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ANMCO position paper 'Hypertrophic cardiomyopathy: from diagnosis to treatment'.

Hypertrophic cardiomyopathy (HCM) is a non-rare genetic cardiomyopathy, with an estimated prevalence of 1:500, characterized by an increase in the left ventricular wall thickness in the absence of increased loading conditions. The hypertrophy is mostly asymmetric and predominantly affects the basal septum and anterior wall. Left ventricular outflow tract obstruction, at rest or after provocative tests, is detected in many patients and represents the primary cause of reduced functional capacity, as well as an independent predictor of sudden cardiac death and advanced heart failure. Until ∼1 yea

Гут Микробиом и мальгический энцефаломилит/хронический синдром утомления (ME/CFS): Понимание механизмов борьбы с заболеваниями.

Myalgic Encephalomyelitis/Chronic Fatige (ME/CFS) — клиническая болезнь, характерная особенность которой заключается в постэкспертальной болезни (PEM). Она может влиять на многие органы и системы, что приводит к серьезному ухудшению качества жизни пациентов. Несмотря на многочисленные постинфекционные, иммунологические, неврологические, метаболические и эндокринные изменения, не существует ни окончательного диагностического маркера, ни утвержденного лечения. Этиология и патофизиология по-прежнему не до конца понимаются; однако появляющиеся данные свидетельствуют о том, что кишечная микробиомия

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… Apart from the profound exhaustion, ME/CFS patients report experiencing a variety of other nonspecific symptoms such as generalized pain, sleep disturbances, flu-like symptoms, joint and muscle pain, anxiety, problems with concentration, thinking and memory, orthostatic intolerance, gastrointestinal …

Cardiac amyloidosis-A review of current literature for the practicing physician.

The amyloidoses are a family of diseases in which misfolded precursor proteins aggregate to form amyloid and deposit in body tissues. A very serious yet underrecognized form of this disease is cardiac amyloidosis, in which amyloid deposits into the extracellular space of the myocardium, resulting in thickening and stiffening of ventricular walls with resultant heart failure and conductive dysfunction. This review provides a discussion of the pathogenesis and clinical presentation of cardiac amyloidosis subtypes, as well as an up-to-date approach to diagnosis and treatment. Significant progress

Гендерное неравенство в когнитивных расстройствах между неврологическими аутоиммунными расстройствами: систематический обзор.

ВВЕДЕНИЕ: Неврологические аутоиммунные расстройства (НКД) часто переплетаются с когнитивными расстройствами (КИ), что представляет собой многоуровневую проблему как с клиническим пониманием, так и с терапевтическим управлением. Усугубленное бремя NAD и CI не только оказывает значительное влияние на качество жизни пациента (QoL), прогнозы состояния и результаты лечения, но и оказывает несоразмерное воздействие на женщин, которые по своей сути более подвержены автоматическому иммунитету. Этот обзор направлен на изучение гендерных когнитивных недостатков, их основополагающих механизмов и их клини

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… Other frequent symptoms include paraesthesia, sleep disturbances such as insomnia and non-restorative sleep, headaches, and orthostatic intolerance. Muscle stiffness and weakness often exacerbate functional limitations. …

Diagnosis and Treatment of Paraneoplastic Neurologic Syndromes.

Paraneoplastic antibody syndromes result from the anti-tumor antibody response against normal antigens ectopically expressed by tumor cells. Although this antibody response plays an important role in helping clear a nascent or established tumor, the engagement of antigens expressed in healthy tissues can lead to complex clinical syndromes with challenging diagnosis and management. The majority of known paraneoplastic antibody syndromes have been found to affect the central and peripheral nervous system. The present review provides an update on the pathophysiology of paraneoplastic neurologic s

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… Autonomic Neuropathy Autonomic neuropathies present with characteristic signs/symptoms of orthostatic intolerance, dry mouth, incontinence, constipation and cardiac arrhythmias. SCLC is a common oncologic association. …

Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies.

The intersection of psychiatry and medicine presents unique diagnostic and ethical challenges, particularly for conditions involving significant brain-body interactions, such as psychosomatic, somatopsychic, and complex systemic disorders. This article explores the historical and contemporary issues in diagnosing such conditions, emphasizing the fragmentation of medical and psychiatric knowledge, biases in clinical guidelines, and the mismanagement of complex illnesses. Diagnostic errors often arise from insufficient integration between general medicine and psychiatry, compounded by the relian

A Rapid Review of Adenocarcinoma and Pulmonary Tumor Thrombotic Microangiopathy: A Deadly Duo.

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare paraneoplastic syndrome associated with various adenocarcinomas, most commonly gastric adenocarcinoma. This condition can progressively worsen pulmonary arterial hypertension, leading to acute or subacute pulmonary heart failure and respiratory insufficiency. This paper examines the pathogenesis, clinical presentation, diagnosis, treatment, and prognosis of PTTM. Given PTTM's poor prognosis, we emphasize treatment strategies. PTTM in adenocarcinoma patients can mimic other pulmonary diseases, causing diagnostic delays. Current PTTM tr

Cardiac Amyloidosis: A Contemporary Review of Medical and Surgical Therapy.

Amyloidosis is a systemic disease initiated by deposition of misfolded proteins in the extracellular space, due to which multiple organs may be affected concomitantly. Cardiac amyloidosis, however, remains a major cause of morbidity and mortality in this population due to infiltrative /restrictive cardiomyopathy. This review attempts to focus on contemporary medical and surgical therapies for the different types of cardiac amyloidosis. Amyloidosis affecting the heart are predominantly of the transthyretin type (acquired in the older or genetic in the younger patients), and the monoclonal immun

Chemotherapy-induced peripheral neuropathy in children and adolescent cancer patients.

Brain cancer and leukemia are the most common cancers diagnosed in the pediatric population and are often treated with lifesaving chemotherapy. However, chemotherapy causes severe adverse effects and chemotherapy-induced peripheral neuropathy (CIPN) is a major dose-limiting and debilitating side effect. CIPN can greatly impair quality of life and increases morbidity of pediatric patients with cancer, with the accompanying symptoms frequently remaining underdiagnosed. Little is known about the incidence of CIPN, its impact on the pediatric population, and the underlying pathophysiological mecha

Помимо генов: 3D-архитектура Эпизвита и Орион с помощью платформы "Орион" открывает общую биологию по всему ME/CFS, длинный COVID, ПТСР, ревматоидный артрит и множественный склероз.

КОЛИЧЕСТВО: Myalgic ensphalomyelit/хронический синдром усталости (ME/CFS), длинный COVID (LC19), посттравматическое стрессовое расстройство (PTSD), ревматоидный артрит (RA) и множественный склероз (MS) являются клинически отличными расстройствами, характеризующимися значительным совпадением симптомов, включая стойкую усталость, когнитивное расстройство, автономную дисфункцию и регулирование иммунной дисфункции. Хотя эти условия различаются в плане диагностики и клинического представления, их основополагающие биологические механизмы по-прежнему плохо понимаются и могут включать совпадающие пути

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… These findings are complemented by evidence of autonomic nervous system imbalance, including orthostatic intolerance and heart rate variability abnormalities [ 26 ]. …

Epidemiology and management of osteoporosis in the People's Republic of China: current perspectives.

With the progressive aging of the population, osteoporosis has gradually grown into a global health problem for men and women aged 50 years and older because of its consequences in terms of disabilities and fragility fractures. This is especially true in the People's Republic of China, which has the largest population and an increasing proportion of elderly people, as osteoporosis has become a serious challenge to the Chinese government, society, and family. Apart from the fact that all osteoporotic fractures can increase the patient's morbidity, they can also result in fractures of the hip an

Rediscovering trazodone for the treatment of major depressive disorder.

Trazodone is a triazolopyridine derivative that belongs to the class of serotonin receptor antagonists and reuptake inhibitors (SARIs). The drug is approved and marketed in several countries worldwide for the treatment of major depressive disorder (MDD) in adult patients. In clinical studies, trazodone has demonstrated comparable antidepressant activity to other drug classes, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline (norepinephrine) reuptake inhibitors (SNRIs). Moreover, the SARI action of trazodone may overcome the

Emerging Insights into Granulomatous and Amyloidogenic Cardiomyopathies.

Background: Granulomatous and amyloidogenic cardiomyopathies are infiltrative conditions that can be fatal if left untreated. Among these, cardiac amyloidosis and cardiac sarcoidosis are significant but often underdiagnosed causes of heart failure, each serving as cardiac manifestations of broader systemic diseases. Advancements in imaging techniques and the emergence of novel therapies-particularly for cardiac amyloidosis-have brought these conditions into sharper focus for both clinicians and researchers. Methods: We conducted a comprehensive review of the literature by searching databases i

Review of cancer therapies for the perioperative physician.

Advances in cancer treatments over the past decades combining chemotherapy with novel technologies in immunotherapies, radiation therapies, and interventional radiology have prolonged life expectancy. Patients have more options for treatments of their primary or metastatic diseases. Increased procedural techniques amid an aging population with multiple comorbidities present risks and challenges in the perioperative period.Chemotherapy remains the mainstay of cancer treatment, can be given intraoperatively, and is combined with other treatment modalities. Immunotherapy is particular to cancer c

The Amyloidosis Forum: a public private partnership to advance drug development in AL amyloidosis.

BACKGROUND: Immunoglobulin light chain (AL) amyloidosis is a rare, multi-systemic disorder characterized by two disease processes: an underlying plasma cell dyscrasia that provides the source of pathologic light chains, and the resulting organ dysfunction caused by deposition of amyloid light chain fibrils. There are no FDA approved treatments for AL amyloidosis; regimens developed for multiple myeloma are used off-label to treat the plasma cell disorder and no therapies are directed at organ deposition. Thus, an unmet medical need persists despite advances in disease management. A public-priv

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… Neurological involvement in AL amyloidosis may be autonomic (e.g. orthostatic intolerance, erectile dysfunction) and/or somatic (e.g. lack of feeling, foot drop). …

Effects of glucocorticoid replacement therapy in patients with pituitary disease: A new perspective for personalized replacement therapy.

Secondary adrenal insufficiency (SAI) is an endocrine disorder due to impaired secretion of ACTH resulting from any disease affecting the pituitary gland. Glucocorticoid replacement therapy is mandatory to ensure patient survival, haemodynamic stability, and quality of life. In fact, a correct dose adjustement is mandatory due to the fact that inappropriately low doses expose patients to hypoadrenal crisis, while inappropriately high doses contribute to glucose metabolic and cardiovascular deterioration. This review analyses the current evidence from available publications on the epidemiology

Decoding chemotherapy-induced peripheral neuropathy: ion channels, disease models, and future directions.

Chemotherapy-induced peripheral neuropathy (CIPN) is a significant side effect of cancer treatments like paclitaxel and oxaliplatin, impacting patient quality of life (QoL). Despite much research, its underlying mechanisms remain unclear and effective therapies are lacking. This review evaluates whether current experimental models accurately reflect CIPN, emphasizing recent molecular and cellular findings, especially the role of sensory ion channels. We outline limitations of existing models and propose more translational preclinical approaches to better capture disease complexity and patient

Advances in the Treatment of Cardiac Amyloidosis.

Opinion statementCardiac amyloidosis is associated with a high mortality rate, a long delay between the first signs and the diagnosis but a short interval between diagnosis and death. This scenario has changed recently due to improved disease awareness among doctors and significant progress in diagnosis thanks to multimodal imaging and a multidisciplinary approach. Therefore, during the last few years, we have had access to specific therapies for those patients. Those therapies are quite different depending on the type of amyloidosis, but there has been real progress. Systemic light chain amyl

Guideline "diagnosis and non interventional therapy of neuropathic pain" of the German Society of Neurology (deutsche Gesellschaft für Neurologie).

2019 the DGN (Deutsche Gesellschaft für Neurology) published a new guideline on the diagnosis and non-interventional therapy of neuropathic pain of any etiology excluding trigeminal neuralgia and CRPS (complex regional pain syndrome). Neuropathic pain occurs after lesion or damage of the somatosensory system. Besides clinical examination several diagnostic procedures are recommended to assess the function of nociceptive A-delta and C-Fibers (skin biopsy, quantitative sensory testing, Laser-evoked potentials, Pain-evoked potentials, corneal confocal microscopy, axon reflex testing). First line

2022 NATIONAL CONGRESS OF THE ITALIAN SOCIETY OF HYPERTENSION (SIIA)

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