Translational Medicine at UniSa最新文献

Introduction: Emergency upper gastrointestinal (GI) endoscopy is often prolonged and complex, performed during high-risk conditions. These procedures can be affected by an increased risk for airway compromise. Scarce literature can be found providing guidance on anesthesiological conduct during upper GI endoscopy in Emergency.

Methods: This was a monocentric retrospective study conducted on 96 patients treated in the Emergency Gastroenterology Unit at AORN Cardarelli, between June and October 2023. Key features of moderate and deep sedation procedures were investigated.

Results: There was no statistically significant difference in the incidence of complications and respiratory depression between the patients receiving moderate sedation versus those treated with deep sedation.

Discussion: Adverse outcomes of sedation and analgesia during endoscopic procedures are rare, even during a deep state of sedation.

Background: The integration of artificial intelligence (AI) in healthcare has the potential to revolutionize clinical practice, particularly in the management of complex conditions such as fibromyalgia (FM). Despite its promise, the adoption of this technology in practice faces several challenges, including limited knowledge and preparedness among healthcare professionals.

Aim: To evaluate the level of knowledge before and after a workshop on AI in FM among clinicians of different disciplines.

Methods: A survey was conducted at the end of the lab. An anonymous 21-item questionnaire was administered to participants.

Results: This survey (n = 26) revealed that while most had extensive clinical experience and some prior exposure to AI, the majority lacked sufficient knowledge and felt unprepared to integrate AI into FM management. Post-congress, perceptions of AI improved for many, but significant barriers remained, including lack of training, resistance to change, and cost concerns. Key benefits identified were symptom monitoring and decision support. Targeted training and technical support were highlighted as essential for effective AI adoption in clinical practice.

Conclusion: Despite a generally positive shift in perception following the congress, many doctors still feel unprepared and lack the necessary knowledge to effectively utilize AI tools. These results underscore the importance of targeted training and support to implement research and facilitate the integration of AI tools in FM and other clinical settings.

Aims: Thrombocytopenia (TCP) following aortic valve replacement (AVR) is a significant concern, with varying degrees of platelet count reduction observed postoperatively. This phenomenon occurs more frequently in patients undergoing surgical biological AVR compared to those receiving mechanical AVR or transcatheter aortic valve implantation (TAVI). This study aimed to investigate the incidence of TCP following surgical AVR with the Inspiris Resilia bioprosthesis compared with Carpentier Magna Ease valve.

Methods: The study retrospectively collected data from 144 patients who underwent isolated AVR between January and December 2023. Patients received either the Inspiris Resilia or the Carpentier Magna Ease valve. Platelet counts were evaluated from admission to discharge, and statistical analyses were performed to identify significant variables correlated to post-operative TCP.

Results: Patients receiving the Inspiris Resilia valve had higher platelet counts from postoperative day 1-3 compared to those with the Carpentier Magna Ease valve. The incidence of moderate-to-severe TCP was significantly lower in the Inspiris Resilia group. However, no significant differences in clinical outcomes, such as bleeding events and blood transfusion rates, were observed between the two groups.

Conclusions: The study showed that the Inspiris Resilia valve is associated with a lower incidence of moderate-to-severe TCP compared to the Carpentier Magna Ease valve. These findings underscore the potential benefits of utilizing the Inspiris Resilia valve to mitigate the risk of TCP post-AVR. Further research with larger cohorts is warranted to validate these results and explore the underlying mechanisms.

A 55-year-old woman with Multiple Scleroris (MS) was referred to undergo a course of conventional physical therapy and cognitive robotic rehabilitation. The neurological examination revealed ataxic gait, dysmetria, nystagmus, cognitive impairment of attention and memory, weakness in the four limbs. To improve balance and walking skills, 20 gait and balance rehabilitation sessions was prescribed, based on conventional physiotherapy and virtual reality. The results were evaluated with balance and walking tests and with objective test C-GAIT. This case report shows improvements in gait and balance in aMS patient obtained with a rehabilitation program that associated C-MILL with traditional physical therapy.

Aims: The international literature underlines that physical activity has a role in preventing cancer and is beneficial for cancer recovery and rehabilitation. Therefore, patient education is essential to stimulate training. Telemedicine and e-health tools like apps and wearables can support patients' education and the monitoring of their health condition and progress.

Methods: The article reports the results of the Oncology in Motion telemedicine program of the National Cancer Institute of Aviano, Italy, to provide breast cancer patients with a personalized fitness path and telemonitoring.

Results: 144 women took part in the program. Low adherence was recorded, performing the customized training schedule and, for those women sticking to the plan, using the technological devices and submitting the training data to the Institute.

Conclusion: Low technology acceptance and literacy, laziness, and lack of collaboration between cancer centers stood among the causes of low adherence, calling for more comprehensive and effective educational programs and support to stimulate physical activity and the use of new devices to get personalized counseling and contribute to the creation of knowledge.

Aim: Placenta accreta (PA) is a condition where the placenta is pathologically adherent to the uterus due to a defect in the basal decidua with myometrium invasion by chorionic villi and is classified based on the depth of myometrial invasion by histology. However, ultrasound and magnetic resonance imaging have excellent accuracy. In this study, we investigated clinical benefits of early instrumental diagnosis of PA, especially in reducing maternal-fetal complications and improving perinatal outcomes. We also evaluated diagnostic accuracy of ultrasound and magnetic resonance imaging on placental invasiveness assessment.

Methods: In this review and observational retrospective study, risk factors of PA were collected, and pregnant women underwent third-trimester ultrasound and magnetic resonance imaging (MRI) to evaluate the degree of infiltration. Imaging results compared to histological findings and surgical evaluation.

Results: A total of 38 patients were diagnosed with at the University Hospital "San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy, by second-trimester ultrasound with high sensitivity (100%) and accuracy (86%). Moreover, 37 of them performed MRI and 60.5% were diagnosed with Accreta, 7.9% increta, 10.5% percreta, and 21.1% not accrue with high sensitivity (100%), specificity (88.9%), and accuracy (97.4%). Histological assay confirmed MRI findings in 96.7% of cases. Risk factors of PA were age >35 years and previous CT scans. In unborn babies, mean 1-min Apgar was 4.3 (range, 3-6), and mean 5-min Apgar was 7.13 (range, 7-9).

Conclusion: MRI could be a not-invasive, specific, sensitive, and accurate diagnostic tool for assessing the degree of infiltration in PA, and could guide clinical decisions, such as delivery plan, thus reducing perioperative and fetal complications.

Despite the advancement in secondary cardiovascular prevention strategies for post-acute coronary syndrome (ACS) patients, the development of new drugs addressing dyslipidemia and the personalization of dual antiplatelet therapies (DAPT), these patients continue to suffer a significant incidence of recurrent ischemic events. Therefore, novel targets that can be tackled to reduce cardiovascular risk are needed to improve the outcome of this very high-risk population. The role of chronic inflammation and inflammasome in the development and progression of atherosclerosis has been broadly investigated in patients with established coronary artery disease (CAD) and recent randomized trials have highlighted the possibility to manage these targets with specific drugs such as colchicine and monocolonal antibodies with a significant improvement of cardiovascular outcomes in post-ACS patients. Lipoprotein(a) [Lp(a)] is the most promising non-traditional risk factor and has shown to predict worse outcome in post-ACS patients. Lowering Lp(a) through PCSK9 inhibitors and specific targeted therapies has shown positive results in reducing adverse cardiovascular events in patients with established CAD. The effect of microbiome and its alteration in gut dysbiosis seems to actively participate in residual cardiovascular risk of CAD patients; however, the risk-modifying effect of targeted-microbiome therapies hasn't been yet investigated in large population-based studies. Long-term outcome of post-ACS patients is a complex puzzle of multiple factors. In this minireview, we summarize the emerging risk factors that may interplay in the residual risk of post-ACS patients and their possible prognostic and therapeutic implications.

Diagnosis of T cell lymphoproliferative disorders requires one or multiple immunophenotypic aberrations, histological tissue structure or composition modifications, and T cell clonality demonstration. Here, we present two T cell lymphoma cases, where TCR clonality was evaluated using the TRBC1 monoclonal antibody combined with a multi-parametric staining for an in-depth immunophenotype of physiological and pathological T cell populations. In the first case, this monoclonal antibody allowed exclusion of reactive lymphoproliferations, while in the second case, it was conclusive for identification of Sezary syndrome cells. We added evidence on clinical utility of TRBC1 antibody (JOVI-1) to disclose monotypic T-cell populations, and TCR clonality evaluated by TRBC1 monoclonal antibody can be efficiently combined with a multi-parametric staining for an in-depth immunophenotype, with high versability of this monoclonal antibody in multi-parametric flow cytometry panel.