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Recenti progressi in medicina最新文献

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In questo numero
2024 Ottobre.
本期内容2024 年 10 月
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43458
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引用次数: 0
[Primary care delivered non-pharmacologic preventive interventions improve function and quality of life but do not decrease the likelihood of hospitalization or need for residential long-term care in older adults.] [初级保健提供的非药物预防性干预可改善老年人的功能和生活质量,但并不能降低老年人住院的可能性或对长期住院护理的需求。]
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43465
Peter K Kurotschka, Henry Barry, Alice Serafini
{"title":"[Primary care delivered non-pharmacologic preventive interventions improve function and quality of life but do not decrease the likelihood of hospitalization or need for residential long-term care in older adults.]","authors":"Peter K Kurotschka, Henry Barry, Alice Serafini","doi":"10.1701/4357.43465","DOIUrl":"https://doi.org/10.1701/4357.43465","url":null,"abstract":"","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":"115 10","pages":"475-476"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Opioid use during pregnancy is not associated with an increased risk of neuropsychiatric disorders in children.] [妊娠期使用阿片类药物与儿童神经精神障碍的风险增加无关]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43468
Alice Serafini, Allen Shaughnessy, Peter K Kurotschka
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引用次数: 0
[Levonorgestrel-releasing intrauetrine devices, compared to no hormonal contraception, are associated with a reduced risk of ischemic stroke and equal risk of intracerebral hemorrhage.] [左炔诺孕酮释放型宫内节育器与不使用激素避孕相比,缺血性中风的风险降低,脑内出血的风险相同。]
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43467
Peter K Kurotschka, Henry Barry, Alice Serafini
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引用次数: 0
L’utilizzo di sacituzumab govitecan in linea avanzata di malattia in paziente anziana con tumore della mammella metastatico divenuto triplo negativo. 在患有三阴性转移性乳腺癌的老年患者的晚期疾病中使用sacituzumab govitecan。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43483
Cinzia Cardalesi

Triple-negative breast carcinoma is known for its aggressive profile and the lack of hormonal or HER2 therapeutic targets. This subtype of tumor is particularly challenging to treat, especially in elderly patients, where tolerance to standard therapeutic regimens may be reduced and multiple comorbidities further complicate clinical management. In this scenario, sacituzumab govitecan (SG) is revolutionizing the therapeutic pathway by offering a particularly active treatment, especially in advanced forms resistant to conventional therapies, with a manageable toxicity profile and reassuring data on efficacy even in case of dose reductions. In this clinical case, we describe the use of SG in a 71-year-old patient diagnosed with metastatic breast cancer histologically shifted from luminal B to triple negative, who had already received numerous and varied hormonal and chemotherapeutic treatment lines. Despite the need for dose reduction due to G3 diarrhea, after 16 months of therapy, the patient continues treatment with minimal impact on quality of life and maintaining stability after a partial response of the disease.

三阴性乳腺癌以其侵袭性特征和缺乏激素或 HER2 治疗靶点而闻名。这种亚型肿瘤的治疗尤其具有挑战性,尤其是老年患者,他们对标准治疗方案的耐受性可能会降低,而且多种合并症会使临床治疗更加复杂。在这种情况下,sacituzumab govitecan(SG)提供了一种特别活跃的治疗方法,尤其是针对对传统疗法耐药的晚期肿瘤,其毒性可控,即使在剂量减少的情况下,疗效数据也令人放心,从而彻底改变了治疗途径。在本临床病例中,我们描述了对一位 71 岁的转移性乳腺癌患者使用 SG 的情况,该患者在组织学上从管腔 B 型乳腺癌转变为三阴性乳腺癌,已经接受过多种不同的激素和化疗治疗。尽管因 G3 腹泻而需要减少剂量,但经过 16 个月的治疗后,患者继续接受治疗,对生活质量的影响微乎其微,并在病情部分反应后保持稳定。
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引用次数: 0
[Medical practices in places of culture and intense architecture: how the visit experience changes.] [文化场所和密集建筑中的医疗实践:就诊体验如何变化]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43462
Eleonora Gerbotto, Guido Giustetto, Raffaella Lecchi, Luca Mo Costabella

Cultura di Base is an experimental project realised in Torino between May and October 2022. Some General Practitioners' offices were moved to cultural places of the city, such as museums, libraries, cultural centers, with recognised quality in terms of space design and architecture. The assumption to be tested is that "intense architecture offices" can improve the experience of the visit and possibly strengthen the relationship between patient and doctor. Our counterfactual impact evaluation, based on a quasi-experimental control group design, evidences a significant positive impact both on the perceptions of waiting time and on the post-visit psychological well-being.

Cultura di Base 是 2022 年 5 月至 10 月期间在都灵实施的一个实验项目。一些全科医生的办公室被搬到了城市的文化场所,如博物馆、图书馆、文化中心等,这些场所的空间设计和建筑质量都得到了认可。我们要测试的假设是,"密集型建筑办公室 "可以改善就诊体验,并有可能加强病人与医生之间的关系。我们的反事实影响评估基于准实验对照组设计,证明对等候时间的感知和就诊后的心理健康都有显著的积极影响。
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引用次数: 0
[Long term survival in patient with metastatic breast cancer treated with sacituzmab govitecan.] [转移性乳腺癌患者接受sacituzmab govitecan治疗后的长期生存率]
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43484
Carlo Mulas, Luigi Mascia

The clinical case presented refers to a woman suffering from metastatic breast cancer treated with sacituzumab govitecan (SG) who has a long progression-free survival. The case is characterized by the extreme aggressiveness of the neoplastic disease that relapses during adjuvant hormonal treatment with a metastatic disease that presents immunohistochemical characteristics different from the primary tumor. After first-line therapy with nabpaclitaxel and atezolizumab and the subsequent one with carboplatin and gemcitabine, both characterized by short PFS, the third line with SG is characterized by obtaining a complete response and a prolonged PFS as well as extreme tolerability that continues to this day after 15 months of treatment.

本临床病例指的是一名患有转移性乳腺癌的妇女,她曾接受过萨库珠单抗-戈维替康(SG)治疗,并获得了较长的无进展生存期。该病例的特点是肿瘤疾病具有极强的侵袭性,在激素辅助治疗期间复发,转移性疾病呈现出不同于原发肿瘤的免疫组化特征。经过纳帕紫杉醇和阿特珠单抗的一线治疗,以及卡铂和吉西他滨的二线治疗后,二者的生存期都很短,而使用 SG 的三线治疗的特点是获得了完全应答,延长了生存期,并且在治疗 15 个月后的今天仍具有极高的耐受性。
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引用次数: 0
Dalla letteratura
2024 Ottobre.
摘自文献 2024 年 10 月。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43459
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引用次数: 0
[Intra-patient cancer heterogeneity and sacituzumab-govitecan efficacy.] [患者内部癌症异质性与Sacituzumab-Govitecan疗效]
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43480
Andrea Fontana, Federica Pantaleo

Advanced triple negative breast cancer (TNBC) represents a challenging clinical condition with limited therapeutics opportunities. However, recently, a new antibody drug conjugated, sacituzumab govitecan, demonstrated a relevant clinical efficacy in this setting of patients. In this report we describe the case of a patient with TNBC diagnosed at the metastatic level when the primary breast tumour presented overexpression of ER end PgR. An important tumoral heterogeneity has been described in breast cancer during its natural evolution and for that reason is important to perform metastatic lesions re-biopsy, when feasible, in order to re-evaluate the biological characteristics and define the optimal therapeutic strategy.

晚期三阴性乳腺癌(TNBC)是一种具有挑战性的临床病症,治疗机会有限。然而,最近一种新型抗体药物--sacituzumab govitecan--在这类患者中显示出了相关的临床疗效。在本报告中,我们描述了一例被诊断为转移性 TNBC 的患者,其原发乳腺肿瘤呈现 ER 末端 PgR 的过度表达。在乳腺癌的自然演化过程中,肿瘤的异质性非常重要,因此,在可行的情况下,对转移病灶进行再次活检非常重要,以便重新评估其生物学特征并确定最佳治疗策略。
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引用次数: 0
[Clinical management of a patient with non-triple-negative breast cancer who converts to a triple-negative subtype at recurrence.] [非三阴性乳腺癌患者在复发时转变为三阴性亚型的临床治疗]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1701/4357.43481
Francesca Poggio

The management of patients with advanced breast cancer is becoming increasingly complex compared to the past, mainly due to numerous therapeutic innovations introduced in the current therapeutic scenario. At the time of metastatic disease diagnosis, as indicated by the guidelines, it is important to perform a biopsy of the metastatic sites to optimize choices and expand therapeutic options. Approximately 25-45% of patients who experience a recurrence of the primary tumor lose hormone receptor expression: in this context, solid data comes from a subanalysis of the randomized clinical trial ASCENT, in which the benefit of a treatment with antibody-drug conjugate sacituzumab govitecan is also confirmed in case of non-triple negative breast cancer at diagnosis that subsequently convert to a triple negative subtype. The case reported below is representative of this clinical situation.

与过去相比,晚期乳腺癌患者的治疗正变得越来越复杂,这主要是由于当前的治疗方案中引入了许多创新疗法。根据指南的指示,在诊断出转移性疾病时,必须对转移部位进行活检,以优化选择并扩大治疗范围。原发肿瘤复发的患者中约有 25%-45% 失去了激素受体表达:在这种情况下,随机临床试验 ASCENT 的一项子分析提供了可靠的数据,其中也证实了在诊断为非三阴性乳腺癌但随后转为三阴性亚型的病例中,使用抗体药物共轭物萨库珠单抗-戈维替康(sacituzumab govitecan)治疗的益处。下面报告的病例就是这种临床情况的代表。
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引用次数: 0
期刊
Recenti progressi in medicina
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