Minerva medica最新文献

{"title":"Gut microbiota and iron homeostasis: implications for glycemic control.","authors":"Isa G Rodrigues, Jose Moreno-Navarrete, José M Fernández-Real","doi":"10.23736/S0026-4806.25.09706-X","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09706-X","url":null,"abstract":"<p><p>The gut microbiome, comprised of diverse microorganisms, plays a critical role in maintaining metabolic, immune, and digestive health. This dynamic ecosystem is highly influenced by external factors such as diet, genetics, environmental factors, and even medication use, including antibiotics. Iron, already bioavailable in the Archean Ocean, is one of the most abundant elements on Earth. All organisms compete or collaborate to obtain iron, demonstrating its relevance in the biological and physiological processes essential to the maintenance of metabolic homeostasis. The bidirectional relationship between the intestinal microbiota, and the host organism in obtaining iron influences both the metabolism of the host, and that of the microbiota. Bacteria in microbiota affects the absorption of iron by the organism, while factors such as iron deficiency or excess in the host modify bacterial biodiversity, its taxonomic composition and its functions. These changes impact bacterial virulence, influencing systemic iron levels, tissue storage and glucose metabolism in the host organism. Patients with changes in glucose metabolism and insulin resistance often present imbalances in iron regulation and alterations in the profile of their intestinal microbiota. The interaction between microbiota, iron and glycemia represents an emerging field of research, standing out as a promising area for nutritional and therapeutic interventions to promote metabolic health. This review explores the relationship between iron metabolism and gut microbiota, highlighting its impact on glucose metabolism.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082966","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 experimental promise and clinical reality of myocardial conditioning for prevention of myocardial ischemia and reperfusion injury: an umbrella review of systematic reviews.","authors":"L Maximilian Buja, Sonya E Fogg","doi":"10.23736/S0026-4806.25.09660-0","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09660-0","url":null,"abstract":"<p><strong>Introduction: </strong>Experimental research sequentially identified reperfusion (in 1972) and conditioning (in 1986) as the two most powerful interventions for reducing acute myocardial infarct (AMI) size following acute coronary occlusion. These discoveries led to further experimental studies on optimal myocardial salvage and intensive clinical efforts to translate these interventions into the management of patients. This umbrella review of systematic reviews addresses the state of research on the effectiveness of pharmacological and interventional conditioning protocols to modulate the impact of ischemia and reperfusion in experimental animals and patients and the comparability of results in experimental animals and humans. This umbrella review documents the paradox of the experimental success of conditioning strategies in the experimental arena and equivocal clinical results of the application of the same conditioning strategies in patients.</p><p><strong>Evidence acquisition: </strong>The review was conducted using the reporting guideline for overviews of reviews of healthcare interventions codified in the PRIOR statement (https://www.equator-network.org/reporting-guidelines/reporting-guideline-for-overviews-of-reviews-of-healthcare-interventions-development-of-the-prior-statement/).</p><p><strong>Evidence synthesis: </strong>The results are summarized in the PRISMA format. A discussion is provided of known and unknown factors responsible for the lack of progress in identifying and implementing interventions to further reduce morbidity and mortality from ischemic heart disease, as well as a practical strategy to achieve timely reperfusion in a larger number of patients experiencing acute coronary syndrome.</p><p><strong>Conclusions: </strong>While awaiting further research to develop a third window of cardioprotection, the most practical approach today is to reduce the morbidity and mortality from IHD is to mount a public education campaign to get the 50% of acute coronary syndrome (ACS) patients with prodromal AMI to the hospital to institute timely reperfusion therapy which has a proven to be the most effective therapy to limit the extend of myocardial damage in patients with IHD. However, the possibility has been raised that the human myocardium may have a genetically determined, primordial non-responsiveness to cardioprotective interventions that exists beyond the established recognized confounding factors. Primordial genetic factors may be particularly difficult to overcome.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083037","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":"Supplementary management of chronic Lyme disease with Pycnogenol®.","authors":"Maria R Cesarone, Shu Hu, Gianni Belcaro, Umberto Cornelli, Beatrice Feragalli, Giovanni B Agus, Marcello Corsi, Claudia Scipione, Valeria Scipione, Ezio Bombardelli, Roberto Cotellese, Francesca Coppazuccari, Morio Hosoi, Pietromaria Bavera, Lars Rosenkvist","doi":"10.23736/S0026-4806.25.09703-4","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09703-4","url":null,"abstract":"<p><strong>Background: </strong>The aim of this pilot supplement registry study was to investigate the efficacy of the anti-inflammatory supplement Pycnogenol^® in subjects with history of Lyme disease and persistent symptoms with no active bacteria present (Stage 2 and 3 of Lyme disease), on the reduction of inflammation and the relieve of the main symptoms. There is currently no specific treatment for this condition.</p><p><strong>Methods: </strong>The subjects were divided into two groups: one group received 150 mg/day of Pycnogenol^® alongside standard management, while the control group received only standard management. The observation period lasted for six months.</p><p><strong>Results: </strong>Forty subjects with history of Lyme Disease and persistent symptoms completed the study: 20 in the Pycnogenol^® group, 20 in the control group. No side effects from the supplementation were observed. The tolerability was optimal as no supplemented subject had to stop management and compliance was optimal with 97% of the Pycnogenol^® capsules correctly used. The two groups were comparable for sex, age distribution and for their main clinical findings and signs/symptoms at inclusion. During the study, corticosteroids at low dose were used on demand in 10% of subjects using Pycnogenol^® and significantly more, in 45% of the control patients (P<0.05). After 6 months, the number of patients experiencing symptoms was significantly lower in the Pycnogenol^® group compared to the control group across all symptoms (P<0.05). After 6 months, the intensity of all symptoms in the Pycnogenol^® group, was significantly lower, according to the scores in comparison with the control group (P<0.05). Plasma oxidative stress was significantly reduced in subjects of the Pycnogenol^® group (P<0.05) in comparison with controls. The improvement in plasma oxidative stress was seen in all subjects using Pycnogenol^®. Knee effusion on ultrasound was seen in 12 subjects of the supplement group at inclusion and in 3 Pycnogenol^® subjects at the end of the study in comparison with 12/20 subjects in the control group at inclusion and 8/20 at the end of the study. (P<0.05). Finally, ESR (Erythrocyte sedimentation rate, a global marker of inflammation) was significantly more reduced in the Pycnogenol^® group by the end of the study compared to controls (P<0.05).</p><p><strong>Conclusions: </strong>In conclusion, the present registry study showed that Pycnogenol^® intake for 6 months in patients with persistent symptoms of Lyme disease can help relieve the main symptoms by reducing inflammation and oxidative stress. Pycnogenol's anti-inflammatory and antioxidant double activity may help safely and effectively controlling the chronic inflammatory process.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082975","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":"Endoscopic ultrasound with bronchoscope fine-needle biopsy in the diagnosis of suspected malignant pulmonary lesions with crown-cut needle: a retrospective study.","authors":"Filippo Lanfranchi, Gioele Castelli, Giacomo Giulianelli, Laura Mancino, Gabriele Foltran, Michele Rizzo, Federico Fracasso, Alberto Pavan, Lorenzo Nicolè, Licia Laurino, Lucio Michieletto","doi":"10.23736/S0026-4806.25.09633-8","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09633-8","url":null,"abstract":"<p><strong>Background: </strong>The role of Transesophageal bronchoscopic ultrasound-guided fine needle aspiration (EUS-B-FNA) in the diagnosis of malignant pulmonary lesions adjacent to the esophagus is a well-known procedure with high diagnostic yield. Moreover, it is indicated for lung cancer staging. Franseen needle tip is a crown-cut needle that allow to obtain tissue cores and provide huge amount of tissue for pathologist's evaluation, moving from fine needle aspiration (FNA) to fine needle biopsy (FNB). Few data about EUS-B-FNB and Franseen needle tip are available in Literature.</p><p><strong>Methods: </strong>Between May 2022 and June 2024, 33 patients with lymphadenopathy who underwent EUS-B with Franseen needle tip were consecutively enrolled. Chest CT scan was performed prior procedure. Lymphnodes' dimension at imaging and EUS-B were recorded. EUS-B-TBNB was performed with 22G or 25G needle size. Diagnostic yield and specimen adequacy (SA) for predictive markers were evaluated.</p><p><strong>Results: </strong>22G needle was used in 18 patients and 25G in 15, and no statistically significant differences were observed between sex and age in the two groups. Overall Diagnostic Yield was 91% (30/33), with no statistically significant differences between 22G and 25G needle group (89% and 93%, respectively). SA for predictive markers was achieved in 20 of 23 patients (87%) with cancer diagnosis, with no significant differences between 22G and 25G group (P=0.59). No adverse events were observed.</p><p><strong>Conclusions: </strong>EUS-B-FNB is a safe and an effective diagnostic method that should be performed in every bronchoscopy suite. Franseen needle tip provides high quality samples for pathologists, avoiding procedure repetition and/or more invasive procedures.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082962","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":"Decoding uterine leiomyosarcoma: is ultrasound diagnosis still a daunting challenge?","authors":"Camilla DI Dio, Stefania Pipitone, Rossella Del Vecchio, Elisa Noce, Marika Denotti, Mauro Ceccanti, Luigi Tarani, Ludovico Muzii, Giampiero Ferraguti, Marco Fiore, Maria G Piccioni","doi":"10.23736/S0026-4806.25.09669-7","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09669-7","url":null,"abstract":"<p><strong>Introduction: </strong>This narrative review, based on the current literature, aims to evaluate whether or not preoperative ultrasound can effectively distinguish between uterine leiomyosarcomas (ULMS) and leiomyomas (ULM).</p><p><strong>Evidence acquisition: </strong>By using PubMed, Scopus and WOS, an extensive literature search was conducted to identify ultrasound characteristics that specifically differentiate uterine ULMS from ULM.</p><p><strong>Evidence synthesis: </strong>This review analyzed several ultrasound features to distinguish ULMS from ULM, including the maximum diameter of myometrial growth, the number of lesions (solitary/multiple), tissue echogenicity (homogeneous/heterogeneous), growth borders (regular/irregular), the presence of cystic regions, shadow presence, subjective color grading, and the vascular pattern of the myometrial lesion (circumferential/intralesional). Our findings suggest that in postmenopausal patients with abnormal uterine bleeding and a new or enlarging mesenchymal mass, ULMS should be suspected. Features such as irregular tumor margins, moderate-to-abundant intralesional blood flow, cystic regions, and lack of calcifications indicate a higher risk of ULMS.</p><p><strong>Conclusions: </strong>Benign and malignant myometrial lesions should be disclosed by algorithms including ultrasound combined with clinical presentations and, if necessary, magnetic resonance imaging. This means that further prospective studies should be conducted to consolidate our findings.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065562","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":"Correlation between endorectal ultrasonography, magnetic resonance imaging and final histological examination in patients undergoing surgery for rectal cancer: a monocentric study on the first 50 cases.","authors":"Alex B Bellocchia, Stefania Soncini, Luca Bonatti, Federico Festa, Luca Cestino, Paolo Arese, Giulia Carbonaro, Giorgia Gavello, Marta Breda, Beatrice Degan, Antonella Evangelista, Salomè Pfannkuche, Dayana Benny, Francesco Quaglino","doi":"10.23736/S0026-4806.25.09542-4","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09542-4","url":null,"abstract":"<p><strong>Background: </strong>Endorectal ultrasound (ERUS) and magnetic resonance imaging (MRI) are key diagnostic tools for rectal cancer staging. ERUS is preferred for early-stage cancer, while MRI is the standard for advanced stages. However, their effectiveness in patients undergoing neoadjuvant therapy (NAT) remains debated. This study compares ERUS and MRI in rectal cancer evaluation, correlating results with final histopathological findings and analyzing a subgroup of patients who received NAT.</p><p><strong>Methods: </strong>A retrospective study (February 2020 to February 2024) included oncology patients with rectal cancer treated electively at our Center, who had undergone both ERUS and MRI staging.</p><p><strong>Results: </strong>Out of 172 surgical patients, 50 met inclusion criteria (42% male, average age 71.9). Surgical procedures included 36 anterior rectal resections and 14 abdominoperineal resections, with a laparoscopic approach in 84% of cases. Additionally, 74% underwent NAT. ERUS showed high sensitivity and specificity for early-stage (T1 and T2) and lymph node detection, while MRI was optimal for T3 and T4 staging. Correlation with histological findings was strong for ERUS and less so for MRI. In NAT patients, results were consistent, but MRI showed better accuracy for lymph node involvement.</p><p><strong>Conclusions: </strong>ERUS and MRI are essential for rectal cancer diagnostics. ERUS is superior for early stages and lymph node evaluation, whereas MRI excels in advanced stages (T3 and T4). In NAT patients, ERUS remains favourable, but MRI's sensitivity and specificity improve for lymph node assessment.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039274","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":"Borderline hyperlipidemia: preventive supplementation with berberine phospholipids to prevent early atherosclerosis evolution.","authors":"Maria R Cesarone, Shu Hu, Gianni Belcaro, Umberto Cornelli, Beatrice Feragalli, Marcello Corsi, Valeria Scipione, Claudia Scipione, Roberto Cotellese, Morio Hosoi, David Cox, Francesca Coppa Zuccari","doi":"10.23736/S0026-4806.25.09637-5","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09637-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The aim of this pilot, efficacy supplement registry was to use a supplementary management with berberine to control hyperlipidemia. Berberine (Berbevis&lt;sup&gt;™&lt;/sup&gt; as Sophy&lt;sup&gt;®&lt;/sup&gt; tablets) was used to control lipids and to evaluate the early evolution of subclinical atherosclerosis in subjects (otherwise healthy, not using drugs) with borderline hyperlipidemia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;One group used berberine supplementation and a standard management (SM), while a second comparative group used only SM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No side effects were observed during the 6 months of berberine supplementation. No tolerability problems were reported. All subjects completed the registry. The groups resulted comparable. At 3 and 6 months the average total cholesterol was decreased more with berberine (P&lt;0.05) and HDL was significantly improved (P&lt;0.5). Triglycerides decreased in the berberine groups (P&lt;0.05), more than in controls. Oxidative stress was significantly more decreased with berberine supplementation (P&lt;0.05). Homocysteine (within normal values) were significantly decreased at 3 and 6 months (P&lt;0.05). Fasting glucose was decreased in the berberine group - at 3 and 6 months - in comparison with controls (P&lt;0.05). Also, glycosylated hemoglobin was reduced with berberine (P&lt;0.05) more than in the SM group. Body weight was also significantly more decreased (P&lt;0.05) with berberine supplementation. The fat proportion also decreased significantly more (P&lt;0.05) with the supplement (P&lt;0.05) than in controls only using the SM. Technical athero-specific measurements: the intima-media thickness (IMT) at the carotids (high-resolution ultrasound) in all subjects was stable with berberine and did not significantly change in 6 months. In SM controls the IMT increase was significant superior at 6 months (P&lt;0.05); more time is needed in this type of observations in subjects with minimal initial alterations at the carotid bifurcations. Endothelial function: after occlusion in normal subjects, with normal arteries, reactive hyperemia (RH) - generally - increases section/flow of more than 30% (up to 50%). The included subjects at the first observation, had a minimal increase in RH after occlusion, as an expression of endothelial dysfunction associated to the hyperlipidemia. RH was significantly increased (P&lt;0.05) with berberine, in comparison with controls, at 3 and 6 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot, concept registry indicates that oral berberine administration is effective in reducing lipids (also decreasing weight, fat percentage and fasting glucose) in otherwise healthy subjects not using other drugs. A longer study, with more advanced hyperlipidemic subjects is suggested. Predictive analytics suggests that a 12-month study with 100 patients, in more advanced hyperlipidemics, also evaluating the carotid intima-media thickness for the analysis of vascular benefits, may produce a stronger ","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045452","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":"Lady Prelox® supplementation alleviates post-surgical menopausal symptoms and improves vaginal mucosal microcirculation.","authors":"Gianni Belcaro, Maria R Cesarone, Claudia Scipione, Valeria Scipione, Umberto Cornelli, Roberta Luzzi, Roberto Cotellese, Mark Dugall, Morio Hosoi, Marcello Corsi, Beatrice Feragalli","doi":"10.23736/S0026-4806.25.09628-4","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09628-4","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047551","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":"Frozen embryo-transfer: a review on the optimal endometrial preparation.","authors":"Aikaterini Selntigia, Francesco Gebbia, Ana Del Arco, Antonio Pellicer, Daniela Galliano","doi":"10.23736/S0026-4806.25.09631-4","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09631-4","url":null,"abstract":"<p><strong>Introduction: </strong>Frozen-thawed embryo transfer (FET) has become a widely adopted method in assisted reproductive technology (ART), thanks to the advancements in vitrification techniques. FET now accounts for a significant proportion of ART cycles, but there is still no clear consensus on the optimal protocol for endometrial preparation. This review aims to evaluate the reproductive outcomes of three commonly used FET protocols: natural cycle (NC), modified natural cycle (mNC), and artificial cycle (AC), with a focus on implantation rates, clinical pregnancy rates (CPR), live birth rates (LBR), and obstetric complications such as hypertensive disorders of pregnancy (HDP) and preeclampsia (PE).</p><p><strong>Evidence acquisition: </strong>Studies published between 2014 and 2024 were reviewed and compared across these protocols.</p><p><strong>Evidence synthesis: </strong>The results show that NC and mNC protocols are associated with higher CPR and LBR compared to AC. AC, on the other hand, is linked to an increased risk of HDP and PE, likely due to the absence of a functional corpus luteum (CL), which plays a vital role in early pregnancy support.</p><p><strong>Conclusions: </strong>The presence of a CL appears to be crucial for minimizing obstetric complications, making NC and mNC preferable options. Future research is needed to refine FET protocols, focusing on personalized approaches to endometrial preparation that optimize both pregnancy outcomes and maternal health.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039380","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 multidisciplinary team reduces the time to idiopathic pulmonary fibrosis diagnosis in a real-life setting.","authors":"Tiziana La Blasca, Alida Benfante, Riccardo Messina, Emanuele Grassedonio, Salvatore Battaglia, Giada Capizzi, Irene Di Leo, Laura Napoli, Sergio Palma, Pietro Provinzano, Alessandra Tomasello, Nicola Scichilone","doi":"10.23736/S0026-4806.25.09643-0","DOIUrl":"10.23736/S0026-4806.25.09643-0","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of idiopathic pulmonary fibrosis (IPF) is fundamental to slow disease progression; multidisciplinary teams (MDTs) play a central role in posing the final diagnosis of IPF, thus aiming to improve patient outcomes. However, the practical implementation of MDTs in clinical real-life settings may be hindered by the lack of local expertise or time constraints, with the diagnosis being made without the support of complementary professional health care figures. This study aims to evaluate the impact of MDT meetings on the latency between the symptom onset and the final diagnosis of IPF.</p><p><strong>Methods: </strong>Patients referred to a regional center for IPF between January 2019 and August 2019 were included. The length of time to pose a definite diagnosis by means of MDT evaluation was compared with that of patients diagnosed elsewhere (no MDT evaluation) in an observational case-control investigation.</p><p><strong>Results: </strong>Among 24 IPF patients, those evaluated by MDT (M/F: 14/2, age: 69.8±8.2 yrs) showed a time interval from the first outpatient visit to the definite diagnosis of 3±2.3 months; on the other hand, patients in the control group (M/F: 7/1, age: 76.9±7.7 yrs) showed a time interval of 12.8±9.4 months (P=0.02). The time elapsed between the onset of symptoms and the definite diagnosis was 11.1±5.3 months for patients evaluated within the MDT, compared to 33.8±21.5 months for the control group (P=0.02).</p><p><strong>Conclusions: </strong>These exploratory findings confirm the essential role of the MDT in the early diagnosis of IPF, thus discouraging the acquisition of diagnosis solely on individual basis. The current findings highlight the need for the implementation of MDTs in clinical practice to optimize patient care.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"101-105"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443132","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}