Panminerva medica最新文献

{"title":"Circulating osteopontin and body composition in systemic lupus erythematosus: a cross-sectional study.","authors":"Pamela Munguía-Realpozo, Claudia Mendoza-Pinto, Ivet Etchegaray-Morales, Laura Serrano-Vertiz, Edith Ramírez-Lara, Blanca G Baez-Duarte, Gabriela Medina-Valeriano, Jorge Ayón-Aguilar","doi":"10.23736/S0031-0808.26.05436-4","DOIUrl":"10.23736/S0031-0808.26.05436-4","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the association between circulating osteopontin (OPN) levels and bioelectrical impedance analysis (BIA)-derived body composition measures in adults with systemic lupus erythematosus (SLE), with body fat percentage as the primary outcome and central adiposity and lean-mass surrogates as secondary outcomes.</p><p><strong>Methods: </strong>Observational cross-sectional study with prospective recruitment of adults with SLE attending a tertiary referral center in Puebla, Mexico. Plasma OPN was quantified by ELISA (Quantikine^®, R&D Systems; coefficient of variation 4.1%). Body composition was assessed by BIA (TANITA BC-545F FitScan) under fasting morning conditions. Associations between OPN and continuous body composition measures were examined using Spearman correlations (pairwise complete data). Sensitivity analyses used linear regression with ln(OPN) as the dependent variable, adjusting for age, sex, disease duration, SLEDAI-2K, and current prednisone exposure.</p><p><strong>Results: </strong>Sixty-two patients were included (96.8% women), mean age 51.3±12.8 years; median disease duration 21.5 years (IQR 18.0-25.0). Disease activity was low (median SLEDAI-2K 0 [IQR 0-2]); 46.8% met LLDAS. Median OPN was 16.11 ng/mL (IQR 7.97-54.06). Mean BMI was 29.3±5.6 kg/m², and 79.5% were overweight/obese. OPN showed no significant association with BMI, body fat percentage, visceral fat rating, muscle mass, or waist circumference. Adjusted regression analyses also remained non-significant.</p><p><strong>Conclusions: </strong>In this SLE cohort with predominantly low activity, circulating OPN levels were not associated with BIA-derived adiposity, central adiposity, or lean-mass surrogates, suggesting that OPN may reflect lupus-related inflammatory biology rather than body composition phenotypes.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"123-129"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369278","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":"Phytodiab® in subjects with metabolic syndrome and early type 2 diabetes: a 12-week observational registry study.","authors":"Gianni Belcaro, Edmondo Ippolito, Ezio Bombardelli, Maria R Cesarone, David Cox, Claudia Scipione, Valeria Scipione, Umberto Cornelli, Marcello Corsi, Beatrice Feragalli, Francesca Coppazuccari, Roberto Cotellese","doi":"10.23736/S0031-0808.26.05441-8","DOIUrl":"10.23736/S0031-0808.26.05441-8","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes associated with increased weight is a common metabolic condition that may progress to chronic disease. This pilot observational registry evaluated the effects of Phytodiab^®, a multi-component natural extract formulation, on metabolic and oxidative parameters in subjects with mild-to-moderate type 2 diabetes managed with diet and lifestyle measures.</p><p><strong>Methods: </strong>Sixty adults with type 2 diabetes, moderately overweight, without diabetic complications and not receiving pharmacological treatment, were included. Subjects followed standard lifestyle management (SM) alone (N.=30) or Phytodiab^® plus SM once daily before the main meal (N.=30) for 12 weeks. Outcomes included body weight, fat mass, fasting glucose, glycated hemoglobin (HbA1c), and plasma oxidative stress measured in Carr units. Safety, tolerability, compliance, and routine blood parameters were monitored.</p><p><strong>Results: </strong>The two groups were comparable at baseline for age, sex distribution, and clinical profile. There were no dropouts and no tolerability problems. Compliance was high, with 96% of tablets correctly used. At 12 weeks, subjects receiving Phytodiab^® showed significant reductions in weight, fat mass, fasting glucose, HbA1c, and oxidative stress compared with controls (P<0.05). Routine laboratory parameters, including kidney and liver function, blood count, coagulation, and platelet activity, remained normal and unchanged.</p><p><strong>Conclusions: </strong>In this 12-week observational registry, Phytodiab^® plus SM was well tolerated and associated with improvements in metabolic and oxidative parameters in otherwise healthy subjects with mild-to-moderate type 2 diabetes managed with lifestyle measures. These findings are exploratory and support further controlled evaluations in larger populations.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":"68 3","pages":"111-115"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220299","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":"Evaluating FIB-4 plus as a noninvasive tool for detecting esophageal varices in advanced hepatitis c fibrosis: a multicenter cohort study.","authors":"Mauricio Castillo-Barradas, Javier I Carrillo-Rojas, Viridiana M Mendoza-Martínez, Daniel Torres-Rubí, Pablo C González-Vera, Reyna Méndez-Del-Monte, Juan M Martín-Bufajer, Carlos A Martínez-Arredondo, Nallely Bueno-Hernández","doi":"10.23736/S0031-0808.26.05424-8","DOIUrl":"10.23736/S0031-0808.26.05424-8","url":null,"abstract":"<p><strong>Background: </strong>In patients with advanced liver fibrosis, one of the most common complications after the development of clinically significant portal hypertension (CSPH) is the appearance of esophageal varices (EV), which require prophylaxis with nonselective beta-blockers (NSBB) to reduce the risk of bleeding. However, there is no practical, simple tool to predict the development of esophageal varices. The aim of the study was to validate the Fibrosis-4 (FIB-4) Plus score as a predictor of EV in a cohort of patients with advanced liver fibrosis due to hepatitis C virus infection (HCV).</p><p><strong>Methods: </strong>Retrospective cohort study in patients with advanced liver fibrosis secondary to chronic HCV infection. Endoscopy was considered the gold standard, and the risk of developing EV was estimated using the FIB-4 Plus score in this study. The concordance between both tests was evaluated using Cohen's kappa (k). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated, and a final cut-off point was proposed using the Youden index.</p><p><strong>Results: </strong>The AUC for the diagnosis of EV was good (0.707±0.17; P<0.001). A value ≥65% on the FIB-4 Plus adequately identifies patients at risk of presenting with an EV of any size, with sensitivity=70.1%, specificity=60.6%, PPV=0.64, and NPV=0.67. When evaluating only the probability of presenting a large EV, sensitivity=82.6%, specificity=50.9%, PPV=0.26, and NPV=0.93 were obtained.</p><p><strong>Conclusions: </strong>With a cut-off point of ≥65%, FIB-4 Plus is useful for predicting the diagnosis of EV in the population with advanced liver fibrosis due to HCV infection, and it could be feasible to use it as an aid in deciding the early initiation of NSBB.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"116-122"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881468","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":"Fluid de-resuscitation in critical illness: are we measuring the right endpoint?","authors":"Mattia Madeo, Nicoletta Cerundolo, Carmine Siniscalchi, Riccardo Simoni, Emanuele Bonu, Tiziana Meschi, Andrea Bruni","doi":"10.23736/S0031-0808.26.05432-7","DOIUrl":"10.23736/S0031-0808.26.05432-7","url":null,"abstract":"","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"144-145"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369320","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":"Multicomponent treatment for laryngopharyngeal reflux disease in patients over 65: age-related differences in patient-reported and endoscopic outcomes compared with younger adults.","authors":"Andrea Nacci, Alberto Galli, Luca Bastiani, Raffaella Sedile, Silvia Capobianco, Giorgio Ciprandi","doi":"10.23736/S0031-0808.26.05447-9","DOIUrl":"10.23736/S0031-0808.26.05447-9","url":null,"abstract":"<p><strong>Background: </strong>Laryngopharyngeal reflux disease (LPRD) in older adults may present with greater endoscopic severity, impaired symptom perception, and increased comorbidity burden, making clinical assessment and treatment selection particularly challenging in this population. Although proton pump inhibitors (PPIs) are commonly used, prolonged treatment in elderly patients raises safety concerns. Multicomponent medical devices, including alginate-based formulations, may offer a PPI-sparing alternative.</p><p><strong>Methods: </strong>This prospective, single-center observational study enrolled 48 patients with clinically confirmed LPRD, stratified into ≥65 years (N.=24) and <65 years (N.=24). Treatment included Tamacid-Pro^®, containing Gingigel Pro^®, sodium alginate, Tamarindus indica seed extract, hyaluronic acid, and vegetal extracts. Patients were assessed with the Revised Reflux Symptom Index (R-RSI), Voice Handicap Index-10 (VHI-10), and Reflux Sign Assessment (RSA) at baseline and after 2 months of treatment; the over-65 group underwent an additional assessment at 3 months. Mixed-effects linear regression models were used for longitudinal analysis.</p><p><strong>Results: </strong>Both groups improved significantly across all outcomes. At 2 months, younger patients showed a greater reduction in R-RSI than older patients (Δ -13.3 vs. -7.3; P=0.016), whereas improvements in VHI-10 and RSA were similar. In patients aged ≥65 years, extending treatment to 3 months produced further clinically meaningful gains, with large effect sizes for R-RSI, VHI-10, and RSA, reaching values broadly comparable to those observed in younger adults at 2 months.</p><p><strong>Conclusions: </strong>The multicomponent medical device Tamacid Pro^® was effective in older patients with clinically confirmed LPRD. Symptom improvement was more gradual in patients aged ≥65 years, but extending treatment to 3 months yields outcomes comparable to those observed in younger adults after 2 months. These findings may support the PPI-sparing strategy in elderly patients and suggest that treatment duration may need to be individualized based on age-related clinical characteristics.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"95-110"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075414","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":"Chronic kidney disease as a systemic disorder: filtration phenotypes, inflammation and cardiovascular risk in the cardio-kidney metabolic era.","authors":"Rodolfo A Valtuille, Elmer A Fernandez","doi":"10.23736/S0031-0808.26.05449-2","DOIUrl":"https://doi.org/10.23736/S0031-0808.26.05449-2","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is increasingly recognized as a systemic disorder driven by metabolic dysfunction, vascular injury, inflammation, and emerging filtration phenotypes. In the cardio-kidney-metabolic (CKM) era, renal biomarkers such as estimated glomerular filtration rate (eGFR) and albuminuria provide essential insight into early metabolic-renal stress and cardiovascular (CV) vulnerability. This narrative review synthesizes contemporary evidence linking CKD to cardiovascular disease (CVD), emphasizing the multidimensional interactions among filtration impairment, glomerular barrier injury, metabolic dysfunction, and inflammatory pathways. Novel filtration phenotypes defined through creatinine-cystatin C (Cr-CysC) eGFR (including glomerular hyperfiltration and selective hypofiltration) highlight the limitations of classical staging and underscore the need for refined risk assessment. The integration of kidney markers into the AHA PREVENT equations represents a major advance, enabling absolute CVD risk estimation across the CKM continuum. Simulation-based analyses of 5000 virtual patients visually demonstrate the nonlinear and synergistic effects of eGFR, albuminuria, age, hypertension, diabetes, and lipid abnormalities on CV risk. Furthermore, disease-modifying therapies such as SGLT2 inhibitors, finerenone, GLP-1 receptor agonists, and anti-obesity interventions provide multisystem benefits that align with CKM pathophysiology. Together, these developments support a unified, continuum-based approach to CKD detection, risk stratification, and prevention, positioning CKD as a central driver of long-term CV outcomes.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":"68 3","pages":"130-143"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220223","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":"Healthy lifestyle programs: good intentions or effective action?","authors":"Gianni Testino, Patrizia Balbinot","doi":"10.23736/S0031-0808.26.05443-1","DOIUrl":"10.23736/S0031-0808.26.05443-1","url":null,"abstract":"","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"145-146"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437502","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 3 Phase-Rhizo Protocol: efficacy of platelet-rich plasma in the treatment of rhizoarthrosis.","authors":"Andrea Parisi, Silvia Sofia, Fulvio A Nicolò, Maria Panzarella, Alessandra Clemente, Luca Devalle, Ezio N Gangemi, Silvia Germano, Claudia Cerato, Giuseppe Pandolfo, Marco Borsetti","doi":"10.23736/S0031-0808.26.05431-5","DOIUrl":"10.23736/S0031-0808.26.05431-5","url":null,"abstract":"<p><strong>Background: </strong>Thumb osteoarthritis (OA) is one of the most common hand disabiliting pathology. To date, many therapies are available, with surgery being the last resort. Given the long post surgical rehabilitation period patients often require a \"bridge\" therapy, in order to surgery. In lasts years Platelet-Rich Plasma (PRP) has demonstrated interesting anti-inflammatory and anabolic effects when injected intra-articularly, including the trapeziometacarpal thumb joint (TMTJ). However, literature is limited and few standardized methods are available to demonstrate its real effectiveness. The aim of the present study is to evaluate effectiveness of 3 Phase Rhizo Protocol in treatment of Thumb OA.</p><p><strong>Methods: </strong>In a two year prospective observational study, 42 patients affected by Stage II-III Thumb OA were treated with the 3 Phase Rhizo Protocol. The desired outcomes, such as pain reduction, increased quality of life and improved hand disfunction, were tested using the Visual Analogue (VAS), Quality of life (QoL) and Quick-Dash (QuickDASH) scores at one, three, six and twelve months.</p><p><strong>Results: </strong>At one year was, a mean reduction in all scores was achieved, which ranged from 26.33% to 53.05%. All results improved from the first few months after the injection, with lasting effects up to six months, followed by a slight decrease without ever returning to the initial values. All scores data were statistically significant (P<0.05).</p><p><strong>Conclusions: </strong>The 3 Phase-Rhizo protocol is a useful method for symptomatic rhizarthrosis, especially in the early stages and refractory to standard treatments, as a bridge between conservative therapy and the surgery.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":"68 2","pages":"61-68"},"PeriodicalIF":4.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472061","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":"Medical decluttering: what it is and why it is important.","authors":"Anna Sirignano, Francesca Murri, Ludovica Ruggiu, Michela Cece, Giuseppe Biondi-Zoccai, Massimo Boni, Francesco Versaci","doi":"10.23736/S0031-0808.26.05427-3","DOIUrl":"10.23736/S0031-0808.26.05427-3","url":null,"abstract":"<p><p>Medical decluttering is a pragmatic, ethics-anchored approach to reduce low-value tests, treatments, documentation, and digital noise while preserving safety, dignity, and outcomes that matter to patients and clinicians. It reframes improvement from \"doing less\" to \"doing better,\" prioritizing value delivered per unit effort and transparent measurement of treatment burden, workload, and harms. We outline why clutter proliferates - decision fatigue, cognitive biases, overdiagnosis, incidental findings, and bureaucratic drift - and how these forces fuel cascades, moral distress, and lost trust. We propose a five-step cycle-Scan, Sort, Select, Safeguard, Sustain-that operationalizes decluttering across patient, team, and system levels through category-first review, explicit thresholds, safety nets, and time-bounded reassessment. Clinical applications include deprescribing with monitored tapers, appropriateness-based testing and screening, pathway redesign to shorten time-to-decision, and courteous refusal scripts paired with contingency plans. Professional practices emphasize agenda setting, message windowing, checklists and dashboards for cognitive offloading, role clarity, digital minimalism, and indication-based telemedicine. Implementation relies on co-designed indicators, governance of order sets and alerts, audit-and-feedback, and rapid learning cycles that balance overuse and underuse while safeguarding equity. By aligning ethics, evidence, and attention, medical decluttering offers a coherent method to reduce cascades, restore focus, and make care simpler, safer, and more humane in internal medicine practice.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"83-91"},"PeriodicalIF":4.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487014","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":"Impact of cardiogenic shock on outcomes in patients with spontaneous coronary artery dissection: a systematic review and meta-analysis.","authors":"Rasha Kaddoura, Yehya A Mahmoud, Dima Nasrallah, Ashraf Ahmed, Ammar Chapra, Mohammed Al-Hijji","doi":"10.23736/S0031-0808.26.05422-4","DOIUrl":"10.23736/S0031-0808.26.05422-4","url":null,"abstract":"<p><strong>Background: </strong>This systematic review evaluated patient characteristics and outcomes of patients presenting with concomitant spontaneous coronary artery dissection (SCAD) and cardiogenic shock (CS) compared with those without CS.</p><p><strong>Methods: </strong>Data from four studies were analyzed. A comprehensive electronic literature search was performed by two authors using PubMed and Embase databases from inspection to February 1^st, 2025. MeSH and broad terms including \"Coronary Artery Dissection, Spontaneous\" OR \"SCAD\" OR \"Coronary Artery Dissection\" were used with and without \"Clinical Trials\" as a search limit.</p><p><strong>Results: </strong>SCAD patients presenting with CS were less likely to be females (OR=0.64, 95% CI: 0.44; 0.94) and have a history of myocardial infarction (OR=0.71, 95% CI: 0.51; 0.99) but more likely to have heart failure (OR=4.79, 95% CI: 3.30) and renal impairment (OR=2.23, 95% CI: 1.43; 3.50) than those without CS. The presence of CS was associated with longer hospital stay (MD=6.53 days, 95% CI: 5.20; 7.86) and worse in-hospital outcomes including death (OR=39.15, 95% CI: 4.73; 324.25), heart failure (OR=5.32, 95% CI: 2.73; 10.37), and stroke (OR=4.91, 95% CI: 2.44; 9.89).</p><p><strong>Conclusions: </strong>In conclusion, concomitant CS with SCAD was associated with worse outcomes than in the absence of CS.</p>","PeriodicalId":19851,"journal":{"name":"Panminerva medica","volume":" ","pages":"69-74"},"PeriodicalIF":4.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593459","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}