1,720 results match your criteria: "University-Hospital of Pisa[Affiliation]"

Effects of Pancreatic Fistula After Minimally Invasive and Open Pancreatoduodenectomy.

JAMA Surg

December 2024

Department of General Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.

Importance: Postoperative pancreatic fistulas (POPF) are the biggest contributor to surgical morbidity and mortality after pancreatoduodenectomy. The impact of POPF could be influenced by the surgical approach.

Objective: To assess the clinical impact of POPF in patients undergoing minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD).

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Background: Despite a reduction of both incidence and mortality from CRC, recent studies have shown an increase in the incidence of early-onset CRC (EO-CRC). Data on this setting are limited. The aim of our study was to evaluate the clinical and molecular profiles of metastatic EO-CRC patients in order to identify differences compared to a late-onset CRC (LO-CRC) control group.

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Article Synopsis
  • * Researchers analyzed data from 1,220 patients with HCV-related cirrhosis, creating a risk model using factors like PIVKA-II levels, age, sex, and liver function markers.
  • * The model demonstrated good accuracy in distinguishing HCC risk, with low, medium, and high-risk groups showing cumulative incidence rates of 2.7%, 4.0%, and 14.3%
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  • - The quality of medical data analysis relies on effective collection and organization methods, and a Decentralized Knowledge Graph (DKG) can improve this in emergency surgery by enhancing information connections while addressing limitations of traditional Knowledge Graphs.
  • - The authors created the Emergency Surgery DKG using the cyb.ai protocol from the Cosmos network, utilizing relevant publications to build a comprehensive resource for emergency surgical knowledge.
  • - The DKG aims to enhance understanding among healthcare providers about medical and surgical relationships, ensuring accessibility for users globally, while emphasizing the importance of user feedback and adherence to ethical guidelines for its continued development and impact.
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Stroke thrombectomy in the elderly: A propensity score matched study on a nationwide real-world registry.

Eur Stroke J

November 2024

IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurologia e Rete Stroke Metropolitana, Bologna, Italy.

Introduction: Data on safety and efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke in older patients are limited and controversial, and people aged 80 or older were under-represented in randomized trials. Our aim was to assess EVT effect for ischemic stroke patients aged ⩾80 at a nationwide level.

Patients And Methods: The cohort included stroke patients undergoing EVT from the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS).

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Background: Acute neuropsychiatric disorders are heterogeneous conditions resulting from interaction between genetic and environmental features. Among these, post infectious forms like Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are common. Preclinical studies suggest a role of CNS T-helper-17/interleukin-17 (IL-17) inflammatory mediated response in the pathogenesis of these disorders.

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Purpose: The current primary hyperparathyroidism (PHPT) presents as a mild disease. We explored skeletal phenotypes in postmenopausal women affected by PHPT, focusing on fracture prevalence.

Methods: PHPT women were retrospectively evaluated at four Italian centers for osteoporosis management (two centers in Milan, = 244; Cuneo, = 128; Pisa, = 131).

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Background: Data published in 2015 showed that patients with early breast cancer (EBC) and a low-risk (LR) Recurrence Score® (RS) result by the 21-gene Oncotype DX® assay ("the test") did not derive benefit from adding chemotherapy (CT) to endocrine therapy (HT), while those with a high-risk (HR) RS result did. However, the role of CT remained uncertain in patients with intermediate-risk (IR) cancers. We designed a study to assess the test's ability to categorize patients with EBC with uncertain biological behavior into the groups (LR and HR) for which the value of additional chemotherapy was defined.

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DNA methylation analysis of multiple genes in thymic epithelial tumors.

Epigenomics

December 2024

Department of Translational Research & of New Surgical & Medical Technologies, University of Pisa, 56126, Pisa, Italy.

To investigate DNA methylation levels of a panel of genes in thymic epithelial tumors (TETs). We selected 15 genes among the most promising epigenetic biomarkers of TETs and evaluated their methylation levels in 71 TET samples. thymic carcinomas (TCs) showed hypermethylation of and genes and reduced methylation levels compared with thymomas (TMs) and healthy thymic tissues.

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Unveiling the prognostic significance of malignant ascites in advanced gastrointestinal cancers: a marker of peritoneal carcinomatosis burden.

Ther Adv Med Oncol

November 2024

Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G.Venezian, 1, Milan 20133, Italy.

Article Synopsis
  • Ascites is a common issue in patients with advanced gastrointestinal cancers that have spread to the peritoneum, impacting survival negatively; this study is the first to look specifically at ascites, peritoneal metastases (PM), and survival in metastatic colorectal cancer (mCRC) and metastatic gastric cancer (mGC).
  • A retrospective analysis of clinical trial data showed that mCRC patients with ascites had significantly shorter progression-free and overall survival compared to those without PM, while gastric cancer patients with ascites also had poorer survival outcomes and higher disease severity scores.
  • The findings suggest that ascites can indicate worse prognoses for certain cancer patients, highlighting the need for more focused research and tailored treatments for these individuals.
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Background: Brown tumors are rare bone manifestations of primary hyperparathyroidism (PHPT) that may occur at different sites either as single or multiple lesions and they can easily be mistaken for malignant lesions. Neither bone site nor morphological or functional imaging are useful to drive the differential diagnosis and biopsy is often the only conclusive procedure.

Case Description: We report the case of a 53 years-old man referred to our outpatient clinic for severe symptomatic PHPT complicated by nephrolithiasis and osteoporosis.

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  • Pregnancy adds complexity to managing lipodystrophy disorders, which have been underreported in terms of related comorbidities and risks for women.
  • A case study highlights a successful pregnancy in a 28-year-old woman with acquired partial lipodystrophy, showing improved glucose control but also leading to preterm delivery and maternal cardiac issues.
  • Research indicates that while many women with various lipodystrophy phenotypes have successful pregnancies, they face high risks, necessitating intensive, multidisciplinary care and further investigation into leptin levels during pregnancy.
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Coronary microvascular dysfunction beyond the spectrum of chronic coronary syndromes.

Prog Cardiovasc Dis

December 2024

Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna; Department of Medical and Surgical Sciences - DIMEC; Alma Mater Studiorum, University of Bologna, Italy. Electronic address:

Article Synopsis
  • Coronary microvascular dysfunction (CMD) is significant beyond chronic coronary syndromes (CCS) and has important implications for heart health and treatment strategies.
  • CMD can be detected using safe, non-invasive methods and is linked to various heart conditions, including heart failure and Takotsubo syndrome, even without the presence of obstructive coronary artery disease.
  • Understanding CMD patterns outside of CCS may help identify disease progression and improve treatment response, acting as a warning sign for adverse cardiac changes.
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Background And Objective: This article uses three different probabilistic convolutional architectures applied to ultrasound image analysis for grading Fatty Liver Content (FLC) in Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) patients. Steatosis is a new silent epidemic and its accurate measurement is an impelling clinical need, not only for hepatologists, but also for experts in metabolic and cardiovascular diseases. This paper aims to provide a robust comparison between different uncertainty quantification strategies to identify advantages and drawbacks in a real clinical setting.

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Background: The Glycemia Risk Index (GRI) describes the quality of glycemic control, emphasizing extreme hypoglycemia and hyperglycemia more than less extreme values. However, a pregnancy-specific GRI (pGRI), tailored to the tighter target glucose range required during pregnancy, has not been established.

Methods: We retrospectively evaluated clinical, metabolic, and Continuous Glucose Monitoring (CGM) data across pregnancy in women with insulin-treated diabetes, managed between September 2021 and March 2024 at the University Hospital of Pisa.

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Direct oral anticoagulants (DOACs) are recommended for the management of thrombosis prophylaxis, especially in patients with atrial fibrillation. As substrates of cytochrome P450 (CYP) 3A4 and/or P-glycoprotein, they are implicated in potential drug-drug interactions. NS5A/NS5B inhibitors are direct-acting agents (DAAs) against the Hepatitis C Virus (HCV) infection that exert a mild inhibition of P-glycoprotein without effects on CYP3A4.

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Introduction: The most frequently used first-line treatment in patients with advanced hepatocellular carcinoma (HCC) is atezolizumab plus bevacizumab. Upon progression after this treatment, the standard of care in many countries is sorafenib, due to the lack of reimbursement for other drugs. Several randomized trials are currently underway to clarify the best second-line therapy in patients with HCC.

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Near-infrared autofluorescence pattern in parathyroid gland adenoma.

Surg Endosc

November 2024

Department of Surgical, Medical, and Molecular Pathology and Critical Area, University of Pisa, 56124, Pisa, Italy.

Background: Parathyroid gland (PG) surgery is often challenging due to the small size and indistinct nature of these glands. The introduction of intraoperative near-infrared autofluorescence (NIRAF) has shown promise in localizing parathyroid tissue. However, the NIRAF features of parathyroid adenomas remain unclear.

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Article Synopsis
  • The study explores the genetic and epigenetic factors involved in the development of Graves' orbitopathy (GO), highlighting that both sex and racial differences indicate a genetic influence on the disease.* -
  • Research shows that while no specific genes have been linked to an increased risk of GO, variations in gene expression and DNA methylation patterns observed in orbital fibroblasts suggest an epigenetic component in its pathogenesis.* -
  • The findings suggest that initial autoimmune triggers may lead to long-lasting changes in gene expression, contributing to the persistence and development of GO, although further examination of histone modifications is needed.*
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Breast implant-associated (BIA) lymphoma is a rare malignancy, typically originating from T-cells; however, few cases of diffuse large B-cell lymphoma (LBCL) have been recently described. These cases share major features: Epstein-Barr virus positivity and a favorable prognosis with surgical intervention alone, hinting at a potential link to fibrin-associated LBCL (FA-LBCL). This study presents the first case of BIA-FA-LBCL in Italy and one of the few assessed from a molecular standpoint so far.

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Article Synopsis
  • Conventional therapy for hypoparathyroidism helps with hypocalcemia symptoms but doesn't fix low parathyroid hormone (PTH) levels; TransCon PTH (palopegteriparatide) is being studied as a potential long-term treatment.
  • A Phase 3 trial involved 82 adults across 21 sites in North America and Europe, with participants receiving TransCon PTH daily during a 156-week open-label period after an initial 26-week placebo-controlled phase.
  • Results showed that by week 52, 81% of participants achieved normal serum calcium levels without needing conventional therapy, improved their quality of life, and experienced mostly mild to moderate side effects, indicating the treatment's sustained efficacy and safety.
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Long-term outcome of Graves' orbitopathy following treatment with sirolimus.

J Endocrinol Invest

October 2024

Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Article Synopsis
  • Sirolimus was found to help people with Graves' orbitopathy (a condition that affects the eyes) more than another medicine called methylprednisolone at the 24-week mark.
  • In the study, 40 patients were treated, and researchers looked at how they felt and their eye symptoms over 48 weeks.
  • While sirolimus showed better results at 24 weeks, both medicines had similar outcomes at 48 weeks, suggesting that longer treatment might be needed for better results.
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  • Thymomas are rare tumors that are usually treated surgically in early stages (I-II), but may require a team approach in more advanced stages (III-IV).
  • This study analyzed data from 195 patients with stage II thymomas who underwent surgery between 2000 and 2020 to evaluate the effectiveness of postoperative radiotherapy (PORT) on disease-free survival (DFS).
  • Results showed that PORT did not improve DFS for stage II thymomas, regardless of subtype or stage, suggesting that patients who have surgery for this condition may not benefit from additional local treatment.
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Editorial: Modern management of ruptured abdominal aortic aneurysm.

Front Cardiovasc Med

September 2024

Division of Vascular and Endovascular Surgery, Department for Visceral-, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus and University Hospital, Technische Universität Dresden, Dresden, Germany.

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