580 results match your criteria: "Policlinico Umberto I "La Sapienza" University of Rome[Affiliation]"

Facial lymphedema (FL) is a potential complication following head-and-neck tumor (HNT) therapy. Conservative management is often difficult, and there is limited literature on surgical treatments for FL. This report presents three cases of FL treated with lymphaticovenular anastomosis (LVA).

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Objectives: This study aims to evaluate the technical and clinical outcomes of the E-nside stent graft for thoraco-abdominal aortic aneurysm (TAAA) and pararenal abdominal aortic aneurysm (PAAA) endovascular treatment at our University Hospital Center.

Methods: We conducted a retrospective analysis of patients electively treated by inner branched EVAR (iBEVAR) between 05/2021 and 03/2023. Demographic, procedural, and clinical data were analyzed.

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Endovascular treatment of lower limb acute DVT: current trends and future directions.

CVIR Endovasc

November 2024

Department of Surgical and Medical Sciences and Translational Medicine School of Medicine and Psychology, "Sapienza" - University of Rome, Rome, Italy.

Unlabelled: AIM OF THE STUDY: This systematic review aims to evaluate the efficacy, safety, and comparative outcomes of endovascular treatments for acute lower limb deep vein thrombosis (DVT), including catheter-directed thrombolysis (CDT), pharmacomechanical thrombectomy (PMT), mechanical thrombectomy, and venous stenting, drawing insights from a diverse range of studies.

Materials And Methods: A comprehensive literature search identified 33 relevant studies, including randomized controlled trials, cohort studies, systematic reviews, and case reports. Data extraction focused on study design, intervention type, outcome measures, and follow-up duration.

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Background: According to the literature, about one third of patients with brain ischemic symptoms lasting <24 h, which are classified as Transient ischemic attacks (TIAs) according to the traditional "time-based" definition, show the presence of acute ischemic lesions at neuroimaging. Recent evidence has shown that the presence of acute ischemic lesions at neuroimaging may impact on the outcome of patients with transient ischemic symptoms treated with dual antiplatelet treatment (DAPT). This uncertainty is even more compelling in recent years as short-term DAPT has become the standard treatment for any non-cardioembolic TIA or minor ischemic stroke.

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Purpose: To evaluate the ability of magnetic resonance imaging (MRI)-based clustering analysis to predict the pathological response to neoadjuvant chemotherapy (NACT) in patients with primary high-grade osteosarcoma.

Materials And Methods: Twenty-two patients were included in this retrospective study. All patients underwent MRIs before and after NACT.

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Purpose: The abundance and distribution of tumor-infiltrating lymphocytes (TILs) as well as that of other components of the tumor microenvironment is of particular importance for predicting response to immunotherapy in lung cancer (LC). We describe here a pilot study employing artificial intelligence (AI) in the assessment of TILs and other cell populations, intending to reduce the inter- or intra-observer variability that commonly characterizes this evaluation.

Design: We developed a machine learning-based classifier to detect tumor, immune, and stromal cells on hematoxylin and eosin-stained sections, using the open-source framework .

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Article Synopsis
  • A study analyzed data from over 65,000 patients who underwent either open partial nephrectomy (OPN) or minimally invasive partial nephrectomy (MIPN) between 2011 and 2021, using a comprehensive insurance claims database.
  • The findings showed a decrease in OPN usage and an increase in MIPN, with 15% of OPN patients experiencing complications compared to 9% for MIPN patients.
  • Social determinants of health (SDOH) significantly influenced postoperative outcomes, with both surgical approaches showing higher complication risks linked to SDOH, but OPN demonstrated a notably higher risk overall.
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  • Excessive heart rates in septic shock patients can negatively impact their health, prompting a study on the use of the ultra-short-acting beta-blocker landiolol to control heart rate without raising the need for vasopressors.
  • Conducted across 20 sites in Europe from 2018 to 2022, the study compared landiolol combined with standard treatment to standard treatment alone in adults with septic shock and high heart rates, focusing on maintaining a target heart rate (80-94 bpm) without increasing vasopressor requirements.
  • Results showed that a higher percentage of patients receiving landiolol achieved the target heart rate compared to those receiving standard treatment (39.8% vs. 23.5%), but there were no
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Characteristics and clinical outcomes of breast cancer in young BRCA carriers according to tumor histology.

ESMO Open

October 2024

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

Article Synopsis
  • Young women with breast cancer have a higher likelihood of carrying harmful BRCA gene variants, but data on tumor histology's prognostic value is limited.
  • A study involving 4,628 patients revealed that lobular tumors are generally diagnosed at a later stage and are more often linked to BRCA2 mutations, while ductal tumors are frequently associated with BRCA1 mutations.
  • Despite differences in tumor characteristics and treatment approaches, the study found no significant differences in disease-free or overall survival between those with ductal and lobular tumors, indicating that histology may not influence prognosis.
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Multiparametric ultrasound evaluation of thyroid nodules.

Ultraschall Med

September 2024

Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo-Patologiche, Umberto I Policlinico di Roma, Italy.

Thyroid nodules are common incidental findings. Most of them are benign, but many unnecessary fine-needle aspiration procedures, core biopsies, and even thyroidectomies or non-invasive treatments have been performed. To improve thyroid nodule characterization, the use of multiparametric ultrasound evaluation has been encouraged by most experts and several societies.

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Mortality in Patients With Sepsis Treated With Esmolol or Landiolol: A Systematic Review and Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis.

Chest

January 2025

Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, Site "Policlinico G. Rodolico", Catania, Italy; Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.

Background: The latest meta-analysis indicated potential survival benefits from ultra-short-acting β-blockers in patients with sepsis with persistent tachycardia. However, subsequent multicenter randomized controlled trials (RCTs) have reported conflicting findings, prompting the need for an updated meta-analysis to incorporate these newly published RCTs.

Research Question: Does the use of ultra-short-acting β-blockers (esmolol or landiolol) in patients with sepsis with persistent tachycardia improve mortality?

Study Design And Methods: We conducted an updated systematic search through April 2, 2024, exploring the MEDLINE, Cochrane Central Register of Controlled Trials, and Embase databases for RCTs reporting mortality in adult patients with sepsis treated with esmolol or landiolol as compared with those treated with neither of these or receiving placebo and published in English.

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Objective: The aim of this study was compare elective surgical repair of popliteal artery aneurysms (PAAs) via a posterior approach vs. endovascular exclusion, analysing early and five year outcomes in a multicentre retrospective study.

Methods: Between January 2010 and December 2023, a retrospectively maintained dataset of all consecutive asymptomatic PAAs that underwent open repair with posterior approach or endovascular repair in 37 centres was investigated.

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Heterozygosity for loss-of-function variants in LZTR1 is associated with isolated multiple café-au-lait macules.

Genet Med

November 2024

Medical Genetics Division, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy. Electronic address:

Purpose: Pathogenic LZTR1 variants cause schwannomatosis and dominant/recessive Noonan syndrome (NS). We aim to establish an association between heterozygous loss-of-function LZTR1 alleles and isolated multiple café-au-lait macules (CaLMs).

Methods: A total of 849 unrelated participants with multiple CaLMs, lacking pathogenic/likely pathogenic NF1 and SPRED1 variants, underwent RASopathy gene panel sequencing.

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The aim of our study is to evaluate the effectiveness and safety of a sutureless off-clamp robot-assisted partial nephrectomy (sl-oc RAPN), particularly its impact on renal function. A multicenter study was conducted from April 2021 to June 2022. Patients diagnosed with a renal mass of >2 cm and a PADUA score of ≤6 consecutively underwent an sl-oc RAPN procedure.

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Introduction: This was an observational, retrospective, multicenter study, enrolling elderly patients (>65 years old) treated with ixekizumab with a diagnosis of psoriasis (PsO) and/or psoriatic arthritis (PsA) during the period 2020 to 2023.

Objectives: Efficacy of ixekizumab in elderly patients in the treatment of moderate to severe psoriasis.

Methods: We included 73 patients with psoriasis (32.

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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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Introduction: Bone metastases negatively affect prognosis in patients with advanced renal cell carcinoma (aRCC). We conducted a systematic literature review to identify clinical trial publications including patients with aRCC with and without bone metastases.

Methods: The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) guidelines and registered with PROSPERO (CRD42022355436).

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To compare perioperative outcomes of patients treated with sutureless off-clamp robotic partial nephrectomy (sl-oc RAPN) by either a novice or an expert robotic surgeon at two different institutions. Data concerning two continuous series of patients with cT1-2N0M0 renal tumors treated with sl-oc RAPN either by a novice or an expert surgeon were extracted from prospectively populated institutional databases over the last 4 years. Perioperative outcomes as well as the baseline characteristics of patients and tumors were compared by using χ and Mann-Whitney tests for categorical and continuous variables, respectively.

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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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Background: Receptor activator of nuclear factor kappa-B ligand (RANKL) can directly promote tumor growth and indirectly support tumor immune evasion by altering the tumor microenvironment and immune cell responses. This study aimed to assess the prognostic significance of soluble RANKL in patients with advanced non-small cell lung cancer (NSCLC) receiving programmed cell death 1 (PD1)/programmed death-ligand 1 (PDL1) checkpoint inhibitor therapy.

Methods: Plasma RANKL levels were measured in 100 patients with advanced NSCLC without bone metastases undergoing monotherapy with PD1/PDL1 checkpoint inhibitors.

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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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Background: Prostate cancer (PCa) treatments are associated with a detrimental impact on bone health (BH) and body composition. However, the evidence on these issues is limited and contradictory. This consensus, based on the Delphi method, provides further guidance on BH management in PCa.

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Article Synopsis
  • - Acquired aplastic anemia (AA) is a rare condition involving low blood cell counts and underdeveloped bone marrow, affecting 2-3 people per million in Western countries and more in East Asia.
  • - Treatments for severe aplastic anemia (SAA) have improved significantly, with hematopoietic stem cell transplantation (HSCT) from a matched sibling donor considered the best first-line approach, although alternatives exist if a sibling donor isn't available.
  • - A guideline developed by pediatric hematologists aims to assist healthcare professionals in diagnosing and managing AA in children, based on evidence gathered and discussions held during consensus conferences, including adaptations made due to the COVID-19 pandemic.
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Background: It is generally perceived that minimally invasive nephroureterectomy (MINU), especially in the form of robotic-assisted laparoscopy, is gaining an increasing role in many institutions.

Objective: The aim of our study was to investigate contemporary trends in the adoption of MINU in the United States compared with open nephroureterectomy (ONU).

Methods: Patients who underwent ONU or MINU between 2011 and 2021 were retrospectively analyzed using PearlDiver Mariner, an all-payer insurance claims database.

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Article Synopsis
  • Short-term dual antiplatelet therapy (DAPT) has been shown to be effective in preventing recurrent strokes after minor ischemic stroke or high-risk transient ischemic attack (TIA) in controlled trials, prompting a need to evaluate its real-world efficacy and safety.
  • The READAPT study observed 1,920 patients in a real-world setting, finding that only a small percentage followed strict research protocols; however, the overall rates of stroke or death due to vascular causes were low (3.9%) and serious bleeding events were rare (0.6%).
  • Most patients did not meet the strict criteria of randomized controlled trials, yet DAPT proved to be both effective and safe, especially in patients with lower NIHSS scores and delayed treatment
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