Grasso C, Bertolotti M, Farotto M
… +10 more, Bertolina C, Blengio F, Bottiglieri A, Cagnazzo C, Lazzari M, Libener R, Prevost C, Rossi M, Ferrante D, Maconi A
Recenti Prog Med
· 2025 Nov · PMID 41176669
·
Publisher ↗
INTRODUCTION: The prognostic potential of history of allergy and atopy in glioblastoma (GBM) patients has been poorly evaluated until now. In the present work, we studied the association between history of allergy/atopy...INTRODUCTION: The prognostic potential of history of allergy and atopy in glioblastoma (GBM) patients has been poorly evaluated until now. In the present work, we studied the association between history of allergy/atopy and survival length in a cohort of GBM patients. We also evaluated the association between already suggested demographic, anamnestic, clinicopathologic and molecular prognostic variables for GBM and survival. METHODS: The study was conducted retrospectively on a cohort of 145 patients diagnosed with GBM between 2015 and 2021. Data were retrieved from clinical charts. Information on history of allergy and atopy was self-reported. RESULTS: Median overall survival was 9.1 months (IQR 4.3-17). Patients with positive history of allergic/atopic diseases were 33 (22.8%). From univariable analysis, patients with allergies had a longer survival time than those with no allergies; however, this result was not statistically significant (HR:0.72; 95%CI 0.49-1.07). Instead, from multivariable analysis, patients aged ≥65 years resulted to have a shorter survival than the others; (HR:2.10; 95%CI 1.35-2.84), while an increased survival length is observed for patient who underwent tumor surgical resection (HR:0.46; 95%CI 0.30-0.72) and receiving adjuvant therapy (HR:0.25; 95%CI 0.17-0.38). CONCLUSION: Although the result was not statistically significant, we found a trend of protective effect of allergies/atopies in GBM patients. In addition, the study confirmed positive effects on GBM survival of some well-known variables, such as surgical resection, adjuvant therapy, and age.
Recenti Prog Med
· 2025 Nov · PMID 41176668
·
Publisher ↗
Adults who think to be at greater risk for developing some disease in the future make different choices about whether to get tested. Incidental findings resulting from patients tested for other clinical purposes, populat...Adults who think to be at greater risk for developing some disease in the future make different choices about whether to get tested. Incidental findings resulting from patients tested for other clinical purposes, population screenings and research programs increase proportionally with genetic testing methodologies available in the market. Consumers can buy home kits online and receive test results without any doctor involved in the process. Increasing options for prenatal care put on women more testing choice and responsibility, which need qualified and punctual support to result more beneficial than detrimental. In our opinion, many issues related to genetic testing (incidental findings, direct-to-consumer use, prenatal care value) are due to lacking medical interpretation or supervision, because the one thing is the patient taking care in autonomy, the other thing is leaving patients alone to figure out whether a certain result is relevant to their health and choices. In particular, a doctor-patient relationship is crucial to avoid genetic reductionism, that is, underestimating the impact of clinical strategies, individual behavior, social network and living environment on health. Taking tests under appropriate medical supervision increases the opportunity to generate value and minimize risk, based on the informed preferences of the individual patient.
Recenti Prog Med
· 2025 Nov · PMID 41176667
·
Publisher ↗
The use of cancer treatments in the terminal stages of life is an increasingly important clinical, ethical, and organizational issue. Despite recommendations from major scientific organizations to reduce active treatment...The use of cancer treatments in the terminal stages of life is an increasingly important clinical, ethical, and organizational issue. Despite recommendations from major scientific organizations to reduce active treatments for patients with a limited life expectancy, significant evidence shows that these therapies continue to be used even during the final days or weeks of life. This trend raises important questions regarding the quality of care, the appropriate balance between risks and benefits, the effective use of healthcare resources, communication between physicians and patients, and the incorporation of palliative care into the overall oncological treatment plan. Given these considerations, it is essential to analyze the clinical and organizational factors that influence these decisions. The goal is to develop effective strategies that promote more appropriate care, encourage the earlier integration of palliative care, and reduce the use of unnecessary or potentially harmful treatments during the terminal phases of illness.
Recenti Prog Med
· 2025 Nov · PMID 41176666
·
Publisher ↗
The Compassionate communities paradigm proposes an integrated model of end-of-life care, in which social, relational, and community dimensions complement medical intervention. Developed within the framework of public hea...The Compassionate communities paradigm proposes an integrated model of end-of-life care, in which social, relational, and community dimensions complement medical intervention. Developed within the framework of public health, the model entails the active involvement of citizens, institutions, and volunteers in local support networks. International evidence indicates benefits in terms of perceived quality of life, reduced isolation, and more appropriate use of healthcare services. In Italy, the "InVita" project has launched a pilot implementation in the province of Reggio Emilia, based on co-design, needs assessment, and both educational and cultural initiatives. The experience suggests the potential for local policies grounded in a renewed literacy around death and care.
Recenti Prog Med
· 2025 Nov · PMID 41176665
·
Publisher ↗
This article surveys how parts of the international medical-scientific and broader academic community have reacted to the current Israel-Palestine war. Journals such as BMJ, BMJ Global Health and The Lancet called for a...This article surveys how parts of the international medical-scientific and broader academic community have reacted to the current Israel-Palestine war. Journals such as BMJ, BMJ Global Health and The Lancet called for a ceasefire and documented the destruction of Gaza's health system; JAMA and NEJM used a more institutional tone, while Nature and Science reported on the collapse of research in Gaza. Professional bodies including the WMA, APHA, BMA and, more recently, the IAGS issued explicit statements. In Italy, orders and societies have responded unevenly. Regarding long-term outcomes of the war, the piece highlights evidence linking severe trauma, malnutrition and environmental exposures to possible epigenetic and intergenerational effects, and argues for symbolic and political pathways toward reconciliation and peace.
Recenti Prog Med
· 2025 Nov · PMID 41176664
·
Publisher ↗
Anticancer treatments at the end of life are considered inappropriate and are used as a quality indicator of clinical behaviours in oncology. However, given the changing of disease trajectories and the availability of ne...Anticancer treatments at the end of life are considered inappropriate and are used as a quality indicator of clinical behaviours in oncology. However, given the changing of disease trajectories and the availability of new, active treatments, it can no longer be considered synonymous of "useless or ineffective treatment". The distance from death is not sufficiently predictable, and treatment choices should ignore this factor. We propose a decision-making process that takes into account the person's wishes and prioritizes the best treatment options in every circumstance.
Recenti Prog Med
· 2025 Nov · PMID 41176663
·
Publisher ↗
Scientific literature and daily experience highlight two worrying phenomena: on the one hand, in the very advanced or even terminal stages of cancer, anticancer therapies are administered with dubious or insufficient and...Scientific literature and daily experience highlight two worrying phenomena: on the one hand, in the very advanced or even terminal stages of cancer, anticancer therapies are administered with dubious or insufficient and ethically disproportionate indications; on the other, the initiation of palliative care, whether simultaneous or end-of-life, is often too late. Moreover, this occurs despite the opposing recommendations of international and italian scientific societies, indicating the need to forgo (withholding or withdrawing) anticancer treatments that lack solid clinical indications and are ethically disproportionate. The problem can be addressed by removing the factors that hinder proper clinical practice, in compliance with the multiple oncology guidelines described in detail in the article by Rossi "The impact of cancer treatments at the end of life: a clinical, ethical and organizational problem" contained in this issue. The main strategies useful for overcoming these obstacles are a better and constant collaboration between oncology teams and palliative care teams in which shared decision-making processes are built that are more responsive to the global needs of the patient and more respectful of the criteria of therapeutic appropriateness and ethical proportionality. In this regard, it is essential to strengthen shared prognostic communication between the two teams to allow patients to make more informed decisions about which therapeutic options to accept in a situation of increasing uncertainty about efficacy due to disease progression.
Recenti Prog Med
· 2025 Oct · PMID 41037390
·
Publisher ↗
Patients with pancreatic cancer frequently present with protein-energy malnutrition, which can negatively affect prognosis and treatment tolerance. We report the clinical case of a 55-year-old man with locally advanced p...Patients with pancreatic cancer frequently present with protein-energy malnutrition, which can negatively affect prognosis and treatment tolerance. We report the clinical case of a 55-year-old man with locally advanced pancreatic adenocarcinoma, deemed unresectable at diagnosis, who experienced severe weight loss (-23 kg in the last 4 months) and marked clinical deterioration. The prescription of supportive parenteral nutrition (PN) allowed stabilization of body weight, improvement of fatigue, and the resumption of chemotherapy cycles that had previously been interrupted due to worsening clinical conditions. After eight cycles of chemotherapy, restaging imaging revealed tumour regression, making a surgical reassessment possible. This case highlights the importance of early nutritional screening and targeted nutritional intervention in oncology patients, in order to optimize ongoing treatment response and broaden therapeutic opportunities.
Riccomi O, Causio FA, De Vita V
… +12 more, Cristiano A, Del Medico M, De Mori L, Battipaglia C, Sawaya M, De Angelis L, Di Pumpo M, Piscitelli A, Risuleo PE, Vojvodic G, Destro Castaniti B, Scarsi N
Recenti Prog Med
· 2025 Oct · PMID 41037388
·
Publisher ↗
Artificial intelligence (AI) adoption in healthcare is rising. Unbiased evaluation requires uncontaminated benchmarks. We evaluated Mistral-7B-Instruct-v0.1 on 1120 human-validated Italian medical multiple-choice questio...Artificial intelligence (AI) adoption in healthcare is rising. Unbiased evaluation requires uncontaminated benchmarks. We evaluated Mistral-7B-Instruct-v0.1 on 1120 human-validated Italian medical multiple-choice questions (SSM). Mistral achieved 40,2% accuracy and 38.8% F1 score on the dataset. Likely causes include English-centric instruction tuning, lack of medical domain knowledge, and prompt misalignment with the task format. These findings suggest that LLMs need further improvements before deployment.
Cocolicchio D, De Vita V, Cuoco F
… +8 more, Tona D, Porcelli M, Postorino D, Scaglioso F, Pascucci D, Regazzi L, Pastorino R, Laurenti P
Recenti Prog Med
· 2025 Oct · PMID 41037387
·
Publisher ↗
The CareVax project aims to enhance vaccination coverage in fragile patients by creating digital pathways between hospitals and local health authorities. It utilizes an automated algorithm to identify eligible patients f...The CareVax project aims to enhance vaccination coverage in fragile patients by creating digital pathways between hospitals and local health authorities. It utilizes an automated algorithm to identify eligible patients for vaccination based on electronic health records and regional vaccine registries. Expected outcomes include improved vaccination rates and a scalable technological model for digital public health.
Abbate S, Leo MC, Bianco F
… +4 more, Ferro D, Tozzi AE, Rocchi F, Pontrelli G
Recenti Prog Med
· 2025 Oct · PMID 41037386
·
Publisher ↗
Clinical research is increasingly regulated. Despite growing artificial intelligence (AI) use in healthcare, there is a lack of adequate tools to support researchers in non profit (AI or not) studies. To assist with the...Clinical research is increasingly regulated. Despite growing artificial intelligence (AI) use in healthcare, there is a lack of adequate tools to support researchers in non profit (AI or not) studies. To assist with the classification of clinical software, ClinEthix, a prototype conversational tool, has been developed to help researchers with regulatory qualification. A survey of 20 researchers found it highly useful, clear and user-friendly. Future developments will integrate LLMs and human feedback to improve accuracy.
Mazzucato S, Lopriore P, Daddoveri F
… +7 more, Lamperti C, Carelli V, Musumeci O, Servidei S, Micera S, Mancuso M, Bandini A
Recenti Prog Med
· 2025 Oct · PMID 41037385
·
Publisher ↗
This study shows that machine learning can accurately distinguish between mitochondrial and nuclear DNA mutations in primary mitochondrial diseases using only non-genetic and non-histological clinical data. While languag...This study shows that machine learning can accurately distinguish between mitochondrial and nuclear DNA mutations in primary mitochondrial diseases using only non-genetic and non-histological clinical data. While language models underperform in comparison, they show potential as complementary diagnostic tools.
Zotti N, Arzilli G, Baglivo F
… +3 more, De Angelis L, Porretta A, Rizzo C
Recenti Prog Med
· 2025 Oct · PMID 41037384
·
Publisher ↗
An AI system based on NLP and machine learning has been developed to identify surgical site infections (SSIs) from hospital discharge letters. After advanced pre-processing and imbalance handling, BERT-FT achieved the be...An AI system based on NLP and machine learning has been developed to identify surgical site infections (SSIs) from hospital discharge letters. After advanced pre-processing and imbalance handling, BERT-FT achieved the best performance (F1=0.79), outperforming TF-IDF and W2V. Large language models (LLMs) showed limitations. The system could support semi-automatic SSI surveillance, with prospects for optimisation in translations, prompts, and infrastructure.
Vella G, Sala F, Pisciotta V
… +1 more, Anzalone C
Recenti Prog Med
· 2025 Oct · PMID 41037383
·
Publisher ↗
We implemented a three-phase AI pipeline for automating epidemiological investigations: structured PDF data extraction, RAG-driven report generation, and final document assembly. Expert validation (n=200) yielded high sc...We implemented a three-phase AI pipeline for automating epidemiological investigations: structured PDF data extraction, RAG-driven report generation, and final document assembly. Expert validation (n=200) yielded high scores for completeness (4.7), accuracy (4.5), relevance (4.6), clarity (4.8), and timeliness (4.4), with inter-rater κ=0.85 and a 60% time reduction. The system is scalable to serve other surveillance systems.
Torsello S, Carli S, Cuzzucoli A
… +1 more, Caligiore D
Recenti Prog Med
· 2025 Oct · PMID 41037382
·
Publisher ↗
This study introduces a multimodal pipeline that combines cognitive tests and MRI data from ADNI and PPMI to examine Parkinson's and Alzheimer's diseases. Using FastSurfer for quick brain volume analysis, it uncovers com...This study introduces a multimodal pipeline that combines cognitive tests and MRI data from ADNI and PPMI to examine Parkinson's and Alzheimer's diseases. Using FastSurfer for quick brain volume analysis, it uncovers common neurobiological mechanisms and patterns of cognitive decline. Early findings support longitudinal multimodal evaluation, advancing precision medicine and personalized clinical decision-making in neurodegenerative disorders.
Leo E, Baglivo F, Starace F
… +4 more, Romigi A, Antelmi E, Rizzo C, Faraguna U
Recenti Prog Med
· 2025 Oct · PMID 41037381
·
Publisher ↗
Using Sleep Medicine guidelines and textbook, we evaluated four large language models (LLMs) (Llama 3.2 3B, Llama 3.3 70B, GPT 4o mini, Gemini 2.0 Flash) on AIMS certification questions, comparing baseline and Retrieval...Using Sleep Medicine guidelines and textbook, we evaluated four large language models (LLMs) (Llama 3.2 3B, Llama 3.3 70B, GPT 4o mini, Gemini 2.0 Flash) on AIMS certification questions, comparing baseline and Retrieval Augmented Generation (RAG) performance. RAG improved accuracy in all models (e.g., Llama 3.2 +9.6 points, Gemini 2.0 +4.0 points), highlighting RAG's role in enhancing LLM reliability in specialized medical domain.
D'Ambrosio A, Baglivo F, De Angelis L
… +2 more, Tecchio F, Rizzo C
Recenti Prog Med
· 2025 Oct · PMID 41037380
·
Publisher ↗
We benchmarked 40 LLMs on a 40 item travel medicine quiz. Bayesian modelling was used to evaluate accuracy, consistency, parsability, and cost metrics. Accuracy spanned 27.9-97.5%; reasoning tuned frontier models (OpenAI...We benchmarked 40 LLMs on a 40 item travel medicine quiz. Bayesian modelling was used to evaluate accuracy, consistency, parsability, and cost metrics. Accuracy spanned 27.9-97.5%; reasoning tuned frontier models (OpenAI o3, Perplexity Sonar Reasoning) topped the benchmark, whereas local small underperformed. Cost accuracy curves revealed five Pareto optimal systems, with o3 being the current best. These findings confirm the performance of current LLMs as public health knowledge support systems.