Strategies for population-level identification of post-acute sequelae of COVID-19 through health administrative data.

Introduction: Post-acute sequelae of COVID-19 (PASC) encompass several clinical outcomes, from new-onset symptoms to both acute and chronic diagnoses, including pulmonary and extrapulmonary manifestations. Health administrative data (HAD) from health information systems allow population-level analyses of such outcomes. Our primary aim was to identify clinical conditions potentially attributable to SARS-CoV-2 infection, and the types of HAD and "diagnostic criteria" used for their detection.

Effectiveness and tolerability of atogepant as preventive treatment in resistant individuals with chronic migraine: Six-month real-world evidence.

BackgroundThe discovery of calcitonin gene-related peptide (CGRP) as a key player in migraine pathophysiology has revolutionized the approach to preventive treatment. Atogepant, an oral small-molecule CGRP receptor antagonist, has shown promising efficacy in randomized controlled trials (RCTs) for both episodic and chronic migraine. However, real-world evidence, particularly in individuals with chronic migraine and multiple preventive treatment failures, remains limited.

Case-mix adjustment through inverse probability weighting to compare health indicators across territories or providers - an application in the agency for health protection of Milan.

Background: The Epidemiological Unit of the Agency for Health Protection of Milan (ATS) calculates several indicators, at hospital and at patients' residence area level (group level of analysis), with monitoring and programming scopes. Outcome indicators are usually influenced by differences in subject case-mix; therefore, adjustment methods are applied to compare each group level with mean ATS values. Inverse probability weighting (IPW) is explored as an alternative to multivariable generalized linear model (GLM), to overcome some limitations of the latter method.

Blood sugar, social struggles: Biomarkers of socioeconomic, gender, and ethnic health disparities in type 2 diabetes care.

Socioeconomic, gender, and ethnic disparities significantly affect Type 2 Diabetes Mellitus (T2DM) management, impacting healthcare access, treatment adherence, and outcomes. This study explores inequalities in glycaemic monitoring and testing in Milan (Northern Italy) using glycated haemoglobin data. Analysing administrative data from 56,795 T2DM patients aged 40 to 85, we assess the interplay of education, gender, and ethnicity in diabetes care.

Harmonization trial on testing strategies in ER+/HER2- breast cancer patients: an Italian experience.

Aims: To date, activating mutations acts as key player to clinically stratify estrogen receptor (ER)+/HER2-advanced breast cancer (BC) patients eligible to novel new generation oral Selective Estrogen Receptor Degraders (SERD) relapsing after first line aromatase inhibitors. Liquid biopsy represents the most useful biological source to detect activating mutations in clinical setting, but the lack of standardized pre-analytical and analytical procedures drastically impacts on detection rate of mutations in diagnostic specimens. Here, we sought to harmonize technical procedures comparing technical performance of diagnostically available testing strategies on a series of three reference specimens (sample A, B, C) harboring p.

Recent advances in liquid biopsy for precision oncology: emerging biomarkers and clinical applications in lung cancer.

Lung Cancer (LC) remains the leading cause of cancer-related mortality. While Tissue Biopsy (TB) remains the gold standard for molecular profiling, its invasiveness and inability to provide real-time monitoring have led to the adoption of Liquid Biopsy (LB) as a minimally invasive alternative. By analyzing different circulating analytes such as cell-free DNA (cfDNA), circulating tumor DNA (ctDNA), Circulating Tumor Cells (CTCs), Extracellular Vesicles (EVs), and Tumor-Educated Platelets (TEPs), LB offers a dynamic approach to assessing tumor heterogeneity, Minimal Residual Disease (MRD), and treatment resistance.

Management of oral anticoagulation after pulsed field ablation for atrial fibrillation: Insights from a multicenter study.

Background: The endothelial injury that can promote thrombus formation during radiofrequency ablation (RFA) of atrial fibrillation does not occur with pulsed field ablation (PFA).

Objective: The purpose of this study was to evaluate different strategies for oral anticoagulation (OAC) management following PFA and RFA.

Methods: Consecutive patients undergoing PFA were propensity score matched with consecutive patients undergoing RFA during the same time period (1:1) and prospectively followed up for 15 months.

The Clinical Impact of the Omicron Variant on Octogenarian Hospitalized COVID-19 Patients: The Results from CoviCamp Cohort.

This study aims to investigate the clinical impact of Omicron Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection on the clinical presentation of Coronavirus Disease 2019 (COVID-19) in the very old (≥80 years old) population. All patients aged 80 years or older, hospitalized from March 2020 to June 2023 with a SARS-CoV-2 infection in one of the 17 COVID-19 units in eight cities of Campania, southern Italy, were enrolled in a multicenter, observational, retrospective study. 341 patients ≥ 80 years of age were included: 80 of them in the Omicron and 261 in the non-Omicron period.

Smaller, cheaper, faster: where next for liquid biopsies?

Introduction: Liquid biopsy (LB) has shifted the paradigm in cancer diagnosis and management, offering a minimally invasive and dynamic approach to understanding tumor biology. Advanced next-generation sequencing (NGS) technologies have significantly improved the accuracy of LB results, enhancing both its analytical and clinical validity. However, tissue biopsy (TB) remains the gold standard for molecular analysis, often negatively impacting the molecular profiling of tumor patients owing to inadequate tissue samples, or lack thereof.

Efficacy and Safety Analysis of Nab-Paclitaxel Treatment in Elderly Patients with HER-2 Negative Metastatic Breast Cancer: NEREIDE Study.

: Older women represent a significant and increasing population of patients with breast cancer, accounting for over 40% of new cases of breast cancer. However, this growing subgroup of patients is still underrepresented in clinical trials, and treatment is usually selected based on limited data from retrospective subgroup analyses. However, the ESMO guidelines for metastatic breast cancer (mBC) suggest that the management decision should not be based on age alone.

Pentaspline Pulsed Field Ablation Versus High-Power Short-Duration/Very High-Power Short-Duration Radiofrequency Ablation in Atrial Fibrillation: A Meta-Analysis.

Background: Pulsed field energy has been proposed as alternative to radiofrequency energy in atrial fibrillation (AF) ablation.

Objective: To compare data from studies assessing AF ablation with pulsed field ablation (PFA) versus high-power short-duration (HPSD) or very HPSD (vHPSD) radiofrequency ablation (RFA) in terms of AF recurrence, procedure-related complications, fluoroscopy and procedure times.

Methods: A search of online scientific libraries (from inception to October 1, 2024) was performed.

Emergency colon cancer diagnosis in people with mental health conditions: a population-based cohort study in northern Italy.

Background: Individuals with mental health conditions may experience disparity in cancer diagnosis and health outcomes. This study aims to examine diagnostic pathways and mortality in patients with colon cancer with pre-existing mental health conditions.

Methods: A population-based cohort study on colon cancer cases diagnosed in 2014-2020 in the provinces of Milan and Lodi, using linked cancer registration and health data.

Tomotherapy With Synchrony Fiducial Tracking for Stereotactic Body Radiotherapy in Prostate Cancer: A Single-Center Experience on Toxicity.

The use of stereotactic body radiation therapy (SBRT) in the treatment of prostate cancer (PC) has increased significantly in recent years. This study aims to evaluate the safety of patients with localized PC undergoing SBRT using Radixact Tomotherapy with Synchrony fiducial tracking, a real-time motion tracking and correction system. This retrospective work analyzes 43 PC patients treated with SBRT from June 2022 to February 2025.

Prevalence, Evolution and Prognostic Factors of PASC in a Cohort of Patients Discharged from a COVID Unit.

: PASC is a potentially debilitating clinical condition consisting of different general symptoms experienced by about 10% of patients with previous SARS-CoV-2 infection. Our study analyses a cohort of patients with a history of hospitalization for COVID-19 and aims to evaluate prognostic factors for experiencing PASC and to investigate the characteristics of patients experiencing PASC symptoms. : This is an observational, monocentric retrospective study including all adult patients admitted to our COVID unit from 28 February 2020 to 30 April 2022, discharged alive, and having performed at least one follow-up visit at our post-COVID outpatient clinic after a minimum of three months from discharge.

Potential Applications of PRP-Enhanced Polybutylene Succinate Graft as Vascular Access for Chemotherapy in Oncological Patients: A Systematic Review.

This systematic review aimed to evaluate the potential of combining platelet-rich plasma (PRP) and polybutylene succinate (PBS) for the development of vascular grafts in patients undergoing chemotherapy. Relevant articles published in English or Italian were selected through a comprehensive search of MEDLINE (via PubMed) and the Cochrane Library. A total of ten screened articles and two additional relevant studies were included.

Impact of Age on Patello-femoral Arthroplasty Outcomes, Osteoarthritis Progression, and Survivorship: The Youngest and Oldest Achieve the Best Results.

Background: Proper patient selection is essential to improve long-term outcomes in patellofemoral arthroplasty (PFA). This study aimed to assess the impact of age on functional outcomes, osteoarthritis (OA) progression, and survivorship in patients who underwent PFA using a modern implant.

Methods: Patients who underwent primary isolated PFA with third-generation prosthesis were retrospectively reviewed.

Does Lateral Extraarticular Tenodesis Lead to Poor Patellofemoral Outcome in ACL Revision on Professional Soccer Players? A Minimum 3-Year, Clinical Radiographic Retrospective Study.

Lateral extra-articular tenodesis (LET) is indicated to decrease the pivot shift and to restore rotational control in anterior cruciate ligament (ACL) surgery. However, there are still concerns regarding the patellofemoral joint, as with increased tension on the iliotibial band, there is a hypothetical increase of lateralizing forces on the lateral patellar surface. To compare clinical and radiographic patellofemoral outcomes of professional soccer players who underwent LET and ACL revision with a control group of professional soccer players who underwent primary ACL reconstruction.

Antenatal care services and pregnancy outcomes during the COVID-19 pandemic in Milan, Lombardy, Italy.

Background: During the COVID-19 pandemic maternity healthcare seeking and provision reduced worldwide. We explored the indirect effects of the pandemic on key pregnancy outcomes and access to antenatal care services.

Methods: Observational cross-sectional study on all pregnancies between years 2019-2020 in Milan metropolitan area (Lombardy, Italy).

[Construction of district-level denominators for monitoring assistance: Methods, data, comparisons, and implications for health monitoring].

Background: Lombardy Region (RL) is organized into 8 Health Protection Agencies (ATS) and 86 Districts, which are responsible for organizing and coordinating territorial health care for reference population ranging between 80,000 and 120,000 inhabitants. RL has implemented the Health Profiles Portal, an advanced system that integrates health care, socio-health, and social data to provide a clear and comparable view of the population's needs at different territorial levels. To develop the portal, it was necessary to construct denominators that would ensure the accuracy and comparability of the healthcare indicators.

[A data-driven approach to optimizing the management of chronic patients within the framework of DM77].

Objectives: to develop tools to identify the most appropriate and/or prioritized sets of patients with stable chronic conditions who are eligible for management by territorial services, to be included in a dedicated care pathway within Community Health Centers (CdC), as outlined in Italian Ministerial Decree 77/2022.

Design: retrospective observational study.

Setting And Participants: subjects residing in the territory of the Health Protection Agency of Milan (ATS Milano) in the year 2023.

Open Biopsy Is a Safe Procedure in Patients Who Have Suspected Periprosthetic Joint Infection of the Hip or Knee and Double-Negative Joint Aspiration.

Background: Diagnosis of periprosthetic joint infection is complex, and it is based on the combination of clinical and laboratory criteria. In case of double culture-negative joint aspirations and suspected periprosthetic joint infection, open biopsies can be performed to identify the underlying microorganism profile to increase the chance of treatment success. The aim of this study was to report the reinfection and rerevision rates of patients who underwent one- or two-stage septic exchange and had an open biopsy during their diagnostic work-up.

In the eye of the storm. Long-term impact of the Covid-19 pandemic on healthcare utilization in Lombardy.

Covid-19 induced an increase in unmet health needs due to mobility restrictions and social distancing policies, fear of contagion and overload of healthcare facilities. Using administrative data for the Metropolitan Area of Milan in Lombardy and a rigorous empirical strategy, this paper investigates the impact of Covid-19 on the provision of outpatient care between January 2018 and June 2021. We find a large and persistent drop in outpatient treatments, with heterogeneous variations across age groups and chronic status of patients, as well as diagnostic categories of treatments.

No additional benefit with detoxification strategies: A real world experience in 200 patients with chronic migraine and either simple or complex MOH treated with CGRP monoclonal antibodies.

BackgroundAlthough withdrawal from analgesics with or without detoxification strategy represented a mainstay in medication overuse headache (MOH) management, recent evidence supports that it is no longer beneficial when CGRP-targeting monoclonal antibodies (CGRP-mAbs) are employed. However, MOH could be stratified into simple and complex MOH phenotypes according to different clinical parameters (i.e.