Minerva medicaPub Date : 2025-10-07DOI: 10.23736/S0026-4806.25.09808-8
Roberto Mattina, Francesco Scaglione
{"title":"Amoxicillin/clavulanate as a cornerstone of antibiotic stewardship: integrating WHO AWaRe principles, Italian recommendations, and evidence-based practice.","authors":"Roberto Mattina, Francesco Scaglione","doi":"10.23736/S0026-4806.25.09808-8","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09808-8","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) remains a critical global health concern, largely driven by inappropriate antibiotic use. To address this challenge, the World Health Organization (WHO) developed the AWaRe (Access, Watch, Reserve) classification, prioritizing the use of Access antibiotics - narrow-spectrum agents with proven efficacy and low resistance potential. Amoxicillin/clavulanate, included in the Access group, is widely endorsed in international and national guidelines, as a first-line option for common community-acquired infections. This Expert Opinion reviews the positioning of amoxicillin/clavulanate within stewardship frameworks, synthesizing its pharmacological characteristics, clinical evidence, and relevance in both Italian and global contexts. The combination of amoxicillin with the β-lactamase inhibitor clavulanic acid provides broad activity against key respiratory pathogens such as Haemophilus influenzae, and Moraxella catarrhalis, including β-lactamase-producing strains. Evidence from randomized controlled trials and meta-analyses demonstrates high bacteriological eradication and clinical cure rates across acute bacterial rhinosinusitis, otitis media, community-acquired pneumonia, and chronic bronchitis exacerbations. In pediatric populations, amoxicillin/clavulanate has shown significant efficacy in protracted bacterial bronchitis and chronic wet cough. Comparative data confirm its equivalence or superiority to macrolides and fluoroquinolones while maintaining a lower resistance selection potential and favorable tolerability. The integration of WHO AWaRe targets, Italian stewardship recommendations, and robust clinical evidence underscores the central role of amoxicillin/clavulanate in rational antibiotic prescribing. Its stewardship-aligned use - emphasizing short-course therapy, targeted prescribing, and avoidance in viral syndromes - represents a pragmatic and evidence-based strategy to optimize treatment outcomes while contributing to AMR mitigation in both national and global contexts.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240628","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":"Therapeutic approaches in the management of chronic kidney disease: the past, the present, and the future.","authors":"Georgia Doumani, Panagiotis Theofilis, Aikaterini Vordoni, Despina Smirloglou, Rigas G Kalaitzidis","doi":"10.23736/S0026-4806.25.09747-2","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09747-2","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) remains a major global health burden, contributing significantly to morbidity, mortality, and healthcare costs. Over the past century, therapeutic approaches to CKD have evolved substantially, reflecting advances in the understanding of renal pathophysiology. Early strategies centered around dietary interventions, notably low-protein diets, aimed at mitigating the progression of renal impairment. Subsequently, rigorous blood pressure control and the introduction of renin-angiotensin-aldosterone system (RAAS) blockade with ACE inhibitors and ARBs markedly improved renal outcomes. In the modern era, the emergence of sodium-glucose cotransporter 2 (SGLT2) inhibitors, non-steroidal mineralocorticoid receptor antagonists (nsMRAs) such as finerenone, and glucagon-like peptide-1 receptor agonists (GLP-1RAs) has redefined the therapeutic landscape, offering robust cardiorenal protection. Despite these advances, CKD often remains a progressive disease, underscoring the need for continued innovation. Future therapeutic strategies, including aldosterone synthase inhibitors, soluble guanylate cyclase activators, and therapies currently in preclinical development - such as gene-editing technologies, novel peptide therapies, and renal regenerative approaches - aim to target the fundamental drivers of CKD progression. These emerging modalities hold the promise not merely of slowing disease progression but potentially restoring renal function. As the field moves toward personalized, mechanism-based interventions, early diagnosis and prompt initiation of therapy will remain pivotal. This review traces the historical evolution of CKD management, highlights contemporary advances, and explores the exciting horizon of future therapeutic opportunities.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234838","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}
Minerva medicaPub Date : 2025-09-26DOI: 10.23736/S0026-4806.25.09737-X
João V Fernandes, João V Ramos, Maurus M Holanda
{"title":"Intravenous recombinant human prourokinase for acute ischemic stroke: a network meta-analysis.","authors":"João V Fernandes, João V Ramos, Maurus M Holanda","doi":"10.23736/S0026-4806.25.09737-X","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09737-X","url":null,"abstract":"<p><strong>Introduction: </strong>Acute ischemic stroke (AIS) requires prompt thrombolytic therapy to restore cerebral perfusion. Recombinant human prourokinase (rhPro-UK) has emerged as a potential alternative to standard agents, but the optimal dosage remains unclear.</p><p><strong>Evidence acquisition: </strong>A systematic review and network meta-analysis was conducted using PubMed and Embase up to January 27, 2025. Eligible studies were randomized controlled trials (RCTs) comparing intravenous rhPro-UK dosages in adults with AIS. Outcomes included changes in NIHSS scores (24 hours and 7 days), mRS scores (0-1 and 0-2), all-cause mortality, serious adverse events (SAEs), and symptomatic intracranial hemorrhage (SIH). Data were analyzed using a Bayesian random-effects model in R (v4.4.2), with results reported as mean differences (MDs), odds ratios (ORs), and risk differences (RDs) with 95% confidence intervals (CIs).</p><p><strong>Evidence synthesis: </strong>Eight RCTs (N.=4309; mean age 64.7 years; 33.1% female) were included. Both 35 mg and 50 mg rhPro-UK improved NIHSS scores at 24 hours (MD: -1.03 and -0.44) and 7 days (MD: -1.19 and -0.86) versus standard care. The combination of 40 mg rhPro-UK + alteplase (ALT) showed the highest probability of achieving mRS 0-2 (OR: 1.59). The 50 mg dose was associated with increased mortality (OR: 2.34), while the 35 mg dose had the highest estimated SIH risk (OR: 4.73).</p><p><strong>Conclusions: </strong>Both 35 mg and 50 mg rhPro-UK improve early neurological outcomes. However, 40 mg rhPro-UK + ALT may offer the most favorable efficacy-safety profile. Further trials are warranted to optimize dosing strategies.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152494","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}
Minerva medicaPub Date : 2025-09-11DOI: 10.23736/S0026-4806.25.09709-5
Alessandro Perencin, Chiara Ceolin, Mario V Papa, Benedetta DI Marzio, Bruno M Zanforlini, Maria Devita, Chiara Curreri, Giulia Gasparini, Giuseppe Sergi, Marina DE Rui
{"title":"Glucagon-like peptide-1 receptor agonists and its possible nephroprotective role: a systematic review.","authors":"Alessandro Perencin, Chiara Ceolin, Mario V Papa, Benedetta DI Marzio, Bruno M Zanforlini, Maria Devita, Chiara Curreri, Giulia Gasparini, Giuseppe Sergi, Marina DE Rui","doi":"10.23736/S0026-4806.25.09709-5","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09709-5","url":null,"abstract":"<p><strong>Introduction: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are commonly used to manage type 2 diabetes (T2DM), offering benefits not only for blood sugar control but also potentially for kidney health. While some studies have looked at kidney function, no review has specifically focused on how these medications impact kidney health in people with diabetes.</p><p><strong>Evidence acquisition: </strong>We conducted a review of existing studies following established guidelines. We searched databases like PubMed, Embase, Web of Science, and the Cochrane Library for studies that examined kidney outcomes - such as estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) - in T2DM patients treated with GLP-1RAs. We also assessed the quality of these studies using well-known bias risk tools.</p><p><strong>Evidence synthesis: </strong>We included 13 studies, including clinical trials and observational research. Overall, the findings suggest that GLP-1RAs may help slow the decline in kidney function, reduce proteinuria and improve other kidney health markers in people with T2DM. However, the results weren't consistent - some studies showed clear benefits, while others found little to no effect.</p><p><strong>Conclusions: </strong>This review highlights the potential for GLP-1RAs to protect kidney function in people with type 2 diabetes. Although the evidence is encouraging, the differences between studies suggest the need for more large-scale, well-designed trials to confirm these effects and help guide treatment decisions.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035030","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":"Short-wave diathermy in the rehabilitation management of tension-type headache associated with neck pain: a case-control study.","authors":"Alessandro Picelli, Rita DI Censo, Diletta Lorenzoni Inama, Cecilia Angeli, Tullio Malgrati, Marta Cappellesso, Vittorio Schweiger, Alvise Martini, Valentina Varalta, Nicola Smania, Mirko Filippetti","doi":"10.23736/S0026-4806.25.09756-3","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09756-3","url":null,"abstract":"<p><strong>Background: </strong>Tension-type headache is the most prevalent neurological disorder worldwide and is frequently associated with neck pain. Musculoskeletal dysfunctions of the cervical spine are commonly reported in patients with tension-type headache, suggesting a potential therapeutic role for physical rehabilitation. Short-wave diathermy is a deep-heating modality known to increase pain thresholds, reduce muscle spasm, and enhance soft tissue extensibility. The aim of this study was preliminary to assess the effectiveness of short-wave diathermy as an adjunct to conventional rehabilitation for adults with tension-type headache associated with neck pain.</p><p><strong>Methods: </strong>This single-center case-control observational study retrospectively analyzed data of 42 adult patients with persistent tension-type headache and neck pain were included. Cases received short-wave diathermy (20 minutes) combined with myofascial release (pompage technique, 20 minutes), while controls underwent pompage and therapeutic neck exercises (20 minutes each). All participants completed ten 45-minute sessions over five weeks. Primary outcome was pain intensity (Numerical Pain Rating Scale). Secondary outcomes included disability (Neck Disability Index) and pressure pain threshold. Assessments were conducted before and one week after treatment completion.</p><p><strong>Results: </strong>After treatment, the Case group showed significantly greater improvements compared to controls in neck pain (P=0.03) and disability (P=0.04). No significant between-group differences were observed in pressure pain threshold measurements at cervical sites.</p><p><strong>Conclusions: </strong>Preliminary findings suggest that short-wave diathermy may serve as a useful adjunct in the rehabilitation of adults with tension-type headache associated with neck pain. Larger randomized controlled studies are needed to confirm these results.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984323","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}
Minerva medicaPub Date : 2025-08-01Epub Date: 2025-04-24DOI: 10.23736/S0026-4806.25.09637-5
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
{"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":"10.23736/S0026-4806.25.09637-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of this pilot, efficacy supplement registry was to use a supplementary management with berberine to control hyperlipidemia. Berberine (Berbevis<sup>™</sup> as Sophy<sup>®</sup> 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.</p><p><strong>Methods: </strong>One group used berberine supplementation and a standard management (SM), while a second comparative group used only SM.</p><p><strong>Results: </strong>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<0.05) and HDL was significantly improved (P<0.5). Triglycerides decreased in the berberine groups (P<0.05), more than in controls. Oxidative stress was significantly more decreased with berberine supplementation (P<0.05). Homocysteine (within normal values) were significantly decreased at 3 and 6 months (P<0.05). Fasting glucose was decreased in the berberine group - at 3 and 6 months - in comparison with controls (P<0.05). Also, glycosylated hemoglobin was reduced with berberine (P<0.05) more than in the SM group. Body weight was also significantly more decreased (P<0.05) with berberine supplementation. The fat proportion also decreased significantly more (P<0.05) with the supplement (P<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<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<0.05) with berberine, in comparison with controls, at 3 and 6 months.</p><p><strong>Conclusions: </strong>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":"285-291"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","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}
Minerva medicaPub Date : 2025-08-01Epub Date: 2025-05-15DOI: 10.23736/S0026-4806.25.09706-X
Isa G Rodrigues, Jose Moreno-Navarrete, José M Fernández-Real
{"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":"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":"329-349"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","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}
Minerva medicaPub Date : 2025-08-01Epub Date: 2025-04-15DOI: 10.23736/S0026-4806.25.09631-4
Aikaterini Selntigia, Francesco Gebbia, Ana Del Arco, Antonio Pellicer, Daniela Galliano
{"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":"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":"300-308"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","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}
Minerva medicaPub Date : 2025-08-01Epub Date: 2025-05-15DOI: 10.23736/S0026-4806.25.09660-0
L Maximilian Buja, Sonya E Fogg
{"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":"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":"292-299"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","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}
Minerva medicaPub Date : 2025-08-01Epub Date: 2024-07-04DOI: 10.23736/S0026-4806.24.09353-4
Xuehua Xu, Hanqi Yu
{"title":"Constructing a needs-based collaborative care model for preterm infants and their families.","authors":"Xuehua Xu, Hanqi Yu","doi":"10.23736/S0026-4806.24.09353-4","DOIUrl":"10.23736/S0026-4806.24.09353-4","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"360-361"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500015","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}