Minerva medica最新文献

{"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}

{"title":"Atrial functional mitral regurgitation: cardiac remodeling and outcome after mini-thoracotomy mitral valve surgery.","authors":"Francesca Cortese, Marco F Costantino, Luisiana Stolfi, Gianpaolo D'Addeo, Filippo Prestipino, Antonella Matera, Riccardo D'Ascoli, Giampaolo Luzi","doi":"10.23736/S0026-4806.25.09469-8","DOIUrl":"10.23736/S0026-4806.25.09469-8","url":null,"abstract":"<p><strong>Background: </strong>The atrial functional mitral regurgitation (AFMR) refers to a newly recognized disease entity in which mitral regurgitation occurs secondary to left atrial (LA) disease, without left ventricular (LV) dilatation and dysfunction (at least initially) and intrinsic mitral valve (MV) disease.</p><p><strong>Methods: </strong>We conducted an observational analysis on 28 subjects, mean age and standard deviation 72.7±8.4 years, with AFMR who underwent mini-thoracotomy MV surgery (mitral annuloplasty and tricuspid ring annuloplasty when needed). No surgical treatment of atrial fibrillation (AF) has been performed.</p><p><strong>Results: </strong>There was no in-hospital mortality. At one-year follow-up, we observe a reverse remodeling of the LV and LA, with a significant reduction of the end-diastolic volume of the LV (110 mL [95-148 mL] vs. 55 mL [48-59 mL], z: -0.7, P<0.001), of antero-posterior (A-P) diameter of left atrium (50 mm [38-60] vs. 46 mm [35-55], z: -3.3, P<0.01) and volume (83.5 mL [63.2-96.5 mL] vs. 63 mL [45.5-78.7 mL], z: -3.2, P<0.01), of the estimated systolic pulmonary artery pressure (PAP) (35 mmHg [30-43] vs. 25 [22-32.7], z: -3.9, P<0.001). Results were not altered by the presence or absence of AF. The overall 1-year survival rates were 100% and all the patients recovered to NYHA functional class I/II at the end of follow-up (z: -6, P<0.001).</p><p><strong>Conclusions: </strong>The results of our small study showed that mini-thoracotomy valve surgery for AFMR is safe and effective. It improves functional class (NYHA) and results in reverse-remodeling of LA, regardless of the presence or absence of AF. A reduction in left ventricular volumes was also observed, although baseline volumes were still within normal limits, as an expression of reduction in left ventricular overload. Mitral insufficiency should be the primary target of treatment, while AF appears to be an epiphenomenon rather than a causal element of AFMR.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"94-100"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723051","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 treatment of adenomyosis-induced ovarian hyperstimulation syndrome with leuprolide.","authors":"Cong Ye, Bo Zhong, Hui Xu, Tong Jia, Hongling Guo","doi":"10.23736/S0026-4806.25.09186-4","DOIUrl":"10.23736/S0026-4806.25.09186-4","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"168-169"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701532","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":"Advancing age and mortality due to pollution exposure: a comprehensive review.","authors":"Yashendra Sethi, Arsalan Moinuddin, Giuseppe Biondi-Zoccai","doi":"10.23736/S0026-4806.24.09611-3","DOIUrl":"10.23736/S0026-4806.24.09611-3","url":null,"abstract":"<p><p>The global aging population has been increasingly vulnerable to environmental stressors, particularly air pollution. Advancing age is associated with physiological declines and a higher prevalence of chronic diseases, heightening susceptibility to pollution-related health effects. This review explores the relationship between advancing age and mortality/morbidity due to pollution exposure, consolidating evidence on how pollution exacerbates health risks in elderly populations. Based on the epidemiological evidence, this comprehensive literature review evaluates the interaction between aging, pollution exposure, and the biological mechanisms that make older adults more vulnerable to pollution-related mortality/morbidity. Google Scholar, PubMed, and Scopus were systematically searched to identify relevant studies, including cohort studies, meta-analyses, and reviews. Studies were selected based on their focus on air pollution, aging populations, and mortality. Inclusion criteria included peer-reviewed articles addressing pollution-related health outcomes in older adults, specifically emphasizing cardiovascular, respiratory, and neurological impacts. Aging amplifies the harmful effects of air pollution through mechanisms like oxidative stress, impaired immune responses, and chronic inflammation. Elderly populations are disproportionately affected by pollutants such as particulate matter (PM2.5), nitrogen dioxide (NO<inf>2</inf>), and ozone. Mortality, specifically due to cardiovascular, respiratory, and neurodegenerative diseases, is significantly higher in older adults exposed to long-term pollution. Air pollution, as an effect modifier, intensifies the health risks associated with aging. Older adults face heightened mortality risks due to pollution, demanding public health strategies to prioritize pollution reduction and protective interventions at individual and population levels.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"122-134"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443130","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":"Liver fibrosis and non-invasive tests: a suggestion.","authors":"Gianni Testino","doi":"10.23736/S0026-4806.25.09681-8","DOIUrl":"10.23736/S0026-4806.25.09681-8","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"166"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575052","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":"Type 2 diabetes, heart failure and the treatment of their comorbidity.","authors":"Si Wang, Sheyu Li","doi":"10.23736/S0026-4806.24.09264-4","DOIUrl":"10.23736/S0026-4806.24.09264-4","url":null,"abstract":"<p><p>Both heart failure and type 2 diabetes are prevalent conditions and share similar pathogenesis, risk factors, and treatment medications. This review aims to inform clinical practice by summarizing the interaction between heart failure and type 2 diabetes, as well as the medications used to manage them. Novel medications such as Sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-likepeptide-1 receptor agonists, and finerenone have been shown to protect patients with type 2 diabetes from hospitalization for heart failure. SGLT2 inhibitors have also proven effective in patients with heart failure, regardless of the presence of type 2 diabetes. When choosing diabetes treatment medications for patients with heart failure and type 2 diabetes, shared decision-making can be helpful in weighing the benefits and harms based on individual scenarios. The selection of guideline-directed medical therapy aligns with patients without type 2 diabetes. Given the rapid evolution of knowledge in this field, clinicians need to stay updated with the latest evidence to provide optimal medical care.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"141-155"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788263","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":"Advancing heart failure management: a comprehensive review of current and emerging therapies for heart failure with preserved ejection failure.","authors":"Siddharth P Agrawal, Ritu C Tated, Darshilkumar Maheta, Wilbert S Aronow","doi":"10.23736/S0026-4806.25.09656-9","DOIUrl":"10.23736/S0026-4806.25.09656-9","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome characterized by diastolic dysfunction and high morbidity. It presents significant challenges in diagnosis and treatment due to its heterogeneous etiology and pathophysiology. This review evaluates the efficacy and clinical utility of current and emerging pharmacological therapies for HFpEF, emphasizing personalized approaches to improve patient outcomes. A comprehensive analysis of literature was conducted to assess the role of established treatments, such as diuretics, RAAS inhibitors, and beta-blockers, alongside emerging therapies, including sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) agonists, and novel agents like mavacamten. SGLT2 inhibitors have demonstrated significant reductions in heart failure hospitalizations and symptom burden, while GLP-1 agonists show promise in managing HFpEF with obesity or metabolic syndrome. Mineralocorticoid receptor antagonists provide benefits in selecting patients, although broader therapeutic options remain limited. Other novel agents, such as nitrates and PDE-5 inhibitors, require further validation through clinical trials. HFpEF management demands a multifaceted approach combining lifestyle interventions, optimized pharmacotherapy, and emerging therapeutic strategies. Personalized treatment plans and continued research are vital for addressing the complexities of this syndrome and improving patient outcomes.</p>","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"113-121"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723049","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}