PANMINERVA MEDICA

Scar improvement after abdominoplasty via fluorescent light energy therapy as an adjunct to the standard of care: a post-market observational investigation of POSAS data
Bollero D, Mehmeti I, Clodoveo ML, Corbo F and Tardugno R
Achieving optimal skin scarring after surgery is a major concern for patients and physicians worldwide. An innovative form of photobiomodulation, namely Fluorescent Light Energy (FLE), is increasingly used in clinical settings as an adjunct to the Standard of Care (SoC) to treat wounds. In Italy, a post-market observational investigation using data from the Patient and Observer Scar Assessment Scale (POSAS) was conducted to confirm the effectiveness of FLE in managing post-abdominoplasty scars as an adjunct to standard of care (SoC).
Physical activity and cardiac rehabilitation after myocardial infarction: the risk of obtaining large benefits
Tonet E, Sabato F, Canovi L, Guidi Colombi G, Campo G, Guardigli G and Perone F
Cardiac rehabilitation (CR) is a cornerstone in the management of patients recovering from myocardial infarction (MI), significantly improving survival, functional capacity, and quality of life. Recent evidence highlights the critical importance of early initiation of rehabilitation, ideally within days to weeks following the acute event. Early cardiac rehabilitation facilitates prompt recovery of cardiovascular function, reduces complications, and enhances patient motivation and adherence to therapeutic regimens. The multidimensional nature of modern CR programs addresses not only physical reconditioning but also psychological, nutritional, and social factors, recognizing the complex interplay affecting patient outcomes. Physical exercise training, tailored to individual risk profiles and functional status, promotes myocardial perfusion, endothelial function, and autonomic balance. Concurrently, psychosocial support targets anxiety, depression, and stress, common sequelae post-MI, which are known to influence prognosis negatively. Nutritional counseling ensures optimal dietary patterns that support cardiovascular health, while smoking cessation and risk factor management are integral components. The multidisciplinary team - comprising cardiologists, physiotherapists, dietitians, psychologists, and nurses - collaborates to develop personalized care plans that maximize patient engagement and long-term adherence. Early, multidimensional cardiac rehabilitation ultimately reduces rehospitalization rates and mortality, improving comprehensive health outcomes. This review underscores the value of initiating rehabilitation promptly after MI and implementing a holistic approach to enhance recovery, prevent recurrent events, and promote sustained lifestyle changes.
Laryngopharyngeal reflux disease: a pilot study with a new multicomponent
Nacci A, Galli A, Bastiani L, Capobianco S and Ciprandi G
This prospective observational study aimed to evaluate the efficacy and safety of a new multicomponent medical device containing Gingigel Pro, sodium alginate, Tamarindus indica, hyaluronic acid, and vegetal extracts in patients with laryngopharyngeal reflux disease (LPRD).
The effect of mental imagery applied during a post-surgical or post-traumatic immobilization period: a systematic review and meta-analysis
Campos-Fernández C, Hernandez-Lucas P and DE Oliveira IM
Limitations in mobility caused by pain, injury, or external immobilization can lead to adverse neuroplastic changes affecting the brain, the nervous system, and sensorimotor function. Mental imagery (MI) has been proposed as a non-invasive, low-cost intervention that may help mitigate these negative effects during periods of immobilization following surgery or trauma. This systematic review and meta-analysis aims to analyse the effects of MI applied during post-surgical or post-traumatic immobilization.
Enteral nutrition and pancreatic enzymes: a synergistic approach to enhance patient outcomes? A randomized controlled trial
Ma L, Wang S, Zhang S, Liu Y and Wang J
Malnutrition is associated with poor outcomes. Exocrine pancreatic insufficiency (EPI) may be an overlooked factor contributing to malnutrition. Early nutritional support improves the prognosis of critically ill patients. The effect of pancreatic enzyme preparations on nutritional status and prognosis in critically ill patients requires further study.
A survey on the attitude of Italian otorhinolaryngologists, pediatricians, and allergologists toward using topical nasal therapy: a comparative analysis among specializations
Ciprandi G, LA Mantia I and Varricchio A
Impact of ventricular arrhythmias on patients with spontaneous coronary artery dissection: a systematic review and meta-analysis
Kaddoura R, Ahmed A, Al-Asnag M, Cader AF and Al-Hijji M
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction. Ventricular arrhythmias may complicate acute SCAD presentation but the impact of ventricular arrhythmias on clinical outcomes is not well-established. This systematic review aimed to compare characteristics and outcomes of SCAD patients with or without concomitant ventricular arrhythmias.
Glucagon-like peptide-1 receptor analogues and beyond: emerging obesity pharmacotherapies
Abburi K, Melson E, Miras AD and Papamargaritis D
Obesity is a chronic disease associated with multiple health risks. Multimodal treatments including lifestyle interventions, pharmacotherapies and bariatric surgery should be the standard of care for obesity management. Bariatric surgery remains the most effective treatment yielding to sustainable weight loss (WL) of about 20-30%. Having understood better the role of the gut-brain axis on appetite, the field of obesity pharmacotherapy has been advancing rapidly. The recent approvals for glucagon-like peptide-1 (GLP-1) receptor agonist (RA) semaglutide 2.4 mg and the dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide as treatments for obesity have raised the bar for WL efficacy for the emerging obesity pharmacotherapies. Combining GLP-1 RA and other entero-pancreatic hormones including GIP, glucagon or amylin receptor agonists (RAs) as well as GIP receptor antagonists have shown promising data in early phases of clinical trials, with some progressing to phase III clinical trials. Notably, the combinations of GLP-1 RA, GIP and glucagon RA (retatrutide) have shown WL efficacy closing on to that observed in bariatric surgery. While entero-pancreatic hormone-based therapies have been the centre of attention for obesity pharmacotherapies, non- entero-pancreatic hormone treatments also hold promise. In this review, we present the future pharmacotherapies for weight management in people with obesity, focusing on entero-pancreatic hormone-based molecules.
Alcohol use disorder: who thinks about addiction? The role of mutual-self-help
Balbinot P and Testino G
In this narrative review, some main points have been addressed. This is to better understand the daily clinical reality. The points are the following: alcohol use disorder (AUD) is not a "self-inflicted disease" but a clinical problem that derives from an incorrect lifestyle; possible presence of psychiatric pathology; possible presence of previous traumas; link with the substance (addiction).
The evolution of interventional pulmonology from rigid bronchoscopy to robotics
DE Pace CC, Tondo P, Minonne C, Paladini L, Piazzolla M, Karaboue M, Lacasella G, Morlino P and Lacedonia D
Interventional pulmonology has evolved over the past century from rudimentary endoscopic procedures to a highly specialized discipline encompassing a wide range of diagnostic and therapeutic techniques. This review outlines the historical milestones that have shaped the field, tracing the progressive development of flexible and rigid bronchoscopy, thoracic ultrasound, robotic systems, and advanced imaging modalities such as cone-beam CT. Each innovation has contributed to enhancing the accuracy, safety, and efficacy of interventions for various pulmonary diseases, including malignancies, interstitial lung disease, airway obstruction, and pleural disorders. The review also explores the role of pioneering figures whose vision and experimentation laid the foundation for modern practices. From Killian's first bronchoscopic foreign body removal to the latest robotic navigation systems, the trajectory of interventional pulmonology illustrates a dynamic interplay between technological advancement and clinical need.
Transforming peripheral nerve surgery with artificial intelligence: a review of surgical advances
Buldu MT, Ezquerro Cortes MR, Panagiotidou A, Fox M, Sinisi M and Simpson AI
Peripheral nerve injuries (PNIs) are challenging to manage due to complex anatomy and variable presentations. Artificial intelligence (AI) techniques are increasingly applied in medicine, and their role in PNI care is emerging. This systematic review aimed to summarize the current applications of AI in the diagnosis, prognosis, and treatment of PNIs.
Benign paroxysmal positional vertigo and the risk of subsequent cerebral ischemic stroke
Ciorba A, Alaimo A, Corazzi V, Bianchini C, Guerzoni F, Migliorelli A, Vicini C, Pelucchi S and Govoni V
"Osteoporosis check": a survey as a proof of concept for the prevention of bone health
Lello S, Capozzi A, Salate Santone F, Russo AM and Evangelista M
Osteoporosis is a chronic disease affecting individual, public and social health. Few data are available about the awareness of osteoporosis in Italy. The main purpose of our study is to evaluate the perception of osteoporosis in a selected sample of subjects of different age and sex.
The challenges of caring for HDV-positive patients: a narrative medicine perspective
Brunetto M, Ciancio A, Coppola N, Santantonio TA, Taibi C, Verucchi G and Lampertico P
Hepatitis D is considered the most severe form of viral hepatitis in humans, and chronic HDV hepatitis patients typically show a more rapid progression to cirrhosis and a higher mortality. While awareness of the disease has increased, it still remains underdiagnosed and of challenging treatment. Besides the physical toll that an HDV infection takes, the psychological impact needs to be considered when treating the infected patients. The aim of this work is to assess the psychological course of the disease from the patient's point of view and the clinicians tasked with the treatment of this specific class of patients. Two surveys covering emotional perspectives about the suspect of the disease, the diagnosis, the therapy, and the relationship between physicians and patients were administered to the clinicians and the patients. The patients reported their journey starting from sentiments of discouragement and fear upon diagnosis, the challenges associated with the disease's symptoms and the therapies, which evolved into a story of endurance, coexistence with the disease, and hope for future scientific advancements. The clinicians reported their challenges in caring for HDV-positive patients, which span from the sub-optimal referral rate, and the lack of therapeutic options to the occasional absence of patient compliance. Although, at the same time they describe elements of satisfaction that come from the efficacy of some treatments and the possibility of the development of novel drugs. In conclusion, the psychological toll that hepatitis D has on patients should be one of the factors driving communication with the physicians.
Mantle cell lymphoma: from pathogenesis to treatment for 2024 and beyond
O'Leary AM and D'Angelo CR
Mantle cell lymphoma (MCL) is a rare B-cell non-Hodgkin lymphoma with multiple subtypes including classical mantle cell lymphoma (cMCL), the leukemic variant of mantle cell lymphoma (LV-MCL), and in situ mantle cell neoplasia (ISMCN). Their clinical presentations differ significantly and range from indolent to very aggressive. The defining genetic feature and chief oncogenic mechanism of MCL involves the t(11;14)(q13;q32) translocation, which results in a fusion of the gene that encodes cyclin D1 (CCND1) and the immunoglobulin heavy chain gene (IGH). As a result of significant variation between subtypes, treatment approaches and prognoses of this disease vary drastically. Current treatment options for MCL range from observation to conventional chemotherapy with or without subsequent stem cell transplantation, to targeted immunotherapies against key molecular targets. The role of stem cell transplant has become more debatable for frontline consolidation therapy. Earlier incorporation of Bruton's tyrosine kinase (BTK) inhibitors is being strongly considered for frontline therapy. Chimeric antigen receptor therapy (CAR-T) therapies have become established treatment options for relapsed/refractory disease. Ongoing frontiers involve optimal management of TP53 mutated MCL and those relapsing with CNS involvement. Novel therapeutic approaches including the development of non-covalent BTK inhibitors and bispecific antibody therapy carry significant promise to further improve outcomes across all subtypes of this disease.
New perspectives in slow coronary flow: a review and update
Martín M, Flores R, Ortiz DE Zárate JF and Rozado J
Since the first description of coronary slow flow by Tambe et al. until today, there have been many publications referring to this entity that is still a source of controversy. Also named in some point as "Y syndrome" it includes a broad spectrum of clinical presentation since angina to acute coronary syndrome or even ventricular arrhythmias and sudden death. Its pathophysiology is multifactorial and has not been completely elucidated yet, involving inflammatory factors, endothelial dysfunction, diffuse microvascular disease, atheromatosis and also metabolic, anatomical and even genetic factors. The diagnostic criteria have also evolved over the years. The main diagnostic test is by angiography, considering coronary slow flow within the spectrum of angina with non-obstructive coronary lesions, however, in recent years controversy has arisen about its true nature. Lately, there have been many studies published contemplating different aspects of this entity, referring either to its pathophysiology or to its diagnosis and treatment. In the present manuscript we make an updated review of coronary slow flow encompassing it in the current cardiological panorama.
An overview of recent developments in clinical trials of anti-diabetic drugs
Madhuri Y, Saifullah Q, Pandey M and Bhattamisra SK
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder affecting over 90% of diabetes patients worldwide. The condition is driven by genetic predispositions, environmental factors, obesity, and physical inactivity. Pharmacological treatments range from metformin to newer agents, including GLP-1 analogues and SGLT-2 inhibitors, which target different aspects of glucose metabolism. The review highlights advancements in clinical trials for T2DM treatments, focusing on recent and ongoing research. Clinical trial data were sourced from ClinicalTrials.gov, and the search criteria focused on trials that were published with monotherapy of T2DM having results within the last six years, specifically from 2019 to 2024. The clinical trials of the patients under the age group of adults (18 to 64 years) and older adults (>64 years) were included. The data are mentioned in inverse chronological order with respect to study duration. The clinical trial data suggest promising results in managing hemoglobin A1c and body weight. However, adverse events such as cardiovascular, gastrointestinal, and bone-related issues and other issues such as diabetic ketoacidosis and pancreatitis were reported in some cases. Dulaglutide, tripeptide, and oral insulin showed promising therapeutic effects in clinical trials. Despite significant progress, the management of T2DM remains challenging, emphasizing the need for ongoing innovation in treatment approaches to improve patient quality of life and reduce the global burden of the disease.
Missed opportunities for health promotion and disease prevention: lifestyle interventions in primary care for individuals with hypertension, hyperlipidemia, obesity and type 2 diabetes
Amghar S, Bärnighausen T and Jani A
Non-communicable diseases (NCDs) like hypertension, type 2 diabetes, hyperlipidemia, and obesity, are a leading cause of mortality and have shown rising prevalence trends over the last few decades. Lifestyle interventions, particularly diet and physical activity, are an effective approach to addressing the underlying risk factors of these preventable NCDs, but their integration into the primary care practice remains underutilized. This review synthesizes evidence from systematic reviews and meta-analyses published between 2019 and 2024 to provide evidence-based recommendations for the integration of lifestyle interventions into primary care pathways. The included articles were noted for their risk of bias because of poor study design. While consideration must be given to the quality of evidence for these interventions because of the risk of bias, there is good evidence to support the use of several types of interventions including: diet modification (e.g. food replacement, calorie restriction, intermittent/periodic fasting); diet education and counselling; individual and group-based exercise interventions; interventions that aim to promote general physical activity in daily life; as well as combined dietary and physical activity interventions delivered individually, in groups, at a community level as well as through smartphone-supported applications. It is important for the health and care community to explore and implement alternative means of generating evidence, integrating lifestyle interventions into care pathways and increasing investment in the lifecycle of these interventions, which can promote health and prevent disease.
Perspectives on the profiling of renal risk in obesity
Docherty NG
With the formal designation of obesity as a primary disease process, early detection of its end-organ consequences and the prognostication of long-term risk will become an important aspect of its clinical management. Obesity is increasingly recognized as a treatable risk factor for chronic kidney disease. However, profiling of kidney health and estimation of renal risk remain relatively underemphasized in obesity and nephrology care guidelines. The establishment of clinical protocols that facilitate the detection of early-stage renal impairment in obesity and incorporate profiling of an individual's risk of progression, could help guide strategies to break the causal association between obesity and chronic kidney disease. Currently, checks on kidney health in patients with obesity are prompted due to the presence of obesity complications such as cardiovascular and/or metabolic disease and routine screening relies upon the use of estimated glomerular filtration rate equations. Ample evidence exists to demonstrate that these equations are of limited utility in the setting of excess body weight and intentional weight loss. The present article presents the case that an expanded model of renal risk profiling should be developed for obesity medicine, suggesting feasible means of incorporating important risk factors and biomarker profiling alongside a more targeted assessment of directly measured GFR and renal functional reserve in at risk patients. The development of such a model or variation thereof should be prioritized to guide the targeted deployment of obesity treatments with proven reno-protective effects.
Results of AIPO Italian survey on sustainability in Interventional Pulmonology
Patrucco F, Fantin A, Di Marco Berardino A, Majori M, Piro R, Pinelli V, Puglisi S, Tagliabue E, Trigiani M, Rinaldo RF, Solidoro P, Barisione E and
Sustainability in medicine is gaining increasing importance. In interventional pulmonology only few studies demonstrated the impact of mechanisms involved in CO2 equivalent production; moreover, operators' sensitivity to sustainability and each center's recycling processes are highly variable. We conducted a national survey among interventional pulmonologists on perception of sustainability resulting from their work, and how endoscopic activity impacts the production of recyclable material.
Deprescription of benzodiazepines and its management according to an overlapping strategy with a low-dose multicomponent medication: a Delphi consensus
Melcarne R, Bernasconi S, Del Prete M, Artizzu S, Guttmann S, Ciprandi G and Gemignani A
About 20% of adults and between 6% and 13% of children experience mild to moderate anxiety and stress-related symptoms. Benzodiazepines (BZDs) are considered the referring medications for early-stage anxiety and stress-related symptoms management. Nevertheless, BZDs must be managed carefully because their use, especially chronic, could be linked with some adverse effects, and can promote the onset of psychological and physical dependence. They also often show progressive tolerance, necessitating an increase in dosage, and therefore their use should be discouraged. In the clinical management of patients with pathological/dysfunctional anxiety, one of the main issues related to the discontinuation of BZDs treatment is the occurrence of rebound effects and withdrawal syndrome, especially in subjects with certain personality disorders and poly-drug users. The deprescription of BZDs is advisable with the availability of other therapies and interventions, especially in elderly subjects. Therefore, an effective and safe alternative pharmacological tool for mild to moderate anxiety and stress-related symptoms is needed. After the identification of potentially new medications to flank BZDs, it is mandatory to revise and improve good clinical practices even through a consensus process.