Italian Journal of Medicine最新文献

{"title":"Different clinical courses with the same findings: two cases of paroxysmal nocturnal hemoglobinuria presenting with thrombocytopenia","authors":"V. Karakuş, E. Kaya, Yelda Dere, F. Şahin","doi":"10.4081/itjm.2021.1319","DOIUrl":"https://doi.org/10.4081/itjm.2021.1319","url":null,"abstract":"Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal stem cell disease that manifests with chronic intravascular hemolysis, thrombosis, and bone marrow failure. Various degrees of cytopenias accompany the disease. Although laboratory and clinical findings are similar, the disease may show different courses and require different treatments. Herein, we report two different courses of PNH with similar clinical and laboratory findings.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45696703","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":"Current challenges in COVID-19 diagnosis: a narrative review and implications for clinical practice","authors":"G. Nucera, Francesco Chirico, V. Raffaelli, P. Marino","doi":"10.4081/itjm.2021.1474","DOIUrl":"https://doi.org/10.4081/itjm.2021.1474","url":null,"abstract":"Early diagnosis of coronavirus disease 2019 (COVID-19) is crucial to early treatment and quarantine measures. In this narrative review, diagnostic tools for COVID-19 diagnosis and their main critical issues were reviewed. The COVID-19 real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test is considered the gold standard test for the qualitative and quantitative detection of viral nucleic acid. In contrast, tests can be used for epidemiological surveys on specific communities, including occupational cohorts, but not for clinical diagnosis as a substitute for swab tests. Computed tomography (CT) scans can be useful for the clinical diagnosis of COVID-19, especially in symptomatic cases. The imaging features of COVID-19 are diverse and depend on the stage of infection after the onset of symptoms. CT sensitivity seems to be higher in patients with positive RT-PCR. Conventional chest sensitivity shows a lower sensitivity. An important diagnostic screening tool is ultrasounds, whose specificity and sensitivity depend on disease severity, patient weight, and operator skills. Nevertheless, ultrasounds could be useful as a screening tool in combination with clinical features and molecular testing to monitor disease progression. Clinical symptoms and non-specific laboratory findings may be useful if used in combination with RT-PCR test and CT-scanning.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41523062","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":"HIV, HCV and SARS-CoV-2: friends or foes? A case report","authors":"E. Garlatti Costa, C. Mazzaro, A. Grembiale, Alessandro Berto, Rita De Rosa, S. Grazioli, M. Tonizzo","doi":"10.4081/itjm.2021.1350","DOIUrl":"https://doi.org/10.4081/itjm.2021.1350","url":null,"abstract":"Data about co-infection of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), HIV, and hepatitis C virus (HCV) are still scarce. We describe a patient hospitalized for sore throat, fatigue, and myalgia with a personal history of HIV and occult HBV infection. His antiretroviral therapy included bictegravir/emtricitabine/tenofovir alafenamide. The nasopharyngeal swab was positive for SARS-CoV-2 and laboratory testing showed acute HCV. Antiretroviral therapy was continued, but no specific therapy for SARS-CoV-2 was started. After 4 weeks, the nasopharyngeal swab resulted negative for SARS-CoV-2 and biochemical tests revealed undetectable HCV RNA with normalization of transaminases. To the best of our knowledge, this is the first reported case of acute HCV in a patient with HIV and SARS-CoV-2 co-infection.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45252563","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":"Lo scompenso cardiaco a 360 gradi","authors":"Giuseppe Di Pasquale","doi":"10.4081/itjm.q.2021.2","DOIUrl":"https://doi.org/10.4081/itjm.q.2021.2","url":null,"abstract":"M. Meschi, P. Gnerre, A. Casola \u0000G. Di Pasquale \u0000 \u0000Il paziente con scompenso cardiaco come paradigma del paziente complesso: il corretto uso dei diuretici ed il blocco sequenziale del nefroneA. Cinque, C. Tarsia, A.G. Posteraro, S. Bianchi, A. Gaspardone \u0000Scompenso cardiaco: differenze di genere?R. Falzone, L. Lenzi, C. Politi \u0000 \u0000Opportunità terapeutiche nel paziente con scompenso cardiaco cronico a frazione d’eiezione depressaA. Navazio, M. Piepoli, G.Q. Villani, G. Halasz, G. Tortorella \u0000Opportunità terapeutiche nel paziente con scompenso cardiaco diastolicoA. Cabassi, G. Regolisti \u0000Scompenso cardiaco: rivalutazione della terapia in fase di ospedalizzazioneF. Corradi, I. Lamberti, G. Gelati, S. Massini \u0000I peptidi natriuretici nella diagnosi e nella stratificazione del rischio nei pazienti con scompenso cardiacoA. Montagnani, L. Luschi, F. Pirrotta, A. Palazzuoli \u0000L’educazione terapeutica nel paziente scompensatoM.D. Corbo, E. Vitale, M. Correale, N.D. Brunetti, M. Iacoviello \u0000 \u0000Il modello del disease management nella gestione dello scompenso cardiacoO. Para \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza dell’AO Ordine Mauriziano di TorinoC. Norbiato, L. Arnaldi, S. Marengo, M. Tricarico, M. Daddea, C. Garza, E. Irene, P. Paolì \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza dell’ASST RhodenseS.A. Berra \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza di PalmanovaC. Battello \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza dell’AUSL di BolognaS. Urbinati, M. Ongari \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza delle Aziende USL della ToscanaA. Fortini, G. Tintori, M. Alessandri \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza marchigianaN. Tarquinio \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza savonese. Il progetto PONTEP. Gnerre, M. Pivari, E. Monaco, M.C. Pistone, M. Basso, P. Bellone, A. Visconti, B. Sardo, B. Zanella, A.M. Saccone, A. Piras, A. Santo, F. Bernardi, S. Lapponia, E. Montanari, R. Rapetti, R. Tassara, L. Parodi \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza campanaF. Gallucci \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza puglieseF. Mastroianni, G. Larizza, F. D’Onofrio, A. Belfiore, M.V. Palma, S. Cataldi \u0000Modelli a confronto nei percorsi gestionali dello scompenso cardiaco: l’esperienza di Sassari. Il progetto LEAPC.A. Usai, F.L. Bandiera \u0000 \u0000Il ruolo delle cure palliative nello scompenso cardiaco end-stageC. Santini, M.S. Fiore","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46540459","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":"Intellectual property protection for scholarly publishing in the Italian framework: a globally open approach for medical and life sciences authors","authors":"Valentina Bozzato, M. Gnoato, Antonia Vilia, Mauro Apostolico","doi":"10.4081/itjm.2021.1473","DOIUrl":"https://doi.org/10.4081/itjm.2021.1473","url":null,"abstract":"This paper aims at analyzing the importance of protection of intellectual property (IP) in biomedical scholarly publications, both for the author’s reputation and the dissemination of scientific knowledge. The laws that regulate IP are very complex and differ from country to country. We shall focus on the Italian framework though many considerations could be applied to foreign contexts. IP is very articulated, yet often ignored, that is worth paying attention to a correct copyright management can help researchers promote their Work and the community to benefit from it. In the scholarly publishing field, there are two main areas: traditional publishers and open-access publishers. The first group requires a fee to access the content they publish and usually ask the authors for a complete transfer of copyright. The possibility to negotiate terms with such publishers is often overlooked: scholarly authors tend to think they do not have leverage in the publishing cycle. The so-called addendum and professional figures, like librarians and attorneys, can help manage the authors’ intellectual property. On the other hand, open-access publishers give free access to published material, guaranteeing the protection of IP: thanks to the Creative Commons Licenses, the authors do not have to surrender their copyright to the publisher and can manage and control the use made out of their Work. Applying the principles put forth in this article implies enhancing research dissemination by increasing its impact and visibility. However, to achieve such a goal, it is necessary to protect intellectual property for the sake of authors, users, and scientific progress.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41508805","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":"Intramucosal duodenal adenocarcinoma concomitant with Saint’s triad","authors":"Matheus Dantas Gomes Gonçalves, Vinicius Grigolli, Thereza Cristina Carvalho Kalmar, V. Modesto dos Santos, Lucimara Sonjia Villela, Lister Arruda Modesto dos Santos","doi":"10.4081/itjm.2021.1376","DOIUrl":"https://doi.org/10.4081/itjm.2021.1376","url":null,"abstract":"Duodenal tubulovillous adenomas are rare and have malignant potential. Their successful management depends on the preoperative diagnosis and adequate excision. Endoscopic mucosal resection or submucosal dissection can control superficial tumors. Adenocarcinoma of the duodenum may originate in tubular or tubulovillous adenoma, and possible diagnostic challenges occur concerning the endoscopic biopsy findings. We report a 62-year-old female with chronic epigastric burning and a bolus sensation. Upper gastrointestinal endoscopy showed a non-ampullary duodenal tumor, and the biopsy study diagnosed a tubulovillous adenoma. Further mucosectomy revealed an intramucosal adenocarcinoma in a tubulovillous adenoma with a tumor-free pedicle. Besides the intestinal neoplasms, the patient had the diagnosis of classical Saint’s triad; and the manifestations were hiatus hernia, gallbladder disorder, and colonic diverticula. The objective is to report two scarcely described conditions and comment on controversial points of view about the concomitance of Saint’s triad and malignancy. Case reports can reduce late diagnosis, enhancing the suspicion index on rare diseases.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48912662","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":"Epicardial fat, gender, and cardiovascular risk","authors":"M. Monti, R. Marchetti, G. M. Vincentelli","doi":"10.4081/itjm.2021.1349","DOIUrl":"https://doi.org/10.4081/itjm.2021.1349","url":null,"abstract":"Epicardial fat (EF) is considered an important risk factor and an active player in the pathogenesis of cardiovascular and metabolic diseases. EF is an endocrine organ that releases hormones and mediators, including the circulating C-reactive protein (CRP), and plays a vital role in modifying the vascular endothelial function and promoting the growth of coronary atherosclerosis. This study aimed to investigate the relationship between CRP concentrations and EF in a cohort of patients with metabolic syndrome at risk for coronary artery disease. In our study, carried out in primary prevention, we enrolled 36 subjects (M/F: 21/15; age: 59.3±0.79 yrs) diagnosed with metabolic syndrome. We have classified the patients into two groups: Men and Women. Besides anthropometric characterization and screening laboratory tests, the subjects performed a multidetector computed tomography scan, which allowed the EF quantification. Mean EF was 115.1 cc in the study population. The average EF of women was 111 cc; the average EF of men was 118 cc (P=0.18). CRP levels were strongly positively correlated with EF area in women (P=0.01), while the correlation was not found in men (P=0.4). Our findings suggest that, in women, the EF produces a greater amount of acute-phase proteins and increases the pro-inflammatory state in the epicardial region. For this reason, we can hypothesize, in women, a different role in the development of atherosclerotic plaque of the epicardial fat compared to men.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49652886","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":"Gender differences in ischemic stroke intra-hospital mortality: a systematic review","authors":"T. Ciarambino, O. V. Giannico, A. Campanile, Antonella Fischetti, Elena Barabgelata, Immacolata Ambrosino, O. Para, C. Politi, M. Giordano","doi":"10.4081/itjm.2021.1378","DOIUrl":"https://doi.org/10.4081/itjm.2021.1378","url":null,"abstract":"The aim was to evaluate whether intra-hospital mortality from ischemic stroke is different in female patients. Methods. Studies were found in PubMed, Web of Science. We excluded 119 records because they did not include relevant reports or data. Studies were eligible for inclusion if enrolled adult patients with ischemic stroke and if the odds ratio (OR) of intra-hospital mortality in females compared to males is provided. Three retrospective cohort studies were eligible for inclusion criteria and so were included in the analysis. Findings: the random effect model showed a pooled significant higher risk of intra-hospital mortality [OR 1.34 (95% confidence interval 1.04, 1.74), P=0.026] in the female group compared to the male group. Our systematic review shows that intra-hospital mortality was significantly higher in female subjects compared to male.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44987658","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":"Treatment and secondary prophylaxis of venous thromboembolism with direct oral anticoagulants in patients with severe hereditary thrombophilia","authors":"P. Madonna, A. Guida, M. Coppola, P. Tirelli, E. Grasso","doi":"10.4081/ITJM.2021.1351","DOIUrl":"https://doi.org/10.4081/ITJM.2021.1351","url":null,"abstract":"Deficiency of protein C (PC), protein S (PS), antithrombin III (AT III), and homozygosity or combined heterozygosity for Factor V Leiden (FVL) and Factor II (FII) 20210A mutation represent severe hereditary thrombophilia (SHT) and are associated with a higher risk of early-onset venous thromboembolism (VTE). In literature, few papers have described the efficacy and safety of therapy with direct oral anticoagulants (DOACs) in VTE occurring in patients with SHT. In our setting, we identified 8 patients who have suffered from early-onset VTE and underwent therapy with DOACs (6 rivaroxaban, 2 apixaban). Among them, 2 AT III deficiency, 2 PC deficiency, 3 PS deficiency, 1 combined heterozygosity for FVL, and FII 20210A were detected. During the follow-up, neither recurrences of VTE nor hemorrhagic episodes were observed. This report describes the efficacy and safety of therapy with anti-Xa in the treatment and secondary prophylaxis of VTE in patients with SHT. Correspondence: Pasquale Madonna, U.O.C. Medicina Interna, P.O. Ospedale del Mare, ASL NA 1 Centro, Napoli, Italy. E-mail: linomadonna@libero.it","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42181328","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":"Is pleural effusion in COVID-19 interstitial pneumonia related to in-hospital mortality?","authors":"A. Cereda, M. Toselli, A. Palmisano, R. Leone, D. Vignale, Valeria Nicoletti, G. Campo, A. Monello, D. Ippolito, Francesco Giannini, A. Esposito","doi":"10.4081/ITJM.2021.1440","DOIUrl":"https://doi.org/10.4081/ITJM.2021.1440","url":null,"abstract":"The recent severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) pandemic has highlighted the importance of pulmonary computed tomography (CT) for diagnosis and prognostic stratification of this new viral pneumonia 1370 lung CT scans (performed at the time of admission) of consecutive patients hospitalized for SARS-CoV-2 in Northern Italy during the first epidemic wave were analyzed by a radiological CoreLab The presence of pleural effusion on pulmonary CT scan was present in 188 patients (13 3% of the population) and identified a population with more comorbidities Patients with pleural effusion had more cardio-respiratory complications with higher mortality Pleural effusion was an independent predictor of death on multivariate analysis with an HR of 1 4 (95% confidence interval 1-1 9) Pulmonary CT pleural effusion was an independent predictor of mortality","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46389707","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}