehabilitation methods-vibrating vaginal cones (VCG) and PFMT exercises (CG)-in improving pelvic floor muscle strength, reducing dyspareunia, and enhancing sexual function in postpartum women.

Diagnostic Performance of PIVKA-II in Italian Patients with Hepatocellular Carcinoma.

Background And Aims: Hepatocellular carcinoma (HCC) represents the second leading cause of cancer deaths worldwide. Six-month imaging along with alpha-fetoprotein (AFP) serum levels detection are the current gold standard to exclude HCC. Protein induced by vitamin K absence (PIVKA-II) has been proposed as a potential screening biomarker for HCC.

Cartilage defect identification on computed tomography arthrography in equine fetlock: Ex-vivo study.

CT arthrography (CTA) for evaluating cartilage defects would be beneficial in clinical practice. Since the contrast medium (CM) volume is often driven by operator experience, the aim was to evaluate the minimum volume of iodinated CM for CTA sufficient to identify iatrogenic cartilage defects in horse fetlock. The study was conducted on ex-vivo 32 distal limbs from adult horses collected at slaughter.

Causes of Sleep Disturbance in Early ASAS Spondyloarthritis: A Retrospective Long-Term Experience.

Sleep disturbance (SD) in the second half of the night due to inflammatory pain was included in the 2009 ASAS classification criteria of Spondyloarthritis (SpA), even though its definition is uncertain. We aimed to investigate SD in early-SpA (e-SpA) patients at T1 (2010-2013), comparing them to long-term SpA (l-SpA) patients at T2 (2023-2024) after at least 10 years of follow-up. At T1, in e-SpA and l-SpA cases, SD, classified as "difficulty in initiating sleep" (DIS), "difficulty in maintaining sleep" (DMS) and "early awakening" (EA), was compared to clinical parameters (ASDAS-CRP, BASDAI, m-HAQ-S, BASMI, MASES, 68/66 joint count, tenderness of sacroiliac joints, fatigue [FACIT] and HADS for anxiety [A] and depression [D]).

Prostatic Artery Embolization in Elderly Comorbid Patients with Benign Prostatic Hyperplasia: Safety, Efficacy, and Predictive Factors of Clinical Failure.

: This study aims to evaluate the safety and efficacy of prostatic artery embolization (PAE) in elderly, multimorbid patients with benign prostatic hyperplasia (BPH). Additionally, it seeks to identify technical and clinical factors that predict clinical failure at the mid-term follow-up. : We analyzed the clinical records of 175 consecutive patients who underwent PAE.

Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled Trials.

Background: Immune checkpoint inhibitors (ICIs), either alone or in combination with platinum-based chemotherapy, are effective in the first-line treatment of metastatic, non-oncogene-addicted, non-small cell lung cancer (NSCLC). However, when NSCLC patients progress, the efficacy of available treatment options is limited.

Methods: We undertook a meta-analysis that compared combination regimens with the current standard of care.

Long-Term Oncological Outcomes Related to Lymphadenectomy in Clinical Stage I NSCLC: A Multicenter Retrospective Experience.

Background: Lymphadenectomy is considered a key part of the radical treatment of resectable lung cancer, although its appropriate extension in early stages is a debated topic due to the great heterogeneity of studies in the literature. This study aims to evaluate the impact of lymphadenectomy extent on survival and recurrence in the treatment of early-stage NSCLC patients undergoing lobectomy and lymph node dissection.

Methods: Data from clinical stage I NSCLC patients undergoing lobectomy and hilar-mediastinal lymphadenectomy at two thoracic surgery centers from 2016 to 2019 were retrospectively evaluated.

Transesophageal echocardiography monitoring for liver transplantation: where are we now?

Intraoperative hemodynamic monitoring is crucial for managing patients with end-stage liver disease (ESLD) undergoing orthotopic liver transplantation (OLT) due to their complex cardiovascular and pulmonary abnormalities. Traditionally, pulmonary artery catheterization (PAC) has been the standard for hemodynamic monitoring during OLT. However, the use of transesophageal echocardiography (TEE) has increased due to its real-time visualization of cardiac and vascular structures, which aids in managing hemodynamic instability during the three surgical phases of OLT: pre-anhepatic, anhepatic, and neo-hepatic.

Esteem body convexity algorithm to prevent leakages in patient with an ostomy: results of an Italian expert opinion.

Stoma surgery is frequently used to treat conditions such as colorectal cancer and inflammatory diseases. While it can extend patients' lives, it often introduces challenges that negatively affect quality of life. Convex skin barriers are commonly recommended for managing flat or retracted stomas and addressing irregular peristomal surfaces, such as creases or folds.

Unconventional use of injectable long-acting cabotegravir and rilpivirine against HIV-1 in PWH in clinical need: 52 weeks real-world data.

Background: Long-acting Cabotegravir and Rilpivirine (LA CAB + RPV) shows potential advantages in heavily comorbid and even in viremic people with HIV (PWH). We assessed LA CAB + RPV durability in a cohort of PWH with a high comorbidity burden and adherence issues.

Methods: Retrospective observational study in two Italian outpatient settings enrolling PWH who switched to LA CAB + RPV from February 2021 to January 2024 in presence of exclusion criteria enlisted in registrational trials or with other worrisome clinical risks.

REVEAL-CP: Selective Screening of Pediatric Patients for Aromatic L-Amino Acid Decarboxylase Deficiency with a Guthrie Card and Structural Modeling of One Index Case.

The main objective of this prospective, multicenter study (REVEAL-CP) was to test children with cerebral palsy-like signs and symptoms for raised 3--methyldopa (3-OMD) blood levels, a biomarker for aromatic L-amino acid decarboxylase deficiency (AADCd). A secondary objective was to characterize the molecular basis for the defective aromatic L-amino acid decarboxylase (AADC) gene product. Patients were identified in pediatric secondary and tertiary care hospitals through database searches and personal communication.

Home-Based Intervention Tool for Cardiac Telerehabilitation: Protocol for a Controlled Trial.

Background: Among cardiovascular diseases, adult patients with congenital heart disease represent a population that has been continuously increasing, which is mainly due to improvement of the pathophysiological framing, including the development of surgical and reanimation techniques. However, approximately 20% of these patients will require surgery in adulthood and 40% of these cases will necessitate reintervention for residual defects or sequelae of childhood surgery. In this field, cardiac rehabilitation (CR) in the postsurgical phase has an important impact on the patient by improving psychophysical and clinical recovery in reducing fatigue and dyspnea to ultimately increase survival.

Clinical Phenotype and Prognosis of Asymptomatic Patients With Transthyretin Cardiac Amyloid Infiltration.

Importance: Patients with transthyretin (ATTR) cardiac amyloid infiltration are increasingly diagnosed at earlier disease stages with no heart failure (HF) symptoms and a wide range of cardiac amyloid infiltration.

Objective: To characterize the clinical phenotype and natural history of asymptomatic patients with ATTR cardiac amyloid infiltration.

Design, Setting, And Participants: This cohort study analyzed data of all patients at 12 international centers for amyloidosis from January 1, 2008, through December 31, 2023.

Classification of paravertebral muscle trophism and its correlation with thoraco-lumbar fascia thickening in patients with chronic low back pain.

Objective: The aim of this work is to demonstrate how the chronicity of low back pain can modify the trophism of the paraspinal muscles, by performing an ultrasound and MRI evaluation of the paraspinal muscles in the lumbar spine and correlating it to the time of onset of low back pain.

Materials And Methods: An ultrasound evaluation was carried out in the lumbar area with a 5-17 MHz linear probe of the paraspinal muscles of the lumbar region, compared with the MRI of the lumbar spine, in patients presented to our attention for chronic low back pain (> 6 months), from January 2021 to January 2023. In each patient, two series of images were analyzed, in the coronal and sagittal planes.

How to perform and evaluate a myocardial perfusion imaging by computed tomography.

Stress computed tomography perfusion (CTP) delivers a comprehensive evaluation of both the anatomical and functional aspects in a single examination. It stands out as the only non-invasive technique capable of quantifying coronary stenosis and assessing its functional impact, offering a consolidated diagnostic and management approach for patients with confirmed or suspected coronary artery disease (CAD). This very practical review ('How to.