Recenti Prog Med
· 2026 Jun · PMID 42345062
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INTRODUCTION: The concept of Brain-Mind Capital integrates mental health and cognitive skills, recognising them as structural determinants of economic growth in knowledge-intensive economies. OBJECTIVES: To analyse the i...INTRODUCTION: The concept of Brain-Mind Capital integrates mental health and cognitive skills, recognising them as structural determinants of economic growth in knowledge-intensive economies. OBJECTIVES: To analyse the implications of the Brain Capital paradigm for the Italian labour market and to assess the role of the National Mental Health Plan (PANSM) 2025-2030 as an instrument of economic policy as well as health policy; introducing the concept of Brain-Mind Capital: the mind as a synthesising element of Brain-Mental Health Capital. METHODS: A narrative review of the international literature on Brain Capital, the burden of disease and the economic costs of mental health, supplemented by a policy analysis of the Italian context. RESULTS: Mental and neurological disorders account for approximately 24% of the global burden of disease and generate economic costs estimated at between 3% and 4% of GDP in industrialised countries. The literature highlights a robust association between mental health, productivity, labour force participation and innovation. In Italy, stagnating productivity and demographic ageing amplify the systemic risk associated with the undervaluation of cognitive capital. The PANSM 2025-2030 represents an opportunity to integrate health policy and labour policy. CONCLUSIONS: Investing in Brain-Mind Capital - that is, in universities, research centres, innovation, public-private partnerships and new knowledge-intensive technologies - constitutes a strategy for national and international competitiveness. Structural integration between mental health and labour policies is necessary to support growth, social cohesion and the sustainability of social security systems.
Valent F, Degani G, Bottussi M
… +11 more, Cappelletti S, Caroselli A, De Liva F, Pagnutti S, Pfeiffer S, Pulacini S, Rossi D, Sodde M, Sousanieh R, Urli K, Casatta L
Recenti Prog Med
· 2026 Jun · PMID 42301627
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BACKGROUND: In the Italian Region Friuli-Venezia Giulia, Herpes Zoster (HZ) vaccination of actively offered free of charge to the population at age 65. Vaccination uptake is below the goal of coverage ≥50% set in the nat...BACKGROUND: In the Italian Region Friuli-Venezia Giulia, Herpes Zoster (HZ) vaccination of actively offered free of charge to the population at age 65. Vaccination uptake is below the goal of coverage ≥50% set in the national vaccination plan. OBJECTIVE: We set up a pilot project with a small number of General Practitioners (GPs) of the Health Authority of Udine, to assess whether GPs can catch-up patients invited for vaccination the previous year but not attending the appointment. METHODS: Twelve GPs voluntarily adhering to the project were provided from the Vaccination Center with 10 doses of vaccine each, corresponding to the immunization of 5 individuals. They contacted patients born in 1959 not adhering to the previous invitation and proposed to immunize them. We assessed whether vaccination coverages increased among patients followed by those GPs and the feasibility of contacting the patient and handling the vaccine. RESULTS: Among participating GPs, from July to December 2025, coverage of patients in the cohort of interest increased from 42.9% to 63.4%. Although some physicians had difficulties in managing the vaccine and some reported that contacting patients is extremely time-consuming, the overall judgment of feasibility of both the contact and information of patients and of the actual vaccine administration was excellent. CONCLUSION: This pilot project suggests that the collaboration with GPs can strongly contribute to improve HZ vaccine uptake. Since such collaboration was considered feasible, more GPs from the same Health Authority may be involved.
Lacerenza LG, Corradini P, Sposato B
… +11 more, Bellucci S, Bonini P, Geraci S, Francardi M, Gepponi A, Spaghetti S, Bechi L, Montagnani A, D'Amato MG, Limbruno U, Meini B
Recenti Prog Med
· 2026 Jun · PMID 42301626
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INTRODUCTION: Heart Failure (HF) represents a critical challenge for the National Health Service (SSN) in terms of mortality and costs, often fueled by fragmented management between hospital and community care. The objec...INTRODUCTION: Heart Failure (HF) represents a critical challenge for the National Health Service (SSN) in terms of mortality and costs, often fueled by fragmented management between hospital and community care. The objective of this study is to analyze the current care pathway and related direct costs (hospitalizations, medications, outpatient services) to identify inefficiencies and propose an improvement model based on Lean and Value-Based Healthcare (VBHC) methodologies. MATERIALS AND METHODS: A retrospective analysis was conducted from January 2022 to December 2023 on a sample of 689 patients with heart failure, utilizing administrative data flows (SDO, SPA, SPF, and SIAD). Lean tools, specifically "As-Is" and "To-Be" Swim Lane maps, were applied to map processes and evaluate hospital-community integration. RESULTS: The total costs generated by the 689 monitored patients amounted to €2,451,475.60. This is broken down as follows: €1,312,227.66 from hospital discharge records (SDO), €169,716.38 from Emergency Department (PS) services, €82,908.64 from outpatient services (SPA), €114,472.92 from pharmaceutical records (SPF), and €772,150 from home care services (SIAD). Significant critical issues emerged in the "As-Is" pathway, revealing analysis biases such as 32.5% of patients not undergoing outpatient visits and 4.7% not receiving specific medications. The "To-Be" model proposes value-centered management through the activation of the Territorial Operations Center (COT), the assignment of a lead physician (tutor), the use of telemedicine, and the integration of the Electronic Health Record (FSE) to overcome the observed biases. CONCLUSIONS: Shifting to an integrated and digitalized model is essential to ensure continuity of care and therapeutic adherence, thereby reducing exacerbations and optimizing the use of public resources.
Recenti Prog Med
· 2026 Jun · PMID 42301625
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Chemical, Biological, Radiological, and Nuclear (CBRN) emergencies represent one of the most complex contexts for defense systems and public health. The use of drones now provides concrete tools to reduce direct personne...Chemical, Biological, Radiological, and Nuclear (CBRN) emergencies represent one of the most complex contexts for defense systems and public health. The use of drones now provides concrete tools to reduce direct personnel exposure, enhance environmental data collection, and optimize healthcare logistics. This paper analyzes the technological evolution of drones in the healthcare sector, highlighting the main types employed and their operational prospects in CBRN emergencies. A central section is devoted to the training of CBRN UAS (Unmanned Aircraft System) operators, considered a strategic prerequisite for the effective integration of these technologies into safety and response protocols. Through a hypothetical/propositional approach, training models based on integrated modules, realistic simulations, and joint-force exercises are outlined, identifying the regulatory and organizational challenges that remain open. The conclusions emphasize the need for a unified training system capable of leveraging the expertise already present within Italian military structures and promoting inter-agency cooperation for a safer and more efficient response to CBRN emergencies.
Recenti Prog Med
· 2026 Jun · PMID 42301624
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Clinical research is a fundamental component of scientific progress and drug development, traditionally divided into profit-driven studies promoted by industry and non-profit studies conducted by public bodies or indepen...Clinical research is a fundamental component of scientific progress and drug development, traditionally divided into profit-driven studies promoted by industry and non-profit studies conducted by public bodies or independent institutions with the aim of improving clinical practice. In Italy, non-profit research was long governed by a restrictive regulatory framework (Ministerial Decree of 17 December 2004), which significantly limited the possibility of exploiting research results for regulatory or commercial purposes, thereby hindering the development and impact of the evidence generated. The new Ministerial Decree of 30 November 2021 introduces a major shift by allowing the transfer of data and results from non-profit studies for regulatory purposes, fostering greater integration between the public sector and industry. However, the practical implementation of this reform presents several challenges, including the lack of clear criteria for the economic valuation of data, uncertainties regarding reimbursable costs, complexities related to data protection and informed consent, and a significant administrative burden on non-profit sponsors. Additional issues concern data quality, the operational sustainability of the system, and restrictions on co-sponsorship, which may reduce the international competitiveness of Italian research. In conclusion, while the new regulatory framework represents a step forward in enhancing the value of independent research, further regulatory clarification and structural interventions are needed to ensure its effective implementation and to fully realize its potential.
Recenti Prog Med
· 2026 Jun · PMID 42301623
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In recent years, interest in therapeutic cannabis has grown even in Italy alongside expanding knowledge of the endocannabinoid system and its potential clinical applications. Nonetheless, significant challenges persist t...In recent years, interest in therapeutic cannabis has grown even in Italy alongside expanding knowledge of the endocannabinoid system and its potential clinical applications. Nonetheless, significant challenges persist that hinder its full integration into medical practice. This editorial examines the misalignment between clinical research and therapeutic use, the methodological limitations of a substantial portion of the available literature, the frequent confusion between recreational and medical use, and the lack of detailed operational guidelines. Regulatory aspects, with particular reference to the Italian framework, as well as barriers to treatment access due to organizational and economic factors, are also discussed. Overall, therapeutic cannabis emerges as a field requiring clinical and regulatory updates based on principles of prescribing appropriateness, equitable access to care, current scientific evidence, and evidence-based medicine.
Recenti Prog Med
· 2026 Jun · PMID 42301622
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The article explores the shift from Asimov's laws, centered on machine obedience, to Kasparov's laws of "hybrid intelligence". While Asimov focused on preventing harm through autonomous constraints, Kasparov emphasizes t...The article explores the shift from Asimov's laws, centered on machine obedience, to Kasparov's laws of "hybrid intelligence". While Asimov focused on preventing harm through autonomous constraints, Kasparov emphasizes that the best performance arises from the optimal orchestration of human, machine, and process. This perspective suggests that a "weak human + machine + superior process" can outperform a "strong human + machine + inferior process". Empirical studies in radiology are consistent with this socio-technical conjecture. Studies in radiology indicate that specific collaboration protocols allow human-AI teams to surpass isolated models. Notably, research confirms that less proficient clinicians embedded in effective protocols can achieve higher accuracy than clinicians with higher baseline accuracy operating under less effective protocols. This framework views AI as a component of "superminds" - collective cognitive architectures that enhance plural decision-making. Ultimately, the value of AI is an emergent property of the organizational system. Rather than focusing solely on model accuracy, designers must create interaction protocols that calibrate trust and prevent professional deskilling. The goal is to move toward a synergy where machines help human collectives become more intelligent.
Ruzza A, Accomando F, Costantini M
… +1 more, Valletta E
Recenti Prog Med
· 2026 May · PMID 42095387
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Collagenous gastritis is a rare pediatric disease characterized by chronic gastritis with superficial, irregular mucosal involvement, focal atrophy of the gastric glands, an inflammatory infiltrate predominantly composed...Collagenous gastritis is a rare pediatric disease characterized by chronic gastritis with superficial, irregular mucosal involvement, focal atrophy of the gastric glands, an inflammatory infiltrate predominantly composed of lymphocytes and plasma cells, and areas of epithelial erosion. Focal collagen deposition in the subepithelial region of the lamina propria is a hallmark feature. Gastric epithelial erosions can cause hematemesis and, more generally, occult gastrointestinal bleeding, leading to chronic iron-deficiency anemia. Currently, there are no established management guidelines, and data on long-term follow-up are lacking. We report a clinical case of collagenous gastritis, emphasizing its features and therapeutic approach.
Confalonieri C, Pangallo V, Lo Cascio G
… +4 more, Trapani F, Granelli MC, Bolzoni M, Magnacavallo A
Recenti Prog Med
· 2026 May · PMID 42095386
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BACKGROUND: Antimicrobial resistance (AMR) is a major global public health challenge, particularly in Italy, where surveillance data show high resistance rates for several pathogen-antibiotic combinations. This study aim...BACKGROUND: Antimicrobial resistance (AMR) is a major global public health challenge, particularly in Italy, where surveillance data show high resistance rates for several pathogen-antibiotic combinations. This study aimed to evaluate trends in systemic antibiotic consumption in hospital settings within a Local Health Authority in Emilia-Romagna using PNCAR indicators. MATERIALS AND METHODS: A retrospective analysis of systemic antibiotic consumption (Anatomical Therapeutic Chemical Classification System - ATC, class J01) was conducted at the Piacenza Local Health Authority between 2021 and 2024, using the WHO AWaRe classification. Data were expressed as DDD and DDD per 100 bed-days across seven hospital departments. The European Surveillance of Antimicrobial Consumption (ESAC) indicator for broad-spectrum antibiotics was calculated. An economic analysis of antibiotic expenditure per inpatient day was also performed and compared with regional and national benchmarks. RESULTS: The hospital antibiotic consumption (ATC J01) showed an overall decline, decreasing from 113.3 DDD/100 bed-days in 2022 to 97.5 in 2024. AWaRe analysis revealed a marked reduction in Access antibiotics and a concomitant increase in Watch agents, while Reserve use remained stable. Amoxicillin-clavulanic acid and ceftriaxone were the most frequently prescribed antibiotics. The ESAC indicator remained stable at approximately 54%. CONCLUSIONS: Contextualizing antibiotic consumption data within local epidemiology allows a more accurate interpretation of prescribing patterns and supports the development of tailored stewardship interventions. Integrating local monitoring with national surveillance systems could strengthen the evaluation of PNCAR targets.
Marullo Reedtz G, Rolle C, Managò M
… +2 more, Marcellusi A, Minghetti P
Recenti Prog Med
· 2026 May · PMID 42095385
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In patients with chronic respiratory failure and a stable oxygen requirement ≤4 L/min, switching from liquid oxygen to oxygen concentrators represents a potential strategy to optimize home oxygen therapy, although struct...In patients with chronic respiratory failure and a stable oxygen requirement ≤4 L/min, switching from liquid oxygen to oxygen concentrators represents a potential strategy to optimize home oxygen therapy, although structured real-world experiences remain limited. This study describes the experience of the COMBO Project implemented by the Turin City Local Health Authority, aimed at the planned implementation of a therapeutic switch from liquid oxygen to oxygen concentrators and the assessment of its organizational and management outcomes. A retrospective descriptive-comparative observational study was conducted by comparing two periods (May-December 2023 and May-December 2024). A total of 129 patients eligible for the therapeutic switch were analyzed; for patients who completed the transition, a descriptive counterfactual scenario was developed to estimate the expected economic impact. The switch was successfully completed by 104 patients (80.6%). During the observation period, a 69% increase in the use of oxygen concentrators and a 3.9% reduction in liquid oxygen consumption were observed. Comparison with the counterfactual scenario showed an expected cost reduction of 2.56%. The main critical issues related to the transition process involved clinical, logistical, and prescribing aspects among patients who did not complete the switch. The COMBO Project experience demonstrates the feasibility of a structured therapeutic switch model in territorial healthcare settings; the value of the intervention lies primarily in process organization and in the coordinating role of the Territorial Pharmaceutical Service, while the observed economic impact should be interpreted as an expected benefit. The model appears potentially replicable in similar healthcare contexts.