Archivio Istituzionale della Ricerca- Università degli Studi di Foggia
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A Prognostic Index for Advanced Biliary Tract Cancer Treated With Cisplatin, Gemcitabine and Durvalumab: The MAGIC-D Index
No full textBackground: Over the years, prognostic indexes have been developed to help clinicians stratify patients with biliary tract cancers (BTC) into risk groups. This study aims to identify a new prognostic index for patients with BTC treated with cisplatin, gemcitabine and durvalumab (CGD) in the first-line setting. Patients and Methods: The study population consisted of patients with BTC from 11 Eastern and Western Countries. Using multivariate analysis for overall survival (OS), we identified 5 baseline statistically significant variables: stage, carcinoembryonic antigen (CEA) levels, albumin levels, gamma glutamyl transferase (GGT) levels, neutrophil-to-lymphocyte ratio (NLR). Metastatic disease is a prognostic factor with a superior weight considering the HR of 3.62, while all the others can be considered prognostic factors with equivalent weight as the HRs are quite similar (HRs between 1.55 and 1.92). Based on these reasons, we developed a prognostic model called the MAGIC-D index by assigning a score of 2 for metastatic disease, and a score of 1 for CEA increased levels, albumin decreased levels, GGT increased levels, NLR ≥ 3. Patients were stratified into three risk groups as follows: low-risk group (Score from 0 to 2), intermediate-risk group (Score from 3 to 4) and high-risk group (Score from 5 to 6). At the first data cutoff (April 2024), these data were available for 319 patients that composed the training cohort used for the analysis. At the second data cutoff (May 2025), 79 patients were further enrolled and composed the validation cohort. Results: Median progression-free survival was 11.7 months in low-risk group (20.7%), 8.7 months in intermediate-risk group (46.4%) and 5.4 months in high-risk group (32.9%) [low-risk hazard ratio (HR): 0.27, intermediate-risk HR: 0.55, high-risk HR: 1, p < 0.0001]. Median OS was 18.4 months in low-risk group,15.9 months in intermediate-risk group and 7.8 months in high-risk group (low-risk HR: 0.17, intermediate-risk HR: 0.43, high-risk HR: 1, p < 0.0001). There was no difference in overall response rate (low-risk: 31.8%, intermediate-risk: 36.5% and high-risk: 25.7%; p = 0.0718), while disease control rate was significantly different across the three risk groups (low-risk: 83.3%, intermediate-risk: 70.9% and high-risk: 60.9%; p < 0.0001) as well as the rate of patients receiving a second-line therapy (low-risk: 54.5%, intermediate-risk: 48.6% and high-risk: 25.7%; p = 0.0061). Finally, the prognostic role in terms of OS and PFS of the MAGIC-D index was confirmed in a validation cohort of 79 patients. Conclusion: The MAGIC-D index is an easy-to-use tool able to stratify patients with BTC with different prognoses undergoing first-line therapy with CGD
Il primato dell’immagine sulla parola nella comunicazione sociale contemporanea: una systematic review
No full textL’epoca contemporanea è segnata da una profonda trasformazione comunicativa, che ha spostato l’asse cognitivo e culturale dal linguaggio verbale alla dimensione visiva. Le immagini non svolgono più una funzione ornamentale, ma rappresentano strutture di pensiero e di trasmissione della conoscenza. La presente revisione sistematica, condotta secondo le linee guida PRISMA 2020, analizza la letteratura pubblicata tra il 2020 e il 2025 concernente il primato dell’immagine nella comunicazione sociale, educativa e scientifica. La ricerca, condotta su cinque database internazionali, ha individuato 20 studi tra RCT, osservazionali, revisioni sistematiche, qualitativi. I risultati attestano che la comunicazione visiva incrementa significativamente la comprensione, la ritenzione mnestica e il coinvolgimento emotivo, fornendo un contributo rilevante in ambito educativo, divulgativo e sanitario
Innovazione: processo decisionale, rappresentazione mentale e semantica, stile di leadership in Imprenditori
No full textQuesta ricerca ha l’obiettivo di indagare l’Innovazione che produce valore, la sua
rappresentazione mentale e semantica, il suo processo decisionale e lo stile di leadership in
tre imprenditori, che producono e commercializzano vino, packaging e scarpe comfort.
L’intervista semistrutturata è il metodo d’indagine utilizzato, affiancato dall’analisi
qualitativa della produzione linguistica dei soggetti del campione. Tecnica dell’associazione
libera a stimoli induttori, leadership in programmazione neurolinguistica, modello della
leadership orientata al cambiamento, leadership con intelligenza emotiva sono i
riferimenti teorici. I risultati evidenziano tre imprenditori orientati alla crescita, alla
riconoscibilità, al nuovo, al mercato, allo stakeholder, al benessere delle persone che
lavorano in azienda. Col piacere che hanno nel fare il proprio lavoro, sono spinti
all’innovazione riconoscendo in essa il motore del proprio esistere, l’energia dello sviluppo
aziendale, l’essenza della propria soddisfazione
Conduction Tissue Inflammation Is Associated With Electrical Instability in Human Myocarditis
No full textCombined biologic therapy targeting B cells and eosinophils in relapsing multiple sclerosis and severe asthma: a case report of ofatumumab and mepolizumab
No full textThe management of multiple sclerosis (MS) in patients with significant comorbidities such as severe asthma presents unique therapeutic challenges. We report a case of successful combined biologic therapy with ofatumumab and mepolizumab in a patient with relapsing MS and pre-existing severe eosinophilic asthma, highlighting the feasibility and safety of dual biologic therapy. To our knowledge, this is the first report of concomitant use of ofatumumab and mepolizumab in a patient with MS and severe eosinophilic asthma, documenting the safety of a non-standard combination strategy in a real-world clinical scenario
The Role of Vericiguat in Heart Failure Therapy: From Clinical Trials to Clinical Practice
No full textHeart failure with reduced ejection fraction (HFrEF) is a progressive condition that is associated with high rates of morbidity, frequent hospitalizations, and significant mortality. Despite advancements in guideline-directed medical therapy (GDMT), many patients continue to be at risk for worsening heart failure (WHF). Vericiguat is a novel soluble guanylate cyclase (sGC) stimulator that targets the impaired nitric oxide (NO)–sGC–cyclic guanosine monophosphate (cGMP) pathway. Thus, by improving vascular and myocardial function, vericiguat offers a promising therapeutic option for patients with HFrEF who remain symptomatic despite receiving optimal medical treatment. This review explores the pathophysiological rationale, mechanism of action, and clinical evidence supporting the use of vericiguat. We analyze data from key randomized controlled trials (RCTs), such as SOCRATES-REDUCED and VICTORIA, as well as meta-analyses, to assess the efficacy and safety of using vericiguat in HFrEF. Additionally, we review real-world studies to evaluate the applicability of vericiguat in clinical practice
ANMCO Position Paper: Diagnosis and treatment of heart failure with preserved systolic function
No full textValidation of the Quality Analysis of Medical Artificial Intelligence (QAMAI) tool: a new tool to assess the quality of health information provided by AI platforms
No full textMeasuring unbearable psychache in suicide risk: psychometric evidence for the Italian UP3 and comparison with the psychache scales
No full textChrysin-Loaded Extracellular Vesicles Attenuate LPS-Induced Neuroinflammation in BV2 Microglial Cells In Vitro: A Novel Neuroprotective Strategy
No full textNeuroinflammation, driven by activated microglia, contributes to the progression of neurodegenerative diseases. Extracellular vesicles mediate intercellular communication and influence immune responses. Chrysin, a natural flavone found in fruits and propolis, has demonstrated anti-inflammatory effects. This study explored the immunomodulatory potential of chrysin-loaded EVs (EVs-Chry) derived from BV2 microglial cells. BV2 cells were treated with chrysin for 24 h to assess cytotoxicity and proliferation. EVs were isolated from treated and untreated cells, characterized by nanoparticle tracking analysis, and applied to naïve BV2 cells prior to LPS stimulation. Effects on cell morphology, migration, cytokine expression (IL-1β, IL-6), inflammasome activity (caspase-1), and apoptosis-related protein Bcl-xL were investigated. Our results show that EVs-Chry significantly reduced LPS-induced cell proliferation, restored resting microglial morphology, and reduced migratory capacity. Furthermore, co-treatment with EVs-Chry and LPS reduced pro-inflammatory cytokines such as IL-1β, IL-6, and caspase-1 expression while enhancing anti-apoptotic Bcl-xL levels, indicating a shift toward an anti-inflammatory, neuroprotective micro-glial phenotype. Together, our results demonstrated that EVs-Chry have neuroprotective effects on LPS-induced microglial activation and modulate microglial responses to inflammatory stimuli, attenuating pro-inflammatory signaling and promoting cellular homeostasis. These findings support the therapeutic potential of EVs-Chry in the context of neuroinflammatory and neurodegenerative disorders