607 results match your criteria: "San Carlo Hospital.[Affiliation]"

Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous entity including patients with different phenotypes of near normal, normal, and supernormal left ventricular (LV) function.

Objectives: To assess the value of resting LV elastance (also known as force) with transthoracic echocardiography (TTE) to identify HFpEF phenotypes.

Methods: In a prospective, observational, multicenter study, 2380 HFpEF patients were recruited from July 2016 to May 2024.

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Objective: Bosentan (BOS) is approved for treating pulmonary arterial hypertension (PAH) and preventing digital ulcers (DU) in systemic sclerosis (SSc). Our study aimed to evaluate whether BOS prescribed for DU could reduce the incidence of PAH in a large SSc cohort from the SPRING registry.

Methods: Patients with SSc from the SPRING registry, meeting ACR/EULAR 2013 classification criteria with data on PAH onset, DU status, BOS exposure, and at least a one-year follow-up between 2015 and 2020, and no known PAH at baseline were included.

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Objectives: External quality assessment (EQA) programs play a pivotal role in harmonizing laboratory practices, offering users a benchmark system to evaluate their own performance and identify areas requiring improvement. The objective of this study was to go through and analyze the UK NEQAS "Immunology, Immunochemistry and Allergy" EQA reports between 2012 and 2021 to assess the overall level of harmonization in autoimmune diagnostics and identify areas requiring improvement for future actions.

Methods: The EQA programs reviewed included anti-nuclear (ANA), anti-dsDNA, anti-centromere, anti-extractable nuclear antigen (ENA), anti-phospholipids, anti-neutrophil cytoplasm (ANCA), anti-proteinase 3 (PR3), anti-myeloperoxidase (MPO), anti-glomerular basement membrane (GBM), rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), mitochondrial (AMA), liver-kidney-microsomal (LKM), smooth muscle (ASMA), APCA, and celiac disease antibodies.

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Establishing an Extracorporeal Cardiopulmonary Resuscitation Program.

Medicina (Kaunas)

December 2024

Department of Health Science, Anesthesia and ICU, School of Medicine, University of Basilicata San Carlo Hospital, 85100 Potenza, Italy.

Extracorporeal cardiopulmonary resuscitation (ECPR) is a complex, life-saving procedure that uses mechanical support for patients with refractory cardiac arrest, representing the pinnacle of extracorporeal membrane oxygenation (ECMO) applications. Effective ECPR requires precise patient selection, rapid mobilization of a multidisciplinary team, and skilled cannulation techniques. Establishing a program necessitates a cohesive ECMO system that promotes interdisciplinary collaboration, which is essential for managing acute cardiogenic shock and severe pulmonary failure.

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Early noninvasive ventilation in general wards for acute respiratory failure: an international, multicentre, open-label, randomised trial.

Br J Anaesth

February 2025

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

Background: The impact of noninvasive ventilation (NIV) managed outside the intensive care unit in patients with early acute respiratory failure remains unclear. We aimed to determine whether adding early NIV prevents the progression to severe respiratory failure.

Methods: In this multinational, randomised, open-label controlled trial, adults with mild acute respiratory failure (arterial oxygen partial pressure/fraction of inspiratory oxygen [Pao/FiO] ratio ≥200) were enrolled across 11 hospitals in Italy, Greece, and Kazakhstan.

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Background: It is crucial to distinguish type-1 myocardial infarction (T1MI) from type-2 myocardial infarction (T2MI) at admission and during hospitalization to avoid unnecessary invasive exams and inappropriate admissions to the acute cardiac care unit.

Objectives: The purpose of the study was to define a simple profile derived from commonly used biomarkers to differentiate T1MI from T2MI.

Methods: We prospectively enrolled in an observational study 213 iconsecutive patients with a provisional diagnosis of non-ST-elevation acute myocardial infarction (NSTEMI) admitted to the Cardiology Department.

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Atrial fibrillation (AF) is one of the most common cardiac arrhythmias of clinical relevance and a major cause of cardiovascular morbidity and mortality. Following a diagnosis of AF, patients are directed towards therapy with anticoagulant drugs to reduce the thromboembolic risk and antiarrhythmics to control their cardiac rhythm, with periodic follow-up checks. Despite the great ease of handling these drugs, we soon realized the need for follow-up models that would allow the appropriateness and safety of these pharmacological treatments to be monitored over time.

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Background: In the PROTECTION trial, intravenous amino acids (AA) decreased the occurrence of acute kidney injury (AKI) in cardiac surgery patients with cardiopulmonary bypass (CPB). Recruitment of renal functional reserve may be responsible for such protection. However, patients with chronic kidney disease (CKD) have diminished renal functional reserve, and AA may be less protective in such patients.

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External quality assurance (EQA) programs play a pivotal role in monitoring laboratory practices, allowing each laboratory to evaluate the consistency of results across different methods as well the ability of individual laboratories to compare and improve over time their own performance. The objective of our study was to analyze the UK NEQAS EQA reports for the "Antibodies to Nuclear and Related Antigens" program from 2013 to 2023, to assess the overall level of harmonization of the responses for anti-nuclear antibody (ANA) testing by indirect immunofluorescence (IIF), in terms of both pattern and titer consensus. As a second aim, we analyzed the impact of the introduction in UK NEQAS EQA reports of the International Consensus on ANA Patterns (ICAP) nomenclature and of digital image recognition on the harmonization of the ANA HEp-2 IIF test.

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Awake veno-venous extracorporeal membrane oxygenation: practical aspects and considerations.

Minerva Anestesiol

December 2024

Department of Medical Science, Surgery and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy.

Veno-venous extracorporeal membrane oxygenation (ECMO) is a life-saving technique in the armamentarium of critical care medicine. It involves extracorporeal blood circulation outside the body, providing temporary respiratory support while allowing the lungs to heal. Traditionally, patients undergoing ECMO require sedation to minimize discomfort and facilitate mechanical ventilation.

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Article Synopsis
  • The meta-analysis reviews the effectiveness of veno-venous extracorporeal membrane oxygenation (VV-ECMO) in treating severe ARDS among COVID-19 versus non-COVID patients.
  • It analyzed 24 studies involving 2,121 patients, finding that non-COVID ARDS patients had a lower mortality risk compared to those with COVID-19 ARDS and required ECMO for longer durations if they had COVID-19.
  • The findings emphasize the need for tailored ECMO strategies based on the viral cause of ARDS to improve clinical outcomes and resource management in current and future health crises.
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Article Synopsis
  • - The study aimed to evaluate the rate of false-positive cases for congenital heart defects (CHDs) during first-trimester fetal heart evaluations conducted by experienced professionals.
  • - It looked at a group of pregnant women suspected of having CHDs during initial screenings, utilizing comprehensive protocols that included critical heart assessment views.
  • - Among the 22 cases analyzed, a high percentage (86.4%) were confirmed to have CHDs, but 13% showed normal heart anatomy, indicating that first-trimester screenings may lead to more false positives than anticipated.
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Recommendations for fast-track extubation in adult cardiac surgery patients: a consensus statement.

Minerva Anestesiol

November 2024

Department of Medicine, Surgery, and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy.

Introduction: Enhanced recovery after cardiac surgery in selected low-risk patients, has the potential to improve outcomes and reduce the burden of healthcare costs. Anesthesia-related challenges play a major role in the successful implementation of Enhanced Recovery After Surgery (ERAS) protocols, with particular emphasis placed on fast-track extubation. Acknowledging the importance of this practice, the Italian Association of Cardiac Anesthesiologists and Intensive Care (ITACTAIC) has advocated for an initiative to establish a consensus offering practical recommendations for fast-track extubation after adult cardiac surgery.

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Article Synopsis
  • Extracorporeal cardiopulmonary resuscitation (ECPR) can improve survival rates in patients with refractory cardiac arrest, but results on neurological outcomes are inconsistent.
  • A study analyzing 9 cohort studies with nearly 5,000 patients found that combining ECPR with an intra-aortic balloon pump (IABP) significantly improved survival rates (32.9% vs. 20.2%).
  • While there was a trend toward better neurological outcomes with ECPR+IABP, the results weren't statistically significant, emphasizing the need for further research in this area.
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Self-perceived attitudes of Italian oncology nurses towards clinical trial involvement: A cohort observational study.

Tumori

December 2024

Laboratorio di Bioinformatica e Biostatistica, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy.

Background: Literature is lacking when it comes to oncology nursing attitudes in clinical trial involvement.

Objective: To assess how Italian oncology nurses perceived their attitudes in clinical trials involvement.

Methods: An on-line cohort observational study was carried out.

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Article Synopsis
  • The study aimed to understand how perioperative hypertension is managed in Europe, given the lack of agreement on blood pressure targets.
  • An online survey involving 339 participants (mostly anesthesiologists) revealed most aim for systolic blood pressure (SBP) between 120-140 mmHg during surgeries.
  • Common medications used include α-adrenoreceptor antagonists, nitrates, and calcium channel blockers, with a preference for those that allow titratable control; less than 20% of procedures experienced treatment failures.
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Background: Systemic steroids are recommended for patients with IgA nephropathy (IgAN) and proteinuria. However, there are concerns about their safety due to an excess of serious adverse events (SAEs) in previous randomised trials. This study evaluates the incidence of SAEs in IgAN patients receiving different treatment regimens in clinical practice.

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Background: Diabetic foot ulcers are chronic, difficult to heal, and potentially life-threatening. Few medical devices have been studied in diabetic ulcers penetrating to bone or tendon.

Methods: We conducted an international, open-label randomized controlled trial, randomly assigning patients with diabetic ulcers penetrating to bone, joint, or tendon 1:1 to intact fish skin graft or standard wound care, with assigned treatment applied through 14 weeks.

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Parathyroid carcinoma and atypical parathyroid tumor: analysis of an Italian database.

Eur J Endocrinol

September 2024

Fondazione FIRMO Onlus, Italian Foundation for the Research on Bone Diseases, 50129 Florence, Italy.

Article Synopsis
  • Atypical parathyroid tumors (aPT) and parathyroid carcinoma (PC) are very rare types of tumors in the parathyroid glands, making up less than 2% of all such tumors.
  • The study looked at patients with aPT and PC to see how they compare in terms of medical features and problems.
  • Both types showed similar symptoms, but PCs had more kidney issues and a higher chance of the disease coming back after surgery, leading to plans for better tracking and study of these tumors in Italy and Europe.
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Objectives: to evaluate over a 48-month follow-up period the: 1) long-term effectiveness and safety; 2) drug retention rate (DRR); 3) impact of comorbidities and bDMARDs line on MDA and DAPSA remission/low disease activity (LDA) of secukinumab in a multicenter Italian cohort of PsA patients.

Methods: Consecutive PsA patients receiving secukinumab were followed prospectively in Italian centers between 2016 and 2023. Disease characteristics, previous/ongoing treatments, comorbidities and follow-up duration were recorded.

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The advent of immunotherapy and antibody-drug conjugates (ADCs) have revolutionized breast cancer treatment, offering new hope to patients. However, challenges, such as resistance and limited efficacy in certain cases, remain. Recently, the combination of these therapies has emerged as a promising approach to address these challenges.

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Article Synopsis
  • * Sometimes, these lipomas can lead to issues like bleeding or blockages, but they are very rare, especially in adults.
  • * Doctors can use special scans to find CLs, but they need to be careful because they look similar to more serious tumors, sometimes requiring surgery to be sure.
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Background: The use of opioids for pain is linked to an increased risk of developing opioid use disorder, and has resulted in the emergence of the opioid crisis over the last few years.

Aim: The systematic review question is "How does the use of opioid medications in pain management, compared with non-opioid medications, affect pain intensity over the short, intermediate, and long-term in adults with acute traumatic pain?".

Methods: The protocol was prospectively registered on the International Prospective Register of Systematic Reviews: CRD42021279639.

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