University of Milan

About: University of Milan is a education organization based out in Milan, Italy. It is known for research contribution in the topics: Population & Medicine. The organization has 58413 authors who have published 139784 publications receiving 4636354 citations. The organization is also known as: Università degli Studi di Milano & Statale.

EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome

Abstract: Objectives Develop recommendations for women9s health issues and family planning in systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). Methods Systematic review of evidence followed by modified Delphi method to compile questions, elicit expert opinions and reach consensus. Results Family planning should be discussed as early as possible after diagnosis. Most women can have successful pregnancies and measures can be taken to reduce the risks of adverse maternal or fetal outcomes. Risk stratification includes disease activity, autoantibody profile, previous vascular and pregnancy morbidity, hypertension and the use of drugs (emphasis on benefits from hydroxychloroquine and antiplatelets/anticoagulants). Hormonal contraception and menopause replacement therapy can be used in patients with stable/inactive disease and low risk of thrombosis. Fertility preservation with gonadotropin-releasing hormone analogues should be considered prior to the use of alkylating agents. Assisted reproduction techniques can be safely used in patients with stable/inactive disease; patients with positive antiphospholipid antibodies/APS should receive anticoagulation and/or low-dose aspirin. Assessment of disease activity, renal function and serological markers is important for diagnosing disease flares and monitoring for obstetrical adverse outcomes. Fetal monitoring includes Doppler ultrasonography and fetal biometry, particularly in the third trimester, to screen for placental insufficiency and small for gestational age fetuses. Screening for gynaecological malignancies is similar to the general population, with increased vigilance for cervical premalignant lesions if exposed to immunosuppressive drugs. Human papillomavirus immunisation can be used in women with stable/inactive disease. Conclusions Recommendations for women9s health issues in SLE and/or APS were developed using an evidence-based approach followed by expert consensus.

The Prevention of Radiocontrast-Agent–Induced Nephropathy by Hemofiltration

Abstract: background Nephropathy induced by exposure to radiocontrast agents, a possible complication of percutaneous coronary interventions, is associated with significant in-hospital and longterm morbidity and mortality. Patients with preexisting renal failure are at particularly high risk. We investigated the role of hemofiltration, as compared with isotonic-saline hydration, in preventing contrast-agent–induced nephropathy in patients with renal failure. methods We studied 114 consecutive patients with chronic renal failure (serum creatinine concentration, >2 mg per deciliter [176.8 µmol per liter]) who were undergoing coronary interventions. We randomly assigned them to either hemofiltration in an intensive care unit (ICU) (58 patients, with a mean [ ± SD] serum creatinine concentration of 3.0 ± 1.0 mg per deciliter [265.2 ± 88.4 µmol per liter]) or isotonic-saline hydration at a rate of 1 ml per kilogram of body weight per hour given in a step-down unit (56 patients, with a mean serum creatinine concentration of 3.1 ± 1.0 mg per deciliter [274.0 ± 88.4 µmol per liter]). Hemofiltration (fluid replacement rate, 1000 ml per hour without weight loss) and saline hydration were initiated 4 to 8 hours before the coronary intervention and were continued for 18 to 24 hours after the procedure was completed. results An increase in the serum creatinine concentration of more than 25 percent from the baseline value after the coronary intervention occurred less frequently among the patients in the hemofiltration group than among the control patients (5 percent vs. 50 percent, P<0.001). Temporary renal-replacement therapy (hemodialysis or hemofiltration) was required in 25 percent of the control patients and in 3 percent of the patients in the hemofiltration group. The rate of in-hospital events was 9 percent in the hemofiltration group and 52 percent in the control group (P<0.001). In-hospital mortality was 2 percent in the hemofiltration group and 14 percent in the control group (P=0.02), and the cumulative one-year mortality was 10 percent and 30 percent, respectively (P=0.01). conclusions In patients with chronic renal failure who are undergoing percutaneous coronary interventions, periprocedural hemofiltration given in an ICU setting appears to be effective in preventing the deterioration of renal function due to contrast-agent–induced nephropathy and is associated with improved in-hospital and long-term outcomes.

Estrogen and Progesterone Receptor Testing in Breast Cancer: ASCO/CAP Guideline Update.

Abstract: PURPOSETo update key recommendations of the American Society of Clinical Oncology/College of American Pathologists estrogen (ER) and progesterone receptor (PgR) testing in breast cancer guideline.M...

The Brezis-Nirenberg result for the fractional Laplacian

Abstract: The aim of this paper is to deal with the non-local fractional counterpart of the Laplace equation involving critical non-linearities studied in the famous paper of Brezis and Nirenberg (1983). Namely, our model is the equation { (−Δ)su− λu = |u|2−2u in Ω, u = 0 in Rn \ Ω , where (−Δ)s is the fractional Laplace operator, s ∈ (0, 1), Ω is an open bounded set of Rn, n > 2s, with Lipschitz boundary, λ > 0 is a real parameter and 2∗ = 2n/(n− 2s) is a fractional critical Sobolev exponent. In this paper we first study the problem in a general framework; indeed we consider the equation { LKu+ λu+ |u|2 −2u+ f(x, u) = 0 in Ω, u = 0 in Rn \ Ω , where LK is a general non-local integrodifferential operator of order s and f is a lower order perturbation of the critical power |u|2−2u. In this setting we prove an existence result through variational techniques. Then, as a concrete example, we derive a Brezis-Nirenberg type result for our model equation; that is, we show that if λ1,s is the first eigenvalue of the non-local operator (−Δ)s with homogeneous Dirichlet boundary datum, then for any λ ∈ (0, λ1,s) there exists a non-trivial solution of the above model equation, provided n 4s. In this sense the present work may be seen as the extension of the classical Brezis-Nirenberg result to the case of non-local fractional operators.

Classification, diagnosis, and approach to treatment for angioedema: consensus report from the Hereditary Angioedema International Working Group

Abstract: Angioedema is defined as localized and self-limiting edema of the subcutaneous and submucosal tissue, due to a temporary increase in vascular permeability caused by the release of vasoactive mediator(s). When angioedema recurs without significant wheals, the patient should be diagnosed to have angioedema as a distinct disease. In the absence of accepted classification, different types of angioedema are not uniquely identified. For this reason, the European Academy of Allergy and Clinical Immunology gave its patronage to a consensus conference aimed at classifying angioedema. Four types of acquired and three types of hereditary angioedema were identified as separate forms from the analysis of the literature and were presented in detail at the meeting. Here, we summarize the analysis of the data and the resulting classification of angioedema.