The GLP-1R agonist semaglutide reshapes pancreatic cancer associated fibroblasts reducing collagen proline hydroxylation and favoring T lymphocyte infiltration.

Background: Metabolic syndrome represents a pancreatic ductal adenocarcinoma (PDAC) risk factor. Metabolic alterations favor PDAC onset, which occurs early upon dysmetabolism. Pancreatic neoplastic lesions evolve within a dense desmoplastic stroma, consisting in abundant extracellular matrix settled by cancer associated fibroblasts (CAFs).

Severity trend of recurrence in pediatric Food Protein-Induced Enterocolitis Syndrome (FPIES).

Background: Reintroduction of offending food in pediatric patients affected by Food Protein-Induced Enterocolitis Syndrome (FPIES) is carried out in hospitals with Oral Food Challenge (OFC), which leads to long waiting time and increases the societal burden of medical cost and human resources.

Objective: The aim of the study is to assess severity trend of acute FPIES adverse reactions over time in the same patient for possible outpatient or home reintroduction of offending food.

Methods: All children (<18 years-old) with a diagnosis of acute FPIES referred to 2 Italian pediatric allergy clinics were retrospectively enrolled.

Fluorescence-guided identification and dissection of retroperitoneal lymphomas (with video).

Surgery, especially if minimally invasive, still plays a role in the diagnosis of suspect lymphoproliferative lesions in challenging locations such as the retroperitoneum. Fluorescence guidance may help in such cases facilitating the visualization of highly vascularized lesions. Our recent experience with a 71-year-old woman with retroperitoneal lymphadenopathy and suspected lymphoma supports this hypothesis.

Understanding maladaptive daydreaming from the attachment framework: The intertwining roles of parental care, unresolved attachment, depression/anxiety and obsessive-compulsive symptoms.

Maladaptive Daydreaming (MD) is an excessive absorption in vivid fantasies interfering with individuals' daily functioning, which has been associated with adverse psychological outcomes and adult attachment insecurities. However, no study to date has addressed the relationships between MD, parental care, unresolved attachment, and psychological symptoms (depression/anxiety and obsessive-compulsive disorder; OCD) in a sample of young adults. In this study, 1295 young adults (401 males) completed an online survey including the Parental Bonding Instrument, Maladaptive Daydreaming Scale, Adult Unresolved Attachment Questionnaire, and the DSM-5 Level 1 Cross-Cutting Symptom Measure.

Bile acid diarrhea in patients with chronic diarrhea. Current appraisal and recommendations for clinical practice.

Bile Acid Diarrhea (BAD) is a common cause of chronic diarrhea, often accompanied by urgency, occasional fecal incontinence, abdominal pain, and fatigue. A nationwide survey has shown limited awareness of BAD within the Italian medical community, prompting a panel of experts to develop a Position Paper that outlines the most practical and cost-saving diagnostic investigations and treatments for this frequently overlooked condition. The document provides an overview of the epidemiology, pathophysiology, clinical manifestations, and classification of the different types of Bile Acid Diarrhea (BAD).

Comparison of Piperacillin-tazobactam and Vancomycin (TZP-VAN) with Piperacillin-tazobactam and Teicoplanin (TZP-TEI) for the risk of Acute Kidney Injury (CONCOMITANT): A prospective observational, multinational, multi-centre cohort study.

Objectives: Both vancomycin (VAN) and teicoplanin (TEI) augment the risk of acute kidney injury (AKI) when combined with piperacillin-tazobactam (TZP). We aimed to compare the risk of AKI among patients receiving TZP-VAN versus TZP-TEI.

Methods: This was a prospective, multinational, multicentre cohort study conducted in 12 centres from Turkiye, Italy and Spain between June 1, 2022, and December 31, 2023.

Return to Sport After Partum in Patients With Diastasis of the Rectus Abdominis Muscles: Ultrasound Evaluation and Rehabilitation Protocol.

Background: Diastasis rectus abdominis is a condition in which the rectus abdominis muscles separate and move laterally, causing stretching of the linea alba tissue with weakness of the abdominal wall. Although it can lead to hernia of the abdominal viscera, diastasis rectus abdominis is not a hernia in itself. This condition is common among women during pregnancy and the postpartum period and can significantly affect their quality of life and their return to sports activity.

Pharmacological differences and switching among anti-CGRP monoclonal antibodies: A narrative review.

Antibodies targeting either the calcitonin gene-related peptide (CGRP), such as galcanezumab, fremanezumab, and eptinezumab, or the receptor (erenumab) have been approved for the prevention of episodic and chronic migraine. Although widely used and generally effective, a proportion of patients discontinue treatment due to lack of efficacy. In both randomized controlled trials and observational studies, all anti-CGRP monoclonal antibodies (mAbs) have consistently demonstrated comparable efficacy and tolerability, suggesting a pharmacological class effect.

Incidence of hospital-acquired infections due to carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa in critically ill patients in Italy: a multicentre prospective cohort study.

Background: Carbapenem-Resistant Gram-Negative Bacteria, including Carbapenem-Resistant Enterobacterales (CRE) and Carbapenem-Resistant Pseudomonas aeruginosa (CRPA), are common causes of infections in intensive care units (ICUs) in Italy.

Objective: This prospective observational study evaluated the epidemiology, management, microbiological characterization, and outcomes of hospital-acquired CRE or CRPA infections treated in selected ICUs in Italy.

Methods: The study included patients with hospital-acquired infections due to CRE and CRPA treated in 20 ICUs from June 2021 to February 2023.

Billing models for measuring nursing care in inpatient and outpatient settings: a scoping review.

Background: The rising cost of healthcare is a concerning issue for healthcare systems. The Diagnosis Related Group (DRG) system lacks direct consideration for costs related to nursing care. Therefore, to date there is no clear picture of billing models that consider also nursing activity when evaluating healthcare service costs or what factors related to nursing care affect the costs of healthcare services and would therefore need to be considered in billing models.

Multi-institutional Knowledge-Based (KB) plan prediction benchmark models for whole breast irradiation.

Purpose: To train and validate KB prediction models by merging a large multi-institutional cohort of whole breast irradiation (WBI) plans using tangential fields.

Methods: Ten institutions (INST1-INST10, 1481 patients) developed their KB-institutional models for left/right WBI (ten models for right and eight models for left). The transferability of models among centers was assessed based on the overlap of the geometric Principal Component (PC1) of each model when applied to other institutions and/or on the presence of significantly different optimization policies.

Impact of particulate matter exposure on melanoma risk: A multicentre case-control study.

Background: The relationship between particulate matter (PM) exposure and melanoma risk remains largely unexplored. This study aims to investigate the association between PM10 and PM2.5 long-term exposure and melanoma risk.

Chronic Endometritis and Endometriosis: Two Sides of the Same Coin?

Both chronic endometritis and endometriosis are common entities in infertile patients. The association and the co-existence of these two entities are poorly evaluated. The aim of this systematic review and meta-analysis was to examine the association between chronic endometritis and endometriosis and to find the prevalence of chronic endometritis in women with endometriosis.

Environmental maternal exposures and the risk of premature birth and intrauterine growth restriction: The Generation Gemelli study protocol of newborn exposome.

Background: The study of women exposures and child outcomes occurring in the first 1,000 days of life since conception enhances understanding of the relationships between environmental factors, epigenetic changes, and disease development, extending beyond childhood and spanning the entire lifespan. Generation Gemelli is a recently launched case-control study that enrolls mother-newborns pairs in one of the largest university hospitals in Italy, in order to examine the association between maternal environmental exposures and intrauterine growth restriction (IUGR) and the risk of premature birth. The study will also evaluate the association of maternal exposures and the health and growth of infants and children up to 24 months of age.

A Long-term Evaluation: Deep Plane versus High SMAS Face Lift.

In the last few years, the Deep Plane Face Lift (DPFL) has gained great popularity among plastic surgeons, even if its origins are traced back to the 1970s. Certainly, it could have some advantages but based on our experience, it can reveal some unpleasant features in the long term. For this reason, the senior authors have adopted the high superficial musculoaponeurotic system (SMAS) Face Lift for many years in their surgical practice.

Biomarker-Directed Radiotherapy in Breast Cancer: A Narrative Review.

Importance: Integration of molecular biomarker information into systemic therapy has become standard practice in breast cancer care. However, its implementation in guiding radiotherapy (RT) is slower. Although postoperative RT is recommended for most patients after breast-conserving surgery and, depending on risk factors, following mastectomy, emerging evidence has indicated that patients with low scores on gene expression signatures or selected clinical-pathological features may have very low local recurrence rates.

Automated system for diagnosing pulmonary fibrosis using crackle analysis in recorded lung sounds based on iterative envelope mean fractal dimension filter.

Patients with pulmonary fibrosis (PF) often experience long waits before getting a correct diagnosis, and this delay in reaching specialized care is associated with increased mortality, regardless of the severity of the disease. Early diagnosis and timely treatment of PF can potentially extend life expectancy and maintain a better quality of life. Crackles present in the recorded lung sounds may be crucial for the early diagnosis of PF.

Why are we not exploring the potential of lower limb muscle power to identify people with sarcopenia?

Sarcopenia refers to a neuromuscular disease characterized by age-related declines in muscle mass and function. Since Professor Rosenberg first introduced the concept of sarcopenia in 1989, numerous operational paradigms have been proposed, tested, and validated against negative outcomes. The most recent recommendations advocate that dynapenia, or reduced of muscle strength, should be used alongside low muscle mass for the identification of sarcopenia.

Successful treatment of a C2 aneurysmal bone cyst with hydroxyapatite and calcium sulfate synthetic bone void filler injection: a case report.

Background: Aneurysmal bone cysts (ABCs) are benign, blood-filled neoplasms causing bone destruction, often requiring resection. However, challenges arise, especially at the cranio-cervical junction, where proximity to critical structures limits removal. Non-surgical options include selective arterial embolization (SAE) as main treatment, while Denosumab and centrifugated bone marrow emerge as experimental alternatives.

Pulmonary Arterial Hypertension Incidence in Scleroderma Patients Treated with Bosentan for Digital Ulcers: Evidence from the Italian SPRING Registry.

Objective: Bosentan (BOS) is approved for treating pulmonary arterial hypertension (PAH) and preventing digital ulcers (DU) in systemic sclerosis (SSc). Our study aimed to evaluate whether BOS prescribed for DU could reduce the incidence of PAH in a large SSc cohort from the SPRING registry.

Methods: Patients with SSc from the SPRING registry, meeting ACR/EULAR 2013 classification criteria with data on PAH onset, DU status, BOS exposure, and at least a one-year follow-up between 2015 and 2020, and no known PAH at baseline were included.