2,654 results match your criteria: "and Sapienza University Hospital "Policlinico Umberto I"[Affiliation]"

Introduction: The increasing prevalence of primary hip arthroplasty has led to a parallel rise in revision cases. Femoral revision often entails compromised bone integrity, requiring consideration of various solutions for optimal reconstructive options. Despite technological advancements, there is limited evidence on the clinical outcomes of the latest modular revision stems.

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The aim of our study is to evaluate the effectiveness and safety of a sutureless off-clamp robot-assisted partial nephrectomy (sl-oc RAPN), particularly its impact on renal function. A multicenter study was conducted from April 2021 to June 2022. Patients diagnosed with a renal mass of >2 cm and a PADUA score of ≤6 consecutively underwent an sl-oc RAPN procedure.

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Purpose: The management of renal masses in the elderly population is particularly challenging, as these patients are often more frail and potentially more susceptible to surgical morbidity. This review aims to provide a comprehensive analysis of the outcomes of partial nephrectomy (PN) for treating renal masses in elderly individuals.

Methods: A systematic electronic literature search was conducted in May 2024 using the Medline (via PubMed) database by searching publications up to April 2024.

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Background: The long-term success rate of pulmonary vein isolation (PVI) is suboptimal due to the presence of non-pulmonary vein (PV) foci that can trigger atrial fibrillation (AF) in up to 11%. Among non-PV triggers, the superior vena cava (SVC) is a major site of origin of ectopic beats initiating AF.

Objective: To compare data from randomized controlled trials (RCTs) assessing PVI + empiric SVC isolation (SVCI) versus PVI alone in terms of AF recurrence, procedure-related complications, and fluoroscopic and procedural times.

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Background: The optimal treatment for acute minor ischemic stroke is still undefined. and options include dual antiplatelet treatment (DAPT), intravenous thrombolysis (IVT), or their combination. We aimed to investigate benefits and risks of combining IVT and DAPT versus DAPT alone in patients with MIS.

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Radiotherapy (RT) plays a critical role in the management of rhabdomyosarcoma (RMS), the prevalent soft tissue sarcoma in childhood. The high risk PAX3-FOXO1 fusion-positive subtype (FP-RMS) is often resistant to RT. We have recently demonstrated that inhibition of class-I histone deacetylases (HDACs) radiosensitizes FP-RMS both in vitro and in vivo.

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Article Synopsis
  • The study focuses on the importance of accurately diagnosing peripheral pulmonary lesions (PPL) using biopsy methods such as endobronchial ultrasound (EBUS), computed tomography (CT), and electromagnetic navigation bronchoscopy (ENB).
  • A systematic review was conducted, including 81 studies from various databases, to evaluate the diagnostic accuracy of these techniques, with CT showing the highest median accuracy and largest potential for complications.
  • The findings suggest that while CT-guided biopsies are the most accurate, they also carry the highest risk of complications; overall, the accuracy calculation must account for indeterminate results treated as false negatives.
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Background: Fractional flow reserve (FFR) represents the gold standard in guiding the decision to proceed or not with coronary revascularization of angiographically intermediate coronary lesion (AICL). Optical coherence tomography (OCT) allows to carefully characterize coronary plaque morphology and lumen dimensions.

Objectives: We sought to develop machine learning (ML) models based on clinical, angiographic and OCT variables for predicting FFR.

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Communication and support of patients and caregivers in chronic cancer care: ESMO Clinical Practice Guideline.

ESMO Open

July 2024

Palliative Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Universita' degli Studi di Brescia, Brescia, Italy.

• ESMO Clinical Practice Guideline with key recommendations for communication and support of cancer patients and caregivers. • The guideline discusses training in communication of oncology clinicians and research on communication in cancer care. • Practical recommendations aim to support oncology clinicians in their communication with patients and caregivers.

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The Role of the Autonomic Nervous System in Epilepsy and Migraine: A Narrative Review.

J Integr Neurosci

July 2024

Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, Sant'Andrea Hospital, 00198 Rome, Italy.

Autonomic symptoms may be local and general clinical manifestations of both epilepsy and migraine caused by the dysfunction of brain areas best known as the central autonomic network. Despite their prevalence, autonomic signs are often misdiagnosed and their treatment is undervalued. This review aims to describe the autonomic manifestations reported during seizures and migraineur attacks according to their presentation, focusing on the role of the central autonomic network (CAN) and on the parasympathetic outflow that often-induced cranial autonomic symptoms (CAS) during migraineur attacks.

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Introduction: Real-life experience with imipenem/cilastatin/relebactam (IMI/REL) for the treatment of KPC-producing complex (KPC-Kp) and difficult-to-treat resistance (DTR) (DTR-PA) infections is herein described.

Methods: Adult patients with KPC-Kp or DTR-PA infections who received ≥48 h of IMI/REL were included. Clinical and microbiological outcomes were retrieved through the medical records.

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Article Synopsis
  • - This national survey aimed to assess the use of liver hypertrophy techniques in Italy, focusing on trends and differences among various medical centers.
  • - In December 2022, 46 centers completed a detailed online questionnaire, revealing that hypertrophy techniques were used in 6.2% of liver resections, with PVE and ALPPS being the most common techniques employed.
  • - The findings indicated that while these techniques play a crucial role in increasing resectability, there is substantial inconsistency in how centers define the need for them and the protocols used for patient allocation.
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  • Ruxolitinib (RUX) is a treatment for myelofibrosis, mainly studied in high-risk patients, but is often given to intermediate-1 patients with limited data on its effects.
  • In a study of 1,055 myelofibrosis patients, over half were classified as intermediate-1 risk, with notable symptoms and some having high-molecular-risk mutations.
  • The study found that after 6 months of RUX treatment, a significant proportion of patients experienced improvements in spleen size and symptoms, with certain factors like the absence of high-molecular-risk mutations being linked to better treatment responses.
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Article Synopsis
  • * Elderly women are particularly affected by CHF, exhibiting unique clinical traits and often maintaining better heart function due to specific health issues.
  • * Current noninvasive monitoring technologies for CHF patients are lacking, and while invasive remote sensors are being tested, implantable devices may not be practical for most patients; new technologies and clinical trials are needed to improve monitoring methods.
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Introduction: Patient engagement is essential to achieve long-term goals in obesity management. It is crucial to identify patients' perspectives, misperceptions and unmet educational needs on obesity etiology and treatments, to establish a correct therapeutic alliance between healthcare providers and patients.

Methods: Objective: This study, promoted by the regional section of the Italian Obesity Society (SIO Lazio), explores attitudes towards obesity, self-awareness, misperceptions of weight loss strategies, experiences of weight stigma and educational needs of patients living with overweight or obesity.

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Background: The programing of subcutaneous implantable cardioverter-defibrillators (S-ICD) in clinical practice has been little studied, as the activation status of the SMART Pass filter, which was implemented to reduce inappropriate shocks.

Purpose: We assessed device programing during follow-up and the rate of detected arrhythmias in consecutive S-ICD recipients.

Methods: We analyzed data from 670 S-ICD patients followed on the remote network at 17 Italian centers for a median of 31 months (25th-75th percentile: 16-51).

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Purpose: To evaluate the incidence of postoperative complications after cytoreductive nephrectomy (CN) following first-line treatment for metastatic renal cell carcinoma (mRCC), and to compare it with postoperative complications of upfront CN.

Methods: For this population-based retrospective study, the PearlDiver Mariner database (PearlDiver Technologies, Colorado Springs, CO), a database of insurance billing records was analyzed. Using relevant ICD-9/10 and CPT codes, patients diagnosed with mRCC between 2011 and 2021, who received first-line systemic molecular therapy (SMT), either tyrosine kinase inhibitors (TKI) or immune-checkpoint inhibitors (ICI), were identified.

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Article Synopsis
  • Enteroviruses (EVs) are common worldwide pathogens, primarily impacting children and causing a range of illnesses, including aseptic meningitis, but their true prevalence and epidemiology remain poorly understood.
  • Research focused on the Lazio region over a decade revealed changes in EV infection trends, particularly influenced by the SARS-CoV-2 pandemic, with a return to pre-pandemic circulation patterns by 2022 but with shifts in dominant strains identified.
  • Ongoing studies are essential to understand the pathogenic potential of prevalent strains and to identify any new recombinant variants.
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Contrast-enhanced ultrasound (CEUS) is an advanced imaging technique that integrates conventional US with the intravenous injection of specific US contrast agents (UCAs), combining the non-invasiveness of US with the higher accuracy of contrast-enhanced imaging. In contrast with magnetic resonance imaging (MRI), computed tomography (CT) and cystoscopy, CEUS has few contraindications, and UCAs are non-nephrotoxic agents that can be safely used in patients with kidney failure. CEUS is a well-established method for the detection of liver lesions and for echocardiography, and its indications are expanding.

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Sarcoidosis versus Granulomatous and Lymphocytic Interstitial Lung Disease in Common Variable Immunodeficiency: A Comparative Review.

Biomedicines

July 2024

Rare Diseases Referral Center, Internal Medicine 1, Department of Medicine (DIMED), AULSS2 Marca Trevigiana, Ca' Foncello Hospital, University of Padova, 35124 Padova, Italy.

Article Synopsis
  • * Sarcoidosis typically affects immunocompetent individuals, while GLILD occurs in those with common variable immunodeficiency (CVID), and distinguishing factors include unique symptoms and specific imaging and histological traits.
  • * Both conditions can lead to significant lung function decline and systemic complications, highlighting the need for further research into their underlying mechanisms and treatment options that may improve patient outcomes when studied together.
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A prevalent condition linked to an elevated risk of cardiovascular disease is sleep apnea. This review examines the connections between cardiac risk, the sympathetic nervous system, and sleep apnea. The increased risk of hypertension, arrhythmias, myocardial infarction, and heart failure was highlighted in the pathophysiology of sleep apnea and its effect on sympathetic activation.

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Mixed cryoglobulinemia vasculitis (MCV) is caused in ~90% of cases by chronic hepatitis C virus (HCVMCV) and more rarely by hepatitis B virus (HBV) infection, or apparently noninfectious. HCVMCV develops in only ~5% of patients with chronic hepatitis C (CHC), but risk factors other than female gender have not been identified so far. We conducted a retrospective case control study investigating whether past active HBV infection, defined by hepatitis B surface antigen (HBsAg) seroclearance and anti-core antibody (HBcAb) positivity, could be a risk factor for developing HCVMCV.

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Purpose: Our purpose was to evaluate the prognostic value of Vesical Imaging Reporting and Data System (VI-RADS) in bladder cancer (BCa) staging and predicting recurrence or progression.

Methods: We retrospectively analyzed the prospectively collected data from 96 patients with bladder tumors who underwent VI-RADS-based multiparametric magnetic resonance imaging (mpMRI) before endourological treatment from April 2021 to December 2022. Diagnostic performance was evaluated by comparing mpMRI reports with final pathology, using logistic regression for muscle-invasive bladder cancer (MIBC) predictors.

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