Clinica Terapeutica最新文献

{"title":"The Reproducibility of Conventional Minimally Invasive Osteosynthesis for the treatment of Intra articular Calcaneal fractures: The Traditional Technique is Regaining Popularity (prospective interventional study).","authors":"S A E Ahmed, A A Mohamed, A I E Mohammed, A Z Ali, N A I Mohamed, H A E Mohamed, E H W Yaser, A I M Mahmoud, A O Mohamed, E M Ibrahim, G A Usama, G A Mahmoud, R E Mohamed","doi":"10.7417/CT.2025.5196","DOIUrl":"10.7417/CT.2025.5196","url":null,"abstract":"<p><strong>Background: </strong>Despite the relative prevalence of intra-articular calcaneal fractures, definitive treatment is controversial. Historically the closed treatment of these injuries had been unsatisfactory. Avoid the soft tissue complications,several minimally-invasive approaches have been proposed throughout the history of calcaneal fracture treatment and recently gained popularity.</p><p><strong>Objective: </strong>The aim of the study was to verify the effectiveness of minimally invasive osteosynthesis for the treatment of intra articular calcaneal fractures in 20 cases.</p><p><strong>Patients and methods: </strong>Twenty one percutaneous and minimally invasive ostyosynsesis of calcaneal fractures in 20 patients were included in prospective interventional study. This study was done at Alzaitoun Specialized Hospital and Al-Azhar University hospitals between October 2022 and January 2024. These patients were followed up for at least 6 months post-operatively. This study included closed intra-articular calcaneal fractures type II and III in adult patients and excluded open, extra-articular, type I and IV fractures.</p><p><strong>Results: </strong>The mean pre-operative Böhler's angle was 17.81 ± 4.48 (range 13 - 25 0) and the mean post-operative Böhler's angle was 29.24 ± 5.15 (range 25 - 40 0) The result was found to be highly significant (p-value <0.001) using paired-samples T test. Restoration of normal range Bohler angle was achieved. The mean pre-operative Gissane angle was 136.95 ± 13.84 (range 110 - 165 0) and the mean post-operative Gissane angle was 117.81 ± 15.66 (range 100 - 145 0). The result was found to be highly significant (p-value <0.001) using paired-samples T test. Restoration of normal range Gissane angle was achieved. These results were found to be highly significant. That meant improvement of Böhler' and Gissane angles after fixation. Sixteen patients (80%) started weight bearing at 12 weeks while two patients (10%) started weight bearing at 16 weeks and two patients (10%) started weight bearing at 10 weeks. Three patients developed superficial wound infection treated by aily dressing and antibiotics for one week. Two patients developed malnion, one patient developed Positional wrist drop, seven patients developed subtalar joint pain, three patients developed Implant com-plications and two patients developed Fixed flat foot.</p><p><strong>Conclusion: </strong>We presented a minimally invasive technique for the treatment of intra-articular calcaneus fractures and could obtain results comparable with other minimally invasive techniques, avoiding the dangerous soft-tissue complications encountered with ORIF. most of cases, Böhler's angle, gissane angle and geometry of the calcaneus were restored to normal values. We believe that our minimally invasive technique is a valuable alternative for management of intra-articular calcaneal fractures.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"136-147"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774710","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":"Two cases of Sexual Activity-Related Deaths due to Vascular Dissection: investigating the Potential Link to phosphodiesterase type 5 inhibitor administration.","authors":"G Napoletano, B Treves, L De Paola, A Ghamlouch, F Del Duca, A De Matteis, L Di Mauro","doi":"10.7417/CT.2025.5191","DOIUrl":"https://doi.org/10.7417/CT.2025.5191","url":null,"abstract":"<p><strong>Abstract: </strong>Sexual activity-related sudden death (SArSD) is an uncommon phenomenon in forensic pathology, typically associated with preexisting vascular abnormalities that rupture due to sudden changes in blood pressure or heart rate during sexual activity. The current report presents two cases of SArSD in men with positive anamnesis for chronic sildenafil use. In Case 1, the cause of death was determined to be an intracranial hemorrhage that occurred shortly before sexual intercourse. In Case 2, death was attributed to the rupture of an abdominal aortic aneurysm, occurring during sexual activity and linked to substance abuse. While both deaths were attributed to SArSD, the potential role of sildenafil in promoting aneurysm formation or rupture remains a subject of debate. Intracerebral hemorrhages associated with sildenafil use appear to exhibit a consistent pattern, commonly affecting the basal nuclei, thalamus, and adjacent cerebral regions, particularly the lateral temporal lobe. Notably, in many cases descri-bed in literature sildenafil doses exceeding 50 mg were reported. The combined effects of sildenafil and substances (such as cocaine) in such events remain largely unexplored, underscoring the need for further research to elucidate their interaction. Cases of vascular dissections occurring independently of sexual activity suggest that sildenafil use warrants caution, particularly in individuals with underlying vascular vulnerabilities. Although rare clinical cases and autopsy findings have suggested a potential association between phosphodiesterase type 5 inhibitors (PDE5i) and hemorrhagic events, such as intracerebral hemorrhages or aneurysm ruptures, current evidence does not indicate that PDE5i have a significant or direct impact on blood pressure capable of causing the acute rupture of a healthy vessel. Nevertheless, further clinical and forensic studies are essential to elucidate the relationship between chronic or acute PDE5i use and hemorrhagic cerebrovascular accidents or aortic dissections.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"70-76"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664863","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":"A rare case of suicide by ingestion of muriatic acid: analysis of the medico-legal evidences.","authors":"M A Sacco, S Gualtieri, M C Verrina, A P Tarallo, P Tarzia, P Ricci, I Aquila","doi":"10.7417/CT.2025.5181","DOIUrl":"https://doi.org/10.7417/CT.2025.5181","url":null,"abstract":"<p><strong>Abstract: </strong>Caustic substances are highly corrosive and dangerous, causing protein denaturation and tissue necrosis by altering pH upon contact. Common examples include muriatic acid, caustic soda, and ammonia. This case study details a 44-year-old man who ingested muriatic acid in a suicide attempt, leading to widespread esophageal and gastric ulcerations, tissue necrosis, pulmonary consolidations, and blood-stream infections (Klebsiella Pneumoniae, Acinetobacter Baumanii complex). Despite medical interventions, the patient died. An autopsy was performed and it revealed extensive multi-organ hemorrhages and systemic damage. The findings highlight the rapid and fatal systemic effects of caustic ingestion, underscoring the importance of immediate emergency care, including esophagogastroduodenoscopy and gastric lavage, to mitigate absorption and systemic impact.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"24-28"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665239","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":"Microscopic and macroscopic findings in cocaine and crack airways injuries: a literature review.","authors":"A Ghamlouch, S De Simone, F Dimattia, B Treves, G Napoletano, A Maiese, L di Mauro, C Trignano, F Del Duca","doi":"10.7417/CT.2025.5193","DOIUrl":"https://doi.org/10.7417/CT.2025.5193","url":null,"abstract":"<p><strong>Abstract: </strong>Cocaine inhalation - and its popular derivative known as crack cocaine - is linked to numerous complications and organ damage, well-recognized in scientific literature, including airway injuries. Airways damage is probably due both to thermal damage by hot vapor and micro-inhalation of crystals, leading to foreign body trauma and inflammation. A brief description of findings is helpful to health professionals - including forensic pathologist - to achieve the correct diagnosis. Our study is of a review of the literature with the aim of investigating the anatomical and pathological basis of damage of upper airways in cocaine crack chronic users. For this purpose, scientific studies that explore the correlation between symptoms related to airway injuries and the corresponding macroscopic and microscopic organ damage in chronic cocaine and crack users were reviewed. Results from 11 studies were reported, involving patients with a history of pharyngodynia, dysphagia, dysphonia, foreign body sensation, and respiratory difficulties. Diagnoses were confirmed through direct or indirect laryngoscopy, with the use of a fiberoptic bronchoscope or flexible endoscope. Macroscopic findings documented edema and inflammation of the epiglottis, false vocal cords, aryepiglottic folds, arytenoid cartilages, and piriform sinuses, and the presence of white plaques and pseudomembranes. Microscopic findings documented inflammatory tissue and necrosis, in one case squamous metaplasia. Our results showed that it is possible to find macroscopic and microscopic lesion in chronic abusers' upper airways and it lays the foundation for future studies in the investigation of the injuries mentioned in post-mortem examinations.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"83-88"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665315","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":"Vaccination plays a fundamental role in healthcare personal health and safety.","authors":"G La Torre","doi":"10.7417/CT.2025.5215","DOIUrl":"10.7417/CT.2025.5215","url":null,"abstract":"<p><strong>Abstract: </strong>Since vaccines are able to reduce the risk for HCWs of getting sick and contribute to stop the spread of microorganisms to others, in this paper a review has been made for comparing the recommendations for HCWs' vaccination in three different counties, Australia, Italy and USA. The results show that, while there is a perfect agreement for the recommended vaccinations for HCWs in these countries, the epidemiological situations of these countries testifies the extreme heterogeneity for the vaccinations indicated in specific circumstances.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"253-254"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774821","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":"An Open-Source Solution for Efficient Healthcare Data Management.","authors":"B Poojar, S K Ashok, S B Rao, S D Ullal, A H Rao, N Shenoy","doi":"10.7417/CT.2025.5210","DOIUrl":"10.7417/CT.2025.5210","url":null,"abstract":"<p><strong>Background: </strong>Data management software plays a pivotal role in healthcare, ensuring the organized storage, analysis, and scrutiny of vast amounts of data. EpiData, an open-source software, is a prime example of a versatile tool used in healthcare settings. This comprehensive article offers an overview of EpiData's historical evolution, functionalities, and practical applications in the healthcare domain.</p><p><strong>Methods: </strong>The article commences with a survey of Epi-Data's evolution and its progressive transformations, highlighting its relevance in the context of open-source medical software. EpiData's noteworthy attributes include its user-friendly interface, data valida-tion, and quality assurance mechanisms. Along with its remarkable versatility in managing healthcare data through \".REC\" and \".QES\" file formats, are discussed. To underscore its distinctive features and advantages, the article compares EpiData to other data management programs. EpiData's adaptability and diverse range of applications are exemplified through its use in clinical research and healthcare data management.</p><p><strong>Results and conclusions: </strong>In conclusion, EpiData is widely employed as a paramount open-source data management tool in healthcare. Its straightforward user interface and embedded safety measures make it an optimal choice for various medical and scientific projects. While EpiData excels in efficiently organizing and analyzing healthcare data, it does have certain limitations concerning advanced functionality and data analytical proficiency. A notable example is the successful two-day course conducted in India in 2013, focusing on quality-assured healthcare data collection using EpiData. A subsequent two-year follow-up study demonstrated the effectiveness of this training in knowledge transfer, offering the potential for integrating EpiData into medical school curricula and research organizations.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"225-232"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774842","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":"Evaluation of neuroprotective role of benfotiamine in Alzheimer's disease model: A randomized control study.","authors":"B Mallika, K Sudha, A Massand, B V Murlimanju, G Sonal, M P Neelam, K Sowndarya","doi":"10.7417/CT.2025.5195","DOIUrl":"10.7417/CT.2025.5195","url":null,"abstract":"<p><strong>Background: </strong>Thiamine deficiency mimics the features of Alzheimer's disease (AD) like cognitive impairment, amyloid and tau deposition. There is growing evidence that links AD with aluminium. The study aims to explore the effect of benfotiamine (BFT), a lipid soluble thiamine derivative, on aluminium induced AD rat model.</p><p><strong>Materials and methods: </strong>All the rats except control group were administered AlCl3 for one month to induce dementia. Positive control group received donepezil; BFT groups received 50 and 300 mg/kg b.w. /day for last 15 days. Morris water maze test was performed to assess learning and memory. Histological changes were studied in C3 region of hippocampus. Acetylcholine esterase (AChE), malondialdehyde, reduced glutathione, nitric oxide, hyperphosphorylated tau proteins and caspase 8 were estimated in brain homogenate.</p><p><strong>Results: </strong>AlCl3 impaired learning and memory significantly and increased AChE, caspase 8, tau proteins. The decrease in NO level was highly significant (p<0.001) in BFT treated rats compared to control. Lower dose of BFT had profound influence on augmenting GSH levels (p=0.012). Further, higher dose of BFT improved learning and memory significantly in AD model (p=0.009) and was more effective in preventing taupathy, apoptosis and neuronal damage by acting as a potent antioxidant.</p><p><strong>Conclusion: </strong>It can be concluded that oral supplementation of 300mg /kg b.w. /day of BFT may reverse AD pathological processes and improve dementia. However, the need of thiamine supplementation in elderly persons to delay or halt the cognitive loss and eventual dementia needs validation by clinical trial.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"127-135"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774784","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":"Adolescent Gender Dysphoria in Italy: Reflections on Triptorelin, Consent, and Care.","authors":"M Lippi, F Orsini, F Damato, R Rinaldi","doi":"10.7417/CT.2025.5186","DOIUrl":"https://doi.org/10.7417/CT.2025.5186","url":null,"abstract":"<p><strong>Abstract: </strong>Since 2018, the Italian National Committee for Bioethics (CNB) has endorsed the off-label use of triptorelin, a gonadotropin-releasing hormone agonist (GnRHa), for managing adolescent gender dysphoria (GD). Administered to suppress puberty, triptorelin provides adolescents time to explore their gender identity without the distress of developing secondary sexual characteristics. However, concerns persist regarding its long-term effects on bone density, brain development, and fertility. Ethical debates focus on the validity of informed consent in minors, given their cognitive and emotional immaturity, and the critical role of families in decision-making. The Italian medical-psychiatric model, requiring a formal GD diagnosis and multidisciplinary over-sight, contrasts with the autonomy-centered informed consent model used elsewhere. This paper advocates for a hybrid approach, integrating strengths of both models to ensure safe, accessible, and individualized care. Further research is essential to clarify the efficacy and risks of triptorelin, ensuring evidence-based, fully informed decisions for adolescents with GD.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"44-47"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665242","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 significance of hospital triage in the context of trauma patients.","authors":"G De Gabriele, E Macorano, A Cristalli, A Colucci, S Di Trani, A Marzaioli, F Mele, F Introna","doi":"10.7417/CT.2025.5183","DOIUrl":"https://doi.org/10.7417/CT.2025.5183","url":null,"abstract":"<p><strong>Background: </strong>In the field of emergency medicine, the question of how to ensure that patients receive the care they require in a timely manner has been a topic of debate for approximately 30 years throughout Europe. This is due to the fact that, as a result of advances in medical science and technology, it is now possible to assess the criticality of a patient's condition with greater accuracy than was previously possible.</p><p><strong>Case report: </strong>Authors analyzed a peculiar case occurred in a hospital in the South of Italy. A patient who had sustained multiple injuries underwent an understate in triage procedure, resulting in an unfavorable outcome. The assignment of a Code Red rather than a Code Blue would have resulted in the initiation of interventional care, including transfer to a hospital with the necessary resources for the subject's condition. This would have increased the likelihood of survival for the subject.</p><p><strong>Discussion: </strong>As illustrated by the presented case, inaccurate triage estimation by nursing staff can have dire consequences, as subsequent control levels are contingent upon the initial triage code assigned to a patient. This exemplifies the necessity for a unified national consensus on triage procedures in emergency departments, irrespective of hospital size.</p><p><strong>Conclusion: </strong>The subject matter is of significant national and international interest. A reformulation of the parameters governing access to emergency care would be necessary in order to significantly reduce the incidence of knowledge-based errors attributable to nurses who are sometimes compelled to work in conditions that are wholly unreliable3. The use of territorial structures located on the territory would be used to manage minor emergencies and appropriately treat patients in need of advanced care. It is possible to propose using local medicine to lessen the burden of emergency rooms, which are increasingly overcrowded with minor emergencies.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"34-35"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663982","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":"Artificial Intelligence in the Service of Medicine: Current Solutions and Future Perspectives, Opportunities, and Challenges.","authors":"S Marinelli, L De Paola, M Stark, G Montanari Vergallo","doi":"10.7417/CT.2025.5192","DOIUrl":"https://doi.org/10.7417/CT.2025.5192","url":null,"abstract":"<p><strong>Objective: </strong>This article aims to identify the opportunities and risks of Artificial Intelligence tools (AIT) applied to clinical practice, while also reflecting on their impact on the doctor-patient relationship.</p><p><strong>Materials and methods: </strong>The authors conducted a systematic literature review following the PRISMA guidelines, selecting the period from 2019 to October 2024. Academic databases PubMed and Scopus were drawn upon by using the keywords and searchstrings \"artificial intelligence\", \"healthcare\", \"informed consent\", and \"doctor-patient relationship\" in titles, abstracts, and keywords.</p><p><strong>Results and discussion: </strong>AIT has proven useful in significantly reducing the time spent on bureaucratic tasks and minimizing errors compared to traditional medicine. However, their effectiveness is highly influenced by the quantity and quality of data used for training. Additionally, there is an issue with the transparency of the decision-making process because AIT and even their programmers are unable to explain their diagnostic and therapeutic recommendations. Therefore, human supervision of AI work is essential.</p><p><strong>Conclusions: </strong>The potential risks of AI for patient safety and personal data security necessitate that governments urge those involved in the production of AI tools to adhere to specific ethical standards developed with the participation of all stakeholders, including patients.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665248","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}