Panminerva medica最新文献

Interventional pulmonology has evolved over the past century from rudimentary endoscopic procedures to a highly specialized discipline encompassing a wide range of diagnostic and therapeutic techniques. This review outlines the historical milestones that have shaped the field, tracing the progressive development of flexible and rigid bronchoscopy, thoracic ultrasound, robotic systems, and advanced imaging modalities such as cone-beam CT. Each innovation has contributed to enhancing the accuracy, safety, and efficacy of interventions for various pulmonary diseases, including malignancies, interstitial lung disease, airway obstruction, and pleural disorders. The review also explores the role of pioneering figures whose vision and experimentation laid the foundation for modern practices. From Killian's first bronchoscopic foreign body removal to the latest robotic navigation systems, the trajectory of interventional pulmonology illustrates a dynamic interplay between technological advancement and clinical need.

Background: Osteoporosis is a chronic disease affecting individual, public and social health. Few data are available about the awareness of osteoporosis in Italy. The main purpose of our study is to evaluate the perception of osteoporosis in a selected sample of subjects of different age and sex.

Methods: This is a survey involving 299 adults (aged 18-75 years) designed to assess knowledge about osteoporosis and fracture risk conducted by a multidisciplinary research team of LUISS Guido Carli University.

Results: The knowledge of osteoporosis resulted almost high among the participants (97%) and most of them considered it a disease (86.1%). Most respondents (30.5%) did not know if they might be at risk of osteoporosis, especially the youngest (43.5%). A high percentage of participants (73.8%) considered a family history of osteoporosis the principal risk factor for bone loss, while only 8.9% thought that moderate to vigorous physical activity could favor bone loss. Many women (17.4%) did not consider menstrual irregularities a risk factor for osteoporosis. As for nutrients, 79.5% and 89.4% of subjects, respectively, thought that vitamin D and calcium might be useful to prevent bone loss. The majority of sample (74.8%) did not know the public and social impact of osteoporosis.

Conclusions: Although this survey involved a selected population and, thus, it cannot reflect the Italian general knowledge of osteoporosis, it might contribute to estimate the actual awareness of osteoporosis among people, regardless of their current bone health status, highlighting areas for further educational and research efforts.

Introduction: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction. Ventricular arrhythmias may complicate acute SCAD presentation but the impact of ventricular arrhythmias on clinical outcomes is not well-established. This systematic review aimed to compare characteristics and outcomes of SCAD patients with or without concomitant ventricular arrhythmias.

Evidence acquisition: A systematic literature search was conducted using PubMed and Embase databases. Odds ratio (OR) and mean difference (MD) with 95% confidence interval (95% CI) were computed using random-effects model.

Evidence synthesis: Four studies enrolling 2365 SCAD patients were included. The pooled prevalence of ventricular arrhythmias was 9.0% (95% CI: 6.0; 14.0, I²=87%) of patients with SCAD. Patients with ventricular arrhythmias were more likely to present with ST-segment elevation myocardial infarction (OR: 3.73, 95% CI: 2.50; 5.57, P<0.0001; I²=0%) and to undergo percutaneous coronary intervention (OR: 2.07, 95% CI: 1.29; 3.32, P=0.0025; I²=0%) than the entire SCAD cohort. They were more likely to have more in-hospital adverse events such as cardiac arrest (OR: 190.61, 95% CI: 4.39; 8275.52, P=0.0064; I²=85%), death (OR: 6.35, 95% CI: 3.04; 13.27, P< 0.0001; I²=0%), stroke (OR: 5.68, 95% CI: 2.00; 16.14, P=0.0011; I²=0%), cardiogenic shock (OR: 17.44, 95% CI: 1.50; 203.06, P=0.0225; I²=65%) and heart failure (OR: 6.98, 95% CI: 2.90; 16.81, P<0.0001; I²=57%) than the entire SCAD cohort. In addition, they experienced more adverse events in terms of all-cause death (OR: 5.76, 95% CI: 1.30; 25.51, P=0.021; I²=2%) and composite events (OR: 1.86, 95% CI: 1.07; 3.23, P=0.0267; I²=0%) at a mean follow-up of 4.26 years.

Conclusions: SCAD patients with concurrent ventricular arrhythmias were more likely to experience in-hospital clinical adverse events such as cardiac arrest, stroke, cardiogenic shock, heart failure, and death than the entire SCAD cohort as well as more death and composite adverse events during follow-up.

Non-communicable diseases (NCDs) like hypertension, type 2 diabetes, hyperlipidemia, and obesity, are a leading cause of mortality and have shown rising prevalence trends over the last few decades. Lifestyle interventions, particularly diet and physical activity, are an effective approach to addressing the underlying risk factors of these preventable NCDs, but their integration into the primary care practice remains underutilized. This review synthesizes evidence from systematic reviews and meta-analyses published between 2019 and 2024 to provide evidence-based recommendations for the integration of lifestyle interventions into primary care pathways. The included articles were noted for their risk of bias because of poor study design. While consideration must be given to the quality of evidence for these interventions because of the risk of bias, there is good evidence to support the use of several types of interventions including: diet modification (e.g. food replacement, calorie restriction, intermittent/periodic fasting); diet education and counselling; individual and group-based exercise interventions; interventions that aim to promote general physical activity in daily life; as well as combined dietary and physical activity interventions delivered individually, in groups, at a community level as well as through smartphone-supported applications. It is important for the health and care community to explore and implement alternative means of generating evidence, integrating lifestyle interventions into care pathways and increasing investment in the lifecycle of these interventions, which can promote health and prevent disease.

Since the first description of coronary slow flow by Tambe et al. until today, there have been many publications referring to this entity that is still a source of controversy. Also named in some point as "Y syndrome" it includes a broad spectrum of clinical presentation since angina to acute coronary syndrome or even ventricular arrhythmias and sudden death. Its pathophysiology is multifactorial and has not been completely elucidated yet, involving inflammatory factors, endothelial dysfunction, diffuse microvascular disease, atheromatosis and also metabolic, anatomical and even genetic factors. The diagnostic criteria have also evolved over the years. The main diagnostic test is by angiography, considering coronary slow flow within the spectrum of angina with non-obstructive coronary lesions, however, in recent years controversy has arisen about its true nature. Lately, there have been many studies published contemplating different aspects of this entity, referring either to its pathophysiology or to its diagnosis and treatment. In the present manuscript we make an updated review of coronary slow flow encompassing it in the current cardiological panorama.

Mantle cell lymphoma (MCL) is a rare B-cell non-Hodgkin lymphoma with multiple subtypes including classical mantle cell lymphoma (cMCL), the leukemic variant of mantle cell lymphoma (LV-MCL), and in situ mantle cell neoplasia (ISMCN). Their clinical presentations differ significantly and range from indolent to very aggressive. The defining genetic feature and chief oncogenic mechanism of MCL involves the t(11;14)(q13;q32) translocation, which results in a fusion of the gene that encodes cyclin D1 (CCND1) and the immunoglobulin heavy chain gene (IGH). As a result of significant variation between subtypes, treatment approaches and prognoses of this disease vary drastically. Current treatment options for MCL range from observation to conventional chemotherapy with or without subsequent stem cell transplantation, to targeted immunotherapies against key molecular targets. The role of stem cell transplant has become more debatable for frontline consolidation therapy. Earlier incorporation of Bruton's tyrosine kinase (BTK) inhibitors is being strongly considered for frontline therapy. Chimeric antigen receptor therapy (CAR-T) therapies have become established treatment options for relapsed/refractory disease. Ongoing frontiers involve optimal management of TP53 mutated MCL and those relapsing with CNS involvement. Novel therapeutic approaches including the development of non-covalent BTK inhibitors and bispecific antibody therapy carry significant promise to further improve outcomes across all subtypes of this disease.

Fever usually is a physiological response to infectious/inflammatory acute events. Namely, fever has positive benefits contrasting noxious agents. However, when fever causes discomfort, it is better to relieve symptoms associated to fever. Antipyretics mainly are non-steroidal anti-inflammatory agents (NSAIDs) and acetaminophen. The NSAIDs class includes many molecules. The most used NSAID to relieve fever is ibuprofen. However, ketoprofen also provides interesting pharmacological characteristics. In particular, salifying ketoprofen with lysine, such as ketoprofen lysine salt (KLS), provides a better and quicker absorption then acid ketoprofen and reduces side effects. The present paper considers the comparative pediatric studies between ketoprofen or KLS and other antipyretics, mainly concerning ibuprofen and acetaminophen. The results showed that ketoprofen and KLS are valuable option in managing children with fever.