Fatebenefratelli Hospital (officially Ospedale San Giovanni Calibita Fatebenefratelli) is a hospital located on the western side of the Tiber Island in Rome. It was established in 1585 and is currently run by the Brothers Hospitallers of Saint John of God. The hospital is known for having sheltered Jews during the Holocaust by diagnosing them with a fictitious disease called "Syndrome K".
Case Report Forms (CRFs) collect data about patients and are at the core of well-established practices to conduct research in clinical settings. With the recent progress of language technologies, there is an increasing interest in automatic CRF-filling from clinical notes, mostly based on the use of Large Language Models (LLMs). However, there is a general scarcity of annotated CRF data, both for training and testing LLMs, which limits the progress on this task. As a step in the direction of providing such data, we present a new dataset of clinical notes from an Italian Emergency Department annotated with respect to a pre-defined CRF containing 134 items to be filled. We provide an analysis of the data, define the CRF-filling task and metric for its evaluation, and report on pilot experiments where we use an open-source state-of-the-art LLM to automatically execute the task. Results of the case-study show that (i) CRF-filling from real clinical notes in Italian can be approached in a zero-shot setting; (ii) LLMs' results are affected by biases (e.g., a cautious behaviour favours "unknown" answers), which need to be corrected.
BACKGROUND:Pericardium is considered electrically inert, but diffuse ST-elevation is an electrocardiographic marker of acute pericarditis. We hypothesised that ST-elevation in acute pericarditis may reflect underlying myocardial involvement. Accordingly, this study aimed to assess the association between ST-elevation and myocardial involvement in pericarditis patients and to further characterise the clinical features and long-term outcomes of myopericarditis compared with isolated pericarditis. METHODS:This longitudinal multicentre study included 351 pericarditis patients (328 recurrent; 180 females), 70/351 with myopericarditis, defined by troponin elevation and/or suggestive cardiac MRI. RESULTS:121 patients had ST-elevation (34.5%); they were younger: 38 years (23-53) vs 47 (31-58) (median (IQR)) (p<0.001), more often male: 63.6% (77/121) vs 40.9% (94/230) (p<0.001) and had higher C reactive protein values: 92.0 (35-170) vs 58.4 mg/L (15.8-137.5) (median (IQR)) (p=0.002) and less frequent pericardial effusions: 71.1% (86/121) vs 83.5% (192/230) (p=0.004).Myocardial involvement was diagnosed in 70/351 (19.9%) patients, occurring more frequently among those with ST-elevation: 26.4% (32/121), compared with those without: 16.5% (38/230) (p=0.035). ST-elevation predicted myocardial involvement with an OR of 1.82 (95% CI 1.07 to 3.10). Compared with isolated pericarditis, patients with myopericarditis were more frequently male: 61.4% (43/70) vs 45.6% (128/281) (p=0.023) and had a higher prevalence of transient systolic dysfunction: 13.5% (7/52) vs 2.1% (3/141) (p=0.004). During follow-up, myopericarditis patients had a lower remission rate: 18.5% (12/65) vs 31.2% (82/263) (p=0.047) and a higher annual hospitalisation rate (median 0.5 vs 0.4/year, p=0.010), while recurrence rates and disease duration were similar. Treatment strategies, including use of corticosteroids and interleukin 1 blockers, were also comparable. CONCLUSIONS:ST-segment elevation in acute pericarditis was associated with myocardial involvement, supporting the concept that the pericardium is electrically inert. Myopericarditis was associated with lower remission rates and slightly higher hospitalisation needs compared to isolated pericarditis, despite otherwise comparable recurrence rates and treatment strategies.
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
Non-metric traits are anatomical variants of the human skeleton that are commonly used as morphological descriptors and have shown potential for personal identification. Although their frequencies are reported for different contemporary and archaeological populations, very little is known about their origins and even less is reported about their reciprocal correlations. This study aims at assessing the possible correlation among 21 different non-metric traits of the cranium (12 pair and symmetric, 9 unpaired and median) to verify if they are correlated one with each other. The variants were observed on 733 CT-scan collected from the radiological databases of two Italian hospitals. A pairwise correlation analysis among features was performed using Pearson’s correlation index (|r|). Results show that only four significant positive correlations were found, namely between number of septa and scallops in the frontal sinuses, between the pneumatization of pterygoid processes and greater wings bilaterally, and between the pneumatization of greater wings and clinoid processes on the left side with a |r| between 0.333 and 0.650. The single negative correlation was between metopism and number of scallops in the frontal sinuses with a |r| of -0.408 (p < 0.05). This study shows that most of anatomical variants are largely independent one from the others: this novel information represents a starting point for an in-depth study on the origin of non-metric traits and confirms their potential for personal identification.
BACKGROUND:Panallergens are ubiquitously expressed molecules that may drive IgE sensitization across diverse allergen sources, thereby shaping complex clinical phenotypes such as asthma and pollen-food allergy syndrome (PFAS). Although several panallergen families have been extensively characterized, unexplained sensitization patterns are still observed in clinical practice. Cyclophilins, a conserved protein family, have recently been proposed as candidate panallergens; however, their molecular, clinical, and functional roles remain largely undefined. METHODS:Within the Panallergens in Pediatrics (PAN-PED) cohort, we investigated 100 Italian children with seasonal allergic rhinitis (SAR) for IgE sensitization to the cyclophilins Bet v 7 and Ara h 18. Functional assays were performed by sensitizing mast cells with patient sera (n = 11) and assessing activation upon stimulation with increasing concentrations of recombinant Bet v 7 (rBet v 7), using CD63 expression as readout. Additional experiments evaluated the impact of heat treatment (60°C, 80°C, or 100°C) and saliva digestion on rBet v 7 activity. RESULTS:rBet v 7 induced mast cell activation in a dose-dependent manner, with peak responses at intermediate allergen concentrations, followed by attenuation at higher doses. rBet v 7 maintained functional activity after exposure to mild heat and saliva. A strong correlation was found between specific IgE levels to Bet v 7 and Ara h 18 (r = 0.996, p < 0.0001). CONCLUSION:Bet v 7 has the functional capacity to activate mast cells and is resistant to mild heat and saliva digestion, supporting its role as a clinically relevant panallergen. In addition, Bet v 7 shows high similarity to cyclophilins from other plant sources and exhibits virtually identical IgE-binding properties to Ara h 18. These findings suggest a potential rationale for considering the inclusion of cyclophilins into molecular diagnostic panels, particularly in children with SAR.
