Recenti Prog Med
· 2025 Dec · PMID 41392786
·
Publisher ↗
INTRODUCTION: The evolving epidemiological landscape of transthyretin amyloid cardiomyopathy (ATTR-CM), particularly in its wild-type form, highlights a progressive increase in diagnoses. This trend calls for a critical...INTRODUCTION: The evolving epidemiological landscape of transthyretin amyloid cardiomyopathy (ATTR-CM), particularly in its wild-type form, highlights a progressive increase in diagnoses. This trend calls for a critical reflection on the economic sustainability of tafamidis treatment, given the expanding eligible patient population and the lack of price renegotiation. METHODS: A retrospective study was conducted on patients treated at an Asl (2023-2025). Persistence and adherence to the treatment were evaluated. A linear regression model estimated future incidence and economic impact. RESULTS: Among 17 patients, persistence was 58.82%, adherence (>80%) 100%. Incidence rose from 15.2 to 35.73 cases/million (2018-2025). The 5-year cost per patient exceeded € 815,000. Based on the ATTR-ACT trial NNT (7.46), 2.3 deaths may be prevented, though this benefit may be overestimated. DISCUSSION: The rising incidence was not followed by a price revision. Use in older, frail patients and the absence of dynamic pricing agreements raise questions about cost-effectiveness and equitable access.
Tsiasiotis E, Scaccabarozzi S, Cricelli C
… +7 more, Gaudioso A, Giorgino F, Oliva F, Cremona K, Perrone Filardi P, Trifirò G, Senni M
Recenti Prog Med
· 2025 Dec · PMID 41392785
·
Publisher ↗
INTRODUCTION AND OBJECTIVES: Clinical research is a strategic priority for the Italian healthcare system, with significant benefits for patients, economy and public health. The Clinical Advancement & Research Excellence...INTRODUCTION AND OBJECTIVES: Clinical research is a strategic priority for the Italian healthcare system, with significant benefits for patients, economy and public health. The Clinical Advancement & Research Excellence (CARE) project identified the main obstacles that limit the full expression of the potential of clinical trials in Italy and proposed concrete solutions. METHODS: Starting with an online survey and following a simplified Delphi method, a multidisciplinary panel of experts identified the main barriers to clinical research in Italy and proposed a set of programmatic instances designed to improve the present situation. The final instances were formulated also based on the review by external stakeholders. RESULTS: The following programmatic instances were developed: 1) support the compliance with trial contract signing times; 2) create a national standard for Clinical Trial Sites (CTS) and a dedicated portal; 3) define the role of General Practitioners; 4) promote campaigns to raise awareness on the importance of clinical research. CONCLUSIONS: The instances presented offer concrete insights to optimize the effectiveness and efficiency of clinical trials in Italy, ensuring international competitiveness and allowing patients to benefit from innovative therapies.
Recenti Prog Med
· 2025 Dec · PMID 41392784
·
Publisher ↗
In the context of clinical research, the Data Protection Impact Assessment (DPIA), as required by Article 35 of the GDPR 2016/679, is an essential tool to ensure the compliant and responsible processing of personal data,...In the context of clinical research, the Data Protection Impact Assessment (DPIA), as required by Article 35 of the GDPR 2016/679, is an essential tool to ensure the compliant and responsible processing of personal data, particularly health and genetic data. The adoption of the DPIA addresses the need to safeguard the fundamental rights and freedoms of data subjects in high-risk scenarios, such as multicenter studies and the use of innovative technologies. This article analyzes the ethical, regulatory, and organizational value of the DPIA in clinical trials, highlighting operational challenges such as lack of resources, insufficient training, interpretative ambiguities, and weak integration with ethics committees. A multidisciplinary approach is proposed that sees the DPIA not merely as a regulatory obligation but as a strategic lever to enhance transparency and quality in research. In conclusion, the importance of clarifying roles and responsibilities is emphasized, while promoting a culture of data protection from the earliest stages.
Libianchi S, Giordano A, Scuderi G
… +6 more, Falconi E, Vagnozzi O, Giustiniani AL, Milani S, Felici FB, Marino D
Recenti Prog Med
· 2025 Dec · PMID 41392783
·
Publisher ↗
Health status and nutrition are fundamental determinants of overall well-being among incarcerated populations, who constitute a particularly vulnerable group. The prison environment functions as a microcosm where the rig...Health status and nutrition are fundamental determinants of overall well-being among incarcerated populations, who constitute a particularly vulnerable group. The prison environment functions as a microcosm where the rights to health and adequate food must be safeguarded without compromise, given that detainees rely entirely on institutional provisions for their care and nourishment. The cultural specificity of immigrant inmates introduces particular needs, including adherence to dietary requirements during Ramadan for individuals of Islamic faith. This raises significant health and nutritional considerations. Prolonged fasting can pose serious health risks, especially for individuals with underlying conditions such as diabetes mellitus, requiring the use of long-acting pharmacological formulations to ensure therapeutic continuity. Furthermore, the adequacy of food - considering its type, timing of administration, and ritual aspects - represents a central component of the rights to health and cultural diversity, as food carries symbolic meanings beyond mere sustenance. The State, responsible for safeguarding the rights and well-being of detainees, must ensure that nutritional provisions are both nutritionally appropriate and culturally respectful. Food is not only a primary necessity but also an element of identity and psychological well-being: inadequate or culturally insensitive meals can negatively affect psycho-physical health, potentially contributing to self-harm and, in severe cases, suicide, which is unfortunately on the rise within Italian prisons. Implementing a more attentive and inclusive food system can therefore improve detainees' health outcomes and promote greater emotional and social stability within correctional facilities.
Recenti Prog Med
· 2025 Dec · PMID 41392782
·
Publisher ↗
On professional social media, "I'm thrilled to share that our paper has just been published…" has become a ritualized form of self-promotion. This manuscript examines how such practices intersect with narcissism, algorit...On professional social media, "I'm thrilled to share that our paper has just been published…" has become a ritualized form of self-promotion. This manuscript examines how such practices intersect with narcissism, algorithms, altmetrics and inequalities (notably gender), shifting attention from methodological quality to the researcher's visibility. It argues for a more reflexive use of social media in science, focusing on questions, methods, limits and implications for patients and policy, rather than on academic ego and visibility metrics.
Recenti Prog Med
· 2025 Nov · PMID 41217044
·
Publisher ↗
There is growing recognition that mucus and mucin biology have a considerable impact on respiratory health, and subsequent global morbidity and mortality. Mucins play a critical role in chronic lung disease, not only by...There is growing recognition that mucus and mucin biology have a considerable impact on respiratory health, and subsequent global morbidity and mortality. Mucins play a critical role in chronic lung disease, not only by providing a physical barrier and clearing pathogens, but also in immune homeostasis. Mucoactive drugs are commonly used to clear the airway in mucus hypersecretory diseases, which can alleviate mucus hypersecretion and increase the efficiency of expectoration. Theoretically, inhaled medications can be directly and rapidly delivered to the lower respiratory tract and exert therapeutic effects, with fewer systemic adverse effects. Ambroxol is a widely used mucoactive drug to treat respiratory diseases associated with abnormal mucus secretion and impaired mucus transport. Moreover, ambroxol stimulates the synthesis of pulmonary surfactant, which, in addition to increasing lung compliance, preventing end-expiratory atelectasis, and facilitating the recruitment of collapsed airways, has anti-inflammatory, anti-infective, and immunoregulatory properties. Ambroxol inhalation represents an efficient way to reduce sputum viscosity, increase expectoration without increasing adverse events.
Salomone S, Pellegrino L, Rinaldi M
… +3 more, Casalone V, Witel G, Borghi F
Recenti Prog Med
· 2025 Nov · PMID 41176683
·
Publisher ↗
INTRODUCTION: Major pancreatic surgery, such as pancreaticoduodenectomy, often involves patients with compromised nutritional status. Parenteral nutrition (PN) may serve as temporary support while awaiting adequate oral...INTRODUCTION: Major pancreatic surgery, such as pancreaticoduodenectomy, often involves patients with compromised nutritional status. Parenteral nutrition (PN) may serve as temporary support while awaiting adequate oral intake. AIM: This report presents a clinical case to discuss the indications, benefits, and implications of PN within an ERAS-based perioperative management protocol. CLINICAL CASE: A 71-year-old woman with recent weight loss and a BMI of 18.28 underwent a Whipple procedure for distal biliary tract cancer. Preoperatively, nutritional supplementation with immunonutrients was initiated. Postoperatively, PN was administered via a peripheral venous line using a three-chamber bag, without central venous catheter placement. Oral feeding was gradually resumed, and PN was discontinued on postoperative day 6. The postoperative course was uneventful, with no clinical or surgical complications. The patient was discharged on postoperative day 8. Histological examination revealed in situ intrabiliary neoplasia without pathological lymph node involvement, and no indication for adjuvant therapy. At the 14-day postoperative dietary follow-up, the patient showed a weight gain of 2 kg and adequate nutritional intake. DISCUSSION: In the setting of high-complexity pancreatic surgery, early and individualized nutritional management is crucial, as recommended by ERAS and ESPEN guidelines. CONCLUSIONS: In this case, peripheral PN proved to be an effective and safe strategy, avoiding the risks associated with central venous catheter placement. The integrated approach supported a rapid nutritional and clinical recovery.
Arrighetti G, Carrozzini A, Gatti C
… +12 more, De Michele F, Sallustio A, Brogi T, Villa A, D'Innocenzo L, Carpino M, Ariani L, Marini M, Pontoriero A, Vagnoni L, Dei I, Prodi E
Recenti Prog Med
· 2025 Nov · PMID 41176674
·
Publisher ↗
Maggi M, Turcato G, Zaboli A
… +4 more, Filippi L, Lucente F, Milazzo D, Wiedermann CJ
Recenti Prog Med
· 2025 Nov · PMID 41176673
·
Publisher ↗
Sepsis remains a leading cause of in-hospital mortality, requiring rapid intervention and patient-tailored treatment strategies. We report the case of a 70-year-old woman with E. coli pyelonephritis presenting with septi...Sepsis remains a leading cause of in-hospital mortality, requiring rapid intervention and patient-tailored treatment strategies. We report the case of a 70-year-old woman with E. coli pyelonephritis presenting with septic shock. She was admitted to a medical High Dependency Unit (HDU) and managed using non-invasive hemodynamic monitoring with NICaS and bedside ultrasound (POCUS). Treatment was adapted in real time, including targeted fluid resuscitation, vasopressors, and inotropes, with patient improvement and stabilization. This case highlights how integrated non-invasive tools can guide sepsis management within HDUs, supporting the role of intermediate care units in national strategies for acute care system reform and resource optimization.