Minerva medica最新文献

{"title":"Tumor-induced osteomalacia: a 2026 update.","authors":"Salvatore Minisola, Seiji Fukumoto, Alessandro Corsi, Luciano Colangelo, Mara Riminucci, Alfredo Scillitani, Jessica Pepe, Cristiana Cipriani","doi":"10.23736/S0026-4806.26.09744-2","DOIUrl":"10.23736/S0026-4806.26.09744-2","url":null,"abstract":"<p><p>Tumor-induced osteomalacia (TIO) is an ultrarare paraneoplastic syndrome caused by overproduction of fibroblast growth factor 23 (FGF23). There is low awareness of the disease so that TIO is underdiagnosed. In addition, symptoms reported by patients with TIO are usually nonspecific thus rendering the diagnosis difficult to be made. Biochemical hallmarks are represented by hypophosphatemia, increased or inappropriately normal levels of FGF23, low to low normal circulating 1,25(OH)<inf>2</inf>D and renal phosphate wasting. From the histological point of view, phosphaturic mesenchymal tumors are the entities responsible in majority of cases. Tumors causing TIO are generally of small size and grow slowly. There are a number of functional and anatomical imaging techniques utilized for tumor localization; ⁶⁸Ga DOTA based technologies have the better sensitivity and specificity in respect to other techniques. Surgery is the treatment of choice; in a very few selected cases non pharmacological and pharmacological treatment are available.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"207-222"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400118","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":"Hypertension management: is lower always better?","authors":"Ahmed B Shamsulddin","doi":"10.23736/S0026-4806.26.09891-5","DOIUrl":"10.23736/S0026-4806.26.09891-5","url":null,"abstract":"<p><p>Systemic arterial hypertension remains the leading modifiable risk factor for cardiovascular mortality, yet the optimal blood pressure target remains a subject of intense global debate. While recent American guidelines advocate for a lower diagnostic threshold (≥130/80 mmHg), European and Asian guidelines largely maintain a conservative threshold (≥140/90 mmHg). This narrative review addresses the central clinical question: \"Is lower always better?\" We synthesize evidence from landmark trials, including SPRINT and STEP, which demonstrate that intensive systolic blood pressure control (<120-130 mmHg) significantly reduces cardiovascular events and mortality, particularly in high-risk phenotypes such as resistant hypertension. However, this benefit is not without cost. We discuss the physiological \"J-curve,\" the increased risk of adverse events such as hypotension and acute kidney injury, and emerging concerns regarding the long-term durability of stroke prevention observed in the ESPRIT trial. Furthermore, the dominant narrative of \"intensification\" is challenged by the recent STOP-Trial, which validated a framework for safe de-prescribing in low-risk hypertensive patients using home-based monitoring. Crucially, the divergent findings of the CREOLE and TOPSPIN trials reveal that therapeutic efficacy varies profoundly by ethnicity and geography, rendering a \"one-size-fits-all\" approach obsolete. We conclude that while intensive control is a life-saving opportunity for high-risk cohorts, it is not a universal mandate. The future of hypertension management lies in the transition from a single numerical target toward precision medicine - utilizing pharmacogenomics and population-specific strategies to maximize protection while minimizing harm, mandating development of \"population-based guidelines\" aiming for personalized blood pressure targets.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"231-246"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213858","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":"Diagnostic accuracy of the Gugging Swallowing Screen and exploratory submental ultrasonographic findings in dysphagia screening for Parkinson disease: a retrospective cross-sectional study using videofluoroscopy as reference standard.","authors":"Rita DI Censo, Mirko Filippetti, Alessandro Zadra, Valentina Businaro, Riccardo Guarise, Sarah Ottaviani, Bruno Bonetti, Vittorio Schweiger, Nicola Smania, Valentina Varalta, Alessandro Picelli","doi":"10.23736/S0026-4806.26.09915-5","DOIUrl":"10.23736/S0026-4806.26.09915-5","url":null,"abstract":"<p><strong>Background: </strong>Oropharyngeal dysphagia is common in Parkinson's disease, but it may remain clinically silent until complications occur. Bedside screening is widely used in routine care, although its diagnostic accuracy remains uncertain. Submental ultrasonography has emerged as a non-invasive adjunct for bedside assessment of swallowing-related structures and movement.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, institutional records of adults with Parkinson's disease assessed between October 2021 and June 2023 were analyzed. Bedside swallowing screening was performed with the Gugging Swallowing Screen. Submental ultrasonography was used to measure tongue thickness and hyoid-thyroid approximation during swallowing. Videofluoroscopic swallowing study served as the reference standard. Swallowing safety was classified as safe or unsafe according to the Penetration-Aspiration Scale, with unsafe swallowing defined as a score of 3-8. The primary outcome was the diagnostic performance of the Gugging Swallowing Screen for identifying unsafe swallowing on videofluoroscopic swallowing study.</p><p><strong>Results: </strong>Thirty-nine participants were enrolled, and 36 completed videofluoroscopic swallowing study. A positive Gugging Swallowing Screen result was observed in 7 of 36 participants, corresponding to 19.4%, whereas unsafe swallowing on videofluoroscopic swallowing study was observed in 12 of 36 participants, corresponding to 33.3%. The Gugging Swallowing Screen showed moderate discriminative ability, with an area under the curve of 0.792. Sensitivity was 58.3%, specificity was 100%, overall accuracy was 86.1%, positive predictive value was 100%, and negative predictive value was 82.8%. Participants with unsafe swallowing had lower tongue thickness and shorter resting and minimum hyoid-thyroid distances.</p><p><strong>Conclusions: </strong>In Parkinson's disease, the Gugging Swallowing Screen may help prioritize referral for instrumental assessment, particularly when abnormal, but it cannot reliably exclude unsafe swallowing when used in isolation. Submental ultrasonographic measures differed between videofluoroscopy-defined swallowing-safety groups; however, their diagnostic utility, optimal cut-offs, and incremental value over the Gugging Swallowing Screen require prospective validation.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"199-206"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595248","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":"MetALD-ALD patients: fate changes in relation to the specialist they meet.","authors":"Gianni Testino","doi":"10.23736/S0026-4806.26.09931-3","DOIUrl":"10.23736/S0026-4806.26.09931-3","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"182-184"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439841","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":"Smoking, healthy lifestyle and adolescence.","authors":"Gianni Testino, Patrizia Balbinot","doi":"10.23736/S0026-4806.26.09936-2","DOIUrl":"https://doi.org/10.23736/S0026-4806.26.09936-2","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393006","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 adherence and health literacy: a perfect match in dyslipidemic patients.","authors":"Beatrice Dal Pino, Andrea Ripoli, Carmen Corciulo, Francesco Sbrana","doi":"10.23736/S0026-4806.26.09899-X","DOIUrl":"https://doi.org/10.23736/S0026-4806.26.09899-X","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267485","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":"Efficacy and safety of oral tapentadol for cancer-related pain: an updated systematic review and meta-analysis.","authors":"Blanca Núñez-Morales, Adriana Bada-Ortí, Laura Rodríguez DE LA O, María Varela-Sánchez, Fernando Neria-Serrano, Beatriz Chacón-Ovejero, Vilma Pacheco-Barcia, Luis Cabezón-Gutiérrez","doi":"10.23736/S0026-4806.26.09857-5","DOIUrl":"10.23736/S0026-4806.26.09857-5","url":null,"abstract":"<p><strong>Background: </strong>This systematic review aims to evaluate the efficacy, safety, and tolerability of oral tapentadol in the management of cancer-related pain in adults. It updates the 2015 Cochrane review on the same topic by including newer trials up to March 2024.</p><p><strong>Methods: </strong>A systematic search of Medline (via PubMed), the Cochrane Central Register of Controlled Trials, and references from the previous review was conducted. Randomized controlled trials comparing oral tapentadol with placebo or other opioids (e.g., morphine, oxycodone, tramadol/paracetamol) in adults with chronic cancer pain were included. The main outcomes assessed were pain reduction, need and dose of rescue medication, adverse events, treatment discontinuation, and patient-reported global impression of change. Risk of bias was evaluated using the Cochrane tool. Meta-analyses were performed using a random-effects model.</p><p><strong>Results: </strong>Five randomized controlled trials comprising 1152 patients were included. Across all outcomes evaluated, there was no significant difference between tapentadol and comparator opioids. Pain reduction was comparable (MD=-0.06; 95% CI: [-0.44, 0.31]), as were adverse effects (RR=0.98; 95% CI: [0.90, 1.08]), need for rescue medication (RR=1.07; 95% CI: [0.93, 1.22]), and dropout rates (RR=1.10; 95% CI: [0.87, 1.40]). All outcomes were rated as inconclusive due to overlapping confidence intervals with the null effect. The overall risk of bias was high in three studies and unclear in two.</p><p><strong>Conclusions: </strong>Tapentadol demonstrated similar efficacy and safety compared to other opioids for cancer-related pain, with no evidence of superiority. Given the limited number and methodological quality of studies, further high-quality trials are needed to establish more robust conclusions.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":"117 3","pages":"126-138"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274364","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":"Medical journalism: a primer for healthcare professionals and journalists in the artificial intelligence era.","authors":"Ambra Cerri, Massimo Boni, Domenico M Giamundo, Giuseppe Biondi-Zoccai, Federico Mereta, Raffaella Cesaroni, Margherita DE Bac, Francesco Versaci","doi":"10.23736/S0026-4806.26.09871-X","DOIUrl":"10.23736/S0026-4806.26.09871-X","url":null,"abstract":"<p><p>Medical journalism is undergoing rapid renewal in a digital environment that accelerates discovery, conversation, and scrutiny across borders. Its purpose extends beyond transmitting facts, aiming to transform evidence into comprehension and comprehension into responsible action for individuals, institutions, and policy. Journalists curate credibility by verifying claims, contextualizing uncertainty, and translating complex study designs, while clinicians expand their societal role by communicating clearly beyond clinical settings. Collaboration between these communities strengthens public understanding and aligns scientific accuracy with narrative clarity, particularly when stakes are high. Ethical foundations remain central: accuracy, independence, transparency, respect for privacy, and avoidance of harm guide reporting choices that shape trust. Interpreting evidence requires attention to design quality, bias, effect size, and clinical relevance, presenting findings in plain language without sensational framing. Healthcare institutions and research centers must also act as reliable anchors within this ecosystem, providing transparent, verifiable data and methodological clarity to support responsible communication. The infodemic challenges all participants, as misinformation spreads quickly through emotionally charged content and algorithmic amplification that reward novelty over truth. Restoring trust calls for humility, timely corrections, consistent messages, and investment in media literacy for citizens and professionals. Artificial intelligence (AI) introduces powerful capabilities for discovery, summarization, personalization, and verification, yet also new risks such as hidden bias and synthetic content. A responsible medical media ecosystem demands shared literacy, collaborative practice, and ethical stewardship today. In this regard, medical communication must increasingly be regarded as a public good, sustained by the joint responsibility of journalists, clinicians, healthcare institutions, and citizens.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"161-175"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694405","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":"Use of the neurostimulator in thyroidectomy procedures: comparison between vagal and recurrent laryngeal nerve stimulation.","authors":"Alessandra D'Orazio, Elena S Orlandoni, Perla Capomagi, Maddalena Baldarelli, Giovanni Lezoche, Mario Guerrieri","doi":"10.23736/S0026-4806.26.09888-5","DOIUrl":"10.23736/S0026-4806.26.09888-5","url":null,"abstract":"<p><strong>Background: </strong>Recurrent laryngeal nerve (RLN) dysfunction represents one of the most feared complications of thyroid surgery, with significant impacts on patients' quality of life due to the potential paralysis of the vocal cords. Although nerve transection is rare, functional loss - non-structural and invisible to the human eye - is the primary cause of this complication. Intraoperative nerve monitoring (IONM), introduced more than 50 years ago and significantly improved over the past decade, represents a crucial tool for preventing this outcome.</p><p><strong>Methods: </strong>This retrospective observational study involves patients undergoing total or partial thyroidectomy at a specialized center in Italy from 2023 to the present and aims to compare the predictive effectiveness of vagus nerve (VN) stimulation versus RLN stimulation, evaluating three techniques (C-IONM, I-IONM, and No-IONM). All patients were monitored using a NIM system (NIM Avalanche SI2), with pre- and postoperative laryngoscopic evaluation.</p><p><strong>Results: </strong>Among 378 patients undergoing thyroid surgery, no significant differences in baseline demographics were observed among groups. The absence of intraoperative neuromonitoring was associated with a significantly higher risk of permanent vocal cord paralysis compared with I-IONM (OR 4.84, P=0.012). C-IONM showed no cases of permanent paralysis and was associated with significantly shorter operative time and reduced length of hospital stay compared with both intermittent monitoring and no monitoring.</p><p><strong>Conclusions: </strong>I-IONM significantly improves neurological safety in thyroid surgery. C-IONM provides the most favorable overall profile, combining comparable safety with improved operative efficiency and postoperative recovery, and represents a promising strategy for further optimization of surgical outcomes.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":"117 3","pages":"115-125"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274403","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":"How to become a centenarian in four weeks?. Myths and limits of longevity recipes: a critical review.","authors":"Michel Poulain, Anne Herm","doi":"10.23736/S0026-4806.26.09890-3","DOIUrl":"https://doi.org/10.23736/S0026-4806.26.09890-3","url":null,"abstract":"<p><p>This critical narrative review examines the widespread belief that exceptional longevity can be achieved through simple behavioral \"recipes,\" frequently promoted in media and commercial discourse. Drawing on research in demography, epidemiology, gerontology, and genetics, the article reassesses commonly cited determinants of extreme longevity, including nutrition, physical activity, social environment, psychological resilience, and genetic factors. Emphasis is placed on the analytical value of studying populations characterized by unusually high survival at advanced ages, commonly referred to as \"longevity Blue Zones.\" Whereas studies of individual centenarians provide only limited evidence linking specific behaviors to survival beyond age 100, population-level observation of validated longevity regions offers a complementary and especially informative framework. Analyses of these populations help identify long-term configurations of social, environmental, and behavioral conditions associated with exceptional survival. Recurrent features include lifelong moderate physical activity embedded in daily routines, relatively stable and frugal dietary patterns, dense family and community networks, and culturally embedded mechanisms of stress regulation and meaning. Although none of these factors alone determines extreme longevity, their sustained interaction across the life course appears to increase the probability of surviving to very advanced ages. The review underscores the importance of distinguishing determinants of healthy ageing from those of exceptional survival. Rather than proposing prescriptive formulas, the study of longevity populations provides a population-based observational model for identifying favorable life-course conditions that support extreme longevity. Such insights are valuable for promoting healthier ageing trajectories while acknowledging the multifactorial and probabilistic nature of survival to extreme ages.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":"117 3","pages":"147-160"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274393","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}