Panminerva medica最新文献

{"title":"New perspectives in slow coronary flow: a review and update.","authors":"María Martín, Raquel Flores, Juan F Ortiz DE Zárate, José Rozado","doi":"10.23736/S0031-0808.25.05311-X","DOIUrl":"https://doi.org/10.23736/S0031-0808.25.05311-X","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mantle cell lymphoma: from pathogenesis to treatment for 2024 and beyond.","authors":"Ashlyn M O'Leary, Christopher R D'Angelo","doi":"10.23736/S0031-0808.25.05268-1","DOIUrl":"https://doi.org/10.23736/S0031-0808.25.05268-1","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketoprofen and ketoprofen lysine salt in managing children with mild-moderate acute pain: evidence emerging from comparative trials.","authors":"Giorgio Ciprandi, Francesco Scaglione","doi":"10.23736/S0031-0808.25.05296-6","DOIUrl":"10.23736/S0031-0808.25.05296-6","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"46-51"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle and elderly.","authors":"Gianni Testino, Patrizia Balbinot","doi":"10.23736/S0031-0808.24.05165-6","DOIUrl":"10.23736/S0031-0808.24.05165-6","url":null,"abstract":"","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"52"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional disparities in the management and outcomes of ST-elevation myocardial infarction: an Italian analysis focusing on time-dependent reperfusion networks and in-hospital logistics.","authors":"Iginio Colaiori, Giuseppe Biondi-Zoccai, Luigi Spadafora, Marco Bernardi, Antonio Aloia, Marco Ancona, Gianfranco Aprigliano, Emanuele Barbato, Cesare Baldi, Carlo Briguori, Paolo Buja, Mauro Cadeddu, Gavino Casu, Alberto De Caterina, Francesco De Felice, Ciro De Simone, Luca Donazzan, Fabio Ferranti, Nicoletta Franco, Achille Gaspardone, Ervis Hiso, Massimo Leoncini, Angelo Leone, Stefano Lucreziotti, Massimo Mancone, Lucia Marinucci, Mauro Maioli, Matteo Montorfano, Salvatore Musarò, Tullio Niglio, Andrea Picchi, Arnaldo Poli, Gerlando Preti, Flavio L Ribichini, Andrea Rolandi, Enrico Romagnoli, Giuseppe M Sangiorgi, Federica Serino, Pierluigi Soldà, Gianluca Tiberti, Fabrizio Tomai, Francesco Tomassini, Fabrizio Ugo, Giovanni Esposito, Francesco Saia, Francesco Versaci","doi":"10.23736/S0031-0808.24.05277-7","DOIUrl":"10.23736/S0031-0808.24.05277-7","url":null,"abstract":"<p><strong>Background: </strong>Prompt reperfusion is critical for patients with ST-segment elevation myocardial infarction (STEMI) to improve outcomes. Yet, variability in regional healthcare delivery may influence treatment times and patient outcomes. We thus aimed at evaluating differences in management and outcomes of STEMI patients across Northern, Central, and Southern Italy, focusing on time-dependent reperfusion and in-hospital logistics.</p><p><strong>Methods: </strong>A prospective observational study conducted from September 1^st to 25^th, 2023, including 554 STEMI patients treated at high-volume hub centers operating 24/7. Data were collected through structured surveys completed by catheterization laboratory directors across different Italian regions. Primary outcomes included door-to-balloon (DTB) time, time from symptom onset to balloon inflation, and regional disparities in pre- and post-PCI management. Secondary outcomes included in-hospital mortality, discharge destinations, and medication regimens.</p><p><strong>Results: </strong>The median DTB time was consistent across regions (30 minutes; IQR: 20-50 minutes). Significant regional disparities were however noted in time from symptom onset to balloon inflation, with Southern and Island regions experiencing longer median times (180 minutes) compared to Central (170 minutes) and Northern (154 minutes) regions (P<0.01). We also found a significant reduction in DTB time associated with ECG teletransmission from ambulances (mean reduction of 25 minutes, P=0.03). In-hospital mortality rates were similar across regions (P=0.83).</p><p><strong>Conclusions: </strong>This comprehensive nationwide analysis highlights significant regional disparities in the management and treatment timelines of STEMI patients in Italy. Despite these differences, in-hospital care was consistently timely across regions, suggesting that pre-hospital logistics critically influence overall treatment times. Enhanced pre-hospital ECG teletransmission could further optimize reperfusion times, potentially improving patient outcomes.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"1-9"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on the profiling of renal risk in obesity.","authors":"Neil G Docherty","doi":"10.23736/S0031-0808.25.05198-5","DOIUrl":"10.23736/S0031-0808.25.05198-5","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"27-36"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diosgenin inhibits the proliferation and migration of MCF-7 breast cancer cells through the demethylation of miR-145 gene.","authors":"Peng Lü, Feng Wu, Feng Li, Kanglian Zhu, Fengqin Shi","doi":"10.23736/S0031-0808.23.04943-1","DOIUrl":"10.23736/S0031-0808.23.04943-1","url":null,"abstract":"","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"55-56"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the application of Internet technology on improving the efficiency of medical care integration management.","authors":"Huaiying Shi, Yichen Zhang, Xing Wang, Lijun Wu, Xun Gong, Xuanxuan Wang","doi":"10.23736/S0031-0808.23.04936-4","DOIUrl":"10.23736/S0031-0808.23.04936-4","url":null,"abstract":"","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"52-54"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9882629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy and safety of colchicine and interleukin-1 antagonists in recurrent pericarditis: a network meta-analysis.","authors":"Dev Desai, Darshilkumar Maheta, Siddharth P Agrawal, Abhijay B Shah, Akx Panchal, Hetvi Shah, Wilbert S Aronow","doi":"10.23736/S0031-0808.24.05269-8","DOIUrl":"10.23736/S0031-0808.24.05269-8","url":null,"abstract":"<p><strong>Introduction: </strong>Despite advancement of therapeutic approaches to recurrent pericarditis, it poses notable challenges to its' management. As per the current guidelines, colchicine is the first line therapy, although, non-conventional treatments like interleukin-1 (IL-1) antagonists (rilonacept, anakinra, goflikicept) are progressively utilized for refractory cases.</p><p><strong>Evidence acquisition: </strong>A comprehensive electronic search identified relevant literature across multiple databases, focusing on recurrence rates and adverse effects associated with each treatment regimen.</p><p><strong>Evidence synthesis: </strong>Eleven studies (6 on colchicine, 5 on IL-1 antagonists) involving 1053 patients were included. Colchicine significantly reduced recurrence risk by 63% (OR 0.37, 95% CI 0.27-0.52). IL-1 antagonists demonstrated superior efficacy: anakinra reduced recurrence by 98% (OR 0.02, 95% CI 0.01-0.07), rilonacept by 98% (OR 0.02, 95% CI 0.01-0.07), and goflikicept by 99% (OR 0.01, 95% CI 0.00-0.05). Adverse effects were comparable between colchicine and IL-1 antagonists except for rilonacept, which showed a higher risk (OR 5.70, 95% CI 2.13-15.27).</p><p><strong>Conclusions: </strong>IL-1 antagonists significantly reduce recurrent pericarditis episodes compared to colchicine, with anakinra, rilonacept, and goflikicept demonstrating high efficacy and acceptable safety profiles. These findings support their consideration as alternative therapies in colchicine-refractory cases of recurrent pericarditis. Further studies are warranted to refine treatment guidelines and optimize patient outcomes.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"37-45"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deprescription of benzodiazepines and its management according to an overlapping strategy with a low-dose multicomponent medication: a Delphi consensus.","authors":"Rocco Melcarne, Sergio Bernasconi, Marco Del Prete, Spartaco Artizzu, Susanna Guttmann, Giorgio Ciprandi, Angelo Gemignani","doi":"10.23736/S0031-0808.25.05330-3","DOIUrl":"https://doi.org/10.23736/S0031-0808.25.05330-3","url":null,"abstract":"<p><strong>Background: </strong>About 20% of adults and between 6% and 13% of children experience mild to moderate anxiety and stress-related symptoms. Benzodiazepines (BZDs) are considered the referring medications for early-stage anxiety and stress-related symptoms management. Nevertheless, BZDs must be managed carefully because their use, especially chronic, could be linked with some adverse effects, and can promote the onset of psychological and physical dependence. They also often show progressive tolerance, necessitating an increase in dosage, and therefore their use should be discouraged. In the clinical management of patients with pathological/dysfunctional anxiety, one of the main issues related to the discontinuation of BZDs treatment is the occurrence of rebound effects and withdrawal syndrome, especially in subjects with certain personality disorders and poly-drug users. The deprescription of BZDs is advisable with the availability of other therapies and interventions, especially in elderly subjects. Therefore, an effective and safe alternative pharmacological tool for mild to moderate anxiety and stress-related symptoms is needed. After the identification of potentially new medications to flank BZDs, it is mandatory to revise and improve good clinical practices even through a consensus process.</p><p><strong>Methods: </strong>Taking into consideration all the above-mentioned premises, the present Delphi Consensus Study has explored whether there is agreement about the use of the low-dose multicomponent natural medication Ignatia-Heel in overlapping with BZDs is appropriate for the reduction and potential discontinuation of BZDs intake in patients on chronic BZDs treatment.</p><p><strong>Results: </strong>The Consensus Study also explored the possibility to maintain symptom remission or low disease activity with the long-term use of Ignatia-Heel in patients with pathological/dysfunctional anxiety, after clinical remission achieved with BZDs. For each questionnaire statement, consensus was achieved (being based on the agreement of at least 66.6% of the Consensus Panel and the acceptance of the scientific committee).</p><p><strong>Conclusions: </strong>Ignatia-Heel can be considered a valid opportunity for the treatment of pathological anxiety favoring the deprescription of BZDs in patients under chronic BZDs treatment and the maintenance of a good control of symptomatology, i.e., a good low disease activity.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":"67 1","pages":"14-26"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}