3,023 results match your criteria: "University - Hospital " Santa Maria della Misericordia"[Affiliation]"

Background: Thyroid nodules are common findings during the diagnostic work-up in potential organ donors. A fast yet thorough assessment to rule out cancer is mandatory but their management remains heterogeneous among hospitals and the evidence in this field is scarce. We present our institutional experience and review the most recent literature on this topic.

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Article Synopsis
  • Researchers believe that lung ultrasound scores (LUS) can better predict cardiac risks in elderly patients undergoing hip fracture surgery, compared to existing methods like the Revised Cardiac Risk Index and ASA Physical Status.
  • The study involved 877 patients across 11 Italian hospitals, finding a significant correlation between higher LUS scores and complications, with a notable incidence of major adverse cardiovascular events (MACE).
  • Results showed that a preoperative LUS score of 8 or higher was more effective at predicting MACE than traditional scoring methods, indicating its potential as a valuable tool for risk assessment in this patient population.
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Multifragmentary and displaced zygomaticomaxillary complex (ZMC) fractures are often a challenge for the maxillofacial surgeon. The aim of this study was to evaluate the improved performance in the management of patients with tripod fracture of the orbito-zygomaticomaxillary complex, using two different methods of virtual surgical planning - virtual reduction and mirroring - compared with traditional management. A cohort of 60 patients was selected and divided into three groups, each consisting of 20 individuals.

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Background: The clinical governance of patients with acute myocardial infarction (AMI) has markedly changed in the last few years. We sought to assess the contemporary in-hospital management patterns of patients with AMI at a country level.

Methods: EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units)-2 was a nationwide, prospective registry aimed to evaluate the current management of patients admitted to intensive cardiac care units (CCUs) for an AMI in Italy.

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Genetic variants in patients with recurrent pericarditis.

J Cardiovasc Med (Hagerstown)

November 2024

Cardiology and Cardiothoracic Department.

Aims: Presence of family cases and multiple recurrences of pericarditis suggest the existence of a possible genetic background in at least 10% of cases. The aim of the present study is to describe the genetic landscape of a cohort of patients with multiple recurrences (at least two recurrences).

Methods: Retrospective cohort study of consecutive adult patients referred for at least two episodes of recurrences in a tertiary referral centre.

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Background: Cardiac resynchronization therapy (CRT) is a guideline-recommended therapy in patients with heart failure with mildly reduced ejection fraction (HFmrEF, 36%-50%) and left bundle branch block or indication for ventricular pacing. Conduction system pacing (CSP) using left bundle branch area pacing or His bundle pacing has been shown to be a safe and physiologic alternative to biventricular pacing (BVP).

Objective: The aim of this study was to compare the clinical outcomes between BVP and CSP for patients with HFmrEF undergoing CRT.

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[Ten questions about infective endocarditis].

G Ital Cardiol (Rome)

October 2024

Unità di Cure Intensive Cardiologiche, Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano.

Infective endocarditis (IE) is an infective process involving the endocardium and, more frequently, the native heart valves, valvular prostheses and cardiac implantable electronic devices. IE can manifest with various non-specific symptoms making the diagnosis challenging. This condition is associated with high in-hospital and long-term mortality.

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The emergence of SARS-CoV-2 and the non-pharmacological interventions adopted to counter its spread appear to have led to changes in the normal circulation and seasonality of respiratory viruses. Our study aims to investigate changes related to the circulation of respiratory viruses, not SARS-CoV-2, among hospitalized patients in Perugia, Central Italy, between 2019 and 2023. The samples were collected from individuals who went to the emergency room (ER) or were hospitalized and analyzed using a molecular multiplex test.

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A new human opisthorchiasis outbreak in central Italy: a never-ending story.

Infection

September 2024

Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Gambuli 1, Perugia, 06100, Italy.

Article Synopsis
  • A study focused on a 2022 outbreak of Opisthorchis felineus infection in Central Italy, tracing 67 individuals with 47 diagnosed cases linked to a lakeshore restaurant, highlighting patterns from previous outbreaks between 2003-2011.* -
  • Symptoms included fever in most patients, with 16 needing hospitalization; diagnostic tests revealed a high percentage of parasitic eggs in feces and significant lab abnormalities, such as eosinophilia.* -
  • The study emphasizes the difficulty in diagnosing asymptomatic cases and raises concerns about the ineffectiveness of albendazole as a treatment option, advocating for better control measures in endemic regions.*
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Surgical management of anastomotic leakage related to ovarian cancer surgery: a narrative review.

Front Surg

September 2024

Department of Medical Area (DMED), Clinic of Obstetrics and Gynecology Unit, Santa Maria Della Misericordia Hospital, Azienda Sanitaria Friuli Centrale, Udine, Italy.

This narrative review describes the state of the art in the management of anastomotic leakage in ovarian cancer. Multiple surgical procedures, including bowel resection, are often required to achieve "optimal" cytoreduction in locally advanced ovarian cancer. Intestinal anastomosis is currently the most common way to restore bowel continuity.

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Background: Voluntary PCa screening frequently results in excessive use of unnecessary diagnostic tests and an increasing risk of detection of indolent PCa and unaffordable costs for the various national health systems. In this scenario, the Italian Society of Urology (Società Italiana di Urologia, SIU) proposes an organized flow chart guiding physicians to improve early diagnosis of significant PCa avoiding unnecessary diagnostic tests and prostate biopsy.

Methods: According to available evidence and international guidelines [i.

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To contrast opportunistic PCa screening, the European Union Council suggested extending screening programs to PCa by recommending the implementation of a stepwise approach in the EU Countries to evaluate the feasibility and effectiveness of an organized program based on PSA testing in combination with additional MRI as a follow-up test. The objective of this expert-based document is to propose an organized PCa screening program according to the EU Council recommendations. The Italian Society of Urology (SIU) developed a team of experts with the aim to report 1) the most recent epidemiologic data about incidence, prevalence, and mortality of PCa; 2) the most important risk factors to identify categories of men with an increased risk to eventually develop the disease; 3) the most relevant studies presenting data on population-based screening; and 4) the current recommendations of the leading International Guidelines.

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Management of infections for patient treated with ibrutinib in clinical practice.

Front Oncol

September 2024

Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncology Research (CREO), University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy.

Ibrutinib, a highly effective inhibitor of the Bruton tyrosine kinase, has significantly transformed the therapeutic approach in chronic lymphocytic leukemia (CLL). Despite these advancements, the disease continues to be characterized by immune dysfunction and increased susceptibility to infections, with mortality rates from infections showing no significant improvement over the past few decades. Therefore, timely prevention, recognition, and treatment of infections remains an important aspect of the standard management of a patient with CLL.

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Efficacy of early use of percutaneous stellate ganglion block for electrical storms.

Eur Heart J Acute Cardiovasc Care

December 2024

Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy.

Article Synopsis
  • Electrical Storm (ES) is a critical condition that can be managed effectively using a technique called Percutaneous Stellate Ganglion Block (PSGB), which has shown positive results when used alongside standard therapy.
  • In a study analyzing 180 patients, those who received PSGB early experienced a significant reduction in arrhythmic events within the hour following the block compared to the hour before, although the overall effectiveness was similar to those who received PSGB later.
  • The findings suggest that early use of PSGB could help reduce the frequency of defibrillations and potentially lessen the risk of a more severe, refractory ES, demonstrating its effectiveness in early treatment settings.
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Background: The impact of the order of treatment with checkpoint inhibitors or BRAF/MEK inhibitors on the development of brain metastases in patients with metastatic unresectable V600-mutant melanoma is unknown. The SECOMBIT trial examined the impact of the order of receipt of these treatments in such patients.

Methods: In this three-arm trial, we reviewed patients without brain metastases who received the BRAF/MEK inhibitors encorafenib and binimetinib until they had progressive disease followed by the immune checkpoint inhibitors ipilimumab and nivolumab (arm A); or treatment with ipilimumab and nivolumab until they had progressive disease followed by encorafenib and binimetinib (arm B); or treatment with encorafenib and binimetinib for 8 weeks followed by ipilimumab and nivolumab until they had progressive disease followed by retreatment with encorafenib arm binimetinib (arm C).

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Bloodstream Infections Due to Wild-Type : Carbapenems and Ceftazidime/Avibactam Prescription Rate and Impact on Outcomes.

Infect Dis Rep

August 2024

Infectious Diseases Clinic, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, 06132 Perugia, Italy.

Background: is one of the major concerns among bacterial diseases even when it shows a wild-type susceptibility pattern. In 2020, EUCAST reconsidered antibiogram interpretation shifting "I" from "intermediate" to "sensible, increased exposure" with possible significant impact on antibiotic prescription. The aim of this study was to evaluate mortality in patients with bloodstream infections treated with antipseudomonal penicillins or cephalosporins vs.

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Non-technical skills for neurosurgeons: An international survey.

Brain Spine

August 2024

Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico "C. Besta", Milano, Italy.

Article Synopsis
  • Neurosurgery requires not only technical skills but also non-technical skills (NTSs) to achieve mastery, highlighting the importance of both in surgical practice.
  • An international survey of 372 neurosurgeons indicates that qualities like attention to detail, humility, and self-awareness are vital for surgical precision and effective teamwork.
  • The study advocates for integrated training that includes simulations and mentorship to enhance NTSs, while also stressing the need for research aimed at improving educational methods, especially in regions with unequal access to neurosurgical care.
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Potential role of glucagon-like peptide-1 (GLP-1) receptor agonists in substance use disorder: A systematic review of randomized trials.

Drug Alcohol Depend

November 2024

Department of Medical and Surgical Sciences and Translational Medicine, Division of General and Hepatobiliary Surgery, St. Andrea Hospital, Sapienza University of Rome, Italy. Electronic address:

Background: Increasing evidence suggests that GLP-1 receptor agonists (GLP-1RA) have a potential use in addiction treatment. Few studies have assessed the impact of GLP-1RA on substance use disorder (SUD), particularly in humans. The study aimed to do systematic review of clinical trials to assess GLP-1RA's effect on reducing SUD in patients.

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Background And Purpose: Although there is extensive evidence about the safety of monoclonal antibodies against calcitonin gene-related peptide (anti-CGRP mAbs) in combination with traditional drugs, scarce data are available on the safety of their combination with other mAbs. This study aimed to evaluate the 6-month effectiveness and tolerability of anti-CGRP mAbs in combination with other mAbs for different diseases.

Methods: Patients included in the Italian Headache Registry and treated concomitantly with an anti-CGRP mAb and another mAb were included.

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A pilot study of chlorambucil in pre-treated metastatic pancreatic adenocarcinoma patients bearing germline BRCA or other DNA damage repair system variants.

Pancreatology

November 2024

Department of Medical Oncology, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. Electronic address:

Backgorund: Pancreatic adenocarcinoma remains a malignancy with a grim prognosis and scarce personalized treatment options. Pathogenic variants of DNA damage repair (DDR) genes are emerging as molecular targets, as they confer a higher sensitivity to DNA-damaging agents. This study aimed at assessing the activity of chlorambucil as salvage therapy in metastatic pancreatic cancer patients bearing a germline pathogenetic variant or variant of uncertain significance on a DDR-related gene.

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Intestinal anti-endomysium antibodies are a specific marker of celiac disease. The diagnostic accuracy of this marker seems high in pediatric patients and has not yet been investigated in adults, so the aim of this prospective multicentric study was to evaluate the specificity and sensitivity of this marker in childhood and adulthood. Pediatric and adult patients undergoing intestinal endoscopy for any intestinal condition were enrolled.

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A compartmental pharmacokinetics (PK) analysis of new extended half-life FVIII concentrates has never been performed in a large cohort of hemophilia patients. An improved PK analysis of individual outcomes may help to tailor hemophilia replacement treatment. PK outcomes after the infusion of a standard single dose of Efmoroctocog alfa were collected from 173 patients with severe/moderately severe hemophilia A in 11 Italian hemophilia centers.

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This video article summarizes a case study involving the use of pelvic sentinel lymph node (SLN) biopsy for endometrial cancer (EC) staging and treatment utilizing a multi-modal infrared signal technology. This innovative approach combines cervical injection of fluorescent dye indocyanine green (ICG) and near-infrared imaging to enhance SLN detection rates in early-stage EC patients. The study showcases the successful application of advanced technology in improving surgical staging procedures and reducing postoperative morbidity for patients.

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