Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli"
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Le ragioni della Rivista di Diritto dell’Ambiente e dell’Energia. La sostenibilità ambientale come valore etico
No full textPsoriasiform Dermatitis: From Pathogenesis to New Therapeutic Opportunities
No full textPsoriasiform dermatitis refers to a spectrum of inflammatory skin disorders that resemble psoriasis both clinically and histologically. These conditions can occur idiopathically or as paradoxical reactions to biologic or targeted therapies, particularly in patients with atopic or autoimmune backgrounds. Histologic features often include acanthosis, parakeratosis, and lymphocytic infiltrates, but without the full molecular signature of classical psoriasis. This review provides an overview of psoriasiform dermatitis with a focus on its clinical presentation, differential diagnosis, and the immune pathways involved. Drug-induced forms, especially those triggered by anti-TNF agents, IL-4/IL-13 blockers, and JAK inhibitors, are highlighted due to their growing clinical relevance. We also summarize the main topical and systemic treatments, including corticosteroids, calcineurin inhibitors, PDE4 inhibitors, and JAK-STAT- or IL-23-targeted therapies. A better understanding of psoriasiform dermatitis is crucial to improve diagnosis and to guide treatment, especially in complex or refractory cases
Clinical Phenotype and Prognostic Significance of Frailty in Transthyretin Cardiac Amyloidosis
No full textBackground: The prevalence and clinical impact of frailty in transthyretin cardiac amyloidosis (ATTR-CA) remains poorly characterized. Objectives: This study aimed to evaluate the prevalence, clinical determinants, and prognostic significance of frailty in a large cohort of patients with ATTR-CA. Methods: Frailty was assessed in 880 patients with ATTR-CA (median age 80 years [Q1-Q3: 75-84 years], 719 [81.7%] male) using the Clinical Frailty Scale (CFS). Frailty was analyzed as a continuous variable and categorized as CFS 1 to 3, CFS 4 or 5, CFS 6 or 7, and CFS 8 or 9. Results: Frailty was observed in 502 (57.1%) patients (CFS 4 or 5: 364 [41.4%]; CFS 6 or 7: 129 [14.7%]; CFS 8 or 9: 9 [1.0%]). Independent predictors of worsening frailty included older age, female sex, non-p.(V142I) hereditary ATTR-CA variants, and National Amyloidosis Centre stage 3 disease. Mortality rates increased incrementally with frailty severity (deaths per 100 person-years: 2.9 vs 11.0 vs 21.1 vs 40.9; log-rank P < 0.001). Frailty was independently associated with higher mortality risk across all age groups, genotypes, and disease stages. Conclusions: Frailty is common in ATTR-CA and is independently linked to increased mortality risk. Incorporating frailty assessment alongside traditional markers enhances prognostication across genotypes and disease severities, particularly for short-term risk estimation
Defining Excellence: The First Core Set of Quality Indicators for the European Paediatric Surgical Audit on Hirschsprung's Disease Care
No full textAim: This study aimed to develop a universally applicable core set of quality indicators for Hirschsprung's disease care through
a consensus- driven process, to standardise and improve care quality across Europe.
Methods: A modified Delphi method was used to achieve consensus among healthcare professionals (HPs) and patient rep
resentatives (PRs) across Europe. Participants completed three rounds of anonymous surveys, rating quality indicators for
Hirschsprung's disease care. A systematic literature review informed the initial item list. Results were analysed using predefined
criteria, and a final consensus meeting established the core set of indicators.
Results: An international panel of 8 PRs and 96 multidisciplinary health care professionals representing 59 European hospitals
completed all questionnaires, eventually including 12 baseline characteristics and 39 indicators. Six of the top 10 indicators were
commonly prioritised by both groups. The remaining items were refined through debate and finalised during a consensus meeting
La vittimizzazione secondaria delle donne vittime di violenza ad opera dell'apparato giudiziario e dei mass media: profili civilistici
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