4,327 results match your criteria: "Sant' Andrea Hospital[Affiliation]"

Evaluate the prevalence of genetic factors in a large population of infertile subjects and define the seminological, hormonal, and ultrasonographic features for each alteration. : This single-center retrospective study included male partners of infertile couples undergoing genetic investigations due to oligozoospermia or azoospermia evaluated from January 2012 to January 2022. The genetic investigations consist of karyotype, gene mutations plus variant of the IVS8-5T polymorphic trait, Y chromosome microdeletion, and Next Generation Sequencing panel to analyze genes implicated in congenital hypogonadotropic hypogonadism (CHH).

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Background: Oesophageal, gastroesophageal, and gastric malignancies are often diagnosed at locally advanced stage and multimodal therapy is recommended to increase the chances of survival. However, given the significant variation in treatment response, there is a clear imperative to refine patient stratification. The aim of this narrative review was to explore the existing evidence and the potential of radiomics to improve staging and prediction of treatment response of oesogastric cancers.

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Objective: During the last decade, the management of gastric intestinal metaplasia (GIM) has been addressed by several distinct international evidence-based guidelines. In this review, we aimed to synthesise these guidelines and provide clinicians with a global perspective of the current recommendations for managing patients with GIM, as well as highlight evidence gaps that need to be addressed with future research.

Design: We conducted a systematic review of the literature for guidelines and consensus statements published between January 2010 and February 2023 that address the diagnosis and management of GIM.

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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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Clinical, Histopathologic, and Genetic Features of Patients With Myofibrillary and Distal Myopathies: Experience From the Italian Network.

Neurology

August 2024

From the UOC di Neurologia (S. Bortolani, G.P., C.S., M.L., M. Mirabella, S.S., M. Monforte, E.R., G.T.), Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome; Department of Neurosciences Rita Levi Montalcini (S. Bortolani, T.E.M.), University of Torino, Italy; Folkhälsan Research Center (M.S.), Helsinki, Finland; Department of Neurosciences, Biomedicine and Movement Sciences (G.V., P.T.), University of Verona; Neuroimmunology and Neuromuscular Disorders Unit (S. Bonanno, M.C., A. Ruggieri, L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute of Experimental Neurology (INSPE) (Y.M.F., S.C.P.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; ERN-NMD Center for Neuromuscular Disorders of Messina (A. Pugliese, C.R., A.T.), Department of Clinical and Experimental Medicine, University of Messina; Fondazione UILDM Lazio Onlus (G.P., C.S.), Rome; Department of Medicine, Surgery and Neurosciences (D.L., A.M.), University of Siena; Neuromuscular Diseases Unit (G.G., R.M.), Department of Systems Medicine, University of Rome Tor Vergata, Rome; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal Infantile Sciences (C.G., M. Grandis), University of Genoa; IRCCS Ospedale Policlinico San Martino (C.G., M. Grandis), Genova; IRCCS Mondino Foundation (S.R.), Pavia; Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche (R.P.B., L.R.), Università degli Studi di Napoli "Federico II," Naples; Neuromuscular and Rare Diseases Unit (D.V.), Department of Neuroscience and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Neurology Unit (F.M., G.P.C.), Department of Neuroscience and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; IRCCS Institute of Neurological Sciences of Bologna (M.L.V., R.L.), UOC Clinica Neurologica; Department of Biomedical and NeuroMotor Sciences (M.L.V., R.L.), University of Bologna; Università Cattolica del Sacro Cuore (E.T., M. Mirabella, S.S., E.R.); Center for Neuromuscular and Neurological Rare Diseases S. Camillo Forlanini Hospital (A. Petrucci), Rome; Department of Clinical and Experimental Medicine (G.R., G.S.), Neurological Clinic, University of Pisa; Neuromuscular and Rare Disease Center (M. Garibaldi, G. Antonini), Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), SAPIENZA University, Sant'Andrea Hospital, Rome; Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit (G. Astrea, A. Rubegni, F.M.S.), IRCCS Stella Maris Foundation, Pisa; Department of Neurosciences (C.I.A.), University of Padova; Department of Neurosciences (A.A.), University Hospitals of Modena; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMo-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Department of Pathophysiology and Transplantation (G.P.C.), Dino Ferrari Center, University of Milan, Italy; and John Walton Muscular Dystrophy Research Centre (J.D.-M., G.T.), Newcastle University and Newcastle Hospitals NHS Foundation Trusts, Newcastle Upon Tyne, United Kingdom.

Article Synopsis
  • The study focuses on diagnosing myofibrillar myopathies (MFM) and distal myopathies (DM), addressing the complexity due to numerous causative genes and overlapping symptoms.
  • It involves a retrospective analysis of data from 132 MFM and 298 DM patients collected from various neuromuscular centers, highlighting demographic, genetic, and clinical details.
  • Results indicate that 63% of patients had molecular confirmation of their condition, with significant findings including common pathogenic variants and varying ages of onset, as well as notable cardiac and respiratory complications linked to specific genetic variants.
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Symptomatic uncomplicated diverticular disease: a critical appraisal.

Expert Rev Gastroenterol Hepatol

July 2024

Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

Introduction: Symptomatic uncomplicated diverticular disease (SUDD) is a clinical condition included in the spectrum of symptomatic diverticular disease. The symptom profile associated with SUDD is highly heterogeneous, as there are currently discordant definitions, that encompass many clinical scenarios.

Areas Covered: We conducted a narrative review to assess the symptom profile and diagnostic criteria of SUDD based on the available evidence.

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Cardioneuroablation has emerged as a potential alternative to cardiac pacing in selected cases with vasovagal reflex syncope, extrinsic vagally induced sinus bradycardia-arrest or atrioventricular block. The technique was first introduced decades ago, and its use has risen over the past decade. However, as with any intervention, proper patient selection and technique are a prerequisite for a safe and effective use of cardioneuroablation therapy.

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The Role of the Autonomic Nervous System in Epilepsy and Migraine: A Narrative Review.

J Integr Neurosci

July 2024

Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, Sant'Andrea Hospital, 00198 Rome, Italy.

Autonomic symptoms may be local and general clinical manifestations of both epilepsy and migraine caused by the dysfunction of brain areas best known as the central autonomic network. Despite their prevalence, autonomic signs are often misdiagnosed and their treatment is undervalued. This review aims to describe the autonomic manifestations reported during seizures and migraineur attacks according to their presentation, focusing on the role of the central autonomic network (CAN) and on the parasympathetic outflow that often-induced cranial autonomic symptoms (CAS) during migraineur attacks.

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Introduction: Eculizumab, a complement active antibody, and efgartigimod, an Fc fragment that blocks neonatal Fc receptor, are both approved to treat generalized myasthenia gravis (gMG) patients. The objective of this study is to describe the clinical response to both treatments in a real-life setting.

Methods: We collected baseline and follow-up clinical data using the Myasthenia Gravis-Activities of Daily Living (MG-ADL), and Quantitative Myasthenia Gravis (QMG).

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Article Synopsis
  • * Comprehensive metabolic screening and personalized preventative measures, like fluid intake and dietary recommendations, are crucial for patients, especially those with specific types of stones.
  • * Continuous monitoring and targeted therapies are essential for managing patients at high risk of stone recurrence to improve long-term outcomes.
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Movement disorder phenotype in CTNNB1-syndrome: A complex but recognizable phenomenology.

Parkinsonism Relat Disord

September 2024

Neurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network on Rare and Complex Epilepsies, EpiCARE, Rome, Italy.

Introduction: CTNNB1 gene loss-of-function variants cause Neurodevelopmental disorder with spastic diplegia and visual defects (NEDSDV, OMIM 615075). Although motor impairment represents a core feature of this condition, the motor phenotype remains poorly described. We systematically assessed a cohort of 14 patients with disease-causing CTNNB1 variants to better characterize the movement disorder phenotype.

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Purpose: To evaluate the incidence of postoperative complications after cytoreductive nephrectomy (CN) following first-line treatment for metastatic renal cell carcinoma (mRCC), and to compare it with postoperative complications of upfront CN.

Methods: For this population-based retrospective study, the PearlDiver Mariner database (PearlDiver Technologies, Colorado Springs, CO), a database of insurance billing records was analyzed. Using relevant ICD-9/10 and CPT codes, patients diagnosed with mRCC between 2011 and 2021, who received first-line systemic molecular therapy (SMT), either tyrosine kinase inhibitors (TKI) or immune-checkpoint inhibitors (ICI), were identified.

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Article Synopsis
  • Cervical cancer poses a major health risk for younger women, and tools like cold knife (CK) and carbon dioxide (CO) laser conization are used to treat pre-invasive lesions with the intent to cure incidental cervical cancer cases.
  • A study involving 1,270 women showed that CO laser conization had a significantly lower rate of positive margins compared to CK conization (4.3% vs. 13.3%).
  • Both techniques demonstrated similar oncological safety in cases of incidental cervical cancer diagnosis, with no recurrences noted after an average follow-up period of 53 months, and CO laser conization generally proved more effective at achieving clean margins.
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Physician-Modified Endografts for Repair of Complex Abdominal Aortic Aneurysms: Clinical Perspectives and Medico-Legal Profiles.

J Pers Med

July 2024

Vascular and Endovascular Surgery Unit, Sant'Andrea Hospital of Rome, Department of General and Specialistic Surgery, "Sapienza" University of Rome, 00185 Rome, Italy.

Standard endovascular aortic repair (EVAR) has become the standard of care for treating infrarenal abdominal aortic aneurysms (AAAs) in patients with favorable anatomies, while patients with challenging AAA anatomies, and those with suprarenal or thoraco-abdominal aneurysms, still need alternative, more complex, solutions, including custom-made branched or fenestrated grafts, which are constrained by production delay and costs. To address urgent needs and complex cases, physicians have proposed modifying standard endografts by manually creating graft fenestrations. This allows for effective aneurysm exclusion and satisfactory patency of visceral vessels.

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Malignant pleural effusion (MPE) from patients with advanced non-small-cell lung cancer (NSCLC) has been proven valuable for molecular analysis; however, simultaneous detection of driver fusions in MPE is still challenging. In this study, we investigated the Idylla™ GeneFusion Panel, a stand-alone test in tissue samples, in the evaluation of , , and ex14 skipping mutations in MPE and compared its performance with routine reference methods (Real-time-based and Next-generation Sequencing-NGS). The inclusion criteria for sample selection were as follows: advanced NSCLC harboring , , fusions or exon-skipping alterations and the availability of MPE collected at diagnosis or disease progression.

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Background: Hereditary breast and ovarian cancer syndrome (HBOC) predisposes women to an increased risk mainly of breast and tubo-ovarian cancer. The aim of the study is to investigate whether being diagnosed with HBOC syndrome is itself a risk factor for sexual dysfunction.

Methods: An ad hoc questionnaire, including baseline demographic and clinical data, and the Sexual Function Questionnaire 28 (SFQ28) were administered to HBOC female carriers (study group) and to a control group.

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Coronary artery calcification is a complex anatomical and histological pathology with different pathways that contribute to calcium deposit and calcification progression. As part of the atherosclerotic process, extensive calcifications are becoming more common and are associated with poorer PCI outcomes if not properly addressed. Since no drug has shown to be effective in changing this process once it is started, proper knowledge of the underlying pathogenesis and how to diagnose and manage it is essential in contemporary coronary intervention.

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Objectives: Neurogenic muscle hypertrophy (NMH) is a rare condition characterized by focal muscle hypertrophy caused by chronic partial nervous injury. Given its infrequency, underlying mechanisms remain poorly understood. Inspired by two clinical cases, we conducted a systematic review to gain insights into the different aspects of NMH.

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Article Synopsis
  • International guidelines recommend using direct oral anticoagulants (DOAC) over vitamin K antagonists (VKA) and dual antithrombotic therapy (DAT) over triple antithrombotic therapy (TAT) for patients on oral anticoagulant therapy undergoing percutaneous coronary intervention (PCI) with stents.
  • A study involving 1234 patients on oral anticoagulants assessed the outcomes of DOAC versus VKA and DAT versus TAT, focusing on net adverse clinical events (NACE) at a one-year follow-up.
  • Results showed DOAC resulted in a lower NACE rate compared to VKA (16% vs 23%), and while DAT and TAT had similar NACE rates, DAT led to
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Article Synopsis
  • The study analyzed HIV-1 sequences from 2386 drug-naïve individuals in Italy from 2015 to 2021 to assess the prevalence of transmitted drug resistance (TDR) among them.
  • TDR prevalence was found to be 8%, with a slight difference between B subtypes (9.5%) and non-B subtypes (6.1%), and it remained stable over the years assessed.
  • The research indicated that certain subtypes were associated with lower TDR rates, emphasizing the need for ongoing monitoring of TDR in newly diagnosed HIV patients to improve treatment strategies.
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Purpose: To evaluate the mid-term clinical outcomes for the non-surgical and surgical management of acute proximal hamstring avulsions.

Methods: Sixty physically active individuals were offered surgical or non-surgical management for their proximal hamstring avulsion injuries. Distal retraction was defined as greater than 2 cm.

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Article Synopsis
  • The Italian guidelines offer evidence-based recommendations for diagnosing and managing colonic diverticulosis and diverticular disease, which are prevalent gastrointestinal disorders in adults.
  • A multidisciplinary panel, formed by experts from five scientific societies, reviewed extensive research to create 14 key questions addressing various aspects of the disease.
  • Topics covered include the management of diverticulosis, treatment of symptomatic and acute diverticular disease, handling complications, preventing recurrent issues, and interventional strategies.
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Article Synopsis
  • Gastric cancer is a major healthcare issue, making it essential to identify high-risk patients and detect precancerous conditions like early intestinal metaplasia (IM).
  • A deep learning system was developed to aid in the detection of IM by analyzing endoscopic image patches using virtual chromoendoscopy from a dataset of images taken at Sant'Andrea University Hospital from January 2020 to December 2023.
  • The system showed promising results, achieving 76% specificity and 72% sensitivity for patch tests, and 70% specificity with 100% sensitivity for complete images, highlighting its potential role in enhancing early diagnostics for gastric precancerous conditions.
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Background: Tumor Necrosis Factor Receptor-Associated Periodic Syndrome (TRAPS) is an autosomal dominant autoinflammatory disorder stemming from mutations in the TNFRSF1A gene affecting the tumor necrosis factor receptor (TNFR)-1. These mutations lead to dysregulated inflammatory responses, primarily mediated by augmented interleukin (IL)-1β release.

Case Presentation: We present the case of a 29-year-old woman with a history of recurrent febrile episodes, abdominal pain, and joint manifestations, eventually diagnosed with TRAPS following genetic testing revealing a heterozygous R92Q mutation in TNFRSF1A.

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