57 results match your criteria: "University of Insubria-ASST Sette Laghi[Affiliation]"

Article Synopsis
  • Kaposi sarcoma herpesvirus/human herpesvirus-8 (HHV-8) poses serious health risks for solid organ transplant recipients, with higher seroprevalence noted in recipients (8.4%) compared to donors (3.3%).
  • Among transplant patients, a specific group of donors (D+) and recipients (R-) showed notable rates of HHV-8-related diseases, like Kaposi sarcoma (KS) and associated inflammatory cytokine syndrome (KICS), emphasizing the importance of careful monitoring.
  • Effective management of HHV-8 diseases, such as KICS, suggests that treatment options like rituximab can significantly impact patient outcomes, highlighting the need for serologic screening and timely interventions.
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Aim: Myopericytoma (MPC) is a rare tumour characterized by a perivascular proliferation of pericytic cells with myoid differentiation and a typical spindle shape. Except for the rare malignant cases, MPC mostly shows a benign course. Symptoms are often non-specific, and the diagnosis could be accidental.

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Background: Expected and unexpected donor-derived infections (DDI) are a rare event in solid organ transplant (SOT) recipients but are potentially associated with significant morbidity and mortality. To assure the microbial safety of transplantation, both national guidelines and the current, regional, and local epidemiology of infectious diseases must be considered.

Methods: In the present paper the strategies adopted by the Italian National Center for Transplantation (CNT) since 2003 and their evolution to guarantee the safety of organ transplantation are reported.

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Sex dependence of postoperative pulmonary complications - A post hoc unmatched and matched analysis of LAS VEGAS.

J Clin Anesth

December 2024

Amsterdam University Medical Center, Department of Anaesthesiology, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands; Amsterdam University Medical Center, Department of Intensive Care, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands.

Article Synopsis
  • The study aimed to investigate whether there are differences in postoperative pulmonary complications (PPCs) between males and females following surgery under general anesthesia, using data from the LAS VEGAS study involving 146 hospitals across 29 countries.
  • A total of 9,697 patients were analyzed in two cohorts: an unmatched cohort (55.1% female, 44.9% male) and a matched cohort (50% female and male), finding no significant differences in PPC rates between the genders in both cohorts.
  • The study concluded that, in this international patient population, the incidence of PPCs did not differ significantly between males and females, as well as noting comparable hospital stays and mortality rates.*
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Risk factors for infection after carbapenem-resistant Acinetobacter baumannii colonization.

Eur J Clin Microbiol Infect Dis

November 2024

Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy.

Purpose: Predicting infection risk in carbapenem-resistant Acinetobacter baumannii (CRAB) colonized patients may help in improving timely appropriate antibiotic therapy. This study aims to explore risk factors for developing infections in hospitalized patients with previous CRAB colonization.

Methods: We performed an observational retrospective cohort study at ASST Sette Laghi-Varese Hospital between January 2020 and December 2022.

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Background: The intrauterine manipulator used during a hysterectomy for endometrial cancer has been suggested as a reason for worsening oncologic outcomes. However, only a few non-randomized retrospective studies have investigated this association.

Primary Objectives: To compare 4-year recurrence-free survival in the group of patients who undergo hysterectomy using an intrauterine manipulator with that of those who undergo hysterectomy without it.

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Article Synopsis
  • A study on perioperative antibiotic prophylaxis (PAP) in lung transplant recipients over a 20-year period revealed significant variation in practices among different centers.
  • The research enrolled 111 lung transplant recipients, finding that most received combination therapy, while the median duration for PAP was 10 days.
  • However, the study concluded that there was no significant difference in preventing early post-operative infections (EPOIs) between combination and single-agent therapies, and duration of PAP also did not impact EPOI rates.
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Perspectives on donor-derived infections from the Notify Library.

Transpl Infect Dis

November 2024

Unit Trapianti Lombardia - NITp Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy.

It is impossible to eliminate the potential for transmission of donor-derived infections (DDI) when using medical products of human origin (MPHO). However, a thoughtful and systematic approach to donor evaluation can mitigate the risk. Prevention is a key issue, and physicians must maintain a high index of suspicion and remain vigilant in evaluating MPHO donors or recipients, as well as stay current on emerging infections.

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Lung transplant recipients (LTRs) respond poorly to vaccination. SARS-CoV-2 pre-exposure prophylaxis (PrEP) with tixagevimab/cilgavimab (TIX/CIL) reduces the incidence of infection and the evolution to severe COVID-19. In vitro data show decreased activity against Omicron variants.

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Intra-abdominal infections (IAIs) are common surgical emergencies and are an important cause of morbidity and mortality in hospital settings, particularly if poorly managed. The cornerstones of effective IAIs management include early diagnosis, adequate source control, appropriate antimicrobial therapy, and early physiologic stabilization using intravenous fluids and vasopressor agents in critically ill patients. Adequate empiric antimicrobial therapy in patients with IAIs is of paramount importance because inappropriate antimicrobial therapy is associated with poor outcomes.

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Unexpected donor-derived fungal infections represent a rare but potentially fatal complication in lung transplant (Tx) recipients. Timely communication of the results of donor cultures and prompt treatment of recipients are crucial to mitigate the consequences of donor-derived transmissions. In this prospective cohort study, all consecutive patients who underwent lung transplantation from 2015 to 2022 were included.

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To investigate the dynamic evolution of vaccine hesitancy toward both COVID-19 and influenza in a context characterized by the compresence of SARS-CoV-2 pandemic and seasonal flu epidemics, a two times repeated cross-sectional exploratory design was performed at Udine Hospital (Italy) following a cohort of 479 adult patients with a previous history of SARS-CoV-2 infection in 2020. Vaccine attitude was assessed through standardized telephone interviews performed at 12 and 18 months after the acute illness. The first interview reported the success of the 2020/21 seasonal influenza immunization with 46.

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This large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs.

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Article Synopsis
  • The document outlines the goal of creating standardized research definitions for invasive fungal diseases (IFD) in adult ICU patients without typical risk factors for these infections.
  • A panel of experts assessed existing definitions and lab tests for IFD, using the RAND/UCLA method to reach a consensus on new definitions.
  • Key standardized definitions were made for conditions like invasive candidiasis and aspergillosis, but more data is needed for other IFDs, with the intent to enhance future research studies.
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Article Synopsis
  • Solid organ transplant (SOT) recipients experience poorer vaccine responses and higher complications from COVID-19, but guidelines for their management are unclear.
  • A survey conducted among members of ESCMID and ESOT explored diverse approaches to handling COVID-19 in SOT recipients, covering prevention and treatment for early, late, and persistent cases.
  • The results indicated significant variability in treatment practices among participating physicians, particularly regarding early and late COVID-19 care, while prophylaxis recommendations showed more agreement.
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Objectives: To assess the prevalence of neuropsychiatric symptoms 2 years after the COVID-19 acute phase and to identify biobehavioral risk factors.

Methods: This 2-year prospective study assessed adult individuals with COVID-19 via face-to-face interview and laboratory testing at onset, and via telephone interview at 2-year follow-up. Data collected included COVID-19 severity and management at onset, as well as depression, anxiety, insomnia, cognitive failure, and fatigue at follow-up using standardized assessment tools.

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Donor-derived infections (DDIs) caused by carbapenem-resistant gram-negative bacteria (CR-GNB) in solid organ transplant recipients are potentially life-threatening. In this prospective study, we evaluated the incidence, factors associated with transmission, and the outcome of recipients with unexpected CR-GNB DDIs after the implementation of our local active surveillance system (LASS). LASS provides for early detection of unexpected donor CR-GNB infections, prophylaxis of recipients at high risk, and early diagnosis and treatment of DDIs.

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Recent advances in cytomegalovirus infection management in solid organ transplant recipients.

Curr Opin Organ Transplant

April 2024

Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy.

Purpose Of Review: Human cytomegalovirus (CMV) continues to be the most important infectious complication following solid organ transplantation (SOT).

Recent Findings: Universal prophylaxis and preemptive therapy are the most adopted strategies for prevention of CMV disease globally. Prophylaxis with valganciclovir is the most widely used approach to CMV prevention, however leukopenia and late onset CMV disease after discontinuation of prophylaxis requires new strategies to prevent this complication.

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Background: Performance of active screening for multidrug-resistant Gram-negative bacteria (MDR-GNB) and administration of targeted antibiotic prophylaxis (TAP) in colonized patients undergoing liver (LT) and/or kidney transplantation (KT) are controversial issues.

Methods: Self-administered electronic cross-sectional survey disseminated from January to February 2022. Questionnaire consisted of four parts: hospital/transplant program characteristics, standard screening and antibiotic prophylaxis, clinical vignettes asking for TAP in patients undergoing LT and KT with prior infection/colonization with four different MDR-GNB (extended-spectrum cephalosporin-resistant Enterobacterales [ESCR-E], carbapenem-resistant Enterobacterales [CRE], multidrug-resistant Pseudomonas aeruginosa [MDR-Pa], and carbapenem-resistant Acinetobacter baumannii [CRAb]).

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Objectives: To describe the dynamics and factors related to natural and hybrid humoral response against the SARS-CoV-2 and risk of reinfection among first-wave patients.

Methods: A prospective longitudinal study with periodic serological follow-up after acute onset of all recovered patients with SARS-CoV-2 infection cared in Udine Hospital (March-May 2020). Nucleocapsid (N) protein and spike receptor-binding domain (S-RBD) antibody tests were used to distinguish natural and vaccine-induced response.

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Article Synopsis
  • The study aimed to summarize lessons learned from a multidisciplinary Italian research team that conducted a longitudinal study on COVID-19 patients over three years, focusing on research design and execution during a pandemic.
  • A qualitative research approach was used to gather personal narratives from team members about their experiences, which were later analyzed and organized into ten main themes related to the challenges and methods of conducting research in such health crises.
  • The findings emphasized the importance of a multidisciplinary perspective, including patient input, in ensuring research quality and consistency during pandemics, suggesting potential improvements in education, clinical practices, and policies.
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Introduction: Polymorphonuclear cell influx into the interstitial and bronchoalveolar spaces is a cardinal feature of severe coronavirus disease 2019 (COVID-19), principally mediated by interleukin-8 (IL-8). We sought to determine whether reparixin, a novel IL-8 pathway inhibitor, could reduce disease progression in patients hospitalized with severe COVID-19 pneumonia.

Methods: In this Phase 3, randomized, double-blind, placebo-controlled, multicenter study, hospitalized adult patients with severe COVID-19 pneumonia were randomized 2:1 to receive oral reparixin 1200 mg three times daily or placebo for up to 21 days or until hospital discharge.

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Cytokine storm and severe hepatitis in pregnancy due to herpes simplex virus 2.

Infection

February 2024

Section of Hematology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, AOU Modena, 41124, Modena, Italy.

Article Synopsis
  • - A pregnant woman experienced hepatitis caused by a primary infection of herpes simplex virus 2, leading to a serious systemic inflammatory response.
  • - She was treated with acyclovir and human immunoglobulin, resulting in positive outcomes for both the mother and her baby.
  • - This case presents the first detailed account of the inflammatory response linked to herpetic hepatitis during pregnancy.
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