Minerva medica最新文献

{"title":"Pitfalls in contrast enhanced ultrasound: lack of washout in malignant liver lesions. A scoping review.","authors":"Kathleen Möller, Mikael Sawatzki, Christian Jenssen, Carla Serra, Sofia Bakken, Christian Görg, Yi Dong, Christoph F Dietrich","doi":"10.23736/S0026-4806.25.09658-2","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09658-2","url":null,"abstract":"<p><p>Contrast-enhanced ultrasound (CEUS) is a reliable examination procedure to differentiate benign and malignant liver lesions, which is superior to contrast enhanced computed tomography (CECT) and equally to contrast enhanced magnetic resonance imaging (CEMRI) in large comparative studies. In this review, the data on the enhancement of malignant liver lesions in the late phase in CEUS are analyzed in detail. Hypoenhancement in the late phase on CEUS with SonoVue^® is a typical feature of metastases and other malignant tumors. However, this is not guaranteed in every case. It is explicitly analyzed in the present studies which malignant lesions did not demonstrate washout in the late phase with SonoVue^®. Lack of washout is known for some hepatocellular carcinomas. However, there are also a few rare exceptions described for metastases of neuroendocrine tumors. The possible causes are analyzed. While metastases and cholangiocellular carcinoma demonstrate an early marked washout, this can start very late in neuroendocrine metastases. Some predominantly well differentiated hepatocellular carcinomas in the cirrhotic liver may also show no or only very delayed and faintly washout in the late phase. Isoenhancement at the beginning of the late phase does not rule out metastases or HCC (in the cirrhotic liver). This contrast behavior is known for some HCC in the cirrhotic liver, but it is atypical, poorly reported and understood, especially in liver metastases. The present review analyzes the data on isoenhancement in the late phase of malignant liver lesions. The novel aspect is the focus on liver metastases.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556322","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":"Oxidative stress in smokers with and without COPD: what variables are associated?","authors":"Aldo Pezzuto, Alberto Ricci, Antonella Tammaro, Alessia Pacini, Claudia Salvucci, Giuseppe Tonini, Valeria Minoia, Valerio Brigato, Elisa Desideri, Noemi Calabrò, Elisabetta Carico","doi":"10.23736/S0026-4806.25.09723-X","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09723-X","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress induced by cigarette smoke compounds is one of the factors responsible for bronchial inflammation and airway structural remodeling. On the other side, the individual antioxidant capacity is variable and representative of the body's immune defenses' state. The aim of this study is to detect the level of oxidative stress and anti-oxidant capacity in smokers, comparing COPD with non-COPD patients. To determine the variables associated with oxidative stress.</p><p><strong>Methods: </strong>Fifty-four patients were assessed by spirometry and questionnaires such as CAT, mMRC, Fagestrom's. The exhaled carbon monoxide (eCO) was measured in order to assess smoking exposure. Serum vitamin-D level was also detected. All patients underwent treatment for smoking cessation by Cytisine, an alkaloid partial agonist of the nicotinic acetylcholine receptor. The diagnosis of COPD was determined based on FEV1/FVC ratio <70%. Oxidative stress and anti-oxidant capacity were determined on a saliva sample using commercial assays, after the last cigarette smoked. Data were analyzed using non-parametric statistical tests.</p><p><strong>Results: </strong>In the overall population, the average value of the pack-years index was 40, the Fagestrom's mean value was 5, BMI was 26, exhaled CO (eCO) was 27 ppm. Comparing the two subgroups, COPD and no-CODP, they were comparable in age, Fagestrom's, pack-years. They obviously differed in the functional variables. The d-ROMs value was significantly higher in smokers who had not developed COPD (P<0.01). This group had a lower level of vitamin D than the COPD group (P<0.03), a different value of cigarettes/day (P<0.0001) as well as the value of eCO were detected (P<0.01). In multiregression analysis d-ROMs value is correlated with pack-years and cigarette/day values. d-ROMs, cigarettes/day, vitamin D value were factors affecting COPD.</p><p><strong>Conclusions: </strong>Our results confirm that tobacco smoking causes oxidative stress, and it is associated with pack-years index and cigarettes/day. COPD patients with a high vitamin D level are protected from oxidative stress.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556321","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":"An overview of the role of serum uric acid to high-density lipoprotein cholesterol ratio in type 2 diabetes mellitus and in other inflammatory and metabolic conditions.","authors":"Gulali Aktas","doi":"10.23736/S0026-4806.25.09712-5","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09712-5","url":null,"abstract":"<p><p>The serum uric acid to HDL cholesterol ratio (UHR) has emerged as a novel biomarker linking metabolic dysfunction and inflammation. Elevated UHR reflects a complex interplay between oxidative stress, endothelial dysfunction, and lipid metabolism, contributing to systemic inflammation and disease progression. Recent studies suggest that UHR may serve as a predictive marker for cardiometabolic risk, offering potential advantages over traditional lipid and uric acid measurements alone. However, the underlying mechanisms remain incompletely understood, and standard reference values have yet to be established. Further research is needed to elucidate the causal relationships and assess the clinical utility of UHR in disease risk stratification and management. Understanding the role of UHR in metabolic and inflammatory pathways could enhance early detection and intervention strategies for at-risk individuals. This review elaborates the role of UHR in various metabolic and inflammatory conditions, including type 2 diabetes mellitus, diabetic chronic complications, metabolic syndrome, cardiovascular disease, insulin resistance, and chronic inflammatory states.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546679","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":"Impact of age, sex, and urban environment on allergen-specific IgE profiles to grass pollen components: a cross-sectional study in Northern Italy.","authors":"Mara DE Amici, Claudio Tirelli, Fiorella Barocci, Lucia Sacchi, Amelia Licari, Alessia Marseglia, Angelo G Corsico, Vanessa Ronzoni, Gian L Marseglia","doi":"10.23736/S0026-4806.25.09673-9","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09673-9","url":null,"abstract":"<p><strong>Background: </strong>Asthma and rhino-conjunctivitis are frequently triggered by sensitization to airborne allergens, particularly grass pollens. This study aimed to assess whether age, sex, and living environment influence allergen-specific IgE responses to grass pollen components, using a molecular diagnostic approach.</p><p><strong>Methods: </strong>A total of 772 patients referred to the Allergology outpatient clinic for suspected grass pollen allergy were enrolled. Allergen-specific IgE levels were measured using the ImmunoCAP ISAC microarray. Patients were stratified into nine groups based on age, sex, and city of residence (Milan, Pavia, and surrounding rural/suburban areas). Sensitization to nine grass pollen components (Cyn d 1, Phl p 1, Phl p 2, Phl p 4, Phl p 5, Phl p 6, Phl p 7, Phl p 11, and Phl p 12) was analyzed.</p><p><strong>Results: </strong>Sensitization patterns varied by sex, age group, and place of residence. Male patients showed higher IgE positivity for Phl p 2 and Phl p 6. Overall, the highest sensitization rates were observed in adolescents and in patients living in Milan. Cyn d 1, Phl p 1, Phl p 4, and Phl p 5 showed widespread sensitization across all groups, though rates were higher in males and in urban areas.</p><p><strong>Conclusions: </strong>This cross-sectional study highlights that demographic and environmental factors - particularly sex, age, and urban living - can influence IgE sensitization to grass pollen components. These findings emphasize the relevance of molecular diagnostics in understanding allergy epidemiology and support the hypothesis that environmental exposure, including air pollution, may affect sensitization profiles.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532105","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":"Heart failure with preserved ejection fraction and atrial fibrillation.","authors":"Thibault Lenormand, Arnaud Bisson, Laurent Fauchier","doi":"10.23736/S0026-4806.25.09602-8","DOIUrl":"10.23736/S0026-4806.25.09602-8","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) are common diseases, inducing increased morbidity and mortality when associated. In this narrative review, we report available evidence in the literature regarding the pathophysiology behind this association, its impact on prognosis, and the therapeutic management of both entities. AF and HFpEF share several pathophysiological mechanisms, most notably inflammation, electrical and structural remodeling of the left atrium with fibrosis and involvement of epicardial adipose tissue, all concurring to left atrial myopathy. AF and HFpEF furthermore favor one another, showing their intricated pathophysiology. The presence of AF in HFpEF worsens patients' prognosis, as does the presence of HFpEF in AF patients. Data on the specific management of this subgroup of patients is scarce. SGLT2 inhibitors appear as the cornerstone of HFpEF treatment, with the same benefit in AF patients. AF management however is less clear, apart for the need for anticoagulation based on the CHA2DS2-VA score. Rate control therapy and rhythm control therapy are in balance for symptom control. Overall, holistic approaches offer the most promises in these comorbid patients. AF and HFpEF partner in comorbid patients and worsen general prognosis. Their management is complex, as is their pathophysiology, and holistic strategies may be the most appropriate way to provide efficient care in these patients.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"234-248"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723053","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":"Treatment of autoimmune hemolytic anemia: novel and investigational approaches.","authors":"Sigbjørn Berentsen","doi":"10.23736/S0026-4806.25.09617-X","DOIUrl":"10.23736/S0026-4806.25.09617-X","url":null,"abstract":"<p><strong>Introduction: </strong>Autoimmune hemolytic anemia (AIHA) is a heterogeneous group of diseases. While corticosteroids remain first-line therapy for the warm-antibody types (wAIHA), they are ineffective in cold agglutinin disease (CAD). During the last couple of decades, several new established or investigational treatment options have appeared. These advances have resulted in improvements of therapy, but also raised new challenges.</p><p><strong>Evidence acquisition: </strong>This review aims at providing an update on AIHA treatment with focus on novel and investigational approaches. PubMed was searched for original research articles and reviews from 2000 through 2024. Selected case reports, published congress presentations, book chapters, and older articles were included when considered relevant.</p><p><strong>Evidence synthesis: </strong>Pathogenetic features and diagnostic workup in AIHA are briefly outlined, and existing therapies for the respective subtypes are reviewed. The evidence for new documented therapies is described, including erythropoietin, fostamatinib, and bortezomib-based combinations in wAIHA; and complement-directed therapies in CAD. Investigational and experimental therapies are also addressed, including inhibitors of the neonatal Fc receptor, cytokine inhibitors, complement blockers, Bruton tyrosine kinase inhibitors, and plasma cell-directed approaches in wAIHA; and Bruton tyrosine kinase inhibitors, plasma-cell directed therapies, novel complement inhibitors, cytokine antagonists, and novel monoclonal antibodies in CAD.</p><p><strong>Conclusions: </strong>Exact diagnostic workup is critical for selection of optimal therapy in AIHA. While therapy is becoming increasingly evidence-based, several unmet needs remain. The ideal therapy has not been found for wAIHA or CAD, and evidence-based options are largely lacking for the still rarer subtypes. Patients with AIHA should be considered for clinical trials.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"249-264"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675103","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":"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":"171-178"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","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":"Correction to: The administration of S. salivarius K12 to children may reduce the rate of SARS-CoV-2 infection.","authors":"Francesco Di Pierro, Maria Colombo","doi":"10.23736/S0026-4806.25.09743-5","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09743-5","url":null,"abstract":"<p><p>This article was published in Volume 112, issue 4 of publishing year 2021, with a mistake in the text and in Table I. The corrections to the text and the correct Table I are the ones included in this erratum. Page 514, second full paragraph, line 30 should read as follows: \"According to Table I, a nasal swab (rapid test) for detection of SARS-CoV-2 specific antigen was performed in 33 countries and in 46 children, respectively, in the treated and in the control groups.\"</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":"116 3","pages":"284"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287683","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":"Psoriasis and diabetes: a review of the pathophysiological and therapeutic interconnections.","authors":"David A De Luca, Cristian Papara, Tomasz Hawro, Diamant Thaçi","doi":"10.23736/S0026-4806.24.09570-3","DOIUrl":"10.23736/S0026-4806.24.09570-3","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a chronic, immune-mediated skin disorder associated with systemic conditions like cardiovascular diseases, metabolic syndrome, and type 2 diabetes mellitus. Individuals with psoriasis show a higher risk of diabetes compared to the general population. This review aims to examine the relationship between the physiopathology and treatment of psoriasis and diabetes mellitus.</p><p><strong>Evidence acquisition: </strong>A systematic search was conducted across PubMed and Google Scholar up to July 2024. Observational studies and clinical trials involving all age groups and genders were included, focusing on the pathophysiology, inflammatory pathways, and therapeutic interventions for psoriasis and diabetes.</p><p><strong>Evidence synthesis: </strong>Evidence consistently showed an increased prevalence of type 2 diabetes among psoriasis patients. The IL-23/IL-17 axis plays a critical role in the inflammation driving both psoriasis and insulin resistance. This inflammation promotes metabolic syndrome components such as obesity. Conversely, insulin resistance and obesity amplify systemic inflammation, creating a vicious cycle in psoriasis patients. Integrated treatment approaches, combining targeted pharmacologic therapies with lifestyle modifications, demonstrated potential in managing both conditions effectively. Multidisciplinary care is vital to address the dermatological and metabolic aspects of these interconnected diseases.</p><p><strong>Conclusions: </strong>The shared inflammatory pathways between psoriasis and type 2 diabetes highlight the complex, bidirectional relationship between the two. Integrated therapeutic strategies that include lifestyle changes and targeted drug interventions show promise in improving outcomes for individuals affected by both conditions.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"195-222"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443131","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":"Cardiovascular-kidney-metabolic syndrome and treatment advances: a narrative review.","authors":"Camilo Pena, Jackeline Flores, Kenneth Nugent","doi":"10.23736/S0026-4806.25.09607-7","DOIUrl":"10.23736/S0026-4806.25.09607-7","url":null,"abstract":"<p><p>The American Heart Association has reformulated the chronic cardiorenal syndromes into the cardiovascular-kidney-metabolic syndrome. This formulation emphasizes the importance of adipose tissue as the key element in the development of chronic diseases, including diabetes, cardiac disease, and renal disease. The pathogenesis involves multidirectional pathways which have adverse effects on the vascular system, the heart, and the kidneys. Important outcomes in these patients include coronary disease, chronic heart failure, diabetes, and renal failure. The development of new drugs, including SGLT2 inhibitors, GLP-1 agonists, and mineralocorticoid receptor blockers have provided important advances in the treatment of these patients, and multiple randomized controlled trials have reported reductions in adverse cardiac and renal outcomes. This review summarizes the clinical trials with these drugs and provides a brief discussion of their pharmacology.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"223-233"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723052","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}