Minerva medica最新文献

{"title":"Gut microbiota and iron homeostasis: implications for glycemic control.","authors":"Isa G Rodrigues, Jose Moreno-Navarrete, José M Fernández-Real","doi":"10.23736/S0026-4806.25.09706-X","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09706-X","url":null,"abstract":"<p><p>The gut microbiome, comprised of diverse microorganisms, plays a critical role in maintaining metabolic, immune, and digestive health. This dynamic ecosystem is highly influenced by external factors such as diet, genetics, environmental factors, and even medication use, including antibiotics. Iron, already bioavailable in the Archean Ocean, is one of the most abundant elements on Earth. All organisms compete or collaborate to obtain iron, demonstrating its relevance in the biological and physiological processes essential to the maintenance of metabolic homeostasis. The bidirectional relationship between the intestinal microbiota, and the host organism in obtaining iron influences both the metabolism of the host, and that of the microbiota. Bacteria in microbiota affects the absorption of iron by the organism, while factors such as iron deficiency or excess in the host modify bacterial biodiversity, its taxonomic composition and its functions. These changes impact bacterial virulence, influencing systemic iron levels, tissue storage and glucose metabolism in the host organism. Patients with changes in glucose metabolism and insulin resistance often present imbalances in iron regulation and alterations in the profile of their intestinal microbiota. The interaction between microbiota, iron and glycemia represents an emerging field of research, standing out as a promising area for nutritional and therapeutic interventions to promote metabolic health. This review explores the relationship between iron metabolism and gut microbiota, highlighting its impact on glucose metabolism.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experimental promise and clinical reality of myocardial conditioning for prevention of myocardial ischemia and reperfusion injury: an umbrella review of systematic reviews.","authors":"L Maximilian Buja, Sonya E Fogg","doi":"10.23736/S0026-4806.25.09660-0","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09660-0","url":null,"abstract":"<p><strong>Introduction: </strong>Experimental research sequentially identified reperfusion (in 1972) and conditioning (in 1986) as the two most powerful interventions for reducing acute myocardial infarct (AMI) size following acute coronary occlusion. These discoveries led to further experimental studies on optimal myocardial salvage and intensive clinical efforts to translate these interventions into the management of patients. This umbrella review of systematic reviews addresses the state of research on the effectiveness of pharmacological and interventional conditioning protocols to modulate the impact of ischemia and reperfusion in experimental animals and patients and the comparability of results in experimental animals and humans. This umbrella review documents the paradox of the experimental success of conditioning strategies in the experimental arena and equivocal clinical results of the application of the same conditioning strategies in patients.</p><p><strong>Evidence acquisition: </strong>The review was conducted using the reporting guideline for overviews of reviews of healthcare interventions codified in the PRIOR statement (https://www.equator-network.org/reporting-guidelines/reporting-guideline-for-overviews-of-reviews-of-healthcare-interventions-development-of-the-prior-statement/).</p><p><strong>Evidence synthesis: </strong>The results are summarized in the PRISMA format. A discussion is provided of known and unknown factors responsible for the lack of progress in identifying and implementing interventions to further reduce morbidity and mortality from ischemic heart disease, as well as a practical strategy to achieve timely reperfusion in a larger number of patients experiencing acute coronary syndrome.</p><p><strong>Conclusions: </strong>While awaiting further research to develop a third window of cardioprotection, the most practical approach today is to reduce the morbidity and mortality from IHD is to mount a public education campaign to get the 50% of acute coronary syndrome (ACS) patients with prodromal AMI to the hospital to institute timely reperfusion therapy which has a proven to be the most effective therapy to limit the extend of myocardial damage in patients with IHD. However, the possibility has been raised that the human myocardium may have a genetically determined, primordial non-responsiveness to cardioprotective interventions that exists beyond the established recognized confounding factors. Primordial genetic factors may be particularly difficult to overcome.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding uterine leiomyosarcoma: is ultrasound diagnosis still a daunting challenge?","authors":"Camilla DI Dio, Stefania Pipitone, Rossella Del Vecchio, Elisa Noce, Marika Denotti, Mauro Ceccanti, Luigi Tarani, Ludovico Muzii, Giampiero Ferraguti, Marco Fiore, Maria G Piccioni","doi":"10.23736/S0026-4806.25.09669-7","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09669-7","url":null,"abstract":"<p><strong>Introduction: </strong>This narrative review, based on the current literature, aims to evaluate whether or not preoperative ultrasound can effectively distinguish between uterine leiomyosarcomas (ULMS) and leiomyomas (ULM).</p><p><strong>Evidence acquisition: </strong>By using PubMed, Scopus and WOS, an extensive literature search was conducted to identify ultrasound characteristics that specifically differentiate uterine ULMS from ULM.</p><p><strong>Evidence synthesis: </strong>This review analyzed several ultrasound features to distinguish ULMS from ULM, including the maximum diameter of myometrial growth, the number of lesions (solitary/multiple), tissue echogenicity (homogeneous/heterogeneous), growth borders (regular/irregular), the presence of cystic regions, shadow presence, subjective color grading, and the vascular pattern of the myometrial lesion (circumferential/intralesional). Our findings suggest that in postmenopausal patients with abnormal uterine bleeding and a new or enlarging mesenchymal mass, ULMS should be suspected. Features such as irregular tumor margins, moderate-to-abundant intralesional blood flow, cystic regions, and lack of calcifications indicate a higher risk of ULMS.</p><p><strong>Conclusions: </strong>Benign and malignant myometrial lesions should be disclosed by algorithms including ultrasound combined with clinical presentations and, if necessary, magnetic resonance imaging. This means that further prospective studies should be conducted to consolidate our findings.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Borderline hyperlipidemia: preventive supplementation with berberine phospholipids to prevent early atherosclerosis evolution.","authors":"Maria R Cesarone, Shu Hu, Gianni Belcaro, Umberto Cornelli, Beatrice Feragalli, Marcello Corsi, Valeria Scipione, Claudia Scipione, Roberto Cotellese, Morio Hosoi, David Cox, Francesca Coppa Zuccari","doi":"10.23736/S0026-4806.25.09637-5","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09637-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The aim of this pilot, efficacy supplement registry was to use a supplementary management with berberine to control hyperlipidemia. Berberine (Berbevis&lt;sup&gt;™&lt;/sup&gt; as Sophy&lt;sup&gt;®&lt;/sup&gt; tablets) was used to control lipids and to evaluate the early evolution of subclinical atherosclerosis in subjects (otherwise healthy, not using drugs) with borderline hyperlipidemia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;One group used berberine supplementation and a standard management (SM), while a second comparative group used only SM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No side effects were observed during the 6 months of berberine supplementation. No tolerability problems were reported. All subjects completed the registry. The groups resulted comparable. At 3 and 6 months the average total cholesterol was decreased more with berberine (P&lt;0.05) and HDL was significantly improved (P&lt;0.5). Triglycerides decreased in the berberine groups (P&lt;0.05), more than in controls. Oxidative stress was significantly more decreased with berberine supplementation (P&lt;0.05). Homocysteine (within normal values) were significantly decreased at 3 and 6 months (P&lt;0.05). Fasting glucose was decreased in the berberine group - at 3 and 6 months - in comparison with controls (P&lt;0.05). Also, glycosylated hemoglobin was reduced with berberine (P&lt;0.05) more than in the SM group. Body weight was also significantly more decreased (P&lt;0.05) with berberine supplementation. The fat proportion also decreased significantly more (P&lt;0.05) with the supplement (P&lt;0.05) than in controls only using the SM. Technical athero-specific measurements: the intima-media thickness (IMT) at the carotids (high-resolution ultrasound) in all subjects was stable with berberine and did not significantly change in 6 months. In SM controls the IMT increase was significant superior at 6 months (P&lt;0.05); more time is needed in this type of observations in subjects with minimal initial alterations at the carotid bifurcations. Endothelial function: after occlusion in normal subjects, with normal arteries, reactive hyperemia (RH) - generally - increases section/flow of more than 30% (up to 50%). The included subjects at the first observation, had a minimal increase in RH after occlusion, as an expression of endothelial dysfunction associated to the hyperlipidemia. RH was significantly increased (P&lt;0.05) with berberine, in comparison with controls, at 3 and 6 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot, concept registry indicates that oral berberine administration is effective in reducing lipids (also decreasing weight, fat percentage and fasting glucose) in otherwise healthy subjects not using other drugs. A longer study, with more advanced hyperlipidemic subjects is suggested. Predictive analytics suggests that a 12-month study with 100 patients, in more advanced hyperlipidemics, also evaluating the carotid intima-media thickness for the analysis of vascular benefits, may produce a stronger ","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lady Prelox® supplementation alleviates post-surgical menopausal symptoms and improves vaginal mucosal microcirculation.","authors":"Gianni Belcaro, Maria R Cesarone, Claudia Scipione, Valeria Scipione, Umberto Cornelli, Roberta Luzzi, Roberto Cotellese, Mark Dugall, Morio Hosoi, Marcello Corsi, Beatrice Feragalli","doi":"10.23736/S0026-4806.25.09628-4","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09628-4","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frozen embryo-transfer: a review on the optimal endometrial preparation.","authors":"Aikaterini Selntigia, Francesco Gebbia, Ana Del Arco, Antonio Pellicer, Daniela Galliano","doi":"10.23736/S0026-4806.25.09631-4","DOIUrl":"https://doi.org/10.23736/S0026-4806.25.09631-4","url":null,"abstract":"<p><strong>Introduction: </strong>Frozen-thawed embryo transfer (FET) has become a widely adopted method in assisted reproductive technology (ART), thanks to the advancements in vitrification techniques. FET now accounts for a significant proportion of ART cycles, but there is still no clear consensus on the optimal protocol for endometrial preparation. This review aims to evaluate the reproductive outcomes of three commonly used FET protocols: natural cycle (NC), modified natural cycle (mNC), and artificial cycle (AC), with a focus on implantation rates, clinical pregnancy rates (CPR), live birth rates (LBR), and obstetric complications such as hypertensive disorders of pregnancy (HDP) and preeclampsia (PE).</p><p><strong>Evidence acquisition: </strong>Studies published between 2014 and 2024 were reviewed and compared across these protocols.</p><p><strong>Evidence synthesis: </strong>The results show that NC and mNC protocols are associated with higher CPR and LBR compared to AC. AC, on the other hand, is linked to an increased risk of HDP and PE, likely due to the absence of a functional corpus luteum (CL), which plays a vital role in early pregnancy support.</p><p><strong>Conclusions: </strong>The presence of a CL appears to be crucial for minimizing obstetric complications, making NC and mNC preferable options. Future research is needed to refine FET protocols, focusing on personalized approaches to endometrial preparation that optimize both pregnancy outcomes and maternal health.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoptysis of unknown origin: let's put in order the puzzle pieces.","authors":"Francesco Gavelli, Mattia Bellan, Filippo Patrucco","doi":"10.23736/S0026-4806.24.09597-1","DOIUrl":"10.23736/S0026-4806.24.09597-1","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"167"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The multidisciplinary team reduces the time to idiopathic pulmonary fibrosis diagnosis in a real-life setting.","authors":"Tiziana La Blasca, Alida Benfante, Riccardo Messina, Emanuele Grassedonio, Salvatore Battaglia, Giada Capizzi, Irene Di Leo, Laura Napoli, Sergio Palma, Pietro Provinzano, Alessandra Tomasello, Nicola Scichilone","doi":"10.23736/S0026-4806.25.09643-0","DOIUrl":"10.23736/S0026-4806.25.09643-0","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of idiopathic pulmonary fibrosis (IPF) is fundamental to slow disease progression; multidisciplinary teams (MDTs) play a central role in posing the final diagnosis of IPF, thus aiming to improve patient outcomes. However, the practical implementation of MDTs in clinical real-life settings may be hindered by the lack of local expertise or time constraints, with the diagnosis being made without the support of complementary professional health care figures. This study aims to evaluate the impact of MDT meetings on the latency between the symptom onset and the final diagnosis of IPF.</p><p><strong>Methods: </strong>Patients referred to a regional center for IPF between January 2019 and August 2019 were included. The length of time to pose a definite diagnosis by means of MDT evaluation was compared with that of patients diagnosed elsewhere (no MDT evaluation) in an observational case-control investigation.</p><p><strong>Results: </strong>Among 24 IPF patients, those evaluated by MDT (M/F: 14/2, age: 69.8±8.2 yrs) showed a time interval from the first outpatient visit to the definite diagnosis of 3±2.3 months; on the other hand, patients in the control group (M/F: 7/1, age: 76.9±7.7 yrs) showed a time interval of 12.8±9.4 months (P=0.02). The time elapsed between the onset of symptoms and the definite diagnosis was 11.1±5.3 months for patients evaluated within the MDT, compared to 33.8±21.5 months for the control group (P=0.02).</p><p><strong>Conclusions: </strong>These exploratory findings confirm the essential role of the MDT in the early diagnosis of IPF, thus discouraging the acquisition of diagnosis solely on individual basis. The current findings highlight the need for the implementation of MDTs in clinical practice to optimize patient care.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"101-105"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID: emerging pathophysiological mechanisms.","authors":"Michael R Mueller, Ravindra Ganesh, Thomas J Beckman, Ryan T Hurt","doi":"10.23736/S0026-4806.25.09539-4","DOIUrl":"10.23736/S0026-4806.25.09539-4","url":null,"abstract":"<p><p>Post-COVID conditions, also termed \"long COVID,\" are a heterogeneous set of conditions persisting greater than 28 days after initial infection. These conditions, which include fatigue, brain fog, orthostatic intolerance, and pain, are a significant source of morbidity and limited function worldwide. Nonetheless, both the pathophysiology and treatment of long COVID remain poorly understood. Several pathophysiologic mechanisms have been proposed including neuroinflammatory drivers, endothelial dysfunction, neurotransmitter dysregulation, mitochondrial dysfunction, autonomic dysfunction, and central sensitization. In this article, we present a conceptual framework for evaluation of long COVID symptoms, as well as the evidence behind their proposed pathophysiologic mechanisms. Patients may struggle with one or more of the proposed mechanisms listed above, and the contributions from each process may vary depending on the patient. Although no FDA-approved therapies exist for long COVID, we review several potential promising and mechanistically plausible therapies.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"156-165"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660177","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":"Obesity and inflammatory response in moderate-to-severe acute respiratory distress syndrome: a single center pilot study.","authors":"Adriano Peris, Marzia Del Re, Manuela Bonizzoli, Chiara Lazzeri, Eleonora Rofi, Gabriella Di Lascio, Lorenzo Fontanelli, Morena Cozzolino, Romano Danesi","doi":"10.23736/S0026-4806.20.06488-5","DOIUrl":"https://doi.org/10.23736/S0026-4806.20.06488-5","url":null,"abstract":"<p><strong>Background: </strong>In acute respiratory distress syndrome (ARDS) obesity is associated with lower mortality but the mechanism(s) have not been elucidated.</p><p><strong>Methods: </strong>We aimed at assessing plasma biomarker levels interleukin-8 (IL-8), matrix metalloproteinase-7 (MMP-7), Toll-like receptor 2 (TLR-2), tumor necrosis factor-α (TNF-α) and procalcitonin (PCT) at baseline and 3 days later in 20 consecutive moderate-severe ARDS consecutively admitted to our Center.</p><p><strong>Results: </strong>Our population includes 20 consecutive mechanically ventilated patients with moderate-to severe ARDS. The incidence of obesity was 40% (8/20). No differences were detectable between obese and normal patients in baseline characteristics. In particular, ICU mortality was comparable between the two subgroups. No differences were detectable between the two subgroups at baseline and after 72 hours in biomarker plasma levels. When examining the behavior of each biomarker, obese patients showed a significant increase in MMP7 and TLR-2 values at 72 hours in respect to baseline, differently from normal patients.</p><p><strong>Conclusions: </strong>Our data strongly suggest that obese patients with moderate to severe ARDS have an altered inflammatory response to acute lung injury, since a significant increase in MMP-7 and TLR-2 was detectable at 72 hours only in these patients. Further investigations are needed to confirm our results in larger cohorts.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":"116 2","pages":"89-93"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096527","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}