Minerva medica最新文献

{"title":"Human in the loop, clinician at the helm: countering bias in medical AI.","authors":"Giovanni Volpe, Tommaso Tonetti, Amedeo Bianchini, Maria C Braccio, Andrea Zanoni","doi":"10.23736/S0026-4806.26.09977-5","DOIUrl":"https://doi.org/10.23736/S0026-4806.26.09977-5","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198256","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":"On-demand multicomponent supplementation with lactoferrin, zinc, and vitamin C during acute respiratory episodes in children with recurrent infections: a pilot retrospective observational study in primary care.","authors":"Giorgio Ciprandi, Gessica Andreoni, Lorenzo Cresta","doi":"10.23736/S0026-4806.26.09949-0","DOIUrl":"https://doi.org/10.23736/S0026-4806.26.09949-0","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077346","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":"Pulmonary hypertension in interstitial lung disease: today's realities, tomorrow's possibilities.","authors":"Debabrata Bandyopadhyay, Jorden E Smith, Huda Asif, Askin Uysal, Jose Herazo-Maya, Theodoros P Karampitsakos, Adriano R Tonelli","doi":"10.23736/S0026-4806.26.09859-9","DOIUrl":"https://doi.org/10.23736/S0026-4806.26.09859-9","url":null,"abstract":"<p><p>Interstitial lung disease-associated pulmonary hypertension (ILD-PH) is a frequent and life-limiting complication of fibrotic lung disease, associated with substantial morbidity, impaired functional capacity, and significantly reduced survival. Under-recognition remains common due to overlapping symptoms with ILD, evolving hemodynamic definitions, and the limited accuracy of current noninvasive screening tools. ILD-PH prevalence varies widely across ILD subtypes, ranging from 3-15% in early disease to more than 60% in lung transplant candidates. Even modest elevations in mean pulmonary artery pressure are prognostically meaningful, while right ventricular dysfunction represents a key determinant of mortality. Pathophysiology reflects a complex interaction between parenchymal fibrosis, chronic hypoxemia, endothelial injury, and progressive pulmonary vascular remodeling. Diagnostic evaluation requires a multimodal approach, with right heart catheterization remaining essential for definitive confirmation. Historically, vasodilator therapies have shown limited benefit; however, inhaled treprostinil has demonstrated improvements in exercise capacity, biomarkers, and clinical worsening, establishing the first evidence-based treatment for ILD-PH. Additional inhaled and targeted agents are in development, and the role of combination therapy is an emerging area of investigation. Optimal management also includes supplemental oxygen, pulmonary rehabilitation, and timely evaluation for lung transplantation. ILD-PH represents a distinct vascular phenotype requiring early detection and tailored treatment strategies. Continued advances in screening algorithms, precision therapeutics, and mechanistic research are critical to transforming ILD-PH from a terminal complication into a modifiable component of the ILD spectrum.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922286","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":"Celiac disease incidence after COVID-19 infection.","authors":"Christina Mastori-Kourmpani, Theodosios D Filippatos, Aris P Agouridis","doi":"10.23736/S0026-4806.26.09921-0","DOIUrl":"https://doi.org/10.23736/S0026-4806.26.09921-0","url":null,"abstract":"<p><strong>Background: </strong>An increased incidence of auto-inflammatory diseases, such as celiac disease (CD), has been reported following coronavirus disease 2019 (COVID-19) pandemic. The aim of this systematic review and meta-analysis was to assess whether COVID-19 is associated with CD risk.</p><p><strong>Methods: </strong>We searched MEDLINE (PubMed), Cochrane Library and Clinicaltrial.gov databases up to October 30, 2025, for studies evaluating the incidence of CD following COVID-19 infection (PROSPERO ID: CRD420251174742). We performed qualitative and quantitative syntheses of retrospective studies to evaluate the role of COVID-19 infection in CD incidence.</p><p><strong>Results: </strong>A total of 4 studies were used in the qualitative and quantitative analysis. The studies were conducted between 2023 and 2024 and included 3,465,996 exposed and 7,044,493 non-exposed COVID-19 people. The results from the pooled synthesis showed no significant difference in CD incidence among exposed and non-exposed people with COVID-19 (risk ratio [RR] 1.25, 95% confidence interval [CI; 0.94, 1.66], P=0.12, I²=87%). Similarly, no difference was observed in CD incidence between COVID-19 and non-COVID-19 patients after performing a leave-one-out sensitivity analysis (RR 1.10 95% CI [1.00, 1.22], P=0.06, I²=0%).</p><p><strong>Conclusions: </strong>These findings suggest that COVID-19 infection does not appear to increase the risk of developing CD.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665395","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 phase III, randomized, double blind, controlled trial to evaluate the efficacy and safety of a fixed combination of intramuscular diclofenac 75 mg + thiocolchicoside 4 mg, compared to diclofenac 75 mg monotherapy and placebo, in the treatment of acute low back pain.","authors":"Cosimo Costantino, Theodoros Kormas, Avraam Ploumis, Panagiotis Karampinas, Attilio Giossi, Emilio Albamonte, Chiara Busso, Ioannis Chatzikomninos, Umile G Longo, Georgios Stranjalis, Mattia Fortina, Maurizio Mancuso, Antonio Ammendolia, Panagiotis Megas, Biagio Trupa, Pierluigi Navarra","doi":"10.23736/S0026-4806.26.09906-4","DOIUrl":"https://doi.org/10.23736/S0026-4806.26.09906-4","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to demonstrate the superiority of diclofenac sodium 75 mg/thiocolchicoside 4 mg/4 mL fixed-dose combination (FDC) for intramuscular (IM) injection vs. diclofenac 75 mg alone or placebo in relieving pain in patients suffering from low back pain (LBP).</p><p><strong>Methods: </strong>Adult patients with acute moderate-severe LBP, i.e., with ≥50 mm at Visual Analogic Scale (VAS) assessment and stable muscle contracture, were randomized to receive diclofenac/thiocolchicoside FDC (N.=68), diclofenac monotherapy (N.=68) or placebo (N.=69), all given IM once-daily in two consecutive days. The primary endpoint was the sum of pain intensity difference from pre-dose to Day 3 in VAS for pain - SPID(0-3). Pain was also measured twice daily up to Day 7.</p><p><strong>Results: </strong>Mean SPID(0-3) was significantly higher with test FDC (116.2 mm) versus diclofenac (94.8 mm) and placebo (62.6 mm). The superiority of FDC over control groups was maintained up to Day 7 - SPID(0-7). Muscle contracture (expressed as Schober's index) decreased more markedly in the test group compared to controls. The results of the 24-item Roland-Morris disability questionnaire confirmed the superiority of FDC over diclofenac and placebo on physical functions. Rescue treatment (oral diclofenac) was used in fewer patients in the FDC group than in control groups. Treatment-related adverse events were reported in fewer patients in the FDC and diclofenac groups (5.9%) compared to the placebo group (16.2%).</p><p><strong>Conclusions: </strong>IM diclofenac + thiocolchicoside FDC was significantly more effective than diclofenac and placebo in the relief of pain and improvement of mobility in patients with acute moderate-severe LBP, and was well tolerated.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665346","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 accuracy of cervical lymph node puncture biopsy and angiography in the early diagnosis of head and neck cancer.","authors":"Youzhen Shi, Ping Xiong","doi":"10.23736/S0026-4806.24.09404-7","DOIUrl":"10.23736/S0026-4806.24.09404-7","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"250-253"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305102","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":"Effects of GLP1-RAs and SGLT2i on liver steatosis and fibrosis in MASLD with type 2 diabetes.","authors":"Andrea Mega, Elmar Aigner, Chiara Turri, Fabio Vittadello, Marco Dauriz, Annarosa Floreani, Luca Marzi, Rodolfo Sacco, Cristina Stasi","doi":"10.23736/S0026-4806.26.09922-2","DOIUrl":"10.23736/S0026-4806.26.09922-2","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder in individuals with type 2 diabetes mellitus (T2DM). MASLD ranges from simple liver steatosis to metabolic dysfunction-associated steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. New glucose-lowering agents have demonstrated benefits beyond glycemic regulation. This study assesses the effects of receptor agonists (GLP-1RA) and SGLT2 inhibitors (SGLT2i) on metabolic parameters, hepatic steatosis, and fibrosis in patients with MASLD and T2DM.</p><p><strong>Methods: </strong>Prospectively, 192 patients were enrolled: 132 added therapy with one novel glucose-lowering drug (GLP-1RA or SGLT2i) or their combination, and 60 patients continued with other glucose-lowering therapies (such as sulfonylureas, PPAR-γ agonists, DPP-4 inhibitors, metformin or insulin). Metabolic parameters, fibrosis indices (APRI, FIB-4, NFS, stiffness), and steatosis assessed by ultrasound-based attenuation imaging (ATT), were evaluated at baseline, 6 and 12 months.</p><p><strong>Results: </strong>The four treatment groups had comparable biochemical profiles. At 6 months, significant reductions were observed in the ALT, AST, GGT, and ALP levels (P<0.01). Both GLP-1RA and SGLT2i significantly improve glycemic control at 6 and 12 months; the reduction in HbA1c was associated with a decrease in serum cholesterol (statistically significant in the SGLT2i group). Non-invasive fibrosis scores (FIB-4, APRI, NFS) showed no significant changes; however, NFS showed modest improvement in the SGLT2i group. Liver stiffness values decreased significantly after 12 months in GLP-1RA, SGLT2i, or combination therapy groups. ATT consistently improved hepatic steatosis.</p><p><strong>Conclusions: </strong>GLP-1RA and SGLT2i improve glycemic control and reduce hepatic steatosis and stiffness in patients with MASLD and T2DM.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"185-198"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595280","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":"Tailored high-dose corticosteroids in patients with diabetes mellitus hospitalized with hypoxemic COVID-19 pneumonia: insights from the CocAA-CoLa Plus Study.","authors":"Jean-Philippe Kevorkian, Claire Vandiedonck, Hanane Bentouhami, Karl Götze, Florine Féron, Jean-Pierre Riveline, Jean-François Gautier, Bruno Mégarbane","doi":"10.23736/S0026-4806.26.09853-8","DOIUrl":"10.23736/S0026-4806.26.09853-8","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"247-250"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220637","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":"Hantavirus outbreak on a cruise ship: a lot of food for thought!","authors":"Giovanni DI Guardo","doi":"10.23736/S0026-4806.26.09926-X","DOIUrl":"10.23736/S0026-4806.26.09926-X","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"179-181"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521837","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":"Co-occurrence of sleep disturbances and perceived stress in law enforcement personnel: a systematic review and meta-analysis.","authors":"Kenzo O Donato, João V Andrade Fernandes, Maria A Pereira, Rebeca Oliveira DA Silva, Bianca S Romeo, Gabriel A Braga DE Souza, Laura Mesquita C Cunha, Akio O Donato, Kaike Costa O DE Jesus, Cristina Salles, Carolina Villa Nova Aguiar","doi":"10.23736/S0026-4806.26.09898-8","DOIUrl":"10.23736/S0026-4806.26.09898-8","url":null,"abstract":"<p><strong>Background: </strong>Police officers are exposed to chronic occupational stressors and circadian disruption, both of which are associated with impaired sleep and adverse psychological outcomes. Although prior studies have demonstrated an association between sleep disturbances and perceived stress, the magnitude of this relationship remain insufficiently synthesized. This study aimed to evaluate the association between sleep quality and perceived stress in law enforcement personnel.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to PRISMA guidelines and the Cochrane Handbook. PubMed, Web of Science, and Cochrane Library were searched for observational studies assessing sleep quality and perceived stress among police officers. Studies including participants with major psychiatric comorbidities were excluded. Data extraction and risk of bias assessment (Appraisal Tool for Cross-Sectional Studies (AXIS) tool were performed independently by two reviewers. Pooled estimates were calculated using standardized mean differences (SMD) under random-effects models, with heterogeneity assessed using the I² statistic.</p><p><strong>Results: </strong>Nine studies comprising 7550 police officers were included, with seven contributing to the meta-analysis. Poor sleep quality was associated with significantly higher perceived stress (SMD 0.76; 95% CI 0.60-0.91; I²=40.3%). Conversely, higher stress levels were associated with worse sleep outcomes (SMD 1.57; 95% CI 1.33-1.82; I²=0%). Sensitivity analyses confirmed the robustness of the results. Although funnel plots were visually inspected, formal assessment of publication bias was not feasible because of the limited number of included studies.</p><p><strong>Conclusions: </strong>There is an association between sleep quality and perceived stress among law enforcement personnel, suggesting a co-occurring cycle of physiological and psychological burden.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":"117 4","pages":"223-230"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032401","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}