246 results match your criteria: "S Martino Hospital[Affiliation]"

Critically ill adult patients with acute leukemia: a systematic review and meta-analysis.

Ann Intensive Care

January 2025

Medical Intensive Care Unit, Saint-Louis Teaching Hospital, Paris University, 1 Avenue Claude Vellefaux, Paris, 75010, France.

Background: To describe the use of life-sustaining therapies and mortality in patients with acute leukemia admitted to the intensive care unit (ICU).

Methods: The PubMed database was searched from January 1st, 2000 to July 1st, 2023. All studies including adult critically ill patients with acute leukemia were included.

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Benralizumab is an anti-IL-5 receptor alpha monoclonal antibody that induces the near-complete depletion of eosinophils. This study aimed to evaluate the long-term safety and effectiveness of benralizumab in patients with severe eosinophilic asthma (SEA) over an extended 48-month follow-up period, offering one of the longest real-world perspectives available. This was a single-arm, retrospective, observational, multicenter study involving 123 SEA patients treated with benralizumab at a dosage of 30 mg every 4 weeks for the first 3 doses and then every 8 weeks.

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Purpose: Prostate cancer treatments paradigms are in continuous evolution, especially in the metastatic setting. In this context, the Genito-Urinary Group of Italian Association of Radiotherapy and Clinical Oncology aimed to create a consensus on radiation therapy indication in de novo metastatic hormone-sensitive prostate cancer both on primary tumor and metastatic sites.

Methods: A panel of experts, involved in clinical management of prostate cancer, through the estimate-talk-estimate method, developed a list of items and correspondent statements on the identified topic.

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The kidney in acute respiratory distress syndrome: victim or partner in crime?

Intensive Care Med

August 2024

Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

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Article Synopsis
  • This clinical practice guideline from the European Society of Intensive Care Medicine focuses on the choice of resuscitation fluids for critically ill adult patients, with two more parts planned to address fluid volume and removal.
  • An international panel of experts used the GRADE methodology to assess the evidence and guide their recommendations.
  • The guideline offers conditional recommendations favoring crystalloids over albumin in various patient scenarios, while also addressing specific cases with varying levels of evidence certainty, such as traumatic brain injury and cirrhosis.
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Aims And Scope: The aim of this panel was to develop consensus recommendations on targeted temperature control (TTC) in patients with severe traumatic brain injury (TBI) and in patients with moderate TBI who deteriorate and require admission to the intensive care unit for intracranial pressure (ICP) management.

Methods: A group of 18 international neuro-intensive care experts in the acute management of TBI participated in a modified Delphi process. An online anonymised survey based on a systematic literature review was completed ahead of the meeting, before the group convened to explore the level of consensus on TTC following TBI.

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Consistency of data reporting in fluid responsiveness studies in the critically ill setting: the CODEFIRE consensus from the Cardiovascular Dynamic section of the European Society of Intensive Care Medicine.

Intensive Care Med

April 2024

DMU CORREVE, Inserm UMR S_999, FHU SEPSIS, Groupe de Recherche Clinique CARMAS, Université Paris-Saclay, AP-HP, Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.

Article Synopsis
  • The purpose of the project was to come up with guidelines for reporting important data about patients' fluids in the ICU.
  • A group of 18 experts worked together to identify key areas and created recommendations through several voting rounds.
  • They ended up with 52 specific recommendations about fluid management for patients in the ICU, covering topics like why fluids are given and how to measure their effects.
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Awake prone positioning in acute hypoxaemic respiratory failure: An international expert guidance.

J Crit Care

December 2023

Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals and School of Medicine, University of Galway, Galway, Ireland. Electronic address:

Background: Awake prone positioning (APP) of non-intubated patients with acute hypoxaemic respiratory failure (AHRF) has been inconsistently adopted into routine care of patients with COVID-19, likely due to apparent conflicting evidence from recent trials. This short guideline aims to provide evidence-based recommendations for the use of APP in various clinical scenarios.

Methods: An international multidisciplinary panel, assembled for their expertise and representativeness, and supported by a methodologist, performed a systematic literature search, summarized the available evidence derived from randomized clinical trials, and developed recommendations using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology.

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Article Synopsis
  • The guidelines aim to update the 2017 clinical practice guideline (CPG) from the European Society of Intensive Care Medicine (ESICM), focusing on adult patients with acute respiratory distress syndrome (ARDS), including cases related to COVID-19.
  • An international panel of clinical experts collaborated to create these guidelines, using established methods like the PRISMA statement for systematic reviews and the GRADE approach for assessing evidence quality and making recommendations.
  • The CPG responds to 21 specific questions and offers recommendations across several areas, such as respiratory support strategies (like high-flow nasal cannula and non-invasive ventilation) and includes expert opinions on clinical practices and future research directions.
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Background: Placement of dental implants into fresh extraction sockets offers some advantages, such as reduced treatment times and enhanced patient comfort. The Er,Cr:YSGG (Erbium, Chromium-doped: Yttrium, Scandium, Gallium, and Garnet) laser can significantly reduce bacterial concentration after the extraction of a compromised tooth. The aim of this article is to provide a clinical protocol for the management of implants placed in infected extraction sites decontaminated with Er,Cr:YSGG laser.

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Article Synopsis
  • * Genetic analysis revealed that certain single-nucleotide polymorphisms (SNPs) related to drug transport and receptor genes can predict the effectiveness and safety of lenalidomide treatment.
  • * Patients with specific genetic profiles (polymorphisms in ABCB1 and VEGF) showed better outcomes, while those with wild-type genotypes had poorer survival rates, highlighting the potential of these SNPs as biomarkers for treatment response and toxicity.
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Physiologic dead space is a well-established independent predictor of death in patients with acute respiratory distress syndrome (ARDS). Here, we explore the association between a surrogate measure of dead space (DS) and early outcomes of mechanically ventilated patients admitted to Intensive Care Unit (ICU) because of COVID-19-associated ARDS. Retrospective cohort study on data derived from Italian ICUs during the first year of the COVID-19 epidemic.

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Prone position for acute respiratory distress syndrome and the hazards of meta-analysis.

Pulmonology

November 2024

Department of Medicine and Surgery, Università degli Studi Milano Bicocca, Milan, Italy; Department of Anesthesia and Intensive Care, Niguarda Hospital, Milan, Italy.

Background: Researchers have tried unsuccessfully for many years using randomized controlled trials to show the efficacy of prone ventilation in treating ARDS. These failed attempts were of use in designing the successful PROSEVA trial, published in 2013. However, the evidence provided by meta-analyses in support of prone ventilation for ARDS was too low to be conclusive.

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Dental implants placed in fresh extraction alveoli provide several advantages, including shorter treatment periods and improved patient comfort. After a compromised tooth extraction, the Er,Cr:YSGG laser can considerably reduce bacterial concentration. The objective of this controlled study conducted after at least 1 year of follow-up was to compare the use of immediate post-extraction implants in infected sites treated with laser (test group) versus conventional implants in edentulous sites (control group) through an analysis of pre- and post-operative radiographs.

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Helicobacter pylori infection is very common and affects more than one-third of adults in Italy. Helicobacter pylori causes several gastro-duodenal diseases, such as gastritis, peptic ulcer and gastric malignancy, and extra-gastric diseases. The eradication of the bacteria is becoming complex to achieve due to increasing antimicrobial resistance.

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Objective: The R.Evolution project aimed to reach a consensus on the main challenges of conducting clinical research in Italy and possible strategies and approaches to address them and optimize clinical research management.

Methods: A scientific board of experts initially discussed potentially critical areas in clinical research conduct and further explored them through an online national survey.

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Objective: The short and long-term outcomes of children with anti-Ro/La-related congenital heart block treated with a combined maternal-neonatal therapy protocol were compared with those of controls treated with other therapies.

Study Design: Sixteen mothers were treated during pregnancy with a therapy consisting of daily oral fluorinated steroids, weekly plasma exchange and fortnightly intravenous immunoglobulins and their neonates with intravenous immunoglobulins (study group); 19 mothers were treated with fluorinated steroids alone or associated to intravenous immunoglobulins or plasma exchange (control group).

Result: The combined-therapy children showed a significantly lower progression rate from 2nd to 3rd degree block at birth, a significant increase in heart rate at birth and a significantly lower number of pacemaker implants during post-natal follow-up with respect to those treated with the other therapies.

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Article Synopsis
  • The quality of GI endoscopy is vital for patient outcomes and experiences, prompting a study on adherence to ESGE measures among Italian endoscopists.
  • A survey from October to December 2018 gathered data from 392 endoscopists, focusing on their compliance with established quality standards during upper and lower GI procedures.
  • Findings indicated low adherence rates, with only 18.2% tracking EGD duration and 52.8% monitoring complications, highlighting significant gaps in the implementation of best practices in GI endoscopy in Italy.
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Background: Few studies have investigated both short- and long-term prognostic factors, and the differences between chronic and acute conditions in the very old critically ill patient. Our study aims to shed light in this field and to provide useful prognostic factors that may support clinical decisions in the management of the elderly.

Methods: Six ICUs collected data concerning 80-year-old (or more) patients admitted in 2015 and 2016 and followed-up until May 2018.

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Background: To produce statements based on the available evidence and an expert consensus (as members of the Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care, SIAARTI) on the use of lung ultrasound for the management of patients with COVID-19 admitted to the intensive care unit.

Methods: A modified Delphi method was applied by a panel of anesthesiologists and intensive care physicians expert in the use of lung ultrasound in COVID-19 intensive critically ill patients to reach a consensus on ten clinical questions concerning the role of lung ultrasound in the following: COVID-19 diagnosis and monitoring (with and without invasive mechanical ventilation), positive end expiratory pressure titration, the use of prone position, the early diagnosis of pneumothorax- or ventilator-associated pneumonia, the process of weaning from invasive mechanical ventilation, and the need for radiologic chest imaging.

Results: A total of 20 statements were produced by the panel.

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Purpose: To provide consensus, and a list of experts' recommendations regarding the basic skills for head-to-toe ultrasonography in the intensive care setting.

Methods: The Executive Committee of the European Society of Intensive Care (ESICM) commissioned the project and supervised the methodology and structure of the consensus. We selected an international panel of 19 expert clinicians-researchers in intensive care unit (ICU) with expertise in critical care ultrasonography (US), plus a non-voting methodologist.

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