Implementing proximity care for people with multiple sclerosis in Italy: the bottom-up approach of the StayHome project.

Objective: In Italy, around 137,000 people live with multiple sclerosis, facing organizational complexities due to the current model's limited focus on proximity care. This project aims to define a proximity model, in accordance with recent developments in the Italian healthcare landscape, engaging over 150 healthcare stakeholders and potentially impacting approximately 14,000 patients.

Methods: An analysis was pursued to map the multiple sclerosis pathway, followed by interviews to capture the actual implementation in Italian Multiple Sclerosis Centers.

A fatal case of peritonitis due to colonic localization of acute myeloid leukemia.

Myeloid sarcoma (MS) is an extramedullary localization of immature granulocyte cells that can occur in association with acute myeloid leukemia (AML). Gastrointestinal involvement is relatively common in MS, but exclusive colonic localization is a rare occurrence. Here, we report on a 53-year-old male patient affected by AML developing a severe abdominal pain caused by intestinal perforation requiring surgical intervention.

Gut Microbiome Implication and Modulation in the Management of Recurrent Urinary Tract Infection.

Urinary tract infections (UTIs) are one of the most common bacterial infections, affecting more than 150 million people each year in the world. UTIs have grown exponentially in the last few years. They represent a major load for both individuals and society.

Impact of Vitamin D Levels on Progression-Free Survival and Response to Neoadjuvant Chemotherapy in Breast Cancer Patients: A Systematic Review and Meta-Analysis.

Breast cancer remains the leading cause of cancer-related deaths among women despite advances in early detection. Neoadjuvant chemotherapy (NACT) is now standard for early-stage BC, with vitamin D (VD) emerging as a potential prognostic biomarker considering its positive pleiotropic effects. This review and meta-analysis assess the impact of baseline VD levels on outcomes in BC patients undergoing NACT.

Long-Term Efficacy and Safety of Nutritional and Pharmacological Strategies for Obesity.

Purpose Of Review: This review examines the long-term efficacy and safety of various nutritional and pharmacological strategies for managing obesity. The focus is on the Mediterranean diet (MedDiet), very low-energy ketogenic therapy (VLEKT), and pharmacological interventions such as naltrexone/bupropion and liraglutide. Given the chronic nature of obesity, understanding the sustainability and impact of these treatments over time is critical.

Prospective per-target analysis of the added value of the PrecisionPoint Transperineal Access System in cognitive prostate biopsy of MRI targets.

Objectives: The objective of this study is to evaluate the diagnostic performance of perineal access cannulas tethered to a biplanar ultrasound probe in cognitive transperineal prostate biopsies of targets identified by multiparametric magnetic resonance imaging (mpMRI) by comparing the results of the PrecisionPoint (PP) Transperineal Access System with the double-freehand (DFH) technique.

Patients And Methods: All patients who underwent cognitive transperineal prostate biopsy of mpMRI targets using the PP or DFH technique between November 2020 and September 2023 were enrolled. All data related to mpMRI target biopsies were stratified by technique, visibility in transrectal ultrasound and analysed by comparing PP versus DFH.

Vacuum extraction is successful in 95% of cases with an occiput posterior position: the results of a prospective, multi-center study.

Background: Occiput-posterior (OP) position is associated with labor arrest, need of operative delivery and failed instrumental vaginal delivery with resulting adverse peripartum outcomes. Vacuum extraction (VE) is the most commonly performed type of instrumental delivery worldwide. This study aimed to investigate the outcome of VE in fetuses with sonographically confirmed OP position prior to the procedure.

Are We Able to Optimize Outcomes and Predict Complications in Pelvic Floor Surgery With a Better Understanding of Hormonal, Microbial and Other Factors? A Report From the ICI-RS 2024.

Introduction: Pelvic organ prolapse (POP) is a common condition, affecting women worldwide and is known to have a significant impact on Health Related Quality of Life (HRQoL). Although there are various treatment options available, including pelvic floor muscle training and support pessaries, many women opt for or require surgery, with a lifetime risk of needing surgery of 12%-19%. As with any operation, this does not come without its complications and the reoperation rate following POP surgery is up to 36%.

Crimean-Congo haemorrhagic fever (CCHF): present and future therapeutic armamentarium.

Crimean-Congo haemorrhagic fever (CCHF) is an emerging severe tick-borne illness. The expanding habitat of ticks, coupled with migratory birds harbouring CCHF-infected ticks, contributes to an increasing number of potential hosts. The seroprevalence of anti-CCHF virus antibodies in livestock is approximately one-quarter, with a noticeable upward trend in recent years.

Protein kinase inhibitors as targeted therapy for glioblastoma: a meta-analysis of randomized controlled clinical trials.

Glioblastoma (GBM) is the most common and lethal primary brain tumor. The standard treatment for newly diagnosed GBM includes surgical resection, when feasible, followed by radiotherapy and temozolomide-based chemotherapy. Upon disease progression, the anti-vascular endothelial growth factor-A (VEGF-A) monoclonal antibody bevacizumab, can be considered.

Consensus of the Italian Primary Immunodeficiency Network on the use and interpretation of genetic testing for the diagnosis of inborn errors of immunity (IEI).

Background: Inborn errors of immunity (IEIs) are more than 500 different rare congenital disorders of the immune system characterized by susceptibility to infections and immune dysregulation. The significant overlap of the clinical features among the different forms may lead to diagnostic delay. High throughput sequencing techniques may allow a timely genetic definition.

When do the pathological signs become evident? Study of human mesenchymal stem cells in MDPL syndrome.

Aging syndromes are rare genetic disorders sharing the features of accelerated senescence. Among these, Mandibular hypoplasia, Deafness and Progeroid features with concomitant Lipodystrophy (MDPL; OMIM #615381) is a rare autosomal dominant disease due to a in-frame deletion in gene, encoding the catalytic subunit of DNA polymerase delta. Here, we investigated how MSCs may contribute to the phenotypes and progression of premature aging syndromes such as MDPL.

Efficacy and Safety of Weekly Calcifediol Formulations (75 and 100 µg) in Subjects with Vitamin D Deficiency: A Phase II/III Randomised Trial.

Background/objective: Optimal vitamin D levels are required for bone health and proper functionality of the nervous, musculoskeletal and immune systems. The objective of this study was to assess the efficacy and safety profiles of new weekly calcifediol formulations with the potential to improve adherence and outcome.

Methods: A Phase II-III, double-blind, randomized, multicentre trial (EudraCT 2020-001099-14 and NCT04735926).

Juxta-anastomotic stenosis in the forearm native arteriovenous fistula: Open surgery or angioplasty?

Background: The juxta-anastomotic stenosis (JAS) represents the major complication of arteriovenous fistula (AVF) during the first months after the surgery and the approach to JAS can be surgical or radiological.

Methods: From 01/02/2016 to 31/12/2020, a total of 976 radiocephalic fistulas have been performed. The 15.

The Objective Response and Disease Control Rates in Patients with Liver Metastastic Breast Cancer Receiving Transarterial Radioembolization: A Meta-Analysis.

Aim: To meta-analyze the utility of transarterial radioembolization (TARE) in patients with liver metastatic breast cancer (BC), based on the objective response rate (ORR) and disease control rate (DCR).

Methods: A literature search was performed retrieving studies with (1) at least 10 patients with liver metastatic BC treated with TARE and (2) adequate information to derive ORR and DCR. The ORR is the ratio between patients with liver lesions showing complete response (CR) or partial response (PR) over the total number of patients treated with TARE; the DCR is the ratio between patients with CR, PR, or stable disease (SD) over the total number of patients treated with TARE.

Safe Integration of Encorafenib plus Binimetinib with Stereotactic Radiosurgery for Melanoma Brain Metastases: a Case Report.

Background: Melanoma brain metastases represents a significant clinical challenge, frequently associated with high morbidity and mortality. Recent advancements in neuroimaging, radiation therapy, and targeted systemic therapies, specifically BRAF and MEK inhibitors, have improved the management of this condition. Nevertheless, the optimal therapeutic approach for melanoma brain metastases remains a subject of ongoing debate, with no universally accepted treatment protocol.

Management of Ureteral Stricture Disease After Radiation Therapy for Pelvic Malignancies: A Retrospective, Multi-Institutional Analysis.

Objectives: A radiation-induced ureteral stricture (RIUS) is a challenging condition in urologic surgery, and the optimal surgical strategy is still a matter of debate. The aim of this study was to report post-operative outcomes of minimally invasive management of this condition from a multi-institutional cohort.

Methods: Data of patients with diagnoses of RIUS at five referral robotic centers between January 2017 and December 2022 were retrospectively analyzed.

Rare connective tissue diseases in patients with C1-inhibitor deficiency hereditary angioedema: first evidence on prevalence and distribution from a large Italian cohort study.

Introduction: In patients with Hereditary Angioedema (HAE) related to primary C1 inhibitor deficiency (C1INH), the defective clearance of immune complexes and apoptotic materials along with impairment of normal humoral response potentially leads to autoimmunity. Few studies report evidence on autoimmune diseases in C1INH-HAE, but no large population studies focus on rare connective tissue diseases (RCTDs). We aim at evaluating for the first time prevalence and distribution of RCTDs - Systemic Lupus Erytematosus (SLE), primary Sjogren Syndrome (SjS), primary antiphospholipid syndrome (APS), Systemic Sclerosis (SSc), and mixed connective tissue diseases (MCTD) in a large Italian cohort of C1INH-HAE patients.

Management of de novo Metastatic Hormone-Sensitive Prostate Cancer (mHSPC) and the role of Radiation Therapy: A Consensus by the Italian Association of Radiotherapy and Clinical Oncology (AIRO).

Purpose: Prostate cancer treatments paradigms are in continuous evolution, especially in the metastatic setting. In this context, the Genito-Urinary Group of Italian Association of Radiotherapy and Clinical Oncology aimed to create a consensus on radiation therapy indication in de novo metastatic hormone-sensitive prostate cancer both on primary tumor and metastatic sites.

Methods: A panel of experts, involved in clinical management of prostate cancer, through the estimate-talk-estimate method, developed a list of items and correspondent statements on the identified topic.