Considerazioni condivise alla luce delle recenti novità nell’ambito dello scompenso cardiaco: ottimizzazione della gestione del paziente con scompenso cardiaco in medicina interna - Dal ricovero al follow-up

Nuova classificazione dello scompenso cardiaco: ridenominazione di Heart failure with mid-range ejection fraction in Heart failure with mildly reduced ejection fraction (HFmrEF), con raccomandazioni terapeutiche più precise in questa fascia di pazienti Il nuovo algoritmo per il trattamento dello scompenso cardiaco a frazione di eiezione ridotta: Simultaneous or Rapid Sequence Initiation of Quadruple Medical Therapy for Heart Failure Ottimizzazione della terapia: l’ospedalizzazione come opportunità. Impiego precoce di sacubitril/valsartan nel paziente ospedalizzato, stabilizzato. Effetti sulla riduzione della mortalità e delle re-ospedalizzazioni. Effetti sul rimodellamento cardiaco. Effetti sulla QoL Sicurezza dell’uso di sacubitril/valsartan anche in presenza di comorbidità e gestione dell’ipotensione Intervento di ottimizzazione della terapia anche nel paziente con scompenso cardiaco cronico ricoverato per altra patologia acuta Terapia delle comorbidità - non cardiovascolari: diabete, iperkaliemia, carenza di ferro e cancro Terapia non farmacologica ed educazione/formazione del paziente e del caregiver Gestione post-ricovero dello scompenso cardiaco: l’ambulatorio divisionale e la rete territoriale

Gravidanza e malattie autoimmuni

Gravidanza e patologie autoimmuniC. Politi, V. Donvito, A. Tincani La contraccezione e la terapia estroprogestinica nelle donne con malattie autoimmuniM. Montesano, R. Picilli, G. Nova, M. Vignali Gravidanza e monitoraggio fetale in pazienti con malattie reumatiche autoimmuniI. Cetin, R. Milazzo, L. Basili Lupus eritematoso sistemico e gravidanzaM. Larosa, A. Doria Artrite reumatoideV.L. Ramoni Sindrome da anticorpi anti-fosfolipidi in gravidanza e puerperioM.C. Gerardi, C. Nalli, D. Lini, A. Tincani Gravidanza e sclerosi sistemica (sclerodermia)A. Brucato, M. Nivuori, A. Mazzone Anticorpi anti-Ro/SSA, sindrome di Sjögren, lupus neonatale e blocco cardiaco congenitoC. Picchi, E. Tombetti, A.L. Brucato Patologie della tiroide in gravidanzaS. De Carolis, E. Barbagelata, I. Ambrosino, S. Tabacco Gestione della gravidanza nelle donne con malattia di Behçet e vasculitiM. Gerosa, M. Cornalba, A. Sinelli, R. Cimaz, R. Caporali Sclerosi multiplaA. Protti, E.L. Susani, L. Saraceno, M.R. Marazzi, E.C. Agostoni Malattie autoinfiammatorie ereditarie e gravidanzaL. Obici Pericardite in gravidanzaE. Barbagelata, I. Ambrosino, E. Bernero, A. Brucato Fisiologia del rene in gravidanzaT. Ciarambino, F. Saladini, D. Manfellotto Terapia con farmaci antireumatici in corso di gravidanza e allattamentoM.C. Gerardi, D. Lini, L. Andreoli Il ruolo delle analisi di laboratorio nella gravidanza delle donne con malattie immunoreumatologicheF. Bartoli, C.B. Chighizola Gravidanza e malattie autoimmuni: il bambinoM. Romano, R. Cimaz Fecondazione medicalmente assistita nelle malattie autoimmuni sistemicheS. Truglia, S. Mancuso, F. Conti Il punto di vista delle pazienti: la ricerca che accarezzaI. Galetti, S. Ostuzzi

Position Paper FADOI – SIGG

Il presente documento è stato redatto nell’ambito del progetto di sensibilizzazione sul tema di Fondazione Onda.

Assessment of quality of life in type 2 diabetes mellitus patients using World Health Organization quality of life-BREF questionnaire and appraisal of diabetes scale - a cross-sectional study

Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.

La malattia da reflusso gastroesofageo nell’ambulatorio di Medicina Interna: quale gestione medica nel 2021?

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Abstract Book of the XXVI Congresso Nazionale della Società Scientifica FADOI, 2-4 ottobre 2021

Book of the XXVI Congresso Nazionale della Società Scientifica FADOI, 2-4 ottobre 2021.

Different clinical courses with the same findings: two cases of paroxysmal nocturnal hemoglobinuria presenting with thrombocytopenia

Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal stem cell disease that manifests with chronic intravascular hemolysis, thrombosis, and bone marrow failure. Various degrees of cytopenias accompany the disease. Although laboratory and clinical findings are similar, the disease may show different courses and require different treatments. Herein, we report two different courses of PNH with similar clinical and laboratory findings.

Gender differences in COVID-19 patients: a regional survey among physicians of Internal Medicine Wards

Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has infected millions of individuals around the World. Hypertension (HT), chronic heart disease (CHD), and diabetes mellitus (DM), particularly in the elderly, increase susceptibility to SARS-CoV-2 infection. However, conflicting results [such as coronavirus 2019 (COVID-19) disease vulnerability, case fatality, etc.] have been reported about the response to infection and COVID-19 outcomes in men and women. Therefore, understanding predictors of Intensive Care Unit (ICU) admission might help future planning and management of the disease. We conducted a multicenter survey about COVID-19 involving internists from Internal Medicine Wards. This survey indirectly allowed us to analyze the information of 2400 patients hospitalized in 35 wards of Internal Medicine of the Campania Region between July and October 2020. Our investigation has detected that the infection is more frequent in males, and the number of male patients hospitalized in ICU is also higher than females, with a large proportion of hypertensive patients. Extensive prospective studies are required to confirm this finding and explore the mechanisms for which hypertensive males are exposed to a higher proportion of admission to ICU and higher case fatality rates.

HIV, HCV and SARS-CoV-2: friends or foes? A case report

Data about co-infection of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), HIV, and hepatitis C virus (HCV) are still scarce. We describe a patient hospitalized for sore throat, fatigue, and myalgia with a personal history of HIV and occult HBV infection. His antiretroviral therapy included bictegravir/emtricitabine/tenofovir alafenamide. The nasopharyngeal swab was positive for SARS-CoV-2 and laboratory testing showed acute HCV. Antiretroviral therapy was continued, but no specific therapy for SARS-CoV-2 was started. After 4 weeks, the nasopharyngeal swab resulted negative for SARS-CoV-2 and biochemical tests revealed undetectable HCV RNA with normalization of transaminases. To the best of our knowledge, this is the first reported case of acute HCV in a patient with HIV and SARS-CoV-2 co-infection.

Lesson learned by COVID-19 outbreak: multilevel triage strategies in patients admitted to the emergency room in southern Italy

After identifying a novel disease inducing a severe acute respiratory syndrome-related to coronavirus 2 (SARS-CoV-2) for epidemic pneumonia in China, the diffusion of infection is ongoing around the world, and Italy has been the second country in which an epidemic has been demonstrated. Clinical features of this infection may be summarized in viral pneumonia that SARS or acute respiratory distress syndrome (ARDS) may complicate. For this reason, this epidemic has been considerably more aggressive than the previous epidemic of SARS and Middle-East respiratory syndrome. Coronavirus disease 2019 (COVID-19) showed an easy diffusion from human to human and also showed to be more contagious than other viruses. So human contact should be avoided at the emergency room and for inpatients too. The Triage should be adapted to these new features in order to speed up procedures for the care of infected patients at high risk of morbidity and mortality for SARS and ARDS and for traditional access to the emergency room. Based on our experiences, this flow chart has been designed with a multi-level triage in which patients have been divided for admission to the emergency room into patients with fever/respiratory symptoms and patients without fever\respiratory symptoms, to improve medical performances while treating COVID-19. This organized, multilevel triage permitted a good selection of patients admitted to the emergency room during the epidemic of COVID-19 in Southern Italy.