1,097 results match your criteria: "Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana"[Affiliation]"

Suboptimal outcomes of sorafenib as a second-line treatment after atezolizumab-bevacizumab for unresectable hepatocellular carcinoma.

Dig Liver Dis

December 2024

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Unit of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Background: Most patients receiving atezolizumab-bevacizumab (AB) for hepatocellular carcinoma will eventually experience disease progression. Randomized clinical trials (RCTs) are undergoing to identify second-line treatments. Where RCTs are unavailable or patients are non-eligible, sorafenib is often prescribed based on approval and reimbursement policies.

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Learning curve stratified outcomes after robotic pancreatoduodenectomy: International multicenter experience.

Surgery

December 2024

Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy; Department of Surgery, University Hospital Southampton NHS, United Kingdom. Electronic address:

Article Synopsis
  • Robotic pancreatoduodenectomy is gaining popularity globally, with positive outcomes reported, but more large-scale studies are needed to assess the impact of the learning curve on these results.* -
  • An extensive study was conducted involving 2,186 patients from 18 centers in 8 countries, analyzing the learning curve and its effects on feasibility (operative time and blood loss) and proficiency (complications and morbidity).* -
  • Findings revealed that a significant reduction in major morbidity occurred after 90 procedures, with improved outcomes across the board, while mortality rates remained steady throughout different experience levels among centers.*
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Article Synopsis
  • Lymphocytic esophagitis (LyE) and eosinophilic esophagitis (EoE) are both immune-mediated diseases affecting the esophagus, but they have distinct clinical features and treatment outcomes.
  • An international retrospective study examined 35 LyE patients compared to 59 EoE patients, focusing on their demographics, symptoms, and endoscopic findings.
  • The study found that LyE patients responded less effectively to proton pump inhibitors and highlighted the need for more research on the treatment differences between the two conditions.
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Background And Aims: Lipids constitute one of the main components of atherosclerosis lesions and are the mediators of many mechanisms involved in plaque progression and stability. Here we tested the hypothesis that lipids known to be involved in plaque development exhibited associations with plaque vulnerability. We used spatial lipidomics to overcome plaque heterogeneity and to compare lipids from specific regions of symptomatic and asymptomatic human carotid atherosclerotic plaques.

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Article Synopsis
  • A panel of Italian intensive care specialists explored the use of angiotensin II (ATII) in treating distributive shock, considering patient factors and the effectiveness of existing treatment protocols.
  • They employed a modified Delphi technique to establish consensus on clinical questions and statements related to ATII, resulting in agreement on 13 key statements from a survey.
  • The panel concluded that ATII could be beneficial for specific patients, particularly those with reduced angiotensin-converting enzyme activity or high renin levels, while also noting potential barriers to its use.
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We know of few studies in the international scientific literature that specifically address the evaluation of surgical and clinical progress among physicians undergoing specialist training in maxillofacial surgery. Identifying a reliable tool to accurately assess both theoretical knowledge and surgical skills of trainees is essential. The primary aim of this study therefore was to design a comprehensive assessment tool that is capable of evaluating both the theoretical and practical skills of physicians undergoing specialist training in maxillofacial surgery.

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Acyl-CoA binding protein for the experimental treatment of anorexia.

Sci Transl Med

August 2024

Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Inserm U1138, Université Paris Cité, Sorbonne Université, 75006 Paris, France.

Extracellular acyl-coenzyme A binding protein [ACBP encoded by diazepam binding inhibitor (DBI)] is a phylogenetically ancient appetite stimulator that is secreted in a nonconventional, autophagy-dependent fashion. Here, we show that low ACBP/DBI plasma concentrations are associated with poor prognosis in patients with anorexia nervosa, a frequent and often intractable eating disorder. In mice, anorexia induced by chronic restraint stress (CRS) is accompanied by a reduction in circulating ACBP/DBI concentrations.

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Epilepsy after acute central nervous system complications of pediatric hematopoietic cell transplantation: A retrospective, multicenter study.

Seizure

October 2024

IRCCS Istituto delle Scienze Neurologiche di Bologna, U.O.C. Neuropsichiatria dell'età pediatrica, Member of the ERN EpiCare, Bologna, , Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy. Electronic address:

Article Synopsis
  • The study investigates long-term epilepsy outcomes in pediatric patients who experienced acute central nervous system complications during hematopoietic cell transplantation (HCT).
  • Data was collected from 94 patients, revealing that common acute complications included posterior reversible encephalopathy syndrome and infections, with a notable incidence of acute symptomatic seizures.
  • Findings indicate that 9.6% of patients were diagnosed with long-term epilepsy, especially those who experienced acute symptomatic status epilepticus, highlighting the need for specialized neurological follow-up in these cases.
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Head and neck squamous cell carcinomas are characterized by a high incidence of recurrence, especially in patients with locally advanced disease. Standard treatment strategies can be associated with severe side effects to healthy tissues that can negatively impact the patient's quality of life. Hyperthermia (HT) is a noninvasive treatment modality that has improved the effectiveness of chemotherapy (CT) and/or radiotherapy (RT) for the management of some solid neoplasms.

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Intraoperative surgical navigation as a precision medicine tool in sinonasal and craniofacial oncologic surgery.

Oral Oncol

October 2024

Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy; Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, Canada. Electronic address:

Introduction: Recent evidence supports the efficacy of surgical navigation (SN) in improving outcomes of sinonasal and craniofacial oncologic surgery. This study aims to demonstrate the utility of SN as a tool for integrating surgical, radiologic, and pathologic information. Additionally, a system for recording and mapping biopsy samples has been devised to facilitate sharing of spatial information.

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Background: Emergency Departments (EDs) across Italy use different triage systems, which vary from region to region. This study aimed to assess whether nurses working in different EDs assign triage codes in a similar and standardized manner.

Methods: A multicenter observational simulation study involved the EDs of Bolzano Hospital, Merano Hospital, Pisa University Hospital, and Rovereto Hospital.

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The Role of the Autonomic Nervous System in Epilepsy and Migraine: A Narrative Review.

J Integr Neurosci

July 2024

Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, Sant'Andrea Hospital, 00198 Rome, Italy.

Autonomic symptoms may be local and general clinical manifestations of both epilepsy and migraine caused by the dysfunction of brain areas best known as the central autonomic network. Despite their prevalence, autonomic signs are often misdiagnosed and their treatment is undervalued. This review aims to describe the autonomic manifestations reported during seizures and migraineur attacks according to their presentation, focusing on the role of the central autonomic network (CAN) and on the parasympathetic outflow that often-induced cranial autonomic symptoms (CAS) during migraineur attacks.

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Radiomics of cardiac magnetic resonance (MR) imaging has proved to be potentially useful in the study of various myocardial diseases. Therefore, assessing the repeatability degree in radiomic features measurement is of fundamental importance. The aim of this study was to assess test-retest repeatability of myocardial radiomic features extracted from quantitative T1 and T2 maps.

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Introduction: The integration of augmented reality (AR) in spine surgery marks a significant advancement, enhancing surgical precision and patient outcomes. AR provides immersive, three-dimensional visualizations of anatomical structures, facilitating meticulous planning and execution of spine surgeries. This technology not only improves spatial understanding and real-time navigation during procedures but also aims to reduce surgical invasiveness and operative times.

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The limited availability of specialized image databases (particularly in hospitals, where tools vary between providers) makes it difficult to train deep learning models. This paper presents a few-shot learning methodology that uses a pre-trained ResNet integrated with an encoder as a backbone to encode conditional shape information for the classification of neonatal resuscitation equipment from less than 100 natural images. The model is also strengthened by incorporating a reliability score, which enriches the prediction with an estimation of classification reliability.

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Background: To date, only two studies have compared the outcomes of patients with liver-limited BRAF V600E-mutated colorectal liver metastases (CRLMs) managed with resection versus systemic therapy alone, and these have reported contradictory findings.

Methods: In this observational, international, multicentre study, patients with liver-limited BRAF V600E-mutated CRLMs treated with resection or systemic therapy alone were identified from institutional databases. Patterns of recurrence/progression and overall survival were compared using multivariable analyses of the entire cohort and a propensity score-matched cohort.

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Gender medicine and sleep disorders: from basic science to clinical research.

Front Neurol

July 2024

Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center and Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.

Article Synopsis
  • There are key differences in sleep patterns and disorders between women and men, influenced by hormonal changes related to reproductive stages like pregnancy and menopause.
  • Women tend to experience more insomnia and report symptoms like fatigue and mood swings more often than men.
  • The review emphasizes the necessity for clinicians and researchers to consider these gender differences in sleep disorders and evaluates current research on women's sleep health.
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Impact of heart failure severity on the mortality benefit of mitral transcatheter edge-to-edge valve repair.

Clin Res Cardiol

July 2024

Division of Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

Article Synopsis
  • Researchers studied how heart failure (HF) affects death rates in patients getting a special heart valve repair called M-TEER, focusing on a condition called secondary mitral regurgitation (SMR).
  • They found that patients with advanced HF (serious heart problems) had a higher chance of dying in the next two years, but those who got much better SMR results had lower death risks.
  • The results showed that improving SMR is important for all patients, whether their heart failure is advanced or not, as it can help them live longer.
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Cardiovascular imaging research and innovation in 2023.

Eur Heart J Imaging Methods Pract

January 2024

Cardiology and Cardiovascular Medicine Department, Fondazione Toscana Gabriele Monasterio, Via Moruzzi, 1, Pisa 56124, Italy.

In 2023, cardiovascular imaging has made significant advancements, in terms of technology, pathophysiology, and clinical application. In this review, the most recent research findings in the field of cardiovascular imaging are discussed. Artificial intelligence and large population cohorts, together with several technical improvements, have had a crucial impact on the technological advancements of echocardiography, cardiovascular magnetic resonance, computed tomography (CT), and nuclear medicine.

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Graves disease: latest understanding of pathogenesis and treatment options.

Nat Rev Endocrinol

November 2024

U.O. Endocrinologia II, Azienda Ospedaliero Universitaria Pisana, University Hospital of Pisa, Pisa, Italy.

Graves disease is the most common cause of hyperthyroidism in iodine-sufficient areas. The main responsible mechanism is related to autoantibodies that bind and activate the thyrotropin receptor (TSHR). Although Graves hyperthyroidism is relatively common, no causal treatment options are available.

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Background: Immune-checkpoint inhibitors (ICIs) have significantly improved metastatic renal cell carcinoma (mRCC) prognosis, although their efficacy in patients with bone metastases (BMs) remains poorly understood. We investigated the prognostic role of natremia in pretreated RCC patients with BMs receiving immunotherapy.

Materials And Methods: This retrospective multicenter study included RCC patients with BMs receiving nivolumab as second-line therapy or beyond.

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Introduction: The administration of proton pump inhibitors (PPIs) is a common practice to reduce gastro-esophageal adverse events associated with drug treatments but may impair absorption and exposure to oncology drugs. This study investigated the effect of concomitant administration of PPIs and pazopanib, sunitinib and cabozantinib on survival of patients with metastatic clear cell renal carcinoma (mRCC).

Patients And Methods: Total 451 patients receiving pazopanib, sunitinib and cabozantinib as first line treatment were enrolled in this retrospective study.

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Article Synopsis
  • The study investigates the impact of hepatic functional reserve and tumor progression on overall survival in patients with hepatocellular carcinoma (HCC) undergoing combination immunotherapy with atezolizumab and bevacizumab.
  • Out of 571 patients analyzed, a significant portion developed tumor progression, while a smaller group experienced hepatic decompensation, both of which greatly affected survival outcomes.
  • Key predictors of poor survival included hepatic decompensation, advanced tumor progression, and specific baseline liver function metrics, with effective antiviral treatment showing potential protective effects against decompensation in patients with viral causes of HCC.
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