Lucis R, Presot NV, Nuovo C
… +2 more, Pipan C, Marino A
Recenti Prog Med
· 2026 Jan · PMID 41568635
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INTRODUCTION: Globalization and increasing migration flows have profoundly reshaped demographic and health landscapes in Europe. Physicians are now required to integrate not only biomedical expertise but also cultural co...INTRODUCTION: Globalization and increasing migration flows have profoundly reshaped demographic and health landscapes in Europe. Physicians are now required to integrate not only biomedical expertise but also cultural competence and knowledge of global disease patterns. Tropical Medicine (TropMed) and Migration Medicine (MigMed) represent two complementary domains bridging infectious disease expertise with social and intercultural dimensions of care. Despite their relevance, several studies highlight significant educational gaps in these fields across Europe. METHODS: We conducted an exploratory, observational study at the University of Udine (Italy) using a self-administered online questionnaire (EUSurvey platform) to assess awareness, knowledge, and educational exposure to TropMed and MigMed among medical students and residents. The survey was open from April to June 2024 and addressed 1,406 eligible participants. Only descriptive statistics were applied given the small and self-selected sample. RESULTS: A total of 48 participants completed the questionnaire (response rate: 3.4%). Awareness of MigMed was limited, with one quarter of respondents unfamiliar with the term, while TropMed was better known. Knowledge of infectious diseases linked to migration varied: tuberculosis and sexually transmitted infections were relatively well known, whereas diseases such as Chagas or Dengue were rarely identified. Educational exposure was scarce: only one third had attended vaccination courses, fewer than 20% had participated in training on migration health, and less than 10% had engaged with activities organized by the Italian Society of Migration Medicine (SIMM). Despite these gaps, a notable minority expressed career aspirations in international or NGO settings. CONCLUSIONS: Although limited by an extremely low response rate, this study highlights a critical educational gap in TropMed and MigMed among future physicians. The lack of engagement itself is a meaningful finding, reflecting limited awareness and interest in topics of growing public health importance. These results call for urgent curricular reforms in Italian medical education, integrating global health, intercultural competence, and equity-oriented training as core components to prepare physicians for a healthcare system increasingly shaped by migration and cultural diversity.
Cremona G, Bersanetti F, Costa F
… +13 more, Beretta M, Maserati M, Dorsi P, Bolzoni M, Muroni M, Merlini C, Cappucciati L, Arcidiacono MA, Conte G, Magon A, Caruso R, Altavilla M, Cavanna L
Recenti Prog Med
· 2026 Jan · PMID 41568634
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INTRODUCTION: Malignant fungating wounds (MFW) pose a significant clinical challenge, affecting patients' quality of life through debilitating symptoms such as pain, exudate, and odor. This study aimed to translate, adap...INTRODUCTION: Malignant fungating wounds (MFW) pose a significant clinical challenge, affecting patients' quality of life through debilitating symptoms such as pain, exudate, and odor. This study aimed to translate, adapt, and validate the Malignant Wound Assessment Tool-Clinical version (MWAT-C) to assess malignant fungating wounds in Italy. METHODS: The study followed a multi-phase methodological design, including a backward and forward translation process and evaluation of the Italian version by 18 healthcare experts. Face and content validity were assessed using a Likert scale to rate item relevance and clarity. RESULTS: The overall S-CVI value was 0.96, with I-CVI values ranging from 0.78 to 1.00. Experts considered items related to pain, odor, and exudate particularly relevant. Some items, such as patient perception of the wound, received lower ratings, highlighting challenges in self-assessment. CONCLUSION: Adopting this tool could improve the quality of care, reduce variability in clinical practices, and facilitate a multidimensional approach. However, further studies are needed to evaluate the scale's inter-rater reliability and internal consistency.
Cannita K, Marcellusi A, Ragonese A
… +16 more, Marinozzi A, Palmarini C, Perrotti F, Irelli A, Di Giacobbe A, Di Santo S, Di Carlo C, Catalani M, Battipane R, Friggi E, Moschetti G, Odio C, Santarelli F, Brucchi M, Di Giosia M, D'Ugo C
Recenti Prog Med
· 2026 Jan · PMID 41568633
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In recent years, proximity of care has taken on a fundamental role in oncological management, improving the humanization and accessibility of treatments. The model of decentralizing oncological care from hospitals to loc...In recent years, proximity of care has taken on a fundamental role in oncological management, improving the humanization and accessibility of treatments. The model of decentralizing oncological care from hospitals to local areas has been supported by national and international healthcare policies, such as the National Cancer Plan 2023-2027 and Ministerial Decree No. 77/2022. The aim of this work is to assess the impact of a hospital-territory integration pathway started by the G. Mazzini Hospital in Teramo, considering both the quality of the services offered and the economic implications for the National Health Service. The integration was achieved through the creation of a territorial oncology center, which provides care through a team of professionals working under the "migrant unit" model. This model focuses on chronic patients and long-term survivors, reducing waiting times and improving access to services. It has alleviated hospital overcrowding, improved organizational efficiency, treatment quality, and the psychological well-being of patients, which was measured using specific quality of life (QoL) questionnaires and financial toxicity assessments. From 1st January 2024 until 31 December 2024 the center managed approximately 3,000 visits, easing the hospital workload by rationalizing space and human resources, and improving access to treatments. An analysis of financial toxicity showed improved cost management, with a significant reduction in the cost per service, dropping from 30 euros in 2021 to about 17 euros in 2024 (-43%). The reorganization also helped reduce hospitalizations by optimizing care settings. Patient satisfaction was high, both in terms of service quality and stress reduction, thanks to a less crowded and more welcoming environment. Decentralization reduced the burden on hospital departments, improved efficiency and patient satisfaction, and lowered costs. The experience suggests that this model could be implemented and scaled in other regional healthcare systems to further enhance overall efficiency.
Stingi A, Aprile G, Aspromonte S
… +8 more, Avancini A, Bettariga F, Carapezza L, Compagni S, Giusti R, Pilotto S, Schirripa M, Loupakis F
Recenti Prog Med
· 2026 Jan · PMID 41568632
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Modern oncology faces the need to integrate high-level evidence, non-pharmacological interventions into care pathways. Among these, structured physical exercise is shifting from a simple "virtuous recommendation" to a tr...Modern oncology faces the need to integrate high-level evidence, non-pharmacological interventions into care pathways. Among these, structured physical exercise is shifting from a simple "virtuous recommendation" to a treatment that concretely influences clinical outcomes. The phase III CHALLENGE trial, conducted on 889 patients with stage II-III colon cancer, demonstrated a 6.4% absolute increase in 5-year disease-free survival (DFS) (HR 0.72) and a 37% reduction in overall mortality (HR 0.63). Observational evidence further confirms benefits in breast, prostate, and lung cancers. This review summarizes the literature, analyzes barriers and implementation strategies (tele-exercise, dedicated professionals, hub-and-spoke models), and assesses psychological and economic impacts.
Recenti Prog Med
· 2026 Jan · PMID 41568631
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HER2-positive breast cancer accounts for approximately 15-20% of all breast tumors and is characterized by a more aggressive biology compared with other subtypes. However, the introduction of anti-HER2 agents has made th...HER2-positive breast cancer accounts for approximately 15-20% of all breast tumors and is characterized by a more aggressive biology compared with other subtypes. However, the introduction of anti-HER2 agents has made this disease increasingly manageable, even in advanced stages. Among the most recent therapeutic advances, trastuzumab deruxtecan (T-DXd) has emerged as a new standard of care, thanks to its remarkable efficacy, ability to induce deep and durable responses, and significant activity in challenging sites such as the central nervous system and bone. Clinicians play a crucial role in ensuring optimal patient management during T-DXd therapy, including the monitoring and prevention of major toxicities (such as interstitial lung disease, nausea and vomiting, and cardiotoxicity), as well as in evaluating potential combinations with locoregional treatments - within an increasingly integrated multidisciplinary team. Maintaining a good quality of life remains essential, particularly for patients achieving long-lasting responses. Finally, results from recent clinical trials suggest a potential role for T-DXd in earlier disease stages, underscoring the growing need for clinical expertise in managing this innovative therapy.
Recenti Prog Med
· 2026 Jan · PMID 41568630
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Informed consent is today an essential element of clinical practice, grounded in the principle of patient self-determination. Its evolution, from the traditional paternalistic model to the recognition of the patient's ri...Informed consent is today an essential element of clinical practice, grounded in the principle of patient self-determination. Its evolution, from the traditional paternalistic model to the recognition of the patient's right to make conscious choices, has been marked by key historical and legal milestones such as the Nuremberg trials, the Tuskegee Study, and, in Italy, the landmark "Massimo" ruling of 1990, later consolidated by Law 219/2017. In General Practice, consent takes on specific features: often implicit, dynamic, and closely linked to the doctor-patient relationship, it goes beyond the mere signing of a form and unfolds throughout the entire care process. Information plays a central role and must be tailored, clear, and proportionate to the patient's level of understanding, while avoiding the pitfalls of excessive "defensive information." In this perspective, informed consent becomes a tool for sharing therapeutic goals and building a decision-making alliance, thereby redefining the very aims of medicine.
Recenti Prog Med
· 2026 Jan · PMID 41568629
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The debate over medical residents' commitment highlights the evolution of the healthcare profession. Moving beyond the rhetoric of "vocation" or initiatory suffering, a new professionalism is emerging. This must integrat...The debate over medical residents' commitment highlights the evolution of the healthcare profession. Moving beyond the rhetoric of "vocation" or initiatory suffering, a new professionalism is emerging. This must integrate scientific expertise with Medical Humanities, be supported by legal and organizational safeguards, and foster a therapeutic relationship built on trust and collaboration among colleagues.
Recenti Prog Med
· 2025 Dec · PMID 41392795
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The aim of this work is to provide an updated overview of the use of sotorasib in advanced NSCLC harboring KRAS G12C mutations, summarizing both clinical trial and real-world evidence supporting its use in pretreated pat...The aim of this work is to provide an updated overview of the use of sotorasib in advanced NSCLC harboring KRAS G12C mutations, summarizing both clinical trial and real-world evidence supporting its use in pretreated patients. The analysis focuses on efficacy, safety, and management of key toxicities, with particular attention to hepatic adverse events. Specific emphasis is also placed on intracranial activity and the use of sotorasib in special subgroups, including frail patients and those with comorbidities, providing a practical framework for daily clinical practice. The objective is to offer evidence-based guidance to facilitate treatment personalization and improve clinical outcomes in this complex patient population.
Collino F, Ferruzzi G, Mossetti E
… +2 more, Merlo F, Berardino M
Recenti Prog Med
· 2025 Dec · PMID 41392794
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Parenteral nutrition (PN), developed since the 1960s with the pioneering work of Dudrick, today represents a safe therapeutic option both as exclusive support and as an integration to enteral nutrition (EN). In criticall...Parenteral nutrition (PN), developed since the 1960s with the pioneering work of Dudrick, today represents a safe therapeutic option both as exclusive support and as an integration to enteral nutrition (EN). In critically ill patients, the risk of malnutrition is high due to profound metabolic alterations and nutritional therapy must be modulated according to the stage of the disease, avoiding both overfeeding and underfeeding. We present the case of a polytraumatized adolescent admitted to intensive care following a serious motorcycle accident. After an initial stabilization phase, early EN was initiated, increasing to 75% of the estimated caloric requirement. The onset of intolerance (vomiting and gastric stagnation - RG) associated with alterations in cholestasis and hepatic cytolysis indices necessitated reducing EN and considering alternative strategies. In the absence of improvement, supplemental parenteral nutrition (SPN) was initiated, with a high-protein mixture, prudent lipid modulation, and daily micronutrient supplementation. EN was maintained at a low dose for trophic purposes. With progressive clinical recovery, the reduction of RG, intestinal canalization, and EN were increased until reaching the caloric requirement, allowing the suspension of SPN and the subsequent transition to oral feeding. This case highlights how, in intensive care, EN and PN should not be considered hierarchical alternatives but rather complementary tools, to be modulated in a personalized and multidisciplinary manner. Targeted management ensures adequate nutritional intake, prevents complications, and improves clinical outcomes in critically ill patients.
Assandri R, Grassini A, Manzoni M
… +2 more, Padrenostro M, Ferrò MT
Recenti Prog Med
· 2025 Dec · PMID 41392790
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Riassunto. Gli inibitori dei checkpoint (ICI) sono anticorpi monoclonali utilizzati come farmaci anti-neoplastici, indicati nel trattamento del carcinoma polmonare a piccole cellule (SCLC) in stadio avanzato. La perdita...Riassunto. Gli inibitori dei checkpoint (ICI) sono anticorpi monoclonali utilizzati come farmaci anti-neoplastici, indicati nel trattamento del carcinoma polmonare a piccole cellule (SCLC) in stadio avanzato. La perdita della tolleranza immunitaria dovuta a tali ICI è associata a disturbi immunomediati quali sindromi neurologiche paraneoplastiche. Data la rarità di questi casi (1% dei pazienti), gli specialisti e i laboratori devono essere pronti a riconoscere e caratterizzare queste eventi clinici. Presentiamo qui il raro caso di un paziente con SCLC avanzato trattato con inibitori del checkpoint che sviluppa un'encefalite come espressione di un evento paraneoplastico. La letteratura evidenzia come la rilevazione di un pannello esteso di autoanticorpi sia ormai diventata necessaria ai fini di una corretta diagnosi. Ma quali tipi di test di laboratorio sono davvero efficaci per l'individuazione di tali anticorpi e quindi per la corretta diagnosi? In questo caso clinico proponiamo l'uso combinato di test tissutali, immunoblot con antigeni ricombinanti e test cellulari. Questa strategia ci ha consentito l'individuazione di anticorpi anti-CRMP5, nel siero e nel liquido cefalo rachidiano del paziente considerati ad alto rischio. Il lavoro infine propone una flow chart diagnostica per la definizione delle specificità anticorpali.