Medicina
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Background and Objectives: Chronic rhinosinusitis (CRS) is a complex inflammatory condition of the nasal passages that severely impairs quality of life. Type 2 CRS is characterized by eosinophilic inflammation, driven by cytokines like IL-4, IL-5, and IL-13. These cytokines are key to CRS pathogenesis and contribute to a heavy disease burden, especially with comorbidities. ⋯ The patients also reported substantial improvements in olfactory function and high satisfaction with the treatment, supporting dupilumab's potential in reducing both symptom severity and inflammation in CRSwNP. Conclusions: These results indicate that dupilumab may be an effective treatment for CRSwNP, offering significant symptom relief, improved olfactory function, and enhanced quality of life. High satisfaction levels suggest that dupilumab may provide therapeutic advantages over the conventional CRS treatments, though further studies are warranted to confirm its long-term benefits.
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Background and Objectives: Hypertension is typically classified into two main groups, "dipper" and "non-dipper", based on nocturnal blood pressure decline. The coronary artery calcium score (CACS) is an essential biomarker used to assess the presence and severity of coronary artery disease (CAD). This study aims to demonstrate the relationship between CACS and hypertensive patients with moderate-to-high cardiovascular disease (CVD) risk classified as either dipper or non-dipper. ⋯ However, in multivariate analysis, only CACS emerged as a significant independent risk factor (p = 0.001), while other variables were not significant (p > 0.05). The area under the curve (AUC) for CACS was 0.759, indicating statistically significant and excellent discriminative capability (p < 0.001, 95% CI: 0.680-0.839). Conclusions: It was concluded that non-dipper hypertension is associated with higher CACS and indicates a higher cardiovascular risk for this group.
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Review Case Reports
The First Case of Streptococcus sinensis Endocarditis in Italy: Case Presentation and Systematic Literature Review.
Almost 25 years have now passed since the first identification of Streptococcus sinensis (S. sinensis). It can cause infections both in immunocompetent and immunocompromised hosts. However, it has been rarely described as an aetiology of infectious endocarditis. ⋯ Demographics, clinical presentation, prognostic factors, treatment, and outcomes were summarized. Despite anecdotic cases being reported, S. sinensis endocarditis can occur and should be promptly and properly identified using accurate diagnostic methods. Continued research into its epidemiology, pathogenesis, antimicrobial resistance, and host interactions is essential for enhancing our knowledge and improving clinical management strategies.
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Review
Antimicrobials in Orthopedic Infections: Overview of Clinical Perspective and Microbial Resistance.
Orthopedic infections are challenging pathologies that impose a heavy burden on patients and the healthcare system. Antimicrobial therapy is a critical component of the successful management of orthopedic infections, but its effectiveness depends on patient-, surgery-, drug-, and hospital-related factors. ⋯ Some approaches for reducing antibiotic resistance emergence in orthopedics are also presented. The use of antibiotics tailored to the microorganism's sensitivity profile, patient factors, and pharmacokinetic profile in terms of monotherapy or combinations, the understanding of microbial pathogenicity and resistance patterns, strict control measures in healthcare facilities, the development of new antimicrobial therapies (drugs, devices, technologies), and patient education for improving compliance and tolerance are some of the most important tools for overcoming microbial resistance.
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Pediatric nephrolithiasis is an ancient and complex disorder that has seen a significant rise in recent decades and the underlying causes contributing to stone formation in children may also be shifting. Historically, kidney stones have been linked to factors such as metabolic disorders, congenital abnormalities, and family history. ⋯ Given this evolving landscape, performing a comprehensive metabolic evaluation during the diagnostic process is essential. A complete metabolic evaluation should thus be performed during the diagnostic assessment to identify any modifiable risk factors predisposing to stone recurrence and reduce the need for surgical management, extrarenal comorbidity, and the increased burden of care.