Systemic Inflammation after Uniport, Multiport, or Hybrid VATS Lobectomy for Lung Cancer.

Background: Different video-assisted thoracic surgery (VATS) approaches can be adopted to perform lobectomy for non-small cell lung cancer. Given the hypothetical link existing between postoperative inflammation and long-term outcomes, we compared the dynamics of systemic inflammation markers after VATS lobectomy performed with uniportal access (UNIVATS), multiportal access (MVATS), or hybrid approach (minimally invasive hybrid open surgery, MIHOS).

Methods: Peripheral blood-derived inflammation markers (neutrophil-to-lymphocyte [NTL] ratio, platelet-to-lymphocyte [PTL] ratio, and systemic immune-inflammation index [SII]) were measured preoperatively and until postoperative day 5 in 109 patients undergoing UNIVATS, MVATS, or MIHOS lobectomy.

Medicolegal Issues: Perception, Awareness, and Behavioral Changes Among Italian Neurosurgical Community: Survey-Based Analysis.

Background: Despite the rising trend of medicolegal challenges in Italy, there is a significant lack of literature on this topic. To provide better understanding of awareness toward medicolegal aspects, defensive behavior, consent-taking practice, and general perceptions of Italian neurosurgeons on this issue, a cross-sectional survey was conducted.

Methods: A questionnaire covering various aspects of medicolegal issues, in an anonymous online form, was sent to neurosurgeons practicing in Italy via e-mail-through a national mailing list-and social media platforms.

Job satisfaction among physicians and nurses involved in the management of multiple sclerosis: the role of happiness and meaning at work.

Objective: Health professionals caring for persons with multiple sclerosis (MS) are faced with increasingly complex working conditions that can undermine their job satisfaction and the quality of their healthcare services. The aim of this study was to delve into health professionals' job satisfaction by assessing the predictive role of happiness and meaning at work. Specifically, it was hypothesized that job meaning would moderate the relationship between job happiness and satisfaction.

Epidemiology, diagnosis and management of Baastrup's disease: a systematic review.

Introduction: Baastrup's disease (BD) is a common cause of low back pain which is often underdiagnosed. It is characterized by adjacent interspinous processes contact and it can be associated with cystic lesions. The aim of this review was to evaluate the epidemiology, diagnosis, and treatment options of patients with BD.

The impact of strategies to manage the COVID-19 pandemic on patients with intrathecal baclofen therapy.

Background: The activities related to intrathecal baclofen (ITB) therapy could not be interrupted at the outbreak of COVID-19 pandemic due to possible life-threatening related complications such as withdrawal and over dosage syndromes. In this study we reported the different adopted strategies to manage patients with an ITB implanted infusion pump during the pandemic period and studied the impact of these strategies on experiences reported from patients and their caregivers, assessed through a specific survey.

Methods: Thirty-five patients (mean age: 43.

The use of mixed reality for the treatment planning of unruptured intracranial aneurysms.

Background: A thorough comprehension of topographic neuroanatomy is paramount in neurosurgery. In recent years, great attention has been raised towards extended reality, which comprises virtual, augmented, and mixed reality (MR) as an aid for surgery. In this paper, we describe our preliminary experience with the use of a new MR platform, aiming to assess its reliability and usefulness in the planning of surgical treatment of unruptured intracranial aneurysms.

A supervised machine-learning algorithm predicts intraoperative CSF leak in endoscopic transsphenoidal surgery for pituitary adenomas.

Background: Despite advances in endoscopic transnasal transsphenoidal surgery (E-TNS) for pituitary adenomas (PAs), cerebrospinal fluid (CSF) leakage remains a life-threatening complication predisposing to major morbidity and mortality. In the current study we developed a supervised ML model able to predict the risk of intraoperative CSF leakage by comparing different machine learning (ML) methods and explaining the functioning and the rationale of the best performing algorithm.

Methods: A retrospective cohort of 238 patients treated via E-TNS for PAs was selected.

Breast cancer related upper limb lymphedema: approach and surgical management.

Lymphedema of the upper extremities in a common, chronic, progressive and debilitating disease, that affects the increasing population of cancer survivors. The gold standard is nowadays an integrated approach, including conservative and surgical treatment. Lymphatic surgery, particularly the physiologic procedures including lymphatic-venous anastomosis and vascularized lymph node transfer, should be offered to lymphedema patients as soon as possible, aimed to ameliorate the subjective symptoms and to interrupt the degeneration cascade that makes this condition progressive over time.

Surgical management of BRCA pathogenic variant carriers with breast cancer: a recent literature review and current state of the art.

Surgical management of breast cancer patients carrying pathogenic variants (PV) on breast cancer genes (BRCA) 1 and 2 has changed throughout the last decade due to growing availability of genetic testing, and has shifted towards the diffusion of bilateral mastectomy. Today's scenario however is in further evolution because of emerging data that suggest a personalized modulation of treatment. In this work we aimed to gather recent evidence supporting a prophylactic or conservative surgical approach in order to define the state of the art in today's treatment of BRCA carriers with breast cancer.

Impact on survival of primary tumor resection in patients with metastatic breast cancer: preliminary results of a retrospective analysis.

Background: Treatment of de-novo metastatic breast cancer is usually centered around systemic therapy, with local therapy (surgery and radiation therapy) largely reserved for palliation in patients with significant symptoms from primary tumor. The efficacy of locoregional treatment like surgery and/or radiotherapy is still controversial and the debate about surgical resection of primary tumor (PT) in de novo metastatic breast cancer (MBC) patients persists.

Methods: All patients with de-novo MBC undergone surgical treatment between January 2015 and January 2020 at the Multidisciplinary Breast Center of the IRCCS A.

Techniques for sentinel node biopsy in breast cancer.

Sentinel node biopsy (SNB) is the standard of care in women with breast cancer (BC) and clinically nonsuspicious axillary lymph nodes (LNs), due to its high negative predictive value (NPV) in the assessment of nodal status. SNB has significantly reduced complications related to the axillary lymph node dissection, such as lymphedema and upper limb dysfunction. The gold standard technique for SNB is the blue dye (BD) and technetium labelled nanocolloid (Tc-99m) double technique.

Validation of a prognostic model including the number of harvested lymph-nodes in the setting of non-small cell lung cancer patients undergoing curative resection: a multicenter analysis.

Background: The prognostic role of the extension of lymphadenectomy in non-small-cell lung cancer is still a debated and intriguing issue. The aim of this study is to validate a prognostic score including the number of resected lymph-nodes previously reported using a large multicenter dataset.

Methods: From 01/2002 to 12/2012, data on 4858 NSCLC patients undergoing curative-intent surgery in six institutions were retrospectively reviewed.

Compassionate use of anti-IL6 receptor antibodies in critically ill patients with acute respiratory distress syndrome due to SARS-CoV-2.

Background: COVID-19 patients developing the acute respiratory distress syndrome (ARDS) show increased production of pro-inflammatory cytokines, including interleukin-6 (IL-6). The use of humanized monoclonal antibody against interleukin-6 receptor (IL-6R) may represent a potential treatment strategy. We analyzed the effects of compassionate use of tocilizumab and sarilumab on clinical outcome of patients affected by ARDS due COVID-19.

Treatment adherence with diclofenac 3% gel among patients with multiple actinic keratoses: an integrated low-intensity intervention program versus standard-of-care.

Background: Diclofenac 3% gel is a widely used topical treatment with proven efficacy in reducing the burden of actinic keratosis (AK); however, clinical benefit might not fully translate in clinical practice as nonadherence is substantial for prolonged treatment regimens. We evaluated the efficacy of an integrated low-intensity intervention program versus standard-of-care on treatment adherence among patients with multiple AK receiving diclofenac in hyaluronic acid gel 3%.

Methods: We designed an open label, randomized, parallel group, interventional, multicenter, longitudinal cohort study including patients with multiple, grade I/II AKs.

Immune system and gut microbiota senescence in elderly IBD patients.

In inflammatory bowel disease (IBD), the loss of immune tolerance against gut microbiota causes chronic inflammation and the progressive accumulation of organ damage in genetically susceptible individuals. In the elderly, IBD is often characterized by a different disease behavior when compared with pediatric and young adult disease. Besides disease behavior, another aspect of the multifaceted impact of age on elderly IBD course is increased susceptibility to infections.

Clear cell endometrial carcinomas with mismatch repair deficiency have a favorable prognosis: A systematic review and meta-analysis.

Introduction: In the ESGO/ESTRO/ESP guidelines for endometrial carcinoma management, the risk category of clear cell carcinoma (CCC) is not well defined. In fact, while p53-abnormal (p53abn) CCC are known to be aggressive, the prognosis of mismatch repair-deficient (MMRd) and p53-wild-type (p53wt) CCCs is less clear.

Objective: To assess the prognostic value of the MMRd and p53wt groups in CCC through a systematic review and meta-analysis.

Lung ultrasound predicts non-invasive ventilation outcome in COVID-19 acute respiratory failure: a pilot study.

Background: The aim of this study is to determine relationships between lung aeration assessed by lung ultrasound (LUS) with non-invasive ventilation (NIMV) outcome, intensive care unit (ICU) admission and mechanical ventilation (MV) needs in COVID-19 respiratory failure.

Methods: A cohort of adult patients with COVID-19 respiratory failure underwent LUS during initial assessment. A simplified LUS protocol consisting in scanning six areas, three for each side, was adopted.

Impact of adenomyosis on the prognosis of patients with endometrial cancer.

Background: Despite the high prevalence of adenomyosis in hysterectomy specimens of endometrial carcinoma (EC) patients, the relationship between adenomyosis and EC prognosis appears unclear.

Objective: To assess the prognostic value of coexistent adenomyosis in patients with EC.

Methods: A systematic review and meta-analysis was performed by searching six electronic databases for studies reporting data on prognosis of EC patients with and without coexistent adenomyosis.

Management of intracranial hypertension following traumatic brain injury: a best clinical practice adoption proposal for intracranial pressure monitoring and decompressive craniectomy. Joint statements by the Traumatic Brain Injury Section of the Italian Society of Neurosurgery (SINch) and the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI).

No robust evidence is provided by literature regarding the management of intracranial hypertension following severe traumatic brain injury (TBI). This is mostly due to the lack of prospective randomized controlled trials (RCTs), the presence of studies containing extreme heterogeneously collected populations and controversial considerations about chosen outcome. A scientific society should provide guidelines for care management and scientific support for those areas for which evidence-based medicine has not been identified.

Bone metabolism in pregnancy and lactation.

Introduction: Different hormonal mechanisms regulate bone metabolism during pregnancy and lactation. In both those periods of life, a fine modulation of calcium metabolism is necessary to meet the needs of foetus and new-born.

Evidence Acquisition: We reviewed scientific literature on the topic "osteoporosis," "pregnancy" and "lactation," evaluating the most relevant data from original articles, reviews and meta-analyses.

Clinical pharmacology of progestins.

Introduction: In this paper, we report general pharmacological profile and major biological activities of natural progesterone (P) and progestins. The aim of this article consists of synthesizing the principal aspects of pharmacology and metabolism of P and progestins related to the clinical consequences of their use.

Evidence Acquisition: We review scientific literature on the topic "progestins," evaluating the most relevant data from original articles, reviews, and meta-analyses.