131 results match your criteria: "S Spirito Hospital[Affiliation]"

Background: Sex may impact clinical outcomes in patients with stroke treated with dual antiplatelet therapy (DAPT). We aimed to investigate the sex differences in the short-term outcomes of DAPT within a real-world population of patients with noncardioembolic mild-to-moderate ischemic stroke or high-risk transient ischemic attack.

Methods: We performed a propensity score-matched analysis from a prospective multicentric cohort study (READAPT [Real-Life Study on Short-Term Dual Antiplatelet Treatment in Patients With Ischemic Stroke or Transient Ischemic Attack]) by including patients with noncardioembolic mild-to-moderate stroke (National Institutes of Health Stroke Scale score of 0-10) or high-risk transient ischemic attack (age, blood pressure, clinical features, duration of transient ischemic attack, presence of diabetes [ABCD] ≥4) who initiated DAPT within 48 hours of symptom onset.

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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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Article Synopsis
  • - Short-term dual antiplatelet treatment (DAPT) shows better effectiveness compared to single antiplatelet treatment (SAPT) for preventing secondary strokes in patients with mild to moderate strokes and high-risk TIAs, according to a study of 2016 patients.
  • - Patients treated with DAPT had a higher likelihood of regaining pre-stroke neurological function within 90 days and showed more early neurological improvement compared to those on SAPT.
  • - The study suggests that DAPT might be a safer and more effective option than SAPT in real-world settings, even for patients not fitting the criteria of major clinical trials.
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  • The study investigates foreign body ingestion (FBI) in children under 18 in Italy, highlighting the prevalence and trends from 2015 to 2020.
  • A total of 5,771 cases were analyzed, with the majority occurring at home, mostly involving children under 6, and commonly featuring blunt objects.
  • The results indicate stable rates of FBI over time, urging the importance of preventive strategies to protect young children, especially those 5 and under, from such incidents.
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  • - The study analyzes the short-term outcomes of patients with minor ischemic stroke from small artery occlusion (SAO-MIS) treated with dual antiplatelet therapy (DAPT) and compares them to patients with other causes of minor strokes.
  • - In a sample of 678 minor ischemic stroke patients, SAO-MIS showed low rates of primary outcomes (1.2% had major cardiovascular events) and a high proportion achieving excellent functional outcomes (75.5%) within 90 days.
  • - Results indicate that SAO-MIS patients have a significantly lower risk of recurrent vascular events compared to non-SAO-MIS patients, while showing similar safety outcomes, suggesting that DAPT is beneficial for SAO-M
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Purpose: To compare different types of short stems (SS) in terms of native hip geometry reproducibility, analyzing centrum-collum-diaphyseal angle (CCD) and femoral offset (FO). These parameters allow the SS to be adapted to patient's anatomy in order to ensure better functional outcomes in total hip arthroplasty (THA).

Methods: A total of 387 cases of SS met the inclusion criteria.

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Background: The optimal treatment for acute minor ischemic stroke is still undefined. and options include dual antiplatelet treatment (DAPT), intravenous thrombolysis (IVT), or their combination. We aimed to investigate benefits and risks of combining IVT and DAPT versus DAPT alone in patients with MIS.

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  • This study investigates the effectiveness of two surfactant administration methods—INtubate-RECruit-SURfactant-Extubate (IN-REC-SUR-E) and less invasive surfactant administration (LISA)—on improving BPD-free survival in preterm infants with respiratory distress syndrome (RDS).
  • A total of 382 preterm infants, born at 24-27 weeks' gestation and not intubated at birth, will be randomly assigned to either method within the first 24 hours of life. The primary outcome being measured is a combination of death or bronchopulmonary dysplasia (BPD) at 36 weeks' postmenstrual age.
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Background:  Increasing evidence suggests that diabetes increases the risk of developing different types of cancer. Hyperinsulinemia, hyperglycemia and chronic inflammation, characteristic of diabetes, could represent possible mechanisms involved in cancer development in diabetic patients. At the same time, cancer increases the risk of developing new-onset diabetes, mainly caused by the use of specific anticancer therapies.

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  • 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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  • The guideline is designed to help healthcare professionals manage sporadic primary hyperparathyroidism (PHPT) in adults, excluding cases during pregnancy.
  • Developed through a systematic review process, the guideline focuses on identifying critical outcomes that impact treatment decisions, emphasizing pharmacological and surgical options.
  • Key recommendations include recommending parathyroidectomy for symptomatic patients or those with specific criteria, while also providing guidance for monitoring other related health issues.
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  • Immunotherapy using immune checkpoint inhibitors (ICI) is becoming common in cancer treatment, but managing related endocrine side effects can be challenging.
  • Different scientific societies have varying guidelines concerning when to conduct endocrine testing for patients undergoing this therapy.
  • A panel of experts from several Italian medical associations has developed a straightforward and practical checklist for assessing endocrine and metabolic health in cancer patients receiving immunotherapy.
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Stalactites in the Right Ventricle.

J Cardiovasc Echogr

February 2024

Emergency-Urgency Department, Cardiology with UTIC, Pescara "S. Spirito" Hospital, Pescara, Italy.

Heart metastatic tumors are more frequent than primary heart tumors. Cardiac metastasis is a rare phenomenon, occurring mainly by direct spread, especially from lung cancer. Cardiac metastases may be asymptomatic or cause arrhythmias, nonspecific electrocardiographic alterations, or mimic a myocardial infarction.

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  • Biological samples, particularly urine, need to be stable over long-term storage and repeated freeze-thaw cycles to ensure accurate analysis of metabolites.
  • This study evaluated the stability of specific metabolites related to arachidonic acid over a period of 10 years and during 10 freeze-thaw cycles using existing urine samples.
  • Results showed that most metabolites remained stable over time and with cycles, but urinary 8-iso-PGF increased significantly after multiple freeze-thaw cycles when no antioxidants were used, highlighting the importance of storage conditions.
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Objectives: Since 2000, we anastomosed the saphenous vein graft to the right coronary artery system using the stump of the right internal thoracic artery as inflow. The long-term results of patients where the right coronary artery was grafted with the right internal thoracic artery or the ascending aorta as saphenous vein inflow has not been reported.

Methods: From 2000 to 2018, 699 consecutive patients had right internal thoracic artery elongated with saphenous vein (I-graft group, n = 358, 51.

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Outcome of primary hemophagocytic lymphohistiocytosis: a report on 143 patients from the Italian Registry.

Haematologica

August 2024

Antonino Trizzino, Simona Gobbi, Fraia Melchionda, Marco Zecca, Elena Mastrodicasa, Massimo Provenzi, Monica Cellini, Daniela Onofrillo, Marco Rabusin, Bernd Raffeiner, Rosamaria Mura, Vito Miraglia, Alessandra Tozzo.

Primary hemophagocytic lymphohistiocytosis (pHLH) is a severe, life-threatening hyperinflammatory syndrome caused by defects in genes of the granule-dependent cytotoxic pathway. Here we investigated the clinical presentation and outcome in a large cohort of 143 patients with pHLH diagnosed in the last 15 years and enrolled in the Italian registry. The median age at diagnosis was 12 months (interquartile range, 2-81), and 92 patients (64%) fulfilled the HLH-2004 criteria.

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This multicenter study in Italian hospitals highlights the epidemiologic disruptions in the circulation of the 5 main respiratory viruses from 2019 to 2023. Our data reveal a resurgence of respiratory syncytial virus and influenza during the 2022-2023 winter season, with an earlier peak in cases for both viruses, emphasizing the importance of timely monitoring.

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  • - The study investigates the safety and effectiveness of the ultrathin Coroflex ISAR NEO polymer-free sirolimus-eluting stent (PF-SES) for patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI), addressing concerns about long-term issues with traditional drug-eluting stents.
  • - Conducted as a multicenter, prospective registry in Italy, the CAESAR study evaluated 425 patients, focusing on outcomes such as target-lesion revascularization (TLR) and major adverse cardiovascular events (MACE) over one year.
  • - Results showed excellent clinical outcomes, with only 0.5% needing additional procedures for ischemia-induced TLR and a low rate of
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Acute bacterial skin and skin structure infections (ABSSSI) and osteoarticular infections compound the burden of morbidity, mortality and prolonged hospitalizations among gram-positive infections. Dalbavancin, a second-generation, intravenous lipoglycopeptide, due to its prolonged half-life, can be a valuable alternative in their treatment when administered as inpatient treatment at the price of an extended hospital stay. Between October 2019 and September 2023, 31 children and adolescents were treated with dalbavancin because of bone and joint infections (n = 12 patients, 39%), ABSSSI (n = 13 patients, 42%), mainly for the limbs, facial cellulitis or complicated ABSSSI (n = 6 patients, 19%), at five Italian pediatric centers.

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Background: The natural history of Crohn's disease (CD) can result in complications requiring surgery. Pediatric data are scarce about major abdominal surgery. The IBD Registry from the Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition has been active since 2008 and collects data from major pediatric IBD centers in Italy.

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Purpose: Treatment of scaphoid fracture sequelae is still an unsolved problem in hand surgery. Custom-made 3D-printed titanium partial and total scaphoid prosthesis and scaphoid interosseous ligament reconstruction (SLIL) are performed in cases of non-union and isolated aseptic necrosis of the proximal scaphoid pole and when it is impossible to save the scaphoid bone, respectively. This study aims to evaluate the clinical, functional and radiographic results after these two prosthesis implantations.

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Background: The comprehensive monitoring of licit and illicit drug consumption plays a crucial role in understanding the complexities of patient conditions and designing effective treatment strategies. In this study, the prevalence of psychoactive prescription drugs, classical illicit drugs, and new psychoactive substances (NPS) were objectively assessed in individuals diagnosed with drug-related psychiatric disorders or episodes.

Methods: Blood, urine, and hair samples were collected from psychiatric patients admitted to the Mental Health Department and Drug Addiction Service of the North Rome Local Health Authority with declared or suspected psychoactive drug use.

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