Panminerva medica最新文献

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.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder affecting over 90% of diabetes patients worldwide. The condition is driven by genetic predispositions, environmental factors, obesity, and physical inactivity. Pharmacological treatments range from metformin to newer agents, including GLP-1 analogues and SGLT-2 inhibitors, which target different aspects of glucose metabolism. The review highlights advancements in clinical trials for T2DM treatments, focusing on recent and ongoing research. Clinical trial data were sourced from ClinicalTrials.gov, and the search criteria focused on trials that were published with monotherapy of T2DM having results within the last six years, specifically from 2019 to 2024. The clinical trials of the patients under the age group of adults (18 to 64 years) and older adults (>64 years) were included. The data are mentioned in inverse chronological order with respect to study duration. The clinical trial data suggest promising results in managing hemoglobin A1c and body weight. However, adverse events such as cardiovascular, gastrointestinal, and bone-related issues and other issues such as diabetic ketoacidosis and pancreatitis were reported in some cases. Dulaglutide, tripeptide, and oral insulin showed promising therapeutic effects in clinical trials. Despite significant progress, the management of T2DM remains challenging, emphasizing the need for ongoing innovation in treatment approaches to improve patient quality of life and reduce the global burden of the disease.

Acute pain is a common symptom experienced by all children. Pain may be due to different causes, but inflammatory pain is the most common. In addition, infectious diseases are characterized by an inflammatory reaction. As a result, inflammatory pain, including pain associated with infections, should be preferably relieved by non-steroidal anti-inflammatory drugs (NSAIDs). In this regard, ketoprofen and ketoprofen lysine salt represent a valuable option also in children with mild-moderate acute pain. This paper presents and discusses the comparative studies between ketoprofen or KLS and other analgesics, mainly concerning ibuprofen and acetaminophen. The results showed that ketoprofen and KLS are an effective, safe, and rapid strategy in relieving mild-moderate acute pain in children.

With the formal designation of obesity as a primary disease process, early detection of its end-organ consequences and the prognostication of long-term risk will become an important aspect of its clinical management. Obesity is increasingly recognized as a treatable risk factor for chronic kidney disease. However, profiling of kidney health and estimation of renal risk remain relatively underemphasized in obesity and nephrology care guidelines. The establishment of clinical protocols that facilitate the detection of early-stage renal impairment in obesity and incorporate profiling of an individual's risk of progression, could help guide strategies to break the causal association between obesity and chronic kidney disease. Currently, checks on kidney health in patients with obesity are prompted due to the presence of obesity complications such as cardiovascular and/or metabolic disease and routine screening relies upon the use of estimated glomerular filtration rate equations. Ample evidence exists to demonstrate that these equations are of limited utility in the setting of excess body weight and intentional weight loss. The present article presents the case that an expanded model of renal risk profiling should be developed for obesity medicine, suggesting feasible means of incorporating important risk factors and biomarker profiling alongside a more targeted assessment of directly measured GFR and renal functional reserve in at risk patients. The development of such a model or variation thereof should be prioritized to guide the targeted deployment of obesity treatments with proven reno-protective effects.