499 results match your criteria: "Valduce Hospital.[Affiliation]"

Integrating Telemedicine in Botulinum Toxin Type-A Treatment for Spasticity Management: Perspectives and Challenges from Italian Healthcare Professionals.

Toxins (Basel)

December 2024

Spasticity and Movement Disorders "ReSTaRt", Physical Medicine and Rehabilitation Section, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy.

(1) Background: Telemedicine is a vital tool for enhancing healthcare accessibility and outcomes at reduced costs. This study aimed to assess the usability of the Maia Connected Care telemedicine platform for managing spasticity in patients receiving botulinum toxin type-A, focusing on the perspectives of Italian physiatrists with expertise in this treatment. (2) Methods: Conducted from March 2023 to June 2023, this multicenter survey involved 15 Italian physicians who used the platform for teleconsultations.

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The impact of obesity on sleep, pulmonary and chest wall restriction in Osteogenesis Imperfecta: a pilot study.

Orphanet J Rare Dis

December 2024

Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Piazza Leonardo da Vinci, 20133, Milan, Italy.

Introduction: Osteogenesis Imperfecta (OI) is characterised by brittle bones, severe skeletal deformities, low sleep quality, and restricted breathing. We aimed to distinguish how disease and obesity affect these results.

Methods: According to BMI, we considered four groups of peer adults (median age: 35.

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Background: Diverting ileostomy is a common procedure in rectal cancer surgery, but it is sometimes associated with a nonnegligible rate of complications. The primary aim of this study was to analyze the incidence and types of stoma-related complications for ileostomy creation after rectal cancer resection. The secondary aims were to report the indications, the technical details, and the efficacy of stoma care provided by ostomy nurses.

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Samples from 34 adult patients newly diagnosed with core binding factor leukemia (CBFL) were collected both at the time of diagnosis and at relapse and were centrally analyzed. Eligible patients received either standard induction CT known as "3 + 7" or an equivalent regimen, according to the recruiting center's policy. Patients who achieved CR or CRi received 3 courses of high-dose ARA-C (Cytarabine) 3000 mg/m every 12 h on days 1, 3, and 5, along with midostaurin at the dose of 50 mg b.

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Article Synopsis
  • Indocyanine green angiography (ICGA) is crucial for diagnosing and tracking choroidal inflammation, particularly choroidal vasculitis, which is often missed by doctors not using this method during posterior uveitis assessments.
  • The study analyzes ICGA signs of choroidal vasculitis, highlighting two main patterns: choriocapillaritis, which shows hypofluorescent areas indicating inflammation, and stromal choroidal vasculitis, characterized by leaking hyperfluorescent vessels.
  • Overall, choroidal vasculitis is commonly found in patients with inflammatory choroid issues, and understanding its ICGA features can improve diagnosis and treatment outcomes.
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Opioid-induced constipation (OIC) is a very common and troublesome gastrointestinal side effect following the use of opioids. Despite existing international guidelines, OIC is largely underdiagnosed and undertreated. ECHO OIC is a European project designed to improve the diagnosis and management of OIC at the primary care level.

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Background: Stroke patients often experience alterations in their subjective feeling of ownership for the affected limb, which can hinder motor function and interfere with rehabilitation. In this study, we aimed at disentangling the complex relationship between sensory impairment, body ownership (BO), and motor control in stroke patients.

Methods: We recruited 20 stroke patients with unilateral upper limb sensory deficits and 35 age-matched controls.

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Article Synopsis
  • The Coma Recovery Scale-revised (CRS-r) is the main tool for assessing patients with Disorders of Consciousness (DoCs), but it has a misdiagnosis rate of about 40%.
  • Recent guidelines recommend adding neurophysiological measures, such as surface electromyography (sEMG), to improve these assessments.
  • The STRIVEfc system was tested on DoCs patients, highlighting that it can reveal subtle muscular activities invisible to clinicians and helps improve diagnostic accuracy by providing additional information through an instrumented version of the CRS-r (ICRS-r).
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  • - The techniques for mitral valve repair have significantly improved, with percutaneous methods now being a safe option for high-risk surgical patients, though using prosthetic devices raises the risk of endocarditis.
  • - A case study describes a 75-year-old man who underwent percutaneous edge-to-edge mitral valve treatment and later developed a fever, leading to a diagnosis of endocarditis caused by Staphylococcus lugdunensis.
  • - The case highlights the critical importance of managing chronic infections in patients with prosthetic implants to minimize the risk of life-threatening complications like endocarditis.
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Background: The diagnostic accuracy of colon capsule endoscopy (CCE) depends on a well-cleansed bowel. Evaluating the cleansing quality can be difficult with a substantial interobserver variation.

Objectives: Our primary aim was to establish a standard of agreement for bowel cleansing in CCE based on evaluations by expert readers.

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  • Blue Rubber Bleb Nevus Syndrome (BRBNS) is a rare congenital condition characterized by vascular malformations in the skin and gastrointestinal tract, but it lacks extensive research and descriptive data.
  • A multicenter study in Europe analyzed 44 BRBNS patients, revealing that the syndrome is typically diagnosed around age 12, primarily through clinical symptoms, with a significant number also experiencing gastrointestinal complications.
  • The study suggests that tests for d-dimer, fibrinogen levels, and Tie2/TEK mutations should be conducted when BRBNS is suspected, as they could aid in confirming the diagnosis.
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  • Primary lymphoma of the female genital tract (PLFGT) is an uncommon type of lymphoma, with a study involving 60 women revealing that many cases were diagnosed around their early 50s.
  • The uterus and ovaries were the most frequently affected sites, and diffuse large B-cell lymphoma (DLBCL) was the predominant subtype found in the majority of patients.
  • The study indicated a median overall survival of approximately 13 years for DLBCL patients, with advanced disease stage correlating to a poorer prognosis, while CNS relapses were notably linked to patients with ovarian involvement who did not receive prophylactic treatment.
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Computer-aided diagnosis for the resect-and-discard strategy for colorectal polyps: a systematic review and meta-analysis.

Lancet Gastroenterol Hepatol

November 2024

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy.

Article Synopsis
  • The study explores the use of computer-aided diagnosis (CADx) in the resect-and-discard strategy for the optical diagnosis of diminutive polyps during colonoscopy, aiming to improve diagnosis and reduce unnecessary pathology assessments.
  • It involved a systematic review of existing research to analyze the effectiveness of CADx systems compared to traditional histology for small polyps (≤5 mm), including comparisons of CADx-assisted and unassisted methods.
  • The meta-analysis included 11 studies with a total of 7400 polyps examined, highlighting the potential benefits and harms of using CADx in terms of accurate diagnosis and avoidance of false positives/negatives.
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Article Synopsis
  • Up to 30% of chronic myeloid leukemia (CML) patients may need a treatment change due to issues with first-line tyrosine kinase inhibitors (TKIs), and bosutinib (BOS) emerges as an effective and safe alternative.
  • A study analyzed 132 CML patients treated with BOS across 18 hematology centers, finding that most patients switched due to intolerance to previous TKIs, with a significant number achieving positive treatment outcomes.
  • The findings suggest that BOS is a preferred treatment choice, particularly for patients who cannot tolerate previous TKIs, demonstrating its safety and effectiveness in real-life settings.
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Spasticity management should be provided within the context of a comprehensive person-centered rehabilitation program. Furthermore, active goal setting for specific spasticity interventions is also important, with a well-established "more is better" approach. It is critical to consider adjunctive therapy and multimodal approaches if patients are not attaining their treatment goals.

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Introduction: Upper limb impairment is a common consequence of stroke, significantly affecting the quality of life and independence of survivors. This scoping review assesses the emerging field of muscle synergy analysis in enhancing upper limb rehabilitation, focusing on the comparison of various methodologies and their outcomes. It aims to standardize these approaches to improve the effectiveness of rehabilitation interventions and drive future research in the domain.

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Accuracy of Computer-aided Diagnosis in Colonoscopy Varies According to Polyp Location: A Systematic Review and Meta-analysis.

Clin Gastroenterol Hepatol

August 2024

IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Article Synopsis
  • - The study investigates how the location of colorectal polyps (proximal vs. distal colon) affects the performance of computer-aided diagnosis (CADx) in identifying neoplastic and non-neoplastic polyps during colonoscopies for polyps sized 5 mm or smaller.
  • - It analyzes data from 11 studies involving 7,782 polyps, showing that CADx has lower specificity and accuracy in the proximal colon compared to the distal colon, while sensitivity is similar between both locations.
  • - The conclusion highlights that while CADx works well for distal polyps, its inadequate performance in the proximal colon means it should not currently be used for those lesions until improved systems are created.
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  • A study evaluated the effectiveness of ChatGPT in answering questions about colorectal cancer (CRC) screening to improve patient awareness and adherence to screening programs.
  • 15 CRC screening questions were assessed by experts and patients, focusing on accuracy, completeness, and comprehensibility.
  • ChatGPT performed well, especially with patients, but highlighted the need for further training to align its responses with scientific evidence and guidelines.
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Introduction: Multiple sclerosis (MS) is a chronic neurodegenerative disease that leads to impaired cognitive function and accumulation of disability, with significant socioeconomic burden. Serious unmet need in the context of managing MS has given rise to ongoing research efforts, leading to the launch of new drugs planned for the near future, and subsequent concerns about the sustainability of healthcare systems. This study assessed the changes in the Italian MS market and their impact on the expenditures of the Italian National Healthcare Service between 2023 and 2028.

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The engagement of temporal attention in left spatial neglect.

Cortex

September 2024

Developmental and Cognitive Neuroscience Lab, General Psychology Department, University of Padova, Italy. Electronic address:

Previous literature showed how left spatial neglect arises from an asymmetrical distribution of spatial attention. However, it was also suggested that left spatial neglect might be partially caused or at least worsened by non-spatial attention disorders of the right-lateralized stimulus-driven attentional fronto-parietal network. Here, we psychophysically tested the efficiency of temporal attentional engagement of foveal perception through meta-contrast (Experiment 1) and "attentional" masking (Experiment 2) tasks in patients with right-hemisphere stroke with left neglect (N+), without left neglect (N-) and matched healthy controls (C).

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Inotropes are prescribed to enhance myocardial contractility while vasopressors serve to improve vascular tone. Although these medications remain a life-saving therapy in cardiovascular clinical scenarios with hemodynamic impairment, the paucity of evidence on these drugs makes the choice of the most appropriate vasoactive agent challenging. As such, deep knowledge of their pharmacological and hemodynamic effects becomes crucial to optimizing hemodynamic profile while reducing the potential adverse effects.

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It is known that in African countries the health condition is problematic, both from a diagnostic and therapeutic point of view. Patients have to travel long distances to access medical care. Many cannot afford the cost of transportation to a medical facility.

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Background: Diverticular disease (DD) represents a common gastrointestinal condition that poses a heavy burden on healthcare systems worldwide. A high degree of uncertainty surrounds the therapeutic approaches for the control of symptoms in patients with symptomatic uncomplicated diverticular disease (SUDD) and primary and secondary prevention of diverticulitis and its consequences.

Objectives: To review the current knowledge and discuss the unmet needs regarding the management of SUDD and the prevention of acute diverticulitis.

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Development and Validation of a Scoring System to Predict Response to Obeticholic Acid in Primary Biliary Cholangitis.

Clin Gastroenterol Hepatol

October 2024

Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza, Italy. Electronic address:

Article Synopsis
  • The study focused on creating a scoring system called the OCA response score (ORS) to predict how individuals with primary biliary cholangitis (PBC) will respond to the treatment using obeticholic acid (OCA).
  • Data were collected from two large cohorts in Italy to derive and validate the score, which includes various clinical factors both before and after six months of treatment.
  • The scoring system demonstrated good predictive ability for treatment response, which could help healthcare providers customize therapies for patients with PBC more effectively.
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