The Gemelli University Hospital (Italian: Fondazione Policlinico Universitario Agostino Gemelli) is a large general hospital in Rome, Italy. With 1575 beds, it is the second-largest hospital in Italy, the largest hospital in Rome and one of the largest private hospitals in Europe. It serves as the teaching hospital for the medical school of the Università Cattolica del Sacro Cuore (the largest privately owned university in Italy, founded in 1921 in Milan), and owes its name to the university founder, the Franciscan friar, physician and psychologist Agostino Gemelli. The hospital provides free medical assistance as part of the Italian national health system as well as paid-for "private" assistance in dedicated hotel-style wards.
BACKGROUND:Endoscopic sleeve gastroplasty (ESG) is an established endoscopic bariatric therapy. Two main platforms are currently used in clinical practice: the OverStitch Endoscopic Suturing System (OESS) and the triangulation Endomina System (ES). Comparative data regarding their technical performance and suture durability remain limited. This experimental study aimed to compare both systems in terms of usability, safety, and durability of full-thickness sutures. METHODS:In this prospective comparative animal study, six adult minipigs were randomized to ESG using either OESS or ES (three animals per group; five sutures per animal). Primary outcomes included ease of use, tissue apposition (TA) tightness assessed at index procedure, day 15 endoscopy, and day 30 necropsy, as well as histological evaluation of serosal fusion and bite size. RESULTS:All procedures were successfully completed without intra-procedural adverse events. Overall ease-of-use scores were higher with ES compared to OESS (median 6 vs 5; p=0.047). Immediate post-procedural TA scores were similar between groups (both tight; p=1). However, at day 15, ES demonstrated significantly higher TA scores than OESS (OR=29.1; 95% CI 4.3-200.3; p=0.026). At day 30 necropsy, TA remained significantly tighter with ES (OR=199.9; 95% CI 2.5-16245; p=0.029). No leaks or abscesses were observed. Histologically, serosal fusion was observed only in the ES group, although differences did not reach statistical significance. CONCLUSION:Both ESG platforms were safe and feasible in this animal model. While immediate suture performance was comparable, the Endomina System demonstrated superior mid-term durability and tighter tissue apposition compared with OverStitch. The clinical relevance of these findings warrants further investigation.
AIMS:We aimed to develop the European Society of Cardiology (ESC) quality indicators (QIs) for myocardial infarction (MI), from 1 year after hospital discharge, corresponding to transition to the chronic coronary syndrome phases. METHODS AND RESULTS:We collaborated with the European Association of Preventive Cardiology (EAPC) and developed QIs for the long-term management of patients following MI. We applied the ESC methodology for QI development by (i) determining key domains of post-MI care; (ii) developing candidate QIs by performing a systematic review of the literature, and (iii) selecting the final set of QIs using a modified Delphi approach. In total, 18 QIs were identified across seven domains of care including (i) structural framework, (ii) risk assessment and follow-up, (iii) pharmacological management, (iv) rehabilitation, behavioural, and preventive interventions, (v) coronary revascularization, (vi) clinical outcomes, and (vii) patient-reported outcomes. CONCLUSION:We present the ESC QIs from 1 year after hospitalization for MI, to standardize and address gaps in care for this high-risk group. These QIs are supported by evidence from contemporary literature, endorsed by expert consensus, and aligned with the 2024 ESC guidelines on the management of chronic coronary syndromes. LAY SUMMARY:Measures to evaluate and improve the long-term management of patients following a heart attack are needed. In this paper, we identified key aspects of care that can help clinicians, decision-makers and patients improve the quality of care, from one year after a heart attack onwards, and help address inequalities and variations in clinical practice.
Main pancreatic duct (MPD) dilation is an imaging finding that encompasses a broad spectrum of benign and malignant etiologies. Differentiating between these conditions is critical for appropriate patient management, and radiologists play a central role in this diagnostic process. CT and MR, particularly with MR cholangiopancreatography (MRCP), are crucial for assessing ductal morphology, parenchymal changes, and associated lesions. Thin-slice dual-phase CT provides excellent spatial resolution and is particularly effective for evaluating pancreatic ductal adenocarcinoma (PDAC), vascular invasion, and metastatic disease. Conversely, MR offers superior soft-tissue contrast and ductal delineation, allowing detailed assessment of subtle strictures, cystic lesions, and intraductal abnormalities.Benign causes of MPD dilation include chronic pancreatitis with ductal calculi, post-inflammatory strictures, low-grade main-duct intraductal papillary mucinous neoplasms (IPMNs), and focal autoimmune pancreatitis. These entities often show gradual ductal narrowing, multiple strictures, or smooth contour irregularities without abrupt cutoff. In contrast, malignant etiologies—such as PDAC, high-grade IPMN, ampullary carcinoma, pancreatic neuroendocrine carcinoma (NET), and metastases—typically present with abrupt ductal truncation, associated mass effect, and upstream atrophy. Recognition of imaging patterns such as the “double duct sign,” enhancing mural nodules, or restricted diffusion improves diagnostic confidence.Technical optimization of CT and MR protocols, awareness of artifacts, and correlation with clinical data are essential to avoid misinterpretation. Radiologists must integrate morphological, functional, and clinical information to ensure accurate characterization of MPD dilation and guide optimal management.
Background To describe medical activity, emergency resource deployment, and patient outcomes during international rugby matches held at a high-capacity stadium. Methods We conducted a retrospective observational study of all medical encounters recorded during seven international rugby matches held at the Olympic Stadium (Rome, Italy) between 2023 and 2025. Event risk assessment and medical planning were performed using a standardized mass-gathering risk stratification approach. Patient Presentation Rate (PPR) and hospital transport rate were calculated per 10,000 attendees. Results Across the seven matches, 451,934 individuals were present at the venue. A total of 162 medical encounters were recorded, corresponding to a PPR of 3.6 per 10,000 attendees. Most presentations were of low acuity, with 86 white-code (53.1%) and 60 green-code (37.0%) cases. Higher-acuity events were uncommon (13 yellow-code [8.0%] and 3 red-code [1.9%]). Twelve patients (0.3 per 10,000) required hospital transport, while 14 refused transfer after on-site assessment. Medical deployment included physicians, anaesthesiology–intensive care specialists, nurses, first responders, advanced life support units, and mobile response teams, ensuring comprehensive on-site coverage. Conclusions Despite formal classification as moderate-to-high risk, medical demand during international rugby matches was low and predominantly consisted of minor presentations. Extensive on-site EMS deployment enabled effective management of medical events and minimised hospital transport. These findings support the potential value of structured, redundancy-based medical models for large stadium-based sporting events.
Optimal long-term management after a first episode of uncomplicated acute diverticulitis (AD) remains debated. Quality of life (QoL) is increasingly recognized as a key outcome to guide individualized decision-making between clinical surveillance and elective sigmoid resection. This single-center prospective longitudinal observational study enrolled adults with a first episode of uncomplicated AD (Hinchey 0-1a). After recovery from the index episode, patients underwent either clinical follow-up (nonsurgery group) or elective laparoscopic sigmoidectomy (surgery group) according to routine clinical decision-making. Diverticulitis-specific QoL was assessed using the DV-QoL questionnaire, retrospectively referring to the month before the index episode and prospectively at 1, 6, and 12 months after post-episode management. The primary aim was to describe and compare DV-QoL trajectories between groups. A DV-QoL score ≥ 3.2 was used to define a non-acceptable symptom state (Patient Acceptable Symptom State (PASS) threshold). Predictors of non-acceptable QoL were explored in conservatively managed patients. A total of 137 patients were included: 96 (70
