Clinica Terapeutica最新文献

{"title":"Pros and cons in the application of smart working.","authors":"C Colaprico","doi":"10.7417/CT.2025.5223","DOIUrl":"10.7417/CT.2025.5223","url":null,"abstract":"<p><strong>Abstract: </strong>Smart working has seen a strong diffusion in all companies around the world as a result of the Covid-19 health emergency, which forced social distancing and reduced travel. The concept of smart working is not simply reduced to working remotely, but represents a profound transformation in the way of working, based on flexibility, the use of digital tools, and the enhancement of individual skills. This letter aims to highlight advantages and disadvantages of this work mode.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 3","pages":"284-285"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310757","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 wound index for hip and knee arthroplasty outcomes: a pilot investigation.","authors":"G Pesel, P Bailo, E Basello, G Nittari, G Pica, F Gibelli, G Ricci","doi":"10.7417/CT.2025.5168","DOIUrl":"10.7417/CT.2025.5168","url":null,"abstract":"<p><strong>Background: </strong>Post-arthroplasty infections pose a challenge in surgery, often necessitating pro-longed antibiotic treatment, implant failure, and revision surgery. To optimize patient outcomes and resource allocation, the present study aimed at test whether the implementation of the ASEPSIS score (i.e., a prognostic indicator based on postoperative variables) would emerge as an effective index to foresee future post-arthroplasty infections and to guide targeted interventions.</p><p><strong>Methods: </strong>We conducted an evaluation of hip and knee replacement patients' progress during their hospital stay, utilizing the ASEPSIS score. Subsequently, we conducted telephone interviews to evaluate the outcomes of their surgical wounds.</p><p><strong>Results: </strong>A robust correlation was observed between this score and the incidence of post-operative infections. Notably, individuals with a lower score exhibited a reduced likelihood of infection, whereas those identified as high-risk were more predisposed to develop infections within 90 days of surgery.</p><p><strong>Conclusions: </strong>While these findings are preliminary, they demonstrate significant promise. As we progress with subsequent studies, employing the validated assessment method from this pilot study, we anticipate further validation of the ASEPSIS score and its potential integration into standard clinical practice.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 1","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434317","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":"Supratentorial glioma grading in children by using apparent diffusion coefficient map: application of histogram analysis based on segmentation.","authors":"V K Ngan, N D Hung, N D Hung, L T Dung, N A Nguyen, P N Tran","doi":"10.7417/CT.2025.5226","DOIUrl":"10.7417/CT.2025.5226","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric low-grade gliomas (pLGGs) and pediatric high-grade gliomas (pHGGs) reportedly exhibit variations in outcomes and treatment. This study aimed to investigate whether histogram analysis (HA) of diffusion-weighted imaging (DWI) imaging using a manually segmented three-dimensional (3D) volume of interest (VOI), excluding cystic or necrotic portions, could demonstrate a higher correlation with the tumor characteristics than an entire tumor VOI, therefore could improve the preoperative evaluation of supratentorial pediatric gliomas.</p><p><strong>Materials and methods: </strong>In a current prospective study, 31 pediatric patients with pathologically-confirmed gliomas who underwent baseline DWI were enrolled. The patients were classified by histopathology according to tumoral grade: 15 had pLGGs and 16 had pHGGs. Tumoral VOIs were calculated and transferred to apparent diffusion coefficient (ADC) maps. Histogram analysis (HA) was performed to determine mean, maximum (max), minimum (min), kurtosis, skewness, entropy, standard deviation (SD), mean of positive pixels (MPP), and uniformity of positive pixel (UPP) values for ADC. Comparisons of the values of each ADC parameter within the entire tumoral VOIs (VOI 1) and the tumoral VOIs excluding cystic or necrotic portions (VOI 2) were performed.</p><p><strong>Results: </strong>In VOI 1 placement, ADCmin and rADCmin were significantly lower in pHGG compared with pLGG with p = 0.004 and 0.002, respectively. In VOI 2 placement, ADCmean, ADCmedian, ADCmin, ADC MPP, rADCmean, rADCmedian, rADCmin and rADC MPP were significantly lower in pHGG compared with pLGG with p < 0.001. The HA parameters and the ratio of HA parameters of peritumoral edema were not statistically significant difference between LGG and HGG groups with p < 0.05. In VOI 1 placement, the ratio of ADCmin had higher diagnostic ability (AUC = 0.838) compared with ADCmin (AUC = 0.800). In VOI 2 placement, ADCmin had highest diagnostic ability with AUC = 0.904. The optimal cut-off for ADCmin was 587x10-6 mm2/s with Se of 93.3%, Sp of 81.2% and Youden index of 0.746. Other parameters such as ADCmean, ADCmedian, ADC MPP, rADCmin, rADC mean, rADCmedian and rADC MPP also showed higher AUC values compared with AUC values in VOI 1 placement.</p><p><strong>Conclusion: </strong>The HA parameters showed value in grading pediatric gliomas. Excluding cystic and necrotic portions from the entire tumor in measuring HA parameters had higher diagnostic value than the entire tumor VOI method. By using this segmentation, ADCmin had the highest performance in the prediction of histological glioma grading, followed by ADCmean, ADCmedian, ADC MPP, rADCmin, rADC mean, rADCmedian and rADC MPP.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 3","pages":"301-309"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310761","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 mothers and postpartum depression: a possible connection? A Scoping review.","authors":"R Ferrara, L Iovino, R Latina, A Avallone, E Greco, G Montanari Vergallo, M Calderaro, P Ricci","doi":"10.7417/CT.2025.5169","DOIUrl":"10.7417/CT.2025.5169","url":null,"abstract":"<p><strong>Abstract: </strong>Motherhood during adolescence is a sensitive phenomenon that draws attention to the mental health of adolescent mothers, including the risk of postpartum depression (PDR). This systematic review explores the correlation between motherhood and the development of PLD in adolescent mothers, analysing the associated risk factors. The included studies investigated the prevalence and risk factors of PPD in adolescent population samples, revealing a significant incidence of depressive disorders among adolescent mothers compared to adult mothers. Among the risk factors identified were low socioeconomic status, limited education and negative family dynamics. These findings highlight the importance of considering teenage pregnancy as a significant risk factor for PLD. Social support and targeted interventions can play a key role in preventing and managing postpartum depression in teenage mothers. Early identification of symptoms related to the mother's mental health during pregnancy and the postpartum period is of paramount importance to ensure the well-being of both mother and child. It is crucial to conduct further research to deepen the understanding of this complex relationship and to develop effective intervention strategies to support young mothers' mental health during the postpartum period. Investing in training health workers to recognise and treat pregnancy- and postpartum-related mental disorders, as well as educating women about available resources and the importance of seeking help when needed, can help reduce the public health burden of these problems.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 1","pages":"81-90"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434318","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":"Enhancing patient safety and delineating professional liability in radiological procedures involving contrast medium administration.","authors":"V Martines, S Magnaldi, N Di Fazio, G Volonnino, E Marinelli, L De Paola","doi":"10.7417/CT.2025.5163","DOIUrl":"10.7417/CT.2025.5163","url":null,"abstract":"<p><strong>Abstract: </strong>Radiological procedures requiring the administration of contrast medium are considered invasive procedures and require obtaining written consent from the patient. The risks of the procedure must be weighed against the risks of a potential missed diagnosis. Understanding the clinical question of the exam is crucial. For evaluating the risks to which the patient is exposed, both in contrast procedures and in the case of magnetic field use, a thorough analysis of the patient's medical history is equally important. The radiologists' liability is intertwined with that of the prescribing physician. However, in the absence of a prescription, demonstrating that correct action was taken may be challenging. Therefore, our opinion is therefore that it is advisable to encourage both the radiologist and the prescribing physician to sign a form that includes the examination indication on one side and the execution technique of the radiological investigations on the other, especially when contrast medium injection is involved.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 1","pages":"42-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434322","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 the psychometric properties of the Stanford Health Assessment Questionnaire Disability Index (HAQ-DI) in people with Parkinson's disease.","authors":"G Galeoto, R Simenon, A Berardi, F Panuccio, J González-Bernal, J Á Seco-Calvo","doi":"10.7417/CT.2025.5224","DOIUrl":"10.7417/CT.2025.5224","url":null,"abstract":"<p><strong>Abstract: </strong>The Stanford Health Assessment Questionnaire Disability Index (HAQ-DI) is a widely used patient-reported outcome for measuring functional disability during Activities of daily living (ADL) performance; Parkinson's Disease (PD) leads to alterations in body function, limited performance in ADLs and increased dependency, resulting in reduced quality of life. The aim of the present study was to analyzed the psychometric properties of HAQ-DI in a population with PD. People with diagnosis of PD were recruited for this study. The psychometric properties analyzed were internal consistency and construct validity using the Parkinson's Disease Questionnaire (PDQ-39) as gold standard. This study was conducted on 34 patients diagnosed with PD from February to October 2023. The internal consistency of the HAQ-DI was alpha=0.93. The study revealed significant correlations between the dimensions of the PDQ-39 and the subcategories of the HAQ-DI (0.03<r>0.91). Significant correlations also emerged between the demographic and clinical characteristics of participants and the subcategories of HAQ-DI. The HAQ -DI is a reliable and valid tool to assess ADLs in people with PD. This is the first study analyzing psy-chometric properties of this well-known assessment tool in a population with neurological disease, representing an important step to compare outcomes and ADLs independence in different populations.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 3","pages":"286-293"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310734","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":"Medicalisation in the Post-Genomic Era: Transformations in Identity, Autonomy, and Ethics.","authors":"M Karaboue, G V Lacasella","doi":"10.7417/CT.2025.5173","DOIUrl":"10.7417/CT.2025.5173","url":null,"abstract":"<p><strong>Abstract: </strong>The advent of the post-genomic society has fundamentally transformed the concept of medicalisation, expanding its scope from disease treatment to reshaping personal identity, autonomy, and societal norms. This paper examines the profound implications of genomic knowledge on individual and collective experiences, exploring its dual roles as a liberating force and a source of new constraints. Key areas of focus include the intersection of genomic data with social structures, the ethical tensions faced by healthcare professionals, and the evolving roles of patients and research subjects in the context of predictive and precision medicine. The discussion highlights the challenges posed by genetic determinism, the ethical complexities of consent, and the societal impact of genomic categorization on equity and justice. By integrating multidisciplinary perspectives, this study offers insights into the promises and perils of genomic innovation, charting pathways for ethical frameworks that balance scientific progress with human dignity and social responsibility.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 1","pages":"109-113"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433731","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":"Clinoptilolite in the drug refractory chronic diarrhoea.","authors":"B Palmieri, M Vadalà","doi":"10.7417/CT.2025.5159","DOIUrl":"10.7417/CT.2025.5159","url":null,"abstract":"<p><strong>Objective: </strong>The aim of study was to assess the safety and tolerability of a specific zeolite powder (Xeoderm powder, Phytoitalia S.r.l -Corbetta, Italy) and its effectiveness on health-related quality of life, bowel habits, psychological status (i.e., anxiety, depression, and stress).</p><p><strong>Materials and methods: </strong>100 patients affected by inadequately treated chronic or recurrent diarrhoea were educated to take Xeoderm [one spoon (15 mg) after lunch and after dinner mixed in 20 ml of water or fruits juice] for 8 weeks, then reduced to one single administration in the evening for one month. The patients were invited to keep records of the number of stool discharge, and of the bowel sounds and movements frequency and intensity, possible haemorrhoids, or anal fissures or anitis symptoms. H.pylori test to assess the presence of H.pylori, a Subject's Global Assessment (SGA) of Relief questionnaire to as-sess the impact of treatment on irritable bowel syndrome, the Bristol Stool Form Scale (BSFS) to evaluate stool form measurement; and the 12-item Short Form Survey (SF-12) to assess the quality of life, were administered before and after treatment to each patient.</p><p><strong>Results: </strong>Zeolite was shown to be quite effective in taking control of the frequent stool's emission. In the majority of clinical cases, in fact whether administered alone or with other curing-disease -tailored-therapies, it reached the required goal to restore the number and quality of stools output, improving the daily life. In addition, patients with irritable bowel disease strongly decreased diarrhoea, reducing the discomfort, and increasing the social self-confidence. Changes in blood and faecal parameters were observed during and after Xeoderm treatment.</p><p><strong>Discussion: </strong>This study provided anecdotal evidence of effectiveness and safety of the prescribed zeolite brand, with improvement of the specific symptoms of diarrhoea: stool consistency, and possible abdominal colicky pain. A reasonable explanation might be that probably some immune modification of the inflammatory background, with reduction of the cytokine cascade normalized the colonic mucosa cells turnover with drainage of submucous oedema and reabsorption of the inflammatory granulocyte and lymphomonocytes infiltration.</p><p><strong>Conclusions: </strong>This specific brand of zeolite has to be taken into account in the symptomatic treatment of acute and chronic diarrhoea especially when anti-diarrhoeic classic protocol has failed.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 1","pages":"6-12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434320","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 effectiveness of the De Ritis ratio in diagnosis and follow-up of Celiac disease: A Retrospective Study.","authors":"M Kıyak, T Düzenli, A İbrahim","doi":"10.7417/CT.2025.5227","DOIUrl":"10.7417/CT.2025.5227","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the efficacy of the De Ritis ratio, which is cheaper and easily accessible compared to celiac antibodies, in the diagnosis of celiac disease and in predicting dietary compliance in follow-up.</p><p><strong>Material and methods.: </strong>152 patients over 18 years of age who were diagnosed with celiac disease during a 4-year period in the gastroenterology department of a tertiary care regional hospital and 237 patients without celiac disease as control group were included. Endoscopy and pathology results, laboratory values and pre-diagnostic De Ritis ratios of both groups were compared. Patients with celiac disease were divided into 2 groups as diet-compliant and diet-incompliant. Laboratory values and De Ritis ratios of these 2 groups at diagnosis and at the end of the first year were compared.</p><p><strong>Results: </strong>There were 152 patients in the celiac group and 237 patients in the control group. AST (p<0.001) and AST/ALT mean value (p<0.001) were higher in the celiac patient group compared to the control group. AST/ALT ratio at the time of diagnosis was similar to the AST/ALT ratio at the end of first year in the diet non-compliant group, but the difference between them was not statistically significant (p=0.945). However, AST/ALT ratio at the end of the first year in diet-compliant celiac patient group was lower than at the time of diagnosis (1.17; 1.02, p<0.001).</p><p><strong>Conclusion: </strong>De Ritis ratio may be a promising inexpensive, simple and easily accessible candidate to help clinicians differentiate Celiac disease and assess disease activity and dietary adherence.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"173 3","pages":"310-316"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310728","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":"Inflammatory signatures and immunomodulation in neonates: a pilot study.","authors":"L Leonardi, V Pennetta, R Laitano, R Carsetti, M Duse, M Fiore, F Natale, L Tarani, A Spalice, E Förster-Waldl","doi":"10.7417/CT.2025.5233","DOIUrl":"10.7417/CT.2025.5233","url":null,"abstract":"<p><strong>Background: </strong>The precise diagnosis of inflammatory responses is essential for managing infectious diseases. Dysregulated inflammatory responses can lead to death and high morbidity in some subjects due to sensitive age, genetic predisposition, or other comorbidities. More specifically, dysregulated immunological development in newborns has been investigated to elucidate inflammatory regulation in prone populations, as being the first step to future immunomodulatory therapeutic interventions. Indeed, compared to adults, neonates display both an immature immune response to microorganisms, due to a diminished Th1 response and an immature compensatory anti-inflammatory response.</p><p><strong>Methods: </strong>In this exploratory study, we aimed to characterize inflammatory signatures in i) preterm newborns, ii) full-term newborns, iii) full-term newborns exposed in-utero to Cytomegalovirus (CMV) infections, and iv) healthy adults as a further control group. Our investigation used a whole-blood approach to quantify the basal and the Toll-like receptors (TLRs)-induced cytokine responses. Samples from cord blood and peripheral blood (of healthy adults) were stimulated or not with ligands for TLR1/2, TLR4, and TLR7/8 to elicit cytokine production.</p><p><strong>Results: </strong>We found that after TLR7/8 stimulation the blood of full-term newborns showed higher concentrations of IL-6 and TNF-α compared to the other groups. Moreover TLR7/8 ligand, compared to other TLR ligands, potentiated pro-inflammatory responses according to the presence of IL-6, TNF-α and CXCL8 in adults, while in preterm new-borns we disclosed TNF-α α elevation. In preterm newborns, we also observed increased TLR1/2-induced IL-10 concentration suggestive of modifications in the immunosuppressive and inflammatory state.</p><p><strong>Conclusions: </strong>Our pilot results strongly encourage further investigations comparing age groups and different immunomodulatory agents further promoting the discussion that TLR7/8 ligands could be suitable vaccine adjuvant candidates for newborns. At the same time, IL-10-associated immunomodulation (monoclonal antibody anti-IL-10, anti-IL-10 receptors, or anti-TLR1/2) might be a future therapeutic option for cases of overwhelming neonatal inflammatory diseases.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 3","pages":"350-357"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310752","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}