Recenti progressi in medicina最新文献

Objectives: To assess the safety profile of dietary supplements with a focus on those purchased online or reported via the internet.

Results: Among the 2,367 reports of Adverse Reactions (ARs) to dietary supplements collected within the Italian Phitovigilance System, 49.4% were from citizens and 33.7% from companies. From these we selected 129 reports (6%) in which an online purchase or an adverse reaction retrieved from the web was indicated (e.g. Amazon®). The most frequent ARs referred to the gastrointestinal tract (31.4%) and the central nervous system (17.6%). Nineteen percent were used for sleep disorders and 14% for disturbances of the prostate.

Conclusions: The Italian Phytovigilance System is the only tool that provides information on the possible risks associated with the use of food supplements purchased online but the quality of the information collected needs to be improved.

Recently, talking about abortion, the Pope has spoken harshly regarding the role played by non-objecting doctors. The article discusses: 1) the ethical and health aspects that the denial of the right to terminate pregnancy entails; 2) the positive results obtained by non-objecting doctors 50 years after the implementation of Law no. 194/1978, in terms of safeguarding women's health and guaranteeing the implementation of a state law.

Triple-negative breast cancer (TNBC) is a heterogeneous disease with an aggressive clinical course and worse outcomes than other breast cancer subtypes. Metastatic triple-negative breast cancer (mTNBC) is characterized by an aggressive clinical course and unfavorable outcomes, despite the pharmacological treatments used. The present clinical case describes a 35-year-old woman affected by TNBC characterized by rapid and subsequent local, cutaneous and lymph node progression of the disease. It was initially necessary to perform surgical treatment without the patient having completed neoadjuvant chemotherapy. 4 months after the end of adjuvant chemotherapy the patient underwent a second surgery. Then, she started the first line and, after 4 cycles, the second line with sacituzumab govitecan (SG) obtaining at the first instrumental re-evaluation a partial skin and lymph node response with a clear reduction in painful symptoms previously reported at the level of the right chest wall and axillary cavity. She continued treatment for a total of 9 cycles. The case confirms the clinical benefit and effectiveness of treatment with SG, in particular it underlines the good control of the disease characterized by a rapid and progressive course with exclusively locoregional extension and good control of symptoms with an improvement in quality of life.

Introduction: The availability of epidemiological data relating to the therapy with somatropin (recombinant Growth Hormone, rGH) is scarce and mostly limited to specific clinical conditions. In Italy, the National Register of rGH users (Registro nazionale degli assuntori dell'ormone della crescita - Rnaoc) has been established since 2004 as recommended by the Italian medicine agency (Aifa). However, prevalence (P) and incidence (I) estimates in the Italian population are lacking.

Methods: Data from the Rnaoc and a questionnaire submitted to all the Italian regions have been used to calculate P and I rates of rGH treatment exposure in the Italian paediatric (0-17 years) and adult (≥18 years) population during 2019-2022; P and I rates of growth hormone deficiency (GHD) in paediatric patients have been estimated as well. Results from the two data sources have been compared.

Results: In 2019-2022, the estimated P rate in the paediatric population was 13,4/10.000, in adults 0,7/10.000 inhabitants; the I rate was 2,3/10.000 and 0,06/10.000 inhabitants, correspondingly. The estimated P rate of paediatric GHD was 8,9/10.000, the I rate was 1,5/10.000 inhabitants, respectively.

Conclusion: Study results showed a better reliability of data collected via questionnaire because more consistent with Italian regional resident populations.

In the Piedmont Region, the first mapping of the organization and research activity of the 18 Health Authorities was conducted in 2022 through the Research and Innovation Department (DAIRI), repeated in 2023. The data showed an increase in scientific production and research funding and a decrease in clinical research, although the most represented infrastructure is for the activation of clinical trials. The importance of creating a regional research system is highlighted.

The metastatic triple negative breast cancer (mTNBC) represents a particularly aggressive form of breast cancer that frequently affects young women under the age of 50. Obesity at the time of breast cancer diagnosis is associated with a worse prognosis. Compared to the recent past, increasing life expectancy and quality of life for patients with mTNBC is now a possible challenge, thanks to a new drug, sacituzumab govitecan (SG), an anti-Trop-2 antibody drug conjugate approved as monotherapy for the treatment of these patients. The presented clinical case documents the efficacy and safety of long-term treatment with SG in an obese young woman with mTNBC who has already undergone multiple treatments. The patient is still responding after 20 months of treatment with good quality of life and social interactions.

The River Sacco Basin (Rsb) is a site of National interest, characterized by several environmental pressures such as industrial facilities. This study investigates the association between long-term exposure to industrial-PM10 and -NOx and cause-specific mortality (non-accidental, cardiovascular, respiratory, and cancer) in the Rsb in the 2006-2018 period. We enrolled 301,681 residents near 14 major industrial plants (grouped into 5 30-km2 spatial domains). Residential exposure to annual PM10 and NOx was considered as categorical exposure (high (>80th percentile), medium (50th-80th), and low (<50th)). We applied adjusted domain specific Cox regression models (covariates: age, sex, and deprivation index) and performed a relative meta-analysis. We obtain a pooled 34% increase in respiratory mortality for high PM10 levels. Elevated risks were also observed for non-accidental and cancer mortality, highlighting the need for continuous monitoring and preventive interventions.

The clinical case described concerns a 53-year-old patient with triple-negative disease, metastatic to the skin, fragile, not due to comorbidities, but due to toxicities from previous antiblastic treatments. The major toxicities reported, even previously, were inherent to bone marrow function, with prolonged neutropenia, despite the use of granulocyte growth factor (GCSF). The patient has no family history of breast cancer and does not have a mutation in the BRCA1/2 genes. In pathological history, only arterial hypertension under medical therapy with nebivolol.