Ospedale D. Cotugno

Pharmacokinetic/Pharmacodynamic Optimization and Therapeutic Drug Monitoring of Beta-Lactam Antibiotics in Abdominal Sepsis: Current Evidence, Challenges, and Clinical Perspectives—A Narrative Review

Background: Abdominal sepsis is associated with profound pharmacokinetic (PK) alterations that make standard beta-lactam dosing regimens potentially inadequate in critically ill patients. Increased volume of distribution, hypoalbuminemia, augmented renal clearance (ARC), acute ki...

Phenotype-based appropriateness of IGM-enriched polyclonal immunoglobulin use in critical illness: report of an expert consensus

Sepsis and septic shock result from a dysregulated host response to infection, encompassing both hyperinflammatory and immunosuppressed phenotypes. Although immunomodulatory adjunctive therapies have been extensively investigated over the past decades, none have demonstrated cons...

Central neurocytomas: Decision-making process of postoperative treatment. Lesson learned

Central neurocytoma is a rare intraventricular tumor with favorable prognosis following gross total resection (GTR). However, the role of Ki67-MIB1 values in the postoperative decision making-process of treatment, as well as the indication for adjuvant radiotherapy, remain debate...

Browser-Native Federated Inference on Existing Italian SSN Clinical Workstations: A Peer-to-Peer Sovereignty-Preserving AI Architecture for Italian Regional Health Networks

Clinical adoption of large language models (LLMs) in public healthcare faces a structural impasse: the capital expenditure of centralised high-performance computing on one side and the privacy risk of routing patient data through third-party cloud interfaces on the other. Italian...

Burned Area Evidence for Process-Sensitive Post-Fire Hydrogeomorphic Monitoring Across Mediterranean and Iberian–Atlantic Regions

In operational terms, post-fire landscapes require monitoring priorities that reflect hydrogeomorphic susceptibility rather than burned extent alone. This study tests whether European Forest Fire Information System (EFFIS) burned area evidence, combined with open terrain, rainfal...

Real-World Antibiotic Strategies for Multidrug-Resistant Pseudomonas aeruginosa: Evidence from the Italian SUSANA Multicentre Study

Background/Objectives: Multidrug-resistant (MDR) Pseudomonas aeruginosa pneumonia and bloodstream infections (BSI) remain challenging because of their severity, limited therapeutic options, and high mortality, despite the availability of novel β-lactam-based agents. We aimed to d...

Discontinuous Peripheral Punctate Echogenic Foci in Thyroid Nodules: A New Sonographic Pattern Suggestive of Papillary Carcinoma

Background: Ultrasound risk stratification systems for thyroid nodules worldwide describe different types of echogenic foci, including punctate echogenic foci (microcalcifications), coarse internal calcifications, and peripheral (rim) calcifications (complete or incomplete), with...

Combined Fine Needle Cytology and Core Needle Biopsy of the Liver in One Setting: An Experience of 29 Cases

INTRODUCTION: Core needle biopsy (CNB) and fine needle aspiration cytology (FNAC) are routinely used in the diagnosis of hepatic nodules. Despite their advantages, both procedures have certain limitations. Recently, the combined use of FNAC and CNB in the same setting has been ex...

Multimodal Assessment of Tissue Response After Thyroid Radiofrequency Ablation: Clinical, Imaging, Histopathological and Molecular Insights

Background: Ultrasound-guided radiofrequency ablation (RFA) has become an established minimally invasive treatment for selected benign and autonomously functioning thyroid nodules. Although clinical outcomes are well documented, the biological mechanisms underlying tissue remodel...