Clinica Terapeutica最新文献

{"title":"Evaluating the Impact of Patient Education on Knowledge, Self-Efficacy, and Quality of Life in Chronic Obstructive Pulmonary Disease.","authors":"L Joseph, R Mahadevan, K S Rashmi, V S Raj","doi":"10.7417/CT.2025.5248","DOIUrl":"10.7417/CT.2025.5248","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) is a progressive inflammatory lung condition with no definitive cure. Acute exacerbations (AE) are critical events that accelerate disease progression, leading to significant deterioration in lung function, reduced health-related quality of life (HRQoL), and increased mortality risk. Effective disease education and self-management strategies play a vital role in mitigating these adverse effects.</p><p><strong>Objective: </strong>This study aims to assess the impact of patient education on disease knowledge using the Bristol COPD Knowledge Questionnaire (BCKQ), self-efficacy via the COPD Self-Efficacy Scale (CSES), HRQoL measured by the St. George Respiratory Questionnaire (SGRQ), and patient satisfaction through the Patient Survey Instrument (PSI). Additionally, the study evaluates the frequency of physician consultations and hospital admissions due to AE through monthly follow-ups over six months.</p><p><strong>Methods: </strong>This pre-post experimental study included 23 COPD patients and was conducted in three phases. The initial phase involved obtaining ethical clearance. The second phase focused on the development, translation, and validation of educational materials, including questionnaires and an educational booklet. The final phase comprised the assessment of patient knowledge, tailored education based on identified knowledge gaps, and follow-up evaluations of disease understanding.</p><p><strong>Results: </strong>Post-education analysis revealed significant improvements in disease knowledge (p=0.000), clinically and statistically meaningful enhancement in HRQoL (mean difference = 11.5, p = 0.003), and increased patient confidence (p=0.005). While consultation frequency remained statistically insignificant (p=0.635), hospitalization rates demonstrated a notable reduction (p=0.000). Patients in GOLD stage 2 exhibited the most pronounced improvements. Overall, 80% of participants expressed satisfaction with healthcare services, treatment, and therapist support.</p><p><strong>Conclusion: </strong>Targeted disease education and self-management interventions effectively enhance patient knowledge, self-efficacy, and HRQoL, while reducing hospitalization rates due to AE. These findings highlight the importance of integrating educational strategies into COPD management, particularly in the early stages of the disease.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"451-458"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735064","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":"Bone marrow edema in osteoarthritis and bone trauma. Diagnose and treatment.","authors":"G Saviola, S Rosini, L Molfetta, L Dalle Carbonare, N Malavolta, M A Mazzei, M Muratore, B Frediani","doi":"10.7417/CT.2025.5254","DOIUrl":"10.7417/CT.2025.5254","url":null,"abstract":"<p><strong>Background: </strong>Bone marrow edema (BME) is a nonspecific response of bone to several different diseases with various pathogenesis or to traumatic events. At the moment BME can clearly be evidenced with RMI only, overall with T2 and STIR sequences, or with dual-energy CT scan. Osteoarthritis (OA) is the most frequent and disabling rheumatological disease affecting millions patients all over the world. Nevertheless traumatic events (TE) are also very common. Both conditions are able to induce BME, but in case of TE diagnosis can be often easy and immediate. Contrary, in OA, BME is not always present, depending on the subtype of the disease. Moreover a correct and meticulous anamnesis and a differential diagnosis with other rheumatological diseases should be performed to avoid false roads.</p><p><strong>Conclusions: </strong>Bisphosphonates (BPs), in particular Neridronate (NER) and Clodronate (CLO) are, at the moment, the most studied treatments for BME. However other cares with hyperbaric oxygen treatment or pulse electromagnetic fields can be also used in TE. In this review GEODEIT (Gruppo Edema Osseo, Diagnosi e Interventi Terapeutici), an italian scientific society discusses about diagnose and treatment of both, OA and TE conditions.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"498-503"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735022","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":"Uterine atony and postpartum haemorrhage: predisposing genetic factors and postmortem findings.","authors":"V Cianci, C Mondello, D Sapienza, A D Genazzani, L Tornese, A Cianci, A Cracò, L Pepe, V Fiorentino, A Ieni, D Speranza, P Gualniera, A Asmundo, C Battipaglia","doi":"10.7417/CT.2025.5250","DOIUrl":"10.7417/CT.2025.5250","url":null,"abstract":"<p><strong>Abstract: </strong>Uterine atony (UA) represents a serious medical condition characterized by ineffective contraction of the uterine muscle after placenta delivery and is responsible for up to 80% of postpartum hemorrhages (PPH) worldwide. UA onset prediction before delivery is still an ongoing challenge, even if many risk factors for UA onset have been identified almost 50% of atonic PPH occur in women without identifiable antepartum risks, making high vigilance during labor essential for all the healthcare providers involved in labor assistance. To prevent the onset of UA in high-risk women, prophylactic measures such as active management of third stage of labor, presence of intravenous access during labor, and presence of cross-matched blood available are recommended. If UA occurs, a conservative management based on uterotonic drugs, tranexamic acid and intrauterine tamponade should be preferred while surgical methods such as arteries ligation or hysterectomy should be considered as a last resort. Finally, the influence of genetic factors on predisposing to the onset, severity, and variable responses to treatment of this pathology was analyzed. Among these genetic factors, it has been observed that mutations affecting the genes encoding for the oxytocin receptor (OXTRs), but also for \"uterine contraction-associated proteins\" (CAPs) such as connexin43, prostaglandin-endoperoxide synthase 2 (Ptgs2), Gap junction protein alpha 1 (Gja1) and COX-2 - determining an abnormal response to hypoxia - may be responsible for the development of postpartum haemorrhage (PPH) due to uterine atony (UA).</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"468-477"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735088","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":"Mapping systems and services through multi-stakeholder perspectives of mental health care provision through non-governmental organizations in Palakkad and Chennai districts of Southern India.","authors":"S Korakkottil, V Gopal, V C Sekaran, A Ramasamy","doi":"10.7417/CT.2025.5246","DOIUrl":"10.7417/CT.2025.5246","url":null,"abstract":"<p><strong>Background: </strong>India has a serious dearth of mental health experts in the field, with only 0.3 psychiatrists for every 100,000 people, far below the global average, which is significantly appearing as a barrier for SDG number 3. Mental health NGOs in India are crucial in filling this gap by providing essential services including counselling, therapy, and medication management and raising mental health awareness. This study aims to map the mental health services provided and explore the stakeholder perspectives on NGO-provided mental health services to identify facilitators and barriers to improving service delivery.</p><p><strong>Methods: </strong>This qualitative, multicentric exploratory study was conducted in two districts of Southern India, Palakkad in Kerala and Chennai in Tamil Nadu. The study mapped NGOs' mental health systems and services, drawing on the perspectives of 30 stakeholders, including key informants, psychologists, counsellors, social workers, volunteers, and psychiatrists. Data was collected between January and April 2024 following ethics clearance and analysed by manual coding and ATLAS.ti software trial version 24.1.0.</p><p><strong>Results: </strong>Thematic analysis revealed key challenges and facilitators, with stigma and funding constraints emerging as commonly discussed barriers, while community engagement and collaborative efforts were frequently cited as enablers of effective service delivery. The study identified the diverse mental health services provided by the NGOs in both places, such as direct counselling, teleconsultations, awareness classes, workshops, and community outreach sessions. Stakeholders highlighted effective community engagement, flexibility, continuous professional development, and strategic public-private partnerships as the facilitators for delivering good-quality services. Challenges for the service implementation included stigma surrounding mental health, competition in the field, and inadequate funding.</p><p><strong>Conclusion: </strong>By addressing identified barriers and leveraging facilitators, NGOs can significantly enhance mental health service provision and outcomes in Palakkad and Chennai districts. Effective communication, local language use, and increased collaboration, including enhancing Public-Private Partnerships, are essential for sustainable mental health initiatives.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"436-444"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735068","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":"Innovative Strategies for Hip Synovial Chondromatosis and Its Medico-Legal Implications.","authors":"G Basile, L Bianco Prevot, V Bolcato, M Basile, L P Tronconi","doi":"10.7417/CT.2025.5253","DOIUrl":"10.7417/CT.2025.5253","url":null,"abstract":"<p><strong>Abstract: </strong>Primary synovial chondromatosis of the hip is a rare pathology characterized by metaplastic changes in the synovium, leading to the formation of cartilage nodules and, eventually, free intra-articular bodies. Early manifestations, such as pain, stiffness, and limited mobility, require timely differential diagnostic process through imaging techniques, with magnetic resonance imaging being the gold standard diagnostic method, complemented by histopathological analysis. Considering the rarity of the condition, the diagnostic suspicion is linked to the expertise of the professional and the referral to specialized centers/professionals. While, the evolution toward minimally invasive surgical techniques and a multidisciplinary approach has improved clinical outcomes, the level of evidence in the different surgical approach are worthy of further long-term investigation. Furthermore, the definition of multidisciplinary diagnostic-therapeutic protocols based on evidence is of importance. In conclusion, the careful management of the condition, along with detailed docu mentation, is essential to minimize medico-legal implications associated with potential diagnostic delays, interpretative errors or improper surgical approach indication.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"495-497"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735066","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":"Anxiety and Depression among Hypertensive Patients and Its Effect on Medication Adherence.","authors":"A N Alkadi, A H Alajlani, A K Alnawah, F M Alturkie, A N Almutawah, E Elsheikh","doi":"10.7417/CT.2025.5244","DOIUrl":"10.7417/CT.2025.5244","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a prevalent chronic condition with significant health implications. Effective management critically relies on patient adherence to prescribed medication regimens. However, mental health disorders like anxiety and depression may influence adherence behaviors. This study aimed to examine the association between anxiety, depression, and medication adherence among hypertensive patients in Saudi Arabia.</p><p><strong>Methods: </strong>This cross-sectional study involved 296 hypertensive patients from ten primary health care centers in Al-Ahsa, Saudi Arabia. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and depression levels, respectively. Medication adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8). Data were analyzed using descriptive statistics, chi-square tests, and multiple linear regression.</p><p><strong>Results: </strong>The prevalence of anxiety and depression varied, with 34.5% reporting mild anxiety, 22.0% moderate anxiety, and 30.4% mild depression. Medication adherence was suboptimal, with 49.3% classified as low adherence. A statistically significant association was observed between anxiety and medication non-adherence (p = 0.007), with higher anxiety levels linked to poorer adherence. However, the relationship between depression and adherence was not significant (p = 0.419). Multiple linear regression analysis confirmed anxiety as a significant negative predictor of medication adherence (B = -1.103, p = 0.016), while depression did not significantly influence adherence.</p><p><strong>Conclusions: </strong>The findings highlight the detrimental impact of anxiety on medication adherence among hypertensive patients in Saudi Arabia. Routine screening for anxiety and implementation of integrated care approaches addressing mental health concerns are crucial for improving adherence and overall disease management.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"418-426"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735021","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":"Burnout between personality traits and bowel disorders. An exploratory study of a sample of nurses students.","authors":"P Ricci, G E Cafiero, E Greco, A Vinci, F Damato, R Ferrara","doi":"10.7417/CT.2025.5249","DOIUrl":"10.7417/CT.2025.5249","url":null,"abstract":"<p><strong>Background: </strong>Burnout is a complex psychosocial syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, with significant implications for both mental and physical health. Nursing students appear particularly vulnerable to burnout, which can be associated with somatic symptoms, including gastrointestinal disturbances. Despite existing evidence suggesting correlations between burnout and physical disorders, the interplay between burnout, personality traits, and somatization remains underexplored.</p><p><strong>Objective: </strong>This study aimed to investigate the relationship between burnout levels, personality traits, and self-reported bowel disorders among nursing students. A secondary objective was to quantify the psychological components associated with these symptoms.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 196 nursing students from Sapienza University of Rome. Participants completed the Maslach Burnout Inventory (MBI), the Personality Assessment Inventory (PAI), and a health status questionnaire. Descriptive statistics, Spearman's correlation with bootstrapping, and multivariable ordinal logistic regression analyses were performed to explore associations between burnout dimensions, personality traits, and somatic symptoms, particularly bowel dysfunction.</p><p><strong>Results: </strong>Burnout components, especially emotional exhaustion and depersonalization, were significantly associated with somatic complaints and self-reported bowel disorders. Female students and those living with others reported higher frequencies of bowel-related symptoms. High PAI somatization and conversion scores were observed among participants with frequent pain and defecation difficulties. Physical activity and adequate sleep appeared as protective factors, while poor sleep quality was associated with higher emotional exhaustion and depersonalization scores.</p><p><strong>Conclusions: </strong>The study highlights the early onset of burnout symptoms among nursing students and their potential somatic correlates, particularly gastrointestinal symptoms. These findings underscore the need for integrated intervention strategies that address both psychological and physical health dimensions in nursing students, with particular attention to lifestyle factors such as sleep and physical activity.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"459-467"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735062","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":"Harnessing Imaging Across Medical Specialties: Present Value and Future Radiomic Horizons","authors":"P Frisina","doi":"10.7417/CT.2025.5243","DOIUrl":"10.7417/CT.2025.5243","url":null,"abstract":"<p><strong>Abstract: </strong>Diagnostic imaging plays a pivotal role across all medical disciplines, serving as the cornerstone for decision-making in both acute and chronic care. This article explores emerging evidence from diverse specialties-ranging from ophthalmology and hepatology to neurology and respiratory medicine-highlighting the indispensable role of imaging in guiding pharmacological, surgical, and rehabilitative strategies. More importantly, it emphasizes the transformative potential of radiomics, a data-driven approach that extracts high-dimensional quantitative features from routine CT, MRI, PET, and ultrasound scans. Unlike traditional qualitative interpretation, radiomics enables the development of predictive models that integrate imaging biomarkers with clinical, molecular, and genomic data. Case examples illustrate how radiomic analysis can improve disease stratification, guide perso-nalized therapies, and accelerate clinical trials. By leveraging existing picture-archiving systems without requiring additional procedures or contrast agents, radiomics offers a non-invasive \"virtual biopsy\" that expands the informational yield of every scan. This paradigm shift toward image-based precision medicine will require interdisciplinary collaboration between radiologists, clinicians, and data scientists but holds the promise of more accurate, efficient, and individualized care. The convergence of radiomic analytics and multidisciplinary practice heralds a new era in which imaging becomes not just a diagnostic tool, but a rich and reusable data asset that shapes therapeutic decisions and health outcomes.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"416-417"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735087","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":"Initial Insights into Targeted Axillary Dissection Post-Neoadjuvant Therapy in Node-Positive Breast Cancer: A Pilot Interventional Study.","authors":"A Aosmali, M Nafie, A Nafie, R Radwan, B Soliman, M Alkhalaf","doi":"10.7417/CT.2025.5252","DOIUrl":"10.7417/CT.2025.5252","url":null,"abstract":"<p><strong>Background: </strong>The most commonly detected malignancy and the second most prevalent cause of cancer-related death in women globally is breast cancer. The treatment of breast cancer is significantly influen-ced by the accurate staging and proper management of axillary lymph nodes (ALNs). The surgical management of the axilla in breast cancer has undergone a significant transformation over the past two decades. The routine axillary lymph nodes (LN) dissection, which is associated with a higher level of morbidity in early-stage node-negative patients, has been replaced by sentinel LN biopsy (SLNB), which was initially investigated in the early nineties. SLNB offers precise evaluations of nodal status and essential staging data.</p><p><strong>Objective: </strong>To determine the accuracy of targeted axillary resection and ensuring surgical removal of clipped nodes would improve accuracy of nodal staging in those patients.</p><p><strong>Patients and methods: </strong>This Pilot Interventional study was conducted at Al Demerdash Hospital, Faculty of Medicine, Ain Shams University, between March 2020 and March 2021. The institutional research and ethics committee reviewed and approved the study protocol. Thirty patients with clinical node-positive breast cancer who were undergoing neo-adjuvant chemotherapy (NACT) were involved in the study.</p><p><strong>Results: </strong>In all, 24 patients with clipped ALNs were stained with patent blue dye and five patients with clipped ALNs were not stained by patent blue dye. Therefore, SLNB was unable to detect five clipped ALNs in five patients, so there is a false-negative rate (FNR) of 17.2%. Therefore, with the targeted procedure we can decrease the FNR of sentinel nodes.</p><p><strong>Conclusion: </strong>Targeted axillary dissection is a feasible technique for axillary management in clinically N1 breast cancer patients who receive NACT and turned to N0. Preoperative clipped node guide wire localization significantly enhances the identification clipped node rate and decreases the FNR of SLNB alone.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"487-494"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735065","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":"Medico legal study on the correct management of the medical clinic in the military field.","authors":"M Salducci, R Raimondi, M S Simonelli","doi":"10.7417/CT.2025.5256","DOIUrl":"10.7417/CT.2025.5256","url":null,"abstract":"<p><strong>Abstract: </strong>This study aims to analyze the best practices and standardized procedures for the management of these resources, examining the ethical, legal and organizational implications. Finally, a scheme for the correct management of a medical clinic is proposed.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"512-514"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735069","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}