[Optimal therapeutic management in the clinical journey of patients with heart failure].

Heart failure (HF) is still characterized by high mortality rates, despite the progress achieved in terms of treatment options. With regard to the treatment of HF with reduced ejection fraction (HFrEF), the 2016 European Society of Cardiology guidelines included in the therapeutic algorithm the angiotensin receptor-neprilysin inhibitor class, whose efficacy in modifying patient prognosis has been extensively proven in many clinical studies. Sacubitril/valsartan, the only representative of this drug class, can effectively affect the natural history of HF, thus reducing cardiovascular mortality (sudden death and death due to worsening cardiac function), total mortality, as well as first and recurrent hospitalization events, by improving renal function, cardiac remodeling, functional capacity and the patient's health-related quality of life.

Anorexia-cachexia syndrome in pancreatic cancer: recent advances and new pharmacological approach.

About 80% of all pancreatic ductal adenocarcinoma patients suffer from a wasting syndrome referred to as the "cancer anorexia-cachexia syndrome" (CACS) characterized by abnormally low weight, weakness and loss of skeletal muscle mass with or without loss of body fat, which directly impacts overall survival, quality of life, and physical activity. The aim of this review was to examine recent findings about CACS' pathophysiology and to describe the current pharmacological approaches. In recent years many efforts were made to improve our knowledge of CACS; currently we know that cachexia arises from a complex and multifactorial interaction between various mechanisms including inflammation, anorexia/malnutrition, alterations of protein and lipid metabolism; consequently its management requires multidisciplinary and multipharmacological approach that should address the different causes underlying this clinical event.

Focus on the intraductal papillary mucinous neoplasm of the pancreas.

Intraductal papillary mucinous neoplasms (IPMNs) are rare pancreatic tumours, accounting for less of 1-2% of all neoplasms of the gland. Main characteristics of IPMNs are their favourable prognosis as these pre-malignant or frankly malignant lesions are usually slow-growing tumours and radical surgery is frequently possible. According with the localization of the lesions, three different entities are identified: the main-duct IPMN (type I), the branch-duct IPMN (type II) and the mixed type (type III, involving both the main pancreatic duct and side branches).

Usefulness of video-capillaroscopy in clinical practice: systematic review of indications and results in rheumatology and in non-rheumatic disorders.

Background: Nailfold video-capillaroscopy (VCP) is nowadays worldwide considered as one of the best diagnostic noninvasive imaging technique able to study microcirculation in vivo.

Aim: To review the applications of VCP in the clinical practice and its results in rheumatic and non-rheumatic diseases.

Methods: Review of literature

Results: The possibility of managing the imaging, by means of dedicated software able to characterize quantitative and qualitative data, represents another relevant property of VCP.

Association of macroamylasemia and type I macro-creatine kinasemia. A case report.

Context: Macroenzymes are serum enzymes presenting a higher molecular mass than the corresponding enzymes normally found in physiologic conditions or specific diseases, causing falsely increased total serum enzyme levels. The occurrence of macroenzymes represents a rare event in clinical practice, leading to unnecessary and often invasive additional diagnostic procedures. Macroamylase and macro-creatine kinase belong to this category and may generate diagnostic confusion in the differential diagnosis between acute pancreatitis and acute myocardial infarction.