272 results match your criteria: "Piazza delle Cliniche[Affiliation]"

The Potential Impact of SGLT2-I in Diabetic Foot Prevention: Promising Pathophysiologic Implications, State of the Art, and Future Perspectives-A Narrative Review.

Medicina (Kaunas)

November 2024

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy.

Article Synopsis
  • Diabetic foot (DF) is a significant public health issue that leads to serious clinical and economic challenges due to factors like neuropathy and blood vessel problems.
  • Sodium-glucose cotransporter 2 inhibitors (SGLT2-i), new oral medications for diabetes, have shown promise in managing diabetes but there's limited data on how they affect DF risk, especially regarding limb amputation.
  • This review explores the current evidence on SGLT2-i's impact on complications associated with DF, highlighting the need for more research to fully understand their potential benefits and future implications.
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Background/objectives: Mental health disorders pose a substantial challenge for healthcare workers, particularly in the post-COVID-19 era. Public health medical residents (PHRs) played a pivotal role during the pandemic and were significantly affected by the heavy workload. This study aims to uncover potential associations between workload characteristics and symptoms of anxiety and insomnia in Italian PHRs based on data collected in 2022 through the Public Health Residents' Anonymous Survey in Italy (PHRASI) study.

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Identification and characterization of a case of mild familial partial lipodystrophy in a carrier of a LMNA p.Arg582Leu variant.

Acta Diabetol

October 2024

Dipartimento Di Promozione Della Salute, Materno-Infantile, Medicina Interna E Specialistica Di Eccellenza (PROMISE), University of Palermo, Piazza Delle Cliniche, 2-90127, Palermo, Italy.

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Article Synopsis
  • Age-related loss of muscle strength and mass, known as sarcopenia, can negatively impact postoperative recovery in older patients, especially those with severe osteoarthritis who need knee surgery.
  • This study reviews existing literature on the effectiveness of prehabilitation and dietary supplementation in improving outcomes for older sarcopenic patients before knee arthroplasty, focusing on interventions that enhance physical function and surgical resilience.
  • Combining exercise training with nutrient supplementation may lead to better functional capacity and reduced surgical complications, highlighting the importance of addressing both sarcopenia and osteoarthritis in this demographic.
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Who and how to screen for endogenous hypercortisolism in type 2 diabetes mellitus or obesity.

J Endocrinol Invest

October 2024

Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.

Article Synopsis
  • The review explores the prevalence of hypercortisolism (Cushing's syndrome) in individuals with diabetes and obesity, aiming to determine if screening is needed for these populations.
  • It finds that Cushing's syndrome prevalence in type 2 diabetes patients ranges from 0.6% to 9.3%, with the overnight dexamethasone suppression test being the most common but with notable false positive rates.
  • The study concludes that clinical judgment is crucial for screening decisions, with the overnight dexamethasone test recommended for diabetes patients, while late-night salivary cortisol tests are also viable for obese patients.
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The promising approach of 3D bioprinting for diabetic foot ulcer treatment: A concise review of recent developments.

Heliyon

September 2024

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) "G. D'Alessandro", University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy.

Diabetic foot ulcer (DFU), one of the most significant complications of diabetes, is a condition that causes anatomical and functional alterations of the foot resulting in an important social and economic impact, related to disability and health care costs. Recently, three-dimensional bioprinting - which allows the fabrication of complex and biocompatible structures - has been identified as a promising approach in the field of regenerative medicine to promote the healing of chronic wounds, such as DFU. In this concise review we highlight the most relevant and recent attempts of using 3D bioprinted constructs - both on animals and people - in order to treat non-healing diabetic ulcers and prevent their worsening.

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The vaginal microbiota (VMB) plays a crucial role in women's health from puberty to menopause. Traditional studies have focused on the microorganisms present within the vaginal environment and their roles in disease onset. However, the dynamic relationship between the VMB and its host remains underexplored.

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Conventional steroids vs. dual-release hydrocortisone on metabolic, cardiovascular, and bone outcomes in adrenal insufficiency: a 10-year study.

Eur J Endocrinol

August 2024

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Endocrinology, University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy.

Objective: Adrenal insufficiency (AI) is characterized by increased mortality compared to general population, mainly due to cardiovascular disease. Conventional glucocorticoid (GC) replacement therapy has a role in determining the increased mortality risk. Primary outcome of the current study was to evaluate the impact of 10 years of conventional GCs and DR-HC on body weight changes in treatment-naive patients with AI.

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Epigenetics of cerebrovascular diseases: an update review of clinical studies.

Epigenomics

September 2024

Internal Medicine & Stroke Care Ward, PROMISE Department, University of Palermo, Piazza delle Cliniche n.2, 90127, Palermo, Italy.

Cerebrovascular diseases, especially stroke, are critical and heterogenous clinical conditions associated with high mortality and chronic disability. Genome-wide association studies reveal substantial stroke heritability, though specific genetic variants account for a minor fraction of stroke risk, suggesting an essential role for the epigenome. Epigenome-wide association studies and candidate gene approaches show that DNA methylation patterns significantly influence stroke susceptibility.

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Background: Current management of COPD is predominantly focused on respiratory aspects. A multidimensional assessment including nutritional assessment, quality of life and disability provides a more reliable perspective of the true complexity of COPD patients.

Methods: This was a prospective observational study of 120 elderly COPD patients at high risk of acute exacerbations.

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Background: Hypoalbuminemia is common in heart failure (HF) patients; however, there are no data regarding the possible long-term prognostic role of serum albumin (SA) in the younger population with chronic HF without malnutrition. The aim of this study was to examine the long-term prognostic role of SA levels in predicting major adverse cardiac events (MACE) in middle-aged outpatients with chronic HF.

Methods: In the present retrospective analysis, 378 subjects with HF were enrolled.

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Technical and health governance aspects of the external quality assessment system for classical and new psychoactive substances analysis testing in blood.

J Pharm Biomed Anal

August 2024

Assessorato regionale della salute, Dipartimento per la pianificazione strategica, piazza Ottavio Ziino, 24, Palermo 90145, Italy.

New psychoactive substances (NPS) are uncontrolled analogues of existing drugs or newly synthesized chemicals that exhibit psychopharmacological effects. Due to their diverse nature, composition, and increasing prevalence, they present significant challenges to the healthcare system and drug control policies. In response, healthcare system laboratories have developed analytical methods to detect NPS in biological samples.

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Exploring the relationship between nocturnal hypertension and atrial fibrillation recurrence.

Hypertens Res

July 2024

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) "G. D'Alessandro", University of Palermo, Piazza delle Cliniche, 90127, Palermo, Italy.

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Food Beliefs and the Risk of Orthorexia in Patients with Inflammatory Bowel Disease.

Nutrients

April 2024

Gastroenterology and Hepatology Section, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2-90127 Palermo, Italy.

Patients with inflammatory bowel disease (IBD) believe that diet plays a significant role in the pathogenesis of their disease and the exacerbation of their symptoms. They often adopt restrictive diets that can lead to malnutrition, anxiety, and stress. Recent studies have found a correlation between IBD and eating disorders, such as anorexia nervosa and ARFID (Avoidant Restrictive Food Intake Disorder).

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Molecular Pathways of Vulnerable Carotid Plaques at Risk of Ischemic Stroke: A Narrative Review.

Int J Mol Sci

April 2024

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy.

The concept of vulnerable carotid plaques is pivotal in understanding the pathophysiology of ischemic stroke secondary to large-artery atherosclerosis. In macroscopic evaluation, vulnerable plaques are characterized by one or more of the following features: microcalcification; neovascularization; lipid-rich necrotic cores (LRNCs); intraplaque hemorrhage (IPH); thin fibrous caps; plaque surface ulceration; huge dimensions, suggesting stenosis; and plaque rupture. Recognizing these macroscopic characteristics is crucial for estimating the risk of cerebrovascular events, also in the case of non-significant (less than 50%) stenosis.

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The PD-1/PD-L1 Axis in the Biology of MASLD.

Int J Mol Sci

March 2024

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza delle Cliniche, 90127 Palermo, Italy.

Metabolic Dysfunction-Associated Steatotic Liver (MASL), previously named nonalcoholic fatty liver (NAFL), is a multifactorial disease in which metabolic, genetic, and environmental risk factors play a predominant role. Obesity and type 2 diabetes act as triggers of the inflammatory response, which contributes to the progression of MASL to Metabolic Dysfunction-Associated Steatohepatitis and the development of hepatocellular carcinoma. In the liver, several parenchymal, nonparenchymal, and immune cells maintain immunological homeostasis, and different regulatory pathways balance the activation of the innate and adaptative immune system.

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Association between Boarding of Frail Individuals in the Emergency Department and Mortality: A Systematic Review.

J Clin Med

February 2024

Department of Health Promotion Science, Maternal and Infant Care, Internal Medicine, and Medical Specialities (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy.

(1) Older patients who attend emergency departments are frailer than younger patients and are at a high risk of adverse outcomes; (2) To conduct this systematic review, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. We systematically searched literature from PubMed, Embase, OVID Medline, Scopus, CINAHL via EBSCOHost, and the Cochrane Library up to May 2023, while for grey literature we used Google Scholar. No time restrictions were applied, and only articles published in English were included.

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Myomectomy is one of the most common surgical procedure in the field of gynecology. However, the role of laparoscopic myomectomy is still debated for many factors, including surgical considerations, safety and fertility concerns, long-term outcomes, and cost-related issues. The aim of this study is to evaluate the surgical peri- and post-operative outcomes of laparoscopic and abdominal myomectomy.

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Serum biomarkers represent a reproducible, sensitive, minimally invasive and inexpensive method to explore possible adverse cardiovascular effects of antineoplastic treatments. They are useful tools in risk stratification, the early detection of cardiotoxicity and the follow-up and prognostic assessment of cancer patients. In this literature review, we aim at describing the current state of knowledge on the meaning and the usefulness of cardiovascular biomarkers in patients with cancer; analyzing the intricate relationship between cancer and cardiovascular disease (especially HF) and how this affects cardiovascular and tumor biomarkers; exploring the role of cardiovascular biomarkers in the risk stratification and in the identification of chemotherapy-induced cardiotoxicity; and providing a summary of the novel potential biomarkers in this clinical setting.

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NAIF: A novel artificial intelligence-based tool for accurate diagnosis of stage F3/F4 liver fibrosis in the general adult population, validated with three external datasets.

Int J Med Inform

May 2024

Unità Operativa Centro Controllo Qualità e Rischio Chimico (CQRC), Azienda Ospedaliera Villa Sofia Cervello, viale Strasburgo 233, 90146 Palermo, Italy; PROMISE-Promotion of Health, Maternal-Childhood, Internal and Specialized Medicine of Excellence G. D'Alessandro, Piazza delle Cliniche, 2, 90127 Palermo, Italy.

Objective: The purpose of this study was to determine the effectiveness of a new AI-based tool called NAIF (NAFLD-AI-Fibrosis) in identifying individuals from the general population with advanced liver fibrosis (stage F3/F4). We compared NAIF's performance to two existing risk score calculators, aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (Fib4).

Methods: To set up the algorithm for diagnosing severe liver fibrosis (defined as Fibroscan® values E ≥ 9.

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Article Synopsis
  • - The study investigates the variation of subclinical psychosis (SP) measures, such as schizotypy and psychotic-like experiences (PLEs), across different geographic regions and how this correlates with the incidence of first-episode psychosis (FEP) in those areas.
  • - Through analysis of data from 1497 controls in 16 sites across 6 countries, researchers found that schizotypy showed significant variation related to site characteristics, while PLEs exhibited less variation; local incidences of FEP were associated with reduced unexplained variance in schizotypy.
  • - Findings highlight that younger, migrant, unmarried, unemployed, and less educated individuals, along with factors like cannabis use and childhood adversity, are linked to SP
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Molecular Pathogenesis of Central and Peripheral Nervous System Complications in Anderson-Fabry Disease.

Int J Mol Sci

December 2023

Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy.

Article Synopsis
  • Fabry disease (FD) is a genetic disorder caused by mutations in the GLA gene on the X chromosome, leading to the buildup of substances like globotriaosylceramide (Gb3) in various body cells, resulting in a range of clinical symptoms.
  • Symptoms of FD include pain crises, digestive issues, skin problems, and increased risk of strokes, which stem from the accumulation of Gb3 disrupting cell functions and causing cell death.
  • Inflammation and immune cell dysfunction play roles in FD's pathology, but there is conflicting evidence regarding inflammation markers and their relationship to disease severity; some studies suggest an autoimmune component as well.
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Human Papillomavirus and Male Infertility: What Do We Know?

Int J Mol Sci

December 2023

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) "G. D'Alessandro", University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy.

In recent years, increasing attention has been paid to understanding the causes of infertility, which is being recognized as a growing health problem affecting large numbers of couples worldwide. Male infertility is a contributing factor in approximately 30-40% of cases, and one of its etiological causes is sexually transmitted infections (STIs). Among sexually transmitted pathogens, human papillomavirus (HPV) can contribute in various ways to the failure of spontaneous and assisted reproduction, acting in the different phases of conception, especially in the early ones.

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The Suitability of RNA from Positive SARS-CoV-2 Rapid Antigen Tests for Whole Virus Genome Sequencing and Variant Identification to Maintain Genomic Surveillance.

Diagnostics (Basel)

December 2023

Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Chromatography and Mass Spectrometry Section, Quality Control and Chemical Risk (CQRC), Via del Vespro, 133, 90127 Palermo, Italy.

Unlabelled: The COVID-19 pandemic has transformed laboratory management, with a surge in demand for diagnostic tests prompting the adoption of new diagnostic assays and the spread of variant surveillance tools. Rapid antigen tests (RATs) were initially used only for screening and later as suitable infection assessment tools. This study explores the feasibility of sequencing the SARS-CoV-2 genome from the residue of the nasopharyngeal swab extraction buffers of rapid antigen tests (RATs) to identify different COVID-19 lineages and sub-lineages.

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