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

Importance: Whether patients with Child-Pugh class B (CP-B) cancer with unresectable hepatocellular carcinoma (uHCC) benefit from active anticancer treatment vs best supportive care (BSC) is debated.

Objective: To evaluate the association of immune checkpoint inhibitor (ICI)-based therapies vs BSC with overall survival (OS) of patients with uHCC and CP-B liver dysfunction.

Design, Setting, And Participants: This retrospective, multicenter, international clinical case series examined data of patients with CP-B with uHCC who were receiving first-line ICI-based regimens from September 2017 to December 2022 whose data were extracted from an international consortium and compared with a cohort of patients with CP-B receiving BSC.

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Background: Personalized radiofrequency (RF) ablation for paroxysmal atrial fibrillation (PAF), adapting the ablation index (AI) to local left atrial wall thickness (LAWT), proved to be highly efficient maintaining high arrhythmia-free survival rates. However, multicentre data are lacking. This multicentre, prospective, non-randomized study was conducted at 5 tertiary hospitals and sought to assess the safety, efficacy, and reproducibility of the LAWT-guided ablation for PAF.

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Background: The TOPAZ-1 phase III trial showed a survival benefit with durvalumab plus gemcitabine and cisplatin in patients with advanced biliary tract cancer (BTC). To understand this combination's real-world efficacy and tolerability, we conducted a global multicenter retrospective analysis of its first-line treatment outcomes.

Methods: We included patients with unresectable, locally advanced, or metastatic BTC treated with durvalumab, gemcitabine, and cisplatin at 39 sites in 11 countries (Europe, the United States, and Asia).

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A randomized phase II trial of Captem or Folfiri as second-line therapy in neuroendocrine carcinomas.

Eur J Cancer

September 2024

Osteoncology and Rare Tumor Center (CDO-TR), IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy; Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Background: Neuroendocrine Carcinomas (NECs) prognosis is poor.No standard second-line therapy is currently recognized after failure of platinum-based first-line treatment. FOLFIRI and CAPTEM regimens have shown promising activity in preliminary studies.

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Article Synopsis
  • * Data from the GIOTTO registry was analyzed, focusing on 657 DMR patients divided based on their EuroSCORE risk level; results indicated higher all-cause mortality associated with a EuroSCORE of 4% or more, as well as specific health factors like low left ventricular ejection fraction.
  • * The findings revealed that over half of the patients with DMR had a low EuroSCORE, and successful M
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Impact of Intraprocedural Mitral Regurgitation and Gradient Following Transcatheter Edge-to-Edge Repair for Primary Mitral Regurgitation.

JACC Cardiovasc Interv

July 2024

Cardiovascular Research Foundation, New York, NY, USA; Department of Clinical Physiology and Echocardiography, Heart Valve Clinic, CHU Lille, Lille, France. Electronic address:

Article Synopsis
  • This study investigates how intraprocedural residual mitral regurgitation (rMR) and mean mitral valve gradient (MPG) affect outcomes for patients with primary mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (TEER).
  • Researchers analyzed data from 1,509 patients in the PRIME-MR registry, focusing on differences in 2-year outcomes based on the severity of rMR and MPG levels.
  • Results indicated that higher levels of rMR (≥2+) were linked to worse clinical outcomes, while MPG did not significantly impact patient prognosis after the procedure.
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Obesity/overweight and its complications are a growing problem in many countries. Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell'Obesità e delle Malattie Metaboliche-SICOB) decided to develop the first Italian guidelines for the endoscopic bariatric treatment of obesity. The creation of SICOB Guidelines is based on an extended work made by a panel of 44 members and a coordinator.

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Background: The primary aims of our cross-sectional observational study were: (i) to determine the prevalence of depressive symptoms in children and adolescents with epilepsy compared to controls and (ii) to explore the difference in depressive symptoms in patients with epilepsy only and those with epilepsy and primary headache as a comorbidity. The secondary objective was to explore parental stress levels.

Methods: 68 pediatric patients aged 6-18 years (44 with epilepsy only and 24 with epilepsy and headache) and 50 controls were recruited.

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Background: The combination of highly localized impedance (LI) and contact force (CF) may improve tissue characterization and lesion prediction during radiofrequency (RF) pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF).

Objective: We report the outcomes of our acute and long-term clinical evaluation of CF-LI-guided PVI in consecutive AF ablation cases from an international multicenter clinical setting.

Methods: Three hundred twenty-four consecutive patients from 20 European centers undergoing RF catheter ablation with the Stablepoint™ catheter were enrolled in the CHARISMA registry.

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Article Synopsis
  • Sinonasal malignancies that invade the orbit have poor prognoses, but a new surgical approach called extended-orbital exenteration (EOE) shows promise in improving outcomes.
  • * A study conducted across three institutions involved 48 orbital dissections and utilized a questionnaire to assess the procedure's feasibility and safety, with feedback from 25 surgeons.
  • * The findings indicate that while endoscopic-EOE is challenging, it is a feasible procedure that needs further clinical validation to evaluate its effectiveness in real-life situations.
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Background Spinal metastatic disease is a silent progressive cancer complication with an increasing prevalence worldwide. The spine is the third most common site where solid tumors metastasize. Complications involved in spinal metastasis include root or spinal cord compression, progressing to a declining quality of life as patient autonomy reduces and pain increases.

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Article Synopsis
  • Pure germinoma is a rare brain tumor that usually starts in the middle of the brain; sometimes it can be found in two places at once or outside the usual spots, which is very uncommon.
  • Researchers reviewed many studies to look at how doctors diagnose and treat patients with these rare brain tumors and to find ways to help them faster.
  • The review showed that most patients needed a biopsy (taking a small sample for testing), and many had these tumors in unusual places, which can make it hard to find and treat them quickly.
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Background: Although nivolumab prolongs overall survival (OS) in pretreated patients with metastatic renal cell carcinoma (mRCC), underlining clinical and biological features of long-term responses are still to be determined. This study aims to investigate clinical and pathological characteristics of mRCC patients who achieved long-term responses during nivolumab treatment.

Materials And Methods: A retrospective analysis was performed on mRCC patients receiving nivolumab as second or further therapy line between May 2016 and January 2019 in 34 Italian Oncology Centres.

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Background: Right ventricular impairment is common among patients undergoing transcatheter edge-to-edge repair for secondary mitral regurgitation (SMR). Adherence to guideline-directed medical therapy (GDMT) for heart failure is poor in these patients.

Objectives: The aim of this study was to evaluate the impact of GDMT on long-term survival in this patient cohort.

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Background: Pancreatic cancer (PC) first-line therapy often consists of polychemotherapy regimens, but choosing a second-line therapy after disease progression, especially following first-line FOLFIRINOX, remains a clinical challenge. This study presents results from a large, multicenter, retrospective analysis of Italian patients with metastatic PC (mPC) treated with Nab-paclitaxel/Gemcitabine (AG) as second or later line of treatment. Main objective of the study is to identify prognostic factors that could inform treatment decisions.

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Antifungal Drug Usage in European Neonatal Units: A Multicenter Weekly Point Prevalence Study.

Pediatr Infect Dis J

November 2024

From the Infectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece.

Background: Data on antifungal prescribing in neonatal patients are limited to either single-center or single-country studies or to 1-day recording. Therefore, we assessed antifungal longitudinal usage in neonatal units (NUs) within Europe.

Methods: CALYPSO, a prospective weekly point prevalence study on antifungal drug usage in NUs in 18 hospitals (8 European countries), was conducted in 2020 during a 12-week period.

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Article Synopsis
  • About 5% of non-small cell lung cancer (NSCLC) involves anaplastic lymphoma kinase (ALK) rearrangements, with EML4-ALK fusions being the most common type.
  • Targeting ALK has improved survival rates for patients with advanced ALK-positive NSCLC, but resistance to treatment and disease progression still occurs.
  • The tumor immune microenvironment (TIME) is crucial for understanding lung cancer development and treatment responses, shifting the focus from just tumor cells to the whole tumor ecosystem.
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Impact of hormone receptor status and tumor subtypes of breast cancer in young BRCA carriers.

Ann Oncol

September 2024

Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy; Medical Oncology Department, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy. Electronic address:

Background: Hormone receptor expression is a known positive prognostic and predictive factor in breast cancer; however, limited evidence exists on its prognostic impact on prognosis of young patients harboring a pathogenic variant (PV) in the BRCA1 and/or BRCA2 genes.

Patients And Methods: This international, multicenter, retrospective cohort study included young patients (aged ≤40 years) diagnosed with invasive breast cancer and harboring germline PVs in BRCA genes. We investigated the impact of hormone receptor status on clinical behavior and outcomes of breast cancer.

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Objective: Wide variations exist in the use of pulmonary artery catheters (PACs) and echocardiography in the field of cardiac surgery.

Design: A national survey promoted by the Italian Association of Cardio-Thoracic Anesthesiologists and Intensive Care was conducted.

Setting: The study occurred in Italian cardiac surgery centers (n = 71).

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The treatment landscape for metastatic renal cell carcinoma (mRCC) has undergone significant transformations in recent years. The introduction of novel combination therapies involving tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors has resulted in improved oncological outcomes compared to traditional TKI monotherapy. In this evolving paradigm, the pivotal role of the multidisciplinary tumor board is underscored, particularly in shaping the therapeutic trajectory for patients eligible for locoregional interventions like cytoreductive nephrectomy and metastasectomy.

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Hypothyroidism and metabolic cardiovascular disease.

Front Endocrinol (Lausanne)

June 2024

Department of Clinical and Experimental Medicine-Endocrinology, University of Messina, Messina, Italy.

Cardiovascular disease (CVD) remains the leading cause of death worldwide, representing a major health issue of social and economic relevance. Both hyperthyroidism and hypothyroidism are very common in the adult population, and both disorders may contribute to the onset and progression of CVD. After a brief description of the role of thyroid hormones (THs) on the physiology of the cardiovascular system and the potential mechanism that links THs alterations with changes in cardiac function, blood pressure, endothelial function, and lipid levels, we review updated data about the clinical impact of overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) on CV risk, CVD, and mortality.

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Prevalence and target attainment of traditional cardiovascular risk factors in patients with systemic lupus erythematosus: a cross-sectional study including 3401 individuals from 24 countries.

Lancet Rheumatol

July 2024

Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece. Electronic address:

Article Synopsis
  • Systemic lupus erythematosus (SLE) significantly increases the risk of cardiovascular disease, prompting a study to evaluate traditional cardiovascular risk factors in SLE patients worldwide between 2015 and 2020.
  • The study included 3,401 SLE patients from 24 countries, predominantly women, revealing high rates of hypertension (35.6%), obesity (23.7%), and hyperlipidaemia (19.8%), with poor control of these risk factors across the board.
  • Notably, patients with antiphospholipid syndrome had higher prevalence of cardiovascular risks but showed better control of blood pressure and lipid levels compared to those without, highlighting international discrepancies in risk factor management.
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Article Synopsis
  • Lateral suspension is a surgical procedure designed to fix apical prolapse by placing T-shaped mesh in the abdomen, but there’s no consensus on its safety or indications.
  • A Delphi process involved 21 international expert surgeons discussing and reaching agreement on various aspects of laparoscopic lateral suspension (LLS) through rounds of statements and discussions.
  • The consensus highlighted LLS as a safe and effective method for treating pelvic organ prolapse, along with key technical details and indications for the procedure.
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Background: In patients complaining common symptoms such as chest/abdominal/back pain or syncope, acute aortic syndromes (AAS) are rare underlying causes. AAS diagnosis requires urgent advanced aortic imaging (AAI), mostly computed tomography angiography. However, patient selection for AAI poses conflicting risks of misdiagnosis and overtesting.

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Acute normovolemic hemodilution in cardiac surgery: Rationale and design of a multicenter randomized trial.

Contemp Clin Trials

August 2024

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.

Article Synopsis
  • The study evaluates acute normovolemic hemodilution (ANH) as a method to decrease the need for red blood cell (RBC) transfusions in patients undergoing elective cardiac surgery, aiming to reduce associated risks and costs.
  • It is a randomized controlled trial conducted in various hospitals, where patients are assigned to either receive ANH before surgery or the best available alternative treatment.
  • The primary goal is to see if ANH lowers the percentage of patients requiring RBC transfusion from 35% to 28%, with secondary outcomes including mortality and complications related to kidney and bleeding issues.
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