Recenti progressi in medicina最新文献

{"title":"[In adults with mild to moderate community-acquired pneumonia, no antibiotic is clearly more effective than any other.]","authors":"Alice Serafini, Allen Shaughnessy","doi":"10.1701/4357.43469","DOIUrl":"https://doi.org/10.1701/4357.43469","url":null,"abstract":"","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506784","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}

{"title":"[The delapril-indapamide combination in treatment of arterial hypertension: practical implications in light of the new guidelines.]","authors":"Paolo Verdecchia, Fabio Angeli","doi":"10.1701/4357.43464","DOIUrl":"10.1701/4357.43464","url":null,"abstract":"<p><p>The recent guidelines issued by the European Society of Hypertension reaffirmed that the degree of control of hypertension remains suboptimal worldwide. In order to increase the proportion of well-controlled patients, in addition to nonpharmacological measures, it is necessary to improve the implementation of drug therapy in the clinical practice as much as possible. Initial therapy should almost always be based on the combination, free or fixed, between ACE inhibitor drugs, or direct angiotensin II inhibitors ('sartans') and diuretics (thiazide or thiazide-like) or calcium channel blockers at the maximum recommended and well-tolerated dose. The combination of the thiazide-like diuretic indapamide with the ACE inhibitor delapril has shown, based on numerous clinical trials and meta-analyses, very good results in terms of antihypertensive efficacy, tolerability, and prevention or regression of organ damage. Indapamide is a thiazide-like diuretic also endowed with direct vasodilator effect and long duration of action. A meta-analysis of 19 randomized clinical trials demonstrated a greater reduction in the incidence of cardiac events, stroke and heart failure with thiazide-like diuretics than with thiazide diuretics. Delapril is a non-sulfhydryl ACE-inhibitor with high affinity for converting enzyme at the cardiac, pulmonary, and peripheral vascular levels. Being strongly lipophilic, delapril inhibits the ACE enzyme at the tissue level more potently than other ACE inhibitors. A peculiar feature of delapril is its weak bradykinin-enhancing effect due to its higher affinity for the C site than the N site of ACE, resulting in a lower incidence of cough and angioneurotic edema compared with other ACE inhibitors. In some meta-analyses, the pressor reduction was statistically, greater with the delapril-indapamide combination than with combinations between hydrochlorothiazide and ACE inhibitors. The combination consists of divisible tablets containing 30 mg delapril and 2.5 mg indapamide, and its pharmacological and clinical properties are not affected by simultaneous food intake. The antihypertensive efficacy of the combination, as well as its components, persists for the entire 24 hours. The recent alarming reports on the incidence of skin cancer during treatment with hydrochlorothiazide should also be a guide in clinical practice toward the preferential choice of a thiazide-like diuretic such as chlorthalidone or indapamide to replace hydrochlorothiazide.</p>","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506792","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}

{"title":"[Tirbanibulin in the treatment of actinic keratoses: description of a case with instrumental evaluation and long-term follow-up.]","authors":"Francesco Lacarrubba, Anna Elisa Verzì, Stefano Dimarco, Ivano Luppino, Federica dall'Oglio, Giuseppe Micali","doi":"10.1701/4357.43475","DOIUrl":"https://doi.org/10.1701/4357.43475","url":null,"abstract":"<p><p>A 72-year-old man presented with actinic keratosis (AK) of the scalp confirmed by line-field confocal optical coherence tomography (LC-OCT) a novel non-invasive skin imaging technique. Patient was treated with Tirbanibulin 1% ointment once a day for 5 consecutive days and, after 8 days from baseline, mild erythema and desquamation was observed on the treated area, associated with mild pruritus. At the same time-point, L'LC-OCT revealed the presence of intraepidermal \"targeted-like\" cells, corresponding to apoptotic keratinocytes. After 2 months, clinical and instrumental examination showed the almost total disappearance of the AK. At the same time-point, a strong improvement of photoaging was noted at the level of the treated area. At 1-year follow-up, no relapse and/or new AK were observed. In conclusion, the reported case is emblematic of the short and long-term efficacy and safety of tirbanibulin in the treatment of AK, as already reported in the literature, as well as of the usefulness of non-invasive imaging technique such as LC-OCT in the therapeutic monitoring.</p>","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506795","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}

{"title":"In questo numero<br>2024 Ottobre.","authors":"","doi":"10.1701/4357.43458","DOIUrl":"https://doi.org/10.1701/4357.43458","url":null,"abstract":"","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506799","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}

{"title":"[Expertise or talent: what is more important in a doctor?]","authors":"Francesca Alvau, Luca De Fiore","doi":"10.1701/4357.43460","DOIUrl":"https://doi.org/10.1701/4357.43460","url":null,"abstract":"<p><p>The authors question whether having an innate talent or possessing acquired professional skills is more important for \"living as a physician.\" The article emphasizes a combination of personal traits, such as compassion, emotional intelligence, and teamwork skills, which are highly significant and complement technical competencies. The authors highlight the importance of being able to make quick decisions and provide emotional support in critical situations, especially in emergency medicine. Furthermore, it is crucial that a group of professionals has a variety of talents, as this can be the basis for more inclusive care. Patience, cited by Roger Federer in a speech at Dartmouth University, is an essential quality for healthcare professionals during years when the healthcare system is experiencing a profound funding crisis. Finally, it is essential for a physician to be adaptable and committed to continuous cultural growth in an evolving healthcare environment.</p>","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506783","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}

{"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":null,"pages":null},"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}

{"title":"[Opioid use during pregnancy is not associated with an increased risk of neuropsychiatric disorders in children.]","authors":"Alice Serafini, Allen Shaughnessy, Peter K Kurotschka","doi":"10.1701/4357.43468","DOIUrl":"https://doi.org/10.1701/4357.43468","url":null,"abstract":"","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506789","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}

{"title":"[Levonorgestrel-releasing intrauetrine devices, compared to no hormonal contraception, are associated with a reduced risk of ischemic stroke and equal risk of intracerebral hemorrhage.]","authors":"Peter K Kurotschka, Henry Barry, Alice Serafini","doi":"10.1701/4357.43467","DOIUrl":"https://doi.org/10.1701/4357.43467","url":null,"abstract":"","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506786","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}

{"title":"L’utilizzo di sacituzumab govitecan in linea avanzata di malattia in paziente anziana con tumore della mammella metastatico divenuto triplo negativo.","authors":"Cinzia Cardalesi","doi":"10.1701/4357.43483","DOIUrl":"10.1701/4357.43483","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506800","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}

{"title":"[Medical practices in places of culture and intense architecture: how the visit experience changes.]","authors":"Eleonora Gerbotto, Guido Giustetto, Raffaella Lecchi, Luca Mo Costabella","doi":"10.1701/4357.43462","DOIUrl":"https://doi.org/10.1701/4357.43462","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":20887,"journal":{"name":"Recenti progressi in medicina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506788","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}