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Quantitative flow ratio for the functional assessment of extracranial internal carotid artery stenosis. 用于颅外颈内动脉狭窄功能评估的定量血流比值。
Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI: 10.23736/S0026-4806.24.09350-9
Luigi DI Serafino, Eugenio Stabile, Giuseppe Giugliano, Raffaele Piccolo, Michele Franzese, Carlo Carbone, Lucia Mitrano, Maria L DE Rosa, Salvatore Esposito, Luca Bardi, Maria Scalamogna, Giovanni Esposito

Background: In asymptomatic patients presenting with significant internal carotid artery (ICA) stenoses undergoing endovascular revascularization, a selective angiography before stenting (CAS) is required. Sometimes, angiographic findings could be discordant from non-invasive assessment and a tool able to evaluate functional relevance of the stenosis could be of value. We sought to evaluate the usefulness of quantitative flow ratio (QFR) as angiography-based tool for functional assessment of ICA stenoses.

Methods: We prospectively enrolled 50 asymptomatic patients undergoing CAS. Peak systolic velocity (PSV, cm/s) assessed at color Doppler echocardiography was used to identify significant stenoses (PSV >125 cm/s). At angiography, assessment of ICA stenosis was obtained visually (%DSVISUAL) and according NASCET criteria (%DSNASCET). Stenoses were considered significant if >60%. After exclusion of 20 vessels, QFR, area stenosis (AS, %) and minimal lumen area (MLA, mm2) were obtained in the remaining 80 vessels.

Results: At linear regression analysis, QFR significantly correlated with PSV (r2=0.52, P<0.001) as well as with %DSNASCET (r2=0.68, P<0.001) and %DSVISUAL (r2=0.71, P<0.001). Using PSV as reference, QFR showed good accuracy to predict functionally significant stenosis (AUC=0.98, P<0.001) with a cut-off value of 0.93. As compared with %DSNASCET and %DSVISUAL, QFR showed a significantly higher accuracy (61% vs. 73% vs. 94%, respectively; P<0.05), sensitivity (43% vs. 61% vs. 93%, respectively; P<0.05) and negative predictive value (46% vs. 51% vs. 85%, respectively; P<0.05) for detecting hemodynamically significant ICA stenoses.

Conclusions: This study suggest the potential benefit of adopting QFR for functional assessment of extracranial ICA stenoses. These data should be validated in larger studies.

背景:无症状的颈内动脉(ICA)明显狭窄患者在接受血管内再通术时,需要在支架植入术(CAS)前进行选择性血管造影。有时,血管造影结果可能与非侵入性评估结果不一致,因此,一种能够评估狭窄功能相关性的工具可能很有价值。我们试图评估定量血流比(QFR)作为基于血管造影的 ICA 狭窄功能评估工具的实用性:我们对 50 名接受 CAS 手术的无症状患者进行了前瞻性研究。彩色多普勒超声心动图评估的峰值收缩速度(PSV,cm/s)用于识别明显的狭窄(PSV >125 cm/s)。在血管造影术中,以肉眼(%DSVISUAL)和 NASCET 标准(%DSNASCET)评估 ICA 狭窄程度。如果狭窄程度大于 60%,则视为严重狭窄。在排除 20 根血管后,获得了剩余 80 根血管的 QFR、狭窄面积(AS,%)和最小管腔面积(MLA,mm2):结果:在线性回归分析中,QFR 与 PSV(r2=0.52)、PNASCET(r2=0.68)、PVISUAL(r2=0.71)、PNASCET 和 %DSVISUAL 显著相关,QFR 显示出更高的准确性(分别为 61% vs. 73% vs. 94%;PConclusions:这项研究表明,采用 QFR 对颅外 ICA 狭窄进行功能评估具有潜在的益处。这些数据应在更大规模的研究中得到验证。
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引用次数: 0
Italian Cardiological Guidelines (COCIS) for Competitive Sport Eligibility in athletes with heart disease: update 2024. 意大利心脏病运动员竞技体育资格指南(COCIS):2024 年更新版。
Pub Date : 2024-10-01 DOI: 10.23736/S0026-4806.24.09519-3
Paolo Zeppilli, Alessandro Biffi, Michela Cammarano, Silvia Castelletti, Elena Cavarretta, Franco Cecchi, Furio Colivicchi, Maurizio Contursi, Domenico Corrado, Antonello D'Andrea, Francesco Deferrari, Pietro Delise, Antonio Dello Russo, Domenico Gabrielli, Franco Giada, Ciro Indolfi, Viviana Maestrini, Giuseppe Mascia, Lucio Mos, Fabrizio Oliva, Zefferino Palamà, Stefano Palermi, Vincenzo Palmieri, Giampiero Patrizi, Antonio Pelliccia, Pasquale Perrone Filardi, Italo Porto, Peter J Schwartz, Marco Scorcu, Fabrizio Sollazzo, Andrea Spampinato, Andrea Verzeletti, Alessandro Zorzi, Flavio D'Ascenzi, Maurizio Casasco, Luigi Sciarra

Nearly 35 years after its initial publication in 1989, the Italian Society of Sports Cardiology and the Italian Federation of Sports Medicine (FMSI), in collaboration with other leading Italian Cardiological Scientific Associations (ANCE - National Association of Outpatient Cardiology, ANMCO - National Association of Inpatient Cardiology, SIC - Italian Society of Cardiology), proudly present the 2023 version of the Cardiological Guidelines for Competitive Sports Eligibility. This publication is an update of the previous guidelines, offering a comprehensive and detailed guide for the participation of athletes with heart disease in sports. This edition incorporates the latest advances in cardiology and sports medicine, providing current information and recommendations. It addresses various topics, including the details of the pre-participation screening in Italy and recommendations for sports eligibility and disqualification in competitive athletes with various heart conditions. This revised version of the Cardiological Guidelines for Competitive Sports Eligibility, recorded in the Italian Guidelines Registry of the Italian Minister of Health, stands as a crucial resource for sports medicine professionals, cardiologists, and healthcare providers, marked by its completeness, reliability, and scientific thoroughness. It is an indispensable tool for those involved in the care, management and eligibility process of competitive athletes with heart conditions.

在 1989 年首次出版近 35 年后,意大利运动心脏病学会和意大利运动医学联合会(FMSI)与意大利其他主要心脏病科学协会(ANCE - 全国门诊心脏病学协会、ANMCO - 全国住院心脏病学协会、SIC - 意大利心脏病学会)合作,隆重推出 2023 版《竞技体育资格心脏病学指南》。该出版物是对之前指南的更新,为患有心脏病的运动员参加体育运动提供了全面而详细的指导。该版本结合了心脏病学和运动医学的最新进展,提供了最新的信息和建议。它涉及多个主题,包括意大利参赛前筛查的细节,以及对患有各种心脏病的竞技运动员的运动资格和取消资格的建议。这本《竞技体育资格心脏病学指南》修订版已收录于意大利卫生部的意大利指南登记处,是运动医学专业人员、心脏病专家和医疗保健提供者的重要资源,其特点是完整、可靠、科学全面。对于那些参与心脏疾病竞技运动员的护理、管理和资格审查过程的人来说,这是一个不可或缺的工具。
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引用次数: 0
Robotic pyelolithotomy for the treatment of large renal stones: a single-center experience over seven years. 机器人肾盂切开术治疗巨大肾结石:单中心七年来的经验。
Pub Date : 2024-10-01 Epub Date: 2024-07-04 DOI: 10.23736/S0026-4806.24.09291-7
Stefano Moretto, Michele Zazzara, Filippo Marino, Arjan Nazaraj, Marcello Scarcia, Giuseppe M Ludovico

Background: Urolithiasis prevalence varies globally between 1-20%, influenced by regional factors. Robotic pyelolithotomy (RPL) presents an interesting alternative to PCNL, considered the gold standard for symptomatic stones smaller than 20 mm, as it carries a risk of significant complications. However, studies on RPL are limited, especially in anatomically complex cases, where RPL proves to be particularly useful. The study aims to update and review outcomes of RPL in a high-volume robotic center.

Methods: A retrospective analysis of 153 patients treated with RPL for staghorn kidney stones at a single center from February 2016 to December 2023 was conducted. Data including demographics, preoperative renal function, stone characteristics, operative and postoperative outcomes, and costs were collected. Stone-free rates (SFR) and complications were assessed at follow-up intervals up to 12 months post-surgery.

Results: The study showed an initial 3-month stone-free rate (SFR) of 93.5%, which decreased to 83.5% at 12-months. This trend may reflect new stone formation rather than procedure failure. Sub-analysis revealed a significant difference in SFR between patients with pelvic and pyelocalyceal stones at each follow-up. Multivariate regression analysis identified in the pyelocalyceal group that higher BMI and larger stones were associated with higher failure rates at both 6 and 12 months.

Conclusions: RPL is a safe and effective treatment for large renal stones, offering a high SFR and low complication rate. It is particularly beneficial in cases with complex anatomy or requiring concurrent renal procedures. However, patient selection is crucial, considering factors like stone location and size. Further research is needed to compare RPL with other treatment methods.

背景:受地区因素影响,全球尿路结石发病率在 1-20% 之间。机器人肾盂取石术(RPL)被认为是治疗小于20毫米的无症状结石的金标准,是PCNL的一种有趣的替代方法,因为它有可能引起严重的并发症。然而,关于RPL的研究却很有限,尤其是在解剖结构复杂的病例中,RPL被证明特别有用。本研究旨在更新和回顾一个高容量机器人中心的 RPL 结果:方法:对2016年2月至2023年12月在一个中心接受RPL治疗的153例鹿角状肾结石患者进行了回顾性分析。收集的数据包括人口统计学、术前肾功能、结石特征、手术和术后结果以及费用。术后随访至12个月,评估无结石率(SFR)和并发症:研究显示,最初 3 个月的无结石率(SFR)为 93.5%,12 个月时降至 83.5%。这一趋势可能反映了新结石的形成,而非手术失败。子分析显示,盆腔结石和肾盂萼膜结石患者在每次随访时的无结石率都有显著差异。多变量回归分析显示,在肾盂结石组中,较高的体重指数和较大的结石与6个月和12个月的较高失败率有关:RPL是一种安全有效的治疗大块肾结石的方法,具有较高的SFR和较低的并发症发生率。它对解剖结构复杂或需要同时进行肾脏手术的病例尤其有益。不过,考虑到结石位置和大小等因素,患者的选择至关重要。还需要进一步研究,将RPL与其他治疗方法进行比较。
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引用次数: 0
Exploring the landscape of academic retractions in medicine: a comprehensive umbrella review. 探索医学界学术撤稿的现状:总括性综合评述。
Pub Date : 2024-10-01 Epub Date: 2024-07-02 DOI: 10.23736/S0026-4806.24.09343-1
Yashendra Sethi, Oroshay Kaiwan, Giacomo Frati, Mariangela Peruzzi, Mattia Galli, Mario Gaudino, Giuseppe Biondi-Zoccai

Introduction: The escalating trend of academic article retractions over the last decades raises concerns about scientific integrity, but heterogeneity in retractions and reasons for them pose a major challenge. We aimed to comprehensively overview systematic reviews focusing on retractions in the biomedical literature.

Evidence acquisition: We abstracted salient features and bibliometric details from shortlisted articles. The Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Research Syntheses was used for validity appraisal.

Evidence synthesis: A total of 11 reviews were included, published between 2016 and 2023, and reporting on a total of 1851 retracted studies. Several major reasons for retractions were identified, spanning both misconduct (e.g., falsification, duplication, plagiarism) and non-misconduct issues (e.g., unreliable data, publishing problems). Correlates include author-related factors (number of authors, nationality) and journal-related factors (impact factor), with repeat offenders contributing significantly. Impacts of retractions is profound, affecting scholarly credibility, public trust, and resource utilization.

Conclusions: In order to prevent retractions and amend their adverse effects, rigorous and transparent reporting standards, enhanced training in research ethics, strengthened peer review processes, and the establishment of collaborative and integrated research integrity offices are proposed.

导言:过去几十年来,学术论文撤稿呈上升趋势,这引起了人们对科学诚信的关注,但撤稿的异质性及其原因构成了一项重大挑战。我们旨在全面综述以生物医学文献中撤稿事件为重点的系统性综述:我们摘录了入围文章的显著特征和文献计量学细节。采用乔安娜-布里格斯研究所(JBI)的系统综述和研究综述核对表进行有效性评估:共纳入了 2016 年至 2023 年间发表的 11 篇综述,共报告了 1851 项撤回研究。撤稿的几个主要原因包括不当行为(如造假、重复、剽窃)和非不当行为(如数据不可靠、出版问题)。相关因素包括与作者有关的因素(作者人数、国籍)和与期刊有关的因素(影响因子),其中惯犯的影响最大。撤稿的影响是深远的,会影响学术可信度、公众信任度和资源利用率:为了防止撤稿并改变其不良影响,建议制定严格透明的报告标准,加强研究伦理培训,强化同行评审程序,并建立协作性综合研究诚信办公室。
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引用次数: 0
Reflux disease: a new multicomponent solution for a multifaceted problem. 反流病:解决多方面问题的多成分新方案。
Pub Date : 2024-10-01 DOI: 10.23736/S0026-4806.24.09552-1
Ignazio LA Mantia, Attilio Varricchio, Cristina Luceri, Giorgio Ciprandi
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引用次数: 0
Can we predict the natural evolution of probiotics? 我们能否预测益生菌的自然进化?
Pub Date : 2024-10-01 Epub Date: 2024-09-12 DOI: 10.23736/S0026-4806.24.09568-5
Francesco DI Pierro
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引用次数: 0
Alcohol-related diseases: from metabolism to the main effect on the body. 与酒精有关的疾病:从新陈代谢到对身体的主要影响。
Pub Date : 2024-10-01 Epub Date: 2024-06-13 DOI: 10.23736/S0026-4806.24.09355-8
Fabio Caputo, Lisa Lungaro, Matteo Guarino, Anna Costanzini, Giacomo Caio, Gianni Testino, Roberto DE Giorgio

Alcohol consumption can cause, beyond addiction, roughly 200 different diseases and at least fourteen types of cancer. In 2016 the WHO estimated that 29% of alcohol-related deaths were mainly due to oncological diseases, liver cirrhosis (20%), and cardiovascular disorders (19%). The aim of this review was to focus on the absorption and metabolism of ethanol and discuss the main conditions caused by alcohol consumption (i.e., liver and cardiovascular diseases, and tumors). This narrative review is based on a detailed analysis of the scientific literature published before January 31, 2024 (PubMed, Web of Science, Scopus, Google Scholar). Approximately 90% of the absorbed alcohol reaches the liver where it is metabolized to acetaldehyde, a highly reactive and toxic compound. The excessive use of alcohol causes damage to several organs and systems, mainly the liver (e.g., steatosis, steato-hepatitis, fibrosis, and cirrhosis), cardiovascular system (cardiomyopathy, arrythmias, arterial hypertension, and stroke), and significantly contribute to the onset of neoplastic lesions to various organs including the esophagus, liver and breast. Even moderate drinking appears not to reduce mortality risk. Alcohol intake is one of the main risk factors for several pathological conditions and social problems, thus drastically impacting on public health. Proper awareness of the high risk related to alcohol consumption is of crucial importance to reduce the harm to public health.

除成瘾外,饮酒还可导致约200种不同的疾病和至少14种癌症。据世界卫生组织 2016 年估计,29% 与酒精有关的死亡主要是由于肿瘤疾病、肝硬化(20%)和心血管疾病(19%)。本综述旨在关注乙醇的吸收和代谢,并讨论饮酒导致的主要疾病(即肝病、心血管疾病和肿瘤)。本叙述性综述基于对 2024 年 1 月 31 日之前发表的科学文献(PubMed、Web of Science、Scopus、Google Scholar)的详细分析。吸收的酒精约有 90% 到达肝脏,在肝脏代谢为乙醛,乙醛是一种高活性、高毒性的化合物。过量饮酒会对多个器官和系统造成损害,主要是肝脏(如脂肪变性、脂肪性肝炎、肝纤维化和肝硬化)、心血管系统(心肌病、心律失常、动脉高血压和中风),并在很大程度上导致食道、肝脏和乳房等多个器官发生肿瘤性病变。即使适量饮酒似乎也不会降低死亡风险。酒精摄入量是导致多种病症和社会问题的主要风险因素之一,因此对公众健康产生了严重影响。正确认识与饮酒有关的高风险对于减少对公众健康的危害至关重要。
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引用次数: 0
Current treatment paradigms for triple-negative breast cancer. 目前治疗三阴性乳腺癌的范例。
Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI: 10.23736/S0026-4806.24.09458-8
Sumeet K Yadav, Roberto A Leon-Ferre

Triple negative breast cancer (TNBC) accounts for 15% of all breast cancers and is characterized by more aggressive biology, significant disease heterogeneity, and worse clinical outcomes. In recent years, improved understanding of TNBC tumor biology and its heterogeneity have led to the identification of new molecular targets, opening avenues for novel treatment strategies. Clinical trials evaluating immunotherapy, poly-ADP ribose polymerase (PARP) inhibitors, and antibody drug conjugates have shown improvement in clinical outcomes, leading to their incorporation to the treatment options available for patients with TNBC. This review aimed to provide the internal medicine specialist and primary care provider with a comprehensive overview of the current systemic therapy approaches for TNBC and introduce clinicians to novel therapies that have recently been added to the treatment armamentarium against this disease.

三阴性乳腺癌(TNBC)占所有乳腺癌的 15%,其特点是更具侵袭性的生物学特性、显著的疾病异质性和较差的临床预后。近年来,人们对 TNBC 肿瘤生物学及其异质性有了更深入的了解,从而发现了新的分子靶点,为新型治疗策略开辟了道路。评估免疫疗法、聚-ADP核糖聚合酶(PARP)抑制剂和抗体药物共轭物的临床试验显示临床疗效有所改善,从而将其纳入TNBC患者的治疗方案中。本综述旨在向内科专科医生和初级保健提供者全面概述目前治疗 TNBC 的系统疗法,并向临床医生介绍最近加入治疗该疾病的新疗法。
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引用次数: 0
Nursing collaboration for minimally invasive left ventricular assist device implantation. 微创左心室辅助装置植入术的护理协作。
Pub Date : 2024-09-26 DOI: 10.23736/S0026-4806.24.09382-0
Mengtian Wang, Min Hong, Xu Zhang, Jintao Liu
{"title":"Nursing collaboration for minimally invasive left ventricular assist device implantation.","authors":"Mengtian Wang, Min Hong, Xu Zhang, Jintao Liu","doi":"10.23736/S0026-4806.24.09382-0","DOIUrl":"https://doi.org/10.23736/S0026-4806.24.09382-0","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335389","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
Research on DRGs payment system in TCM medical institutions by taking chronic hepatitis B of TCM single disease as an example. 以中医单病种慢性乙型肝炎为例,研究中医医疗机构 DRGs 支付制度。
Pub Date : 2024-09-26 DOI: 10.23736/S0026-4806.24.09385-6
Qian DU, Qiang Huang, Liang Chen, Chunming Wu, Sanhai Liu
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引用次数: 0
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Minerva medica
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