5,491 results match your criteria Recenti Progressi in Medicina [Journal]


[Out-patient management of nausea and vomiting in multiday therapy of acute myeloid leukemia in the elderly. Use of granisetron in slow-release transdermal formulation. Clinical case].

Recenti Prog Med 2019 Mar;110(3):10e-13e

Nausea and vomiting induced by chemotherapy (CINV) occur in 70-80% of onco-haematological patients undergoing antiblastic therapy. The anti-emetic therapy chosen according to the guidelines and characteristics of the single patient solve CINV in about 80% of cases. The concept of supportive care, which includes the treatment of CINV, has been formalized by the Multinational Association Supportive Care in Cancer (MASCC) to prevent and manage the side effects of antiblastic therapy. Read More

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http://dx.doi.org/10.1701/3132.31185DOI Listing
March 2019
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[Opioid-induced constipation in oncologic patient: a clinical case treated with naloxegol].

Authors:
Pasquale Gallo

Recenti Prog Med 2019 Mar;110(3):6e-9e

Oncologic patients on opioid therapy due to pain may have several side effects, including respiratory depression (in about 1% of cases), pruritus (up to 10% of cases), nausea (in 25-32% of cases), sedation (in 20- 60% of cases); but the most far-reaching side effect (up to 95% of cases) that can occur is constipation. The socalled "opioid-induced constipation" (OIC) can develop at the start of opioid therapy and can last as long as continued use. The OIC is a real change in intestinal habits that occurs when opioid treatment is started; it is noted with a reduced frequency of episodes of defecation, with a development or worsening of the effort to defecation, with a feeling of incomplete emptying and a perception on the part of the patient to live in a stressful way the act of defecation. Read More

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http://dx.doi.org/10.1701/3132.31184DOI Listing
March 2019
1 Read

[Breaktrough cancer pain in metastatic prostate adenocarcinoma: a case report.]

Recenti Prog Med 2019 Mar;110(3):3e-5e

The pain associated with frequent secondary bone involvement can negatively affect the quality of life of patients affected by metastatic prostate cancer. Its proper diagnostic framework is important to optimize the treatment. We describe the case of a patient suffering from breaktrough cancer pain treated with sublingual fentanyl. Read More

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http://dx.doi.org/10.1701/3132.31183DOI Listing

La gestione dei sintomi nel paziente oncologico.

Authors:
Marco Platania

Recenti Prog Med 2019 Mar;110(3):1e-2e

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http://dx.doi.org/10.1701/3132.31182DOI Listing

[Role of 18F-FDG PET/CT in comparison with CECT for whole-body assessment of patients with esophageal cancer.]

Recenti Prog Med 2019 Mar;110(3):144-150

UO Medicina Nucleare, DIM, Università di Bari "Aldo Moro", Bari.

Aim: We aimed to evaluate the role of 18F-FDG PET/CT in the TNM staging of esophageal cancer in comparison with contrast-enhancement computed-tomography (CECT). Futhermore we set out to determine the role of semiquantitative PET parameters.

Methods: 55 patients performed 18F-FDG PET/CT and CECT. Read More

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http://dx.doi.org/10.1701/3132.31142DOI Listing

[Immunoterapia in prima linea nel carcinoma polmonare non a piccole cellule in stato avanzato di malattia: una scelta favorevole in termini di costo-efficacia?]

Recenti Prog Med 2019 Mar;110(3):138-143

Department of Oncology, Mater Salutis Hospital, Az. ULSS 9 Scaligera, Legnago (VR), Italy.

Riassunto. Introduzione. L'analisi è limitata agli studi registrativi randomizzati di fase III in prima linea per il tumore polmonare metastatico non a piccole cellule (mNSCLC). Read More

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http://dx.doi.org/10.1701/3132.31141DOI Listing
March 2019
1 Read

[Continuity and school reentry support of patients with serious diseases: experiences in pediatric oncology.]

Recenti Prog Med 2019 Mar;110(3):131-137

SC Pediatria, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milano.

Dealing with a serious illness always implies, and particularly for a child, important physical and psychological stresses. If on the one hand, the adult could have adaption's resources which allow him to deal with the illness's implications, on the other hand, for a child, the interference of the disease with growing steps may cause serious problems. For this reason, the clinicians and the family have to support the educational and social continuity of the child's interactions. Read More

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http://dx.doi.org/10.1701/3132.31140DOI Listing

[The new oncological mutational model. What changes in regulatory processes and in the reimbursement of cancer target therapies.]

Recenti Prog Med 2019 Mar;110(3):122-130

Fondazione Ricerca e Salute (ReS), Roma.

The progressive diffusion of genomic profiling tests based on next-generation sequencing (NGS), the development of new mutation-driven drugs, and the "agnostic approval" processes of FDA and EMA represent a considerable phenomenon in the development of oncology and Precision Medicine. These have started the mutational oncology model that supports and integrates the traditional histological one. This new model, although still preliminary, is deeply different from the histological method. Read More

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http://dx.doi.org/10.1701/3132.31139DOI Listing

[CIPOMO position paper about conflict of interest.]

Authors:

Recenti Prog Med 2019 Mar;110(3):119-121

A substantial part of the final cost of health-related products is due to marketing, and the revenue from sales is, at least in some cases, disproportionally higher than the development costs. In this context, financial interests can add to drug pricing and prevail over healthcare issues and equity of access to services. Conflict of interest (COI) is a «condition in which the professional judgment concerning a primary interest (the health of a patient or the reliability of research results or the impartiality of clinical informations) tends to be unduly influenced by a secondary interest (for example an economic gain or a career advantage)». Read More

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http://dx.doi.org/10.1701/3132.31138DOI Listing

[Symptom assessment and chemical coping detection: the assessment of the cancer patient's symptoms between consumption, use and abuse.]

Recenti Prog Med 2019 Mar;110(3):115-117

Oncologia Medica, Azienda Ospedaliero-Universitaria Sant'Andrea, Roma - Oncologia Medica B, Policlinico Umberto I , Roma.

Substance abuse is frequently under-diagnosed among cancer patients. Alcoholism is a problem afflicting about 18% of the general population. This percentage is higher in hospitalized patients. Read More

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http://dx.doi.org/10.1701/3132.31137DOI Listing
March 2019
3 Reads

[Professional societies and conflict of interests governance.]

Recenti Prog Med 2019 Mar;110(3):113-114

Dipartimento di Scienze Economico-Sociali e Matematico-Statistiche, Università di Torino.

The complexity of health systems often implies a condition of conflict of interests for many of the players involved: health professionals, managers of the NHS, pharmaceutical, medical devices or food industries, publishers and communication agencies, conference event organizers. Conflict of interests is a condition of risk, not a sentence of guilt: for this reason, conflict of interests should be managed through information and training of health personnel. Scientific societies play an important role being active in updating their members (conferences, meetings, e-learning and residential training courses) and influencing healthcare with the production of clinical practice guidelines. Read More

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http://dx.doi.org/10.1701/3132.31136DOI Listing
March 2019
1 Read

Dalla letteratura.

Authors:

Recenti Prog Med 2019 Mar;110(3):109-112

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http://dx.doi.org/10.1701/3132.31135DOI Listing

In questo numero.

Authors:

Recenti Prog Med 2019 Mar;110(3):107

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http://dx.doi.org/10.1701/3132.31134DOI Listing

[Somatization].

Authors:
Rino Scuccato

Recenti Prog Med 2019 Feb;110(2):100-105

Neurologo libero professionista, Vicenza.

Functional disorders that we observe neurologically primarily pose terminology problems: some of them such as migraine, narcolepsy, restless legs syndrome have a recognized nosographic status, although without demonstrable lesions; others are interpreted only as somatic manifestations of psychic conflicts. There is also the risk that the "functional" diagnosis masks - as prejudice - lesional pathologies not adequately investigated with the available technology, leading to serious clinical errors. Moreover, even in presence of a probable psychogenic disorder, patients tend to reject the "functional" diagnosis, for cultural reasons linked to the old philosophical separation between diseases of the body and mind (the latter with a "lower" status). Read More

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http://dx.doi.org/10.1701/3112.31007DOI Listing
February 2019
1 Read

Which is the destiny of ulipristal acetate for uterine fibroids? A commentary on the Italian medicines agency (AIFA) pronouncements

Recenti Prog Med 2019 02;110(2):98-99

Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, University of Ferrara.

The 19 of February 2018 the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco) temporary stopped the new administration of Ulipristal Acetate (UPA) for treating uterine leiomyomas symptoms, because liver injury and hepatic failure had been reported in relationship with UPA use. After the European Medicines Agency review of risks of UPA, the 3 of August 2018 the AIFA produced another note, disclosing that a cause-effect relationship between the UPA use and liver injury is not proved and that some patients can be discontinuously treated if surgery is not recommended. However, a close monitoring of hepatic function must be done in Ulipristal users. Read More

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http://dx.doi.org/10.1701/3112.31006DOI Listing
February 2019
1 Read

Pulmonary embolism: a retrospective comparative study between patients with atypical vs typical clinical presentation

Recenti Prog Med 2019 02;110(2):93-97

Department of Internal Medicine, Ospedali Riuniti di Ancona, Italy.

Background: Natural history and outcomes of patients with pulmonary embolism (PE) without typical symptoms (atypical PE) remain unclear. The aim of the study is to compare the clinical characteristics and the prognosis between typical PE and atypical PE.

Methods: We retrospectively analyzed data from consecutive patients admitted to the Emergency Department (ED) because of a diagnosis of PE and classified them in two groups: typical PE and atypical PE. Read More

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http://dx.doi.org/10.1701/3112.31005DOI Listing
February 2019

[Spontaneous rectus sheath hematoma as a complication of anticoagulant and antiplatelet therapy: a case report.]

Recenti Prog Med 2019 Feb;110(2):89-92

UOC Cardiologia Riabilitativa CTO, ASST Gaetano Pini/CTO, Milano.

Spontaneous rectus sheath hematoma (RSH) is an uncommon and often clinically misdiagnosed cause of abdominal pain, characterized by a presence of blood within rectus muscle sheath, with palpable mass. Hemorrhage may originate from the epigastric artery and branches or directly from rectus sheath rupture. The most frequent cause of hematoma is anticoagulant therapy. Read More

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http://dx.doi.org/10.1701/3112.31004DOI Listing
February 2019
1 Read

[Social media and people with HIV: results from an Italian survey.]

Recenti Prog Med 2019 Feb;110(2):86-88

Coordinamento Nazionale Marketing Sociale - Onlus.

HIV continues to be an important public health problem. The web, social media and new mobile technologies are gaining considerable potential in overcoming the stigma in order to promote continuity of care, the possibility to stay in contact with one's doctor and with the peer community, offering an alternative to traditional social structures. The purpose of this survey it was to investigate the opinions and behavior of people with HIV regarding the use of these technologies. Read More

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http://dx.doi.org/10.1701/3112.31003DOI Listing
February 2019
1 Read

[Turn-over of non-tenured public health research personnel in an Italian public research institute (IRCCS).]

Recenti Prog Med 2019 Feb;110(2):75-85

SSD Epidemiologia Analitica e Impatto Sanitario, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano - Direzione Scientifica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano.

Background: The objective is to show variations in the number of non-tenured personnel (NTP) in a public health research centre (IRCCS) between 30th June 2016 and 31st December 2017. In this time interval, the issue of NTP was at the centre of governmental discussions.

Methods: Data collection was performed from CVs and scientific publications of NTP working at the Fondazione IRCCS Istituto Nazionale dei Tumori (INT). Read More

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http://dx.doi.org/10.1701/3112.31002DOI Listing
February 2019

[The biological resources and molecule archives organization: turn a need into an opportunity for the Smart Specialization Strategy of the Lazio region.]

Recenti Prog Med 2019 Feb;110(2):68-74

Istituto Superiore di Sanità, Roma.

Smart Specialization Strategy (S3) of Lazio defines smart specialization strategies to bring out the excellence of the territory with prospects of success on the global market. Chemical-pharmaceutical, biomedical and biotechnological field is one of the 7 sectors considered of greatest interest for the S3. Key engine of biotechnology development are biological materials and associated data, stored in biobanks. Read More

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http://dx.doi.org/10.1701/3112.31001DOI Listing
February 2019

[Clinical research coordinators: a crucial resource.]

Recenti Prog Med 2019 Feb;110(2):65-67

Unità di Biostatistica e Sperimentazioni Cliniche, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC).

The increasing complexity that characterizes the world of clinical trials, both in terms of procedures and bureaucracy, has made it necessary to create dedicated infrastructures composed of experienced and qualified personnel, who constantly work to ensure high ethical and qualitative standards. A key role in these infrastructures is played by the clinical research coordinator, a key figure able to manage the workflow required, placing himself as a reference for the coordination of the various activities and professional figures involved. The literature has widely demonstrated how the presence of this professional figure is a valid contribution both from a documentary and administrative point of view as well as a crucial resource for what concerns the indicators of ethics and quality of research. Read More

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http://dx.doi.org/10.1701/3112.31000DOI Listing
February 2019

[Precarious employment in public Health research: an initiative to improve working and contractual conditions of precarious workers.]

Recenti Prog Med 2019 Feb;110(2):63-64

Gruppo di lavoro Epidemiologia e Precariato dell'Associazione Italiana di Epidemiologia - Dipartimento di Scienze Cliniche e Biologiche, Università di Torino.

The problem of precarious employment is particularly rooted in epidemiological and public health research. Through a shared path, within the Italian Association of Epidemiology, a commitment document on precariousness in the epidemiological field has been produced with the aim of improving the working and contractual conditions of the precarious personnel involved in the initiative. If this experience were repeated in other scientific associations, the number of precarious workers with more protection would increase. Read More

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http://dx.doi.org/10.1701/3112.30999DOI Listing
February 2019

[Reflections on time. From the clinic to climate change.]

Authors:
Rodolfo Saracci

Recenti Prog Med 2019 Feb;110(2):61-62

Ex-Presidente, International Epidemiological Association.

The often heard 'time is money' formula is today generally applied to all human activities: it implies that a gain in time is a gain in money, with the consequence of introducing a generalized pressure to minimize the execution time of all and every human operation. There are however processes that are just destroyed when their execution speed becomes faster and faster: any music piece, whose time structure is essential, is a prototype of these phenomena. Two apparently remote phenomena as the doctor-patient interaction and the control of global climatic change belong for different reasons to the same category of phenomena the priority of which cannot be derived using the 'time is money' formula but requires - before any accounting calculation - considering their intrinsic value for health and medicine. Read More

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http://dx.doi.org/10.1701/3112.30998DOI Listing
February 2019

Dalla letteratura.

Authors:

Recenti Prog Med 2019 Feb;110(2):55-59

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http://dx.doi.org/10.1701/3112.30997DOI Listing
February 2019

In questo numero.

Authors:

Recenti Prog Med 2019 Feb;110(2):53

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http://dx.doi.org/10.1701/3112.30996DOI Listing
February 2019

In ricordo di Lisa Schwartz (30 giugno 1963 - 29 novembre 2018).

Authors:

Recenti Prog Med 2019 Jan;110(1):52

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http://dx.doi.org/10.1701/3089.30823DOI Listing
January 2019

[Stories of foreigners].

Authors:
Rino Scuccato

Recenti Prog Med 2019 Jan;110(1):48-51

Neurologo libero professionista, Vicenza.

Immigrant foreigners who attend a public neurology clinic live in our country for a long time and they usually have a fair degree of integration into the cultural fabric. They do not seem to have pathologies or social problems different from those of the Italian users of the same service. However, many of them carry personal and collective stories of deprivation, struggle and suffering that can not be considered common. Read More

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http://dx.doi.org/10.1701/3089.30822DOI Listing
January 2019

[Encephalitis by type B influenza: a pediatric clinical case and literature review.]

Recenti Prog Med 2019 Jan;110(1):42-46

UOC di Pediatria e Neonatologia, Ospedale di Ravenna, AUSL della Romagna.

We report the case of a 6-year-old girl who presented with encephalitis during type B influenza. The clinical picture was characterized by an alteration of the state of consciousness associated with focal neurological signs with electroencephalographic changes and brain MRI. Clinical improvement was rapid and without neurological outcomes. Read More

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http://dx.doi.org/10.1701/3089.30821DOI Listing
January 2019
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[The heart failure management in Sicily: cognitive analysis of clinical features.]

Recenti Prog Med 2019 Jan;110(1):33-41

UO Cardiologia, Dipartimento per la Cura e lo Studio delle Patologie Cardiotoraciche e dei Trapianti Cardiotoracici, IRCCS - ISMETT, Palermo.

Introduction: Heart failure (HF) is a main issue of modern healthcare system. Patient affected are continuously growing in number and age; therefore, an integrated management between different parts of healthcare system is crucial to optimize outcome and sustainability. So far, little is known about clinical pathways of HF patients in Sicily. Read More

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http://dx.doi.org/10.1701/3089.30820DOI Listing
January 2019

[Heart failure in Apulia Region - Italy (Local Health Unit Barletta-Andria-Trani): analysis of the therapeutic pathways, healthcare resource consumption and related costs.]

Recenti Prog Med 2019 Jan;110(1):23-32

CliCon, Health Economics and Outcomes Research, Ravenna.

Background: Heart failure (HF) is commonly reported, it is estimated to affect 10% of subjects aged over 70 years. Objectives of this study were to describe clinical and demographic characteristics of patients with HF diagnosis, to analyze therapeutic pathways and to estimate healthcare resources consumption.

Methods: Data on patients aged ≥18 years with a hospitalization discharge diagnosis of HF between 01/01/2010 and 31/12/2014 and in treatment with HF-related drugs were extracted from the administrative databases of the Italian Local Health Unit of Barletta-Andria-Trani (BT). Read More

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http://dx.doi.org/10.1701/3089.30819DOI Listing
January 2019

[Appropriateness, self-audit and extractors in general medicine.]

Recenti Prog Med 2019 Jan;110(1):18-22

MGI Medoacus, ASL 6 Euganea, Carmignano di Brenta (Padova).

The author presents the results of a personal audit proposed to the GPs by the ASL 6 Euganea of the Veneto Region. The results obtained show significant differences between the data provided by the pharmaceutical sector and those obtained by consulting the individual database. The therapeutic adherence of antihypertensive drugs appears to be particularly discordant. Read More

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http://dx.doi.org/10.1701/3089.30818DOI Listing
January 2019
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[To tell science. Risks, opportunities and new tools of communication.]

Authors:
Gianna Milano

Recenti Prog Med 2019 Jan;110(1):11-17

Giornalista scientifico.

The New York Times recently celebrated the 40th anniversary of its historic "Science section" with a special issue. An opportunity to reflect on the state of the art of scientific journalism. After having seen the inserts dedicated to science flourish in the '70s and '80s, in recent times the major Italian weekly and several newspapers have decided - with rare exceptions - to eliminate them. Read More

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http://dx.doi.org/10.1701/3089.30817DOI Listing
January 2019
7 Reads

[Adherence to chronic polytherapy in secondary prevention of myocardial infarction: limits and perspectives.]

Recenti Prog Med 2019 Jan;110(1):7-9

Dipartimento di Epidemiologia del SSR - Regione Lazio, ASL Roma 1.

Patients who have had an acute myocardial infarction (MI) are at increased risk of mortality and morbidity. International guidelines agree on the use of combination of the following drugs: platelet antiplatelets, β-blockers, ACEI⁄ARBs and statins. The benefits of chronic polytherapy in reducing cardiovascular disease have been clearly shown. Read More

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http://dx.doi.org/10.1701/3089.30816DOI Listing
January 2019
1 Read

Dalla letteratura.

Authors:

Recenti Prog Med 2019 Jan;110(1):3-5

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http://dx.doi.org/10.1701/3089.30815DOI Listing
January 2019
3 Reads

In questo numero.

Authors:

Recenti Prog Med 2019 Jan;110(1)

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http://dx.doi.org/10.1701/3089.30814DOI Listing
January 2019
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[How to implement the guidelines in clinical practice. The experiences in digestive endoscopy.]

Authors:
Emilio Di Giulio

Recenti Prog Med 2018 Dec;109(12):614-618

UOD di Endoscopia Digestiva. Azienda Ospedaliera Sant'Andrea, Sapienza Università di Roma.

The gap between the evidences produced by scientific research and its application in clinical practice has gained considerable interest in recent years. The guidelines are the best and most accessible elaboration of the evidence, but their implementation for good clinical practice requires complex and targeted interventions, often hampered by several cultural, organizational and structural barriers. The literature provides several intervention tools today to bridge this gap. Read More

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http://dx.doi.org/10.1701/3082.30748DOI Listing
December 2018
12 Reads

[New organ allocation criteria in liver transplantation.]

Recenti Prog Med 2018 Dec;109(12):609-613

Unità Operativa di Epatologia e Trapianto, Dipartimento di Area Medica (DAME), Azienda Ospedaliero-Universitaria Integrata, Udine.

The organ allocation modality in the liver transplant represents a fundamental step for the correct success of the transplantation procedure. The practical effects deriving from the adoption of the organ allocation models do not imply only clinical repercussions but also concern important ethical aspects. Alongside the general principles of fairness, justice and transparency, the organ allocation models should be aimed at providing for each patient who waits for an organ, the possibility of accessing it, preserving and maximizing the outcome of the transplant in terms of survival and quality of life. Read More

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http://dx.doi.org/10.1701/3082.30747DOI Listing
December 2018
2 Reads

Direct-acting antiviral agents and risk of hepatocellular carcinoma: is it still a clinical dilemma?

Recenti Prog Med 2018 12;109(12):605-608

Section of Gastroenterology and Hepatology, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBiMIS), University of Palermo, Italy.

Direct-acting antivirals (DAAs) revolutionised the treatment of chronic HCV-related disease achieving high rates of sustained virological response (SVR), also in more advanced patients, with a good safety profile and a proven positive effect on the reduction of risk of HCC occurrence. Nevertheless, patients with an history of successfully treated early HCC were initially excluded from pivotal trials. Although some initial retrospective studies, affected by several methodological issues, raised concerns regarding a possible harmful effect on the risk of HCC recurrence after antiviral therapy, more recent prospective studies and meta-analyses provided evidence that risk of HCC recurrence after DAA therapy is similar, or even lower, than that observed in patients treated with interferon or in DAA-untreated controls. Read More

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http://dx.doi.org/10.1701/3082.30746DOI Listing
December 2018
1 Read

[Infections and antimicrobial stewardship in cirrhotic patients.]

Recenti Prog Med 2018 Dec;109(12):600-604

SC Malattie infettive, Dipartimento Scienze Mediche e Malattie Infettive, Fondazione IRCCS Policlinico San Matteo, Università di Pavia.

The aim of this review is to focus on the recent knowledge on antibiotic stewardship and empiric antibiotic treatment in cirrhotic patients. The application of antimicrobial stewardship (AS) rules appears to be the most appropriate strategy to globally manage cirrhotic patients with infectious complications: indeed they represent a unique way to provide both early diagnosis and appropriate therapy in order to avoid not only antibiotic over-prescription but, more importantly, selection and spread of antimicrobial resistance. Moreover, cirrhotic patients must be considered "frail" and susceptible to healthcare associated infections: applying AS policies would assure a cost reduction and thus contribute to the improvement of public health strategies. Read More

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http://dx.doi.org/10.1701/3082.30745DOI Listing
December 2018
1 Read

[Inflammatory and neoplastic cholangiopathies.]

Recenti Prog Med 2018 Dec;109(12):595-599

Dipartimento di Medicina Interna e Specialità Mediche, Policlinico Umberto I, Sapienza Università di Roma.

The biliary tree consists of mature epithelial cells called cholangiocytes and is subdivided in intra and extrahepatic bile ducts. They facilitate the secretion and modification of the bile constituents and act as transport ducts of bile to the intestine. The alteration of the normal function of cholangiocyte, can lead to the development of multiple biliary diseases, known as cholangiopathies, generally chronic, with a progressive course and which often are lacking of an effective treatment, determining a poor prognosis, even lethal, for the patient. Read More

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http://dx.doi.org/10.1701/3082.30744DOI Listing
December 2018
9 Reads

[Clinical outcomes and hospital costs of hepatic encephalopathy: an analysis of "real life" data from Marche Region.]

Recenti Prog Med 2018 Dec;109(12):585-594

Unità Complessa di Gastroenterologia ed Epatologia, Ospedale San Filippo Neri, Roma.

Hepatic encephalopathy (HE) describes a spectrum of potentially reversible neuropsychiatric changes observed in patients with hepatic dysfunction and/or portosystemic shunt. The aim of this study is to compare data from clinical trials and observational studies with Italian real-world (RW) data as for clinical outcomes; other aim is to evaluate economic burden of hepatic encephalopathy related to hospitalization for overt HE. The work is based on data from the Health Information Systems (SIS) of Marche Region, Italy (about 1. Read More

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http://dx.doi.org/10.1701/3082.30743DOI Listing
December 2018
3 Reads

[Role and clinical meaning of non-invasive tests in the evaluation of portal hypertension in patients with advanced chronic liver disease].

Recenti Prog Med 2018 Dec;109(12):574-584

Unità Operativa di Gastroenterologia, Borgo Trento, Azienda Ospedaliera Universitaria Integrata, Verona.

Portal hypertension (PH) is the main driver of complications in patients with advanced chronic liver disease (ACLD). Correctly identifying the presence and severity of PH is crucial for the management and prognosis of compensated ACLD (cACLD) patients. Over the last 20 years, several non-invasive tests (NITs) have been proposed for PH assessment; among these, liver (LSM) and spleen (SSM) stiffness measurement by transient elastography are the most validated and accurate predictors of clinically significant PH (CSPH) and its complications, such as gastroesophageal varices, clinical decompensation and hepatocellular carcinoma. Read More

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http://www.recentiprogressi.it/articoli.php?archivio=yes&
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http://dx.doi.org/10.1701/3082.30742DOI Listing
December 2018
8 Reads

[Microbiota and inflammatory bowel disease: an update.]

Recenti Prog Med 2018 Dec;109(12):570-573

UOC Medicina Interna e Gastroenterologia, Area Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma - equal contributors.

Over the last few years, the gut microbiota has been the focus of countless studies conducted both on mouse models and human population, aimed at analyzing its functions and interactions with the host, including nutrition, metabolic homeostasis, protection from infections and development of systemic and mucosal immunity both in inflammatory bowel disease (IBD) as well as other intestinal and extra-intestinal diseases. In IBD microbiota is impaired in overall composition and biodiversity, stability as well as functions. Microbial signature of IBD can be considered also a decrease in F. Read More

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http://www.recentiprogressi.it/articoli.php?archivio=yes&
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http://dx.doi.org/10.1701/3082.30741DOI Listing
December 2018
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[Immunotherapy and cancer: towards 2020.]

Recenti Prog Med 2018 Dec;109(12):566-569

Bristol-Myers Squibb Italia.

Immunotherapy is a novel treatment strategy that, even though implemented decades ago, has emerged with important clinical data in the last 10 years and is fulfilling the promise of prolonging survival in several types of cancer by restoring the immune system activity against the tumor. To understand its benefits it is necessary to correctly evaluate the right endpoints and to know and manage the toxicity profile. The two immune-checkpoint receptors that have been most actively studied in the context of clinical cancer immunotherapy are the cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) and the programmed cell death protein-1 (PD-1), which are both inhibitory receptors and regulate immune responses at different levels and by different mechanisms. Read More

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http://www.recentiprogressi.it/articoli.php?archivio=yes&
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http://dx.doi.org/10.1701/3082.30740DOI Listing
December 2018
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[Revival of evidence-based medicine in gastroenterology.]

Recenti Prog Med 2018 Dec;109(12):563-565

Senior Directors, Unità Complessa di Gastroenterologia ed Epatologia, Ospedale San Filippo Neri, Roma.

The evidence-based medicine (EBM) in gastroenterology is born with the XIII International Congress of Gastroenterology, the world congress of Gastroenterology, held in Rome in 1988. A clinical epidemiology manual was placed in the congress bag for each participant. The book contained an approach to biostatistics, interpretation of epidemiological data, clinical trials, meta-analysis and decision analysis. Read More

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http://dx.doi.org/10.1701/3082.30739DOI Listing
December 2018
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[Second-line treatment with FOLFIRI plus aflibercept in a patient with right-sided, BRAF mutated metastatic colon cancer.]

Recenti Prog Med 2018 Nov;109(11):27e-29e

This is the case report of a woman with more than 70 years and good PS, with diagnosis of right sided, BRAF mutated and MSI-high colon cancer, diffusively metastatic to lymph nodes. The treatment sequencing of FOLFOXIRI bevacizumab (I line) and FOLFIRI aflibercept (II line) allowed to maximally shrink the disease burden and dramatically extend survival thanks to the treatments' intensification (due to BRAF mutation-related aggressiveness) and the immune-modulating effects of anti-angiogenic treatments (due to immune-suppressive burden associated with MSI-high status). Read More

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http://dx.doi.org/10.1701/3031.30304DOI Listing
November 2018
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[Perioperative treatment with FOLFIRI plus aflibercept in a patient with RAS and BRAF wild-type, left-sided colon cancer, with early relapse following adjuvant oxaliplatin- based treatment due to potentially resectable liver metastases].

Recenti Prog Med 2018 Nov;109(11):24e-26e

This is a "best practice" case report of a non-uncommon clinical scenario, referring to an early liver relapse, judged as technically resectable, following adjuvant oxaliplatin-based treatment for left-sided, RAS and BRAF wild-type colon cancer. The choice of aflibercept vs cetuximab/panitumumab relies on the need to counteract an aggressive disease, without loosing the chance of radical surgery, nor loosing treatment options in the third-line setting. Treatment decisions are evidence-based on efficacy data of neoadjuvant anti-angiogenic treatment, as well as on the detrimental effect derived from the addition of cetuximab to perioperative chemotherapy. Read More

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http://dx.doi.org/10.1701/3031.30303DOI Listing
November 2018
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[Treatment with FOLFIRI plus aflibercept in a patient with RAS and BRAF wild-type, right-sided colon cancer and potentially resectable liver metastases].

Recenti Prog Med 2018 Nov;109(11):20e-23e

This is the case report of a patient with right-sided, RAS and BRAF wild-type metastatic colorectal cancer, with borderline/potentially resectable liver-limited disease. Following neoadjuvant treatment with FOLFOX plus bevacizumab and radical resection, an early intra-hepatic disease relapse was observed and deemed as potentially resectable. Therefore, treatment with FOLFIRI plus aflibercept was started: a major partial response and radical re-resection were achieved. Read More

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http://dx.doi.org/10.1701/3031.30302DOI Listing
November 2018
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[The inhibition of angiogenic pathway in second line treatment of metastatic colorectal cancer.]

Recenti Prog Med 2018 Nov;109(11):15e-19e

The inhibition of the antiangiogenic pathway in association with chemotherapy significantly improved disease control and overall survival both in the upfront and in second line treatment of metastatic colorectal cancer patients. The VELOUR study had showed a significant improvement in overall survival with the addition of aflibercept, an antiangiogenic chimeric protein, to FOLFIRI (5-flourouracil, leucovorin, irinotecan) in patients who progressed after an oxaliplatin based chemotherapy (with or without bevacizumab) in first line treatment or within 6 months from the completion of adjuvant chemotherapy. Subgroup analyses from VELOUR trial show that the benefit of aflibercept is independent from previous exposure to bevacizumab in first line. Read More

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http://dx.doi.org/10.1701/3031.30301DOI Listing
November 2018
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[Treatment of persistent opioid-induced constipation in patients with hematological malignancies: case report].

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Recenti Prog Med 2018 Nov;109(11):11e-14e

Opioid-induced bowel dysfunction wich comprises several other gastrointestinal complaints; could be highly debilitating, thus significantly deteriorating patients' quality of life. In particular, opioid-induced constipation (OIC) is the most frequent symptom. Therefore patients with haematological malignances need special attention of these disabling symptoms, which should be prevented by a correct evaluation of diet, age, intestinal habits, history of prior bowel disorders as well as constipating effects of other concomitant medication. Read More

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http://dx.doi.org/10.1701/3031.30300DOI Listing
November 2018
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