2,949 results match your criteria: "Universitaria Pisana[Affiliation]"

How do I manage disseminated Mycobacterium avium complex disease in people with HIV?

Clin Microbiol Infect

December 2024

Department of Clinical and Experimental Medicine, Infectious Diseases Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy; StopTB Italia ODV, Milan, Italy. Electronic address:

Background: Advanced HIV disease (AHD) is increasing, with late presentation accounting for half of newly diagnosed people with HIV (PWH) in Europe. Mortality in late-presenting PWH remains high, and Mycobacterium avium complex (MAC) disease, among other opportunistic infections, presents several diagnostic and treatment challenges that lead, ultimately, to a poor clinical outcome.

Objectives: We aimed to provide guidance on the diagnosis and treatment of disseminated MAC disease (dMACd) in PWH.

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Therapeutic drug monitoring of antibiotics for methicillin-resistant Staphylococcus aureus infections: an updated narrative review for clinicians.

Clin Microbiol Infect

August 2024

Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy. Electronic address:

Background: Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are associated with high mortality rates. Optimal antibiotic dosage plays a crucial role in reducing MRSA burden; thus, the use of therapeutic drug monitoring (TDM) in the clinical practice, especially of new drugs such as ceftobiprole, ceftaroline, dalbavancin, and oritavancin, should be implemented.

Objectives: We aim to examine and summarize the available evidence about TDM of anti-MRSA molecules, with a focus on pneumonia, endocarditis and vascular infections, and bone and joint infections.

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Combined generalized and focal epilepsy with reflex features in Adaptor protein complex 4-associated hereditary spastic paraplegias: A cohort observational study.

Seizure

October 2024

Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Article Synopsis
  • Patients with AP-4 deficiency have developmental delays and seizures that start early in life, along with other issues like trouble with speech and movement.
  • The study looked at how these seizures happen and how patients respond to treatment, finding various types of seizures and some unique brain wave patterns.
  • Overall, while epilepsy can develop at different ages, many patients had a good outlook, and they didn’t seem to be resistant to medications.
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Article Synopsis
  • The percutaneous treatment of structural heart disease (SHD) is advancing quickly, with the EAPCI's Core Curriculum (CC) defining the necessary competencies for newly trained interventional cardiologists (IC).
  • SHD interventional cardiologists manage adult patients throughout the entire treatment process, requiring skills in advanced imaging and planning software, as well as proficiency in procedures related to the aortic, mitral, and tricuspid heart valves.
  • Completing specialized SHD training typically takes at least 18 months, though it can be shortened to 1 year for focused training on specific areas, with the goal of promoting standardized, high-quality training across Europe for better patient care and future certifications.
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Wolfram Syndrome 1: A Neuropsychiatric Perspective on a Rare Disease.

Genes (Basel)

July 2024

Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, 98125 Messina, Italy.

Article Synopsis
  • * The disorder is caused by mutations in a gene on chromosome 4p16, which produces a protein called wolframin, crucial for cellular functions related to insulin signaling and stress response.
  • * Currently, there are no specific treatments for WS1; however, early diagnosis and genetic counseling can help manage symptoms and extend care to affected families, highlighting the need for ongoing research to find new therapies.
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Background: Lumbar foraminal stenosis (LFS) involves the narrowing of neural foramina, leading to nerve compression, significant lower back pain and radiculopathy, particularly in the aging population. Management includes physical therapy, medications and potentially invasive surgeries such as foraminotomy. Advances in diagnostic and treatment strategies are essential due to LFS's complexity and prevalence, which underscores the importance of a multidisciplinary approach in optimizing patient outcomes.

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Article Synopsis
  • Doctors are studying how a procedure called transcatheter tricuspid valve interventions (TTVI) affects patients with heart issues, specifically focusing on something called mitral regurgitation (MR) after the procedure.
  • They looked at data from a big group of patients and found that many showed improvement in MR after the procedure, but some got worse.
  • They discovered that certain factors, like successful procedures and specific treatments, could help predict whether a patient’s MR would improve or get worse after TTVI.
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Purpose: In response to hypoxia, sympathetic fibers to the retina activate β-adrenoceptors (β-ARs) that play an important role in the regulation of vascular and neuronal functions. We investigated the role of β3-AR using the mouse model of oxygen-induced retinopathy (OIR).

Methods: Mouse pups were exposed to 75% oxygen at postnatal day 7 (PD7) followed by a return to room air at PD12.

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Article Synopsis
  • The use of temporary mechanical circulatory support (tMCS) in patients with cardiogenic shock has grown, primarily guided by observational studies and expert opinions.
  • Imaging plays a crucial role in every stage of patient care, from diagnosis to monitoring and eventual weaning from support.
  • This manuscript presents expert consensus and practical guidelines on the use of imaging in conjunction with tMCS, emphasizing evidence-based practices and current best standards.
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Suboptimal outcomes of sorafenib as a second-line treatment after atezolizumab-bevacizumab for unresectable hepatocellular carcinoma.

Dig Liver Dis

December 2024

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Unit of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Background: Most patients receiving atezolizumab-bevacizumab (AB) for hepatocellular carcinoma will eventually experience disease progression. Randomized clinical trials (RCTs) are undergoing to identify second-line treatments. Where RCTs are unavailable or patients are non-eligible, sorafenib is often prescribed based on approval and reimbursement policies.

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Learning curve stratified outcomes after robotic pancreatoduodenectomy: International multicenter experience.

Surgery

December 2024

Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy; Department of Surgery, University Hospital Southampton NHS, United Kingdom. Electronic address:

Article Synopsis
  • Robotic pancreatoduodenectomy is gaining popularity globally, with positive outcomes reported, but more large-scale studies are needed to assess the impact of the learning curve on these results.* -
  • An extensive study was conducted involving 2,186 patients from 18 centers in 8 countries, analyzing the learning curve and its effects on feasibility (operative time and blood loss) and proficiency (complications and morbidity).* -
  • Findings revealed that a significant reduction in major morbidity occurred after 90 procedures, with improved outcomes across the board, while mortality rates remained steady throughout different experience levels among centers.*
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Article Synopsis
  • Lymphocytic esophagitis (LyE) and eosinophilic esophagitis (EoE) are both immune-mediated diseases affecting the esophagus, but they have distinct clinical features and treatment outcomes.
  • An international retrospective study examined 35 LyE patients compared to 59 EoE patients, focusing on their demographics, symptoms, and endoscopic findings.
  • The study found that LyE patients responded less effectively to proton pump inhibitors and highlighted the need for more research on the treatment differences between the two conditions.
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Recent advances in the use of tyrosine kinase inhibitors against thyroid cancer.

Expert Opin Pharmacother

August 2024

Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.

Introduction: Oncogenic tyrosine kinases (TK) are enzymes that play a key role in cell growth and proliferation and their mutations can lead to uncontrolled cell growth and development of aggressive cancer. This knowledge has led to the development of new classes of drugs, Tyrosine kinase inhibitors (TKI). They target oncogenic kinases who are associated with advanced radioactive iodine (RAI) refractory TC, which is not able to uptake RAI anymore and/or still grows between consecutive treatments with Iodine 131 (I131).

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Background And Aims: Lipids constitute one of the main components of atherosclerosis lesions and are the mediators of many mechanisms involved in plaque progression and stability. Here we tested the hypothesis that lipids known to be involved in plaque development exhibited associations with plaque vulnerability. We used spatial lipidomics to overcome plaque heterogeneity and to compare lipids from specific regions of symptomatic and asymptomatic human carotid atherosclerotic plaques.

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Article Synopsis
  • A panel of Italian intensive care specialists explored the use of angiotensin II (ATII) in treating distributive shock, considering patient factors and the effectiveness of existing treatment protocols.
  • They employed a modified Delphi technique to establish consensus on clinical questions and statements related to ATII, resulting in agreement on 13 key statements from a survey.
  • The panel concluded that ATII could be beneficial for specific patients, particularly those with reduced angiotensin-converting enzyme activity or high renin levels, while also noting potential barriers to its use.
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Imaging detected coronary and carotid atherosclerosis in the general population: is prevalence still different between sexes?

Eur Heart J Cardiovasc Imaging

November 2024

Cardiovascular Department, Fondazione Toscana Gabriele Monasterio, Via G. Moruzzi 1, Pisa 56126, Italy.

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Not all carbapenem-resistant Pseudomonas aeruginosa strains are alike: tailoring antibiotic therapy based on resistance mechanisms.

Curr Opin Infect Dis

December 2024

Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.

Purpose Of Review: To correlate the resistance mechanisms and the susceptibility to new antibiotics in Pseudomonas aeruginosa .

Recent Findings: Definition of antibiotic resistance in Pseudomonas aeruginosa is still debated. Carbapenem-resistant Pseudomonas aeruginosa (CRPA) and difficult-to-treat resistant Pseudomonas aeruginosa (DTR-PA) are used but which of them better correlate with the risk of mortality remains debated.

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We know of few studies in the international scientific literature that specifically address the evaluation of surgical and clinical progress among physicians undergoing specialist training in maxillofacial surgery. Identifying a reliable tool to accurately assess both theoretical knowledge and surgical skills of trainees is essential. The primary aim of this study therefore was to design a comprehensive assessment tool that is capable of evaluating both the theoretical and practical skills of physicians undergoing specialist training in maxillofacial surgery.

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Acyl-CoA binding protein for the experimental treatment of anorexia.

Sci Transl Med

August 2024

Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Inserm U1138, Université Paris Cité, Sorbonne Université, 75006 Paris, France.

Extracellular acyl-coenzyme A binding protein [ACBP encoded by diazepam binding inhibitor (DBI)] is a phylogenetically ancient appetite stimulator that is secreted in a nonconventional, autophagy-dependent fashion. Here, we show that low ACBP/DBI plasma concentrations are associated with poor prognosis in patients with anorexia nervosa, a frequent and often intractable eating disorder. In mice, anorexia induced by chronic restraint stress (CRS) is accompanied by a reduction in circulating ACBP/DBI concentrations.

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Epilepsy after acute central nervous system complications of pediatric hematopoietic cell transplantation: A retrospective, multicenter study.

Seizure

October 2024

IRCCS Istituto delle Scienze Neurologiche di Bologna, U.O.C. Neuropsichiatria dell'età pediatrica, Member of the ERN EpiCare, Bologna, , Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy. Electronic address:

Article Synopsis
  • The study investigates long-term epilepsy outcomes in pediatric patients who experienced acute central nervous system complications during hematopoietic cell transplantation (HCT).
  • Data was collected from 94 patients, revealing that common acute complications included posterior reversible encephalopathy syndrome and infections, with a notable incidence of acute symptomatic seizures.
  • Findings indicate that 9.6% of patients were diagnosed with long-term epilepsy, especially those who experienced acute symptomatic status epilepticus, highlighting the need for specialized neurological follow-up in these cases.
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Head and neck squamous cell carcinomas are characterized by a high incidence of recurrence, especially in patients with locally advanced disease. Standard treatment strategies can be associated with severe side effects to healthy tissues that can negatively impact the patient's quality of life. Hyperthermia (HT) is a noninvasive treatment modality that has improved the effectiveness of chemotherapy (CT) and/or radiotherapy (RT) for the management of some solid neoplasms.

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