Archivio istituzionale della Ricerca - Università degli Studi di Parma
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Effectiveness and safety of baricitinib in severe alopecia areata: 48-week results
No full textBackground: Alopecia areata (AA) is an autoimmune condition leading to hair loss. Baricitinib, a Janus kinase (JAK) inhibitor, has demonstrated efficacy in controlled clinical trials, but real-world data on its long-term effectiveness and safety remain limited. Objectives: This study aimed to assess the real-life effectiveness and safety of baricitinib 4 mg daily in Italian adult patients with severe AA over a 48-week treatment period. Methods: We conducted a 48-week retrospective, observational, multicenter study across 27 Italian university hospitals. Adult patients (18–65 years) with severe AA (Severity of Alopecia Tool [SALT] score ≥ 50) who initiated baricitinib 4 mg daily treatment between November 2022 and October 2023 were included. Effectiveness was measured by the percentage of patients achieving SALT ≤20 at week 48. Secondary outcomes included changes in mean SALT score, trichoscopic findings, patient-reported quality of life (Skindex-16, Hospital Anxiety and Depression Scale [HADS]), and Clinician-Reported Outcomes (ClinRO) for eyebrows and eyelashes. Adverse events were also documented. Results: A total of 253 patients (66.8% females, mean age 40.0 ± 12.6 years) were included. By week 48, 63.2% achieved SALT ≤20, and 75.5% achieved SALT ≤30. The mean SALT score significantly decreased from 93.7 ± 14.1 at baseline to 26.5 ± 33.0 at week 48 (p < 0.001). Trichoscopic assessment showed a decline in yellow dots (97.6%–50.2%), black dots (43.5%–9.1%), and dystrophic hairs (14.6%–4.3%), whilst regrowing hairs increased (7.1%–80.2%). Skindex-16 scores improved significantly (57.1 ± 25.0 to 30.0 ± 17.8, p < 0.001), as did HADS Anxiety (8.21 ± 9.38 to 4.62 ± 4.21, p < 0.001) and HADS Depression (6.36 ± 4.55 to 3.70 ± 4.11, p < 0.001). Adverse events were reported in 9.4% of patients. Conclusion: This real-world study confirms the effectiveness of baricitinib in achieving significant hair regrowth and improving psychological well-being in severe AA patients
Influence of sleep quality on aggressive behaviours: Predictive validity of the Brøset Violence Checklist-revised
No full textIntroduction: Violent behaviours in acute psychiatric settings represent a critical issue within health systems. Prompt identification of patients at risk is a priority for nurses. The Brøset Violence Checklist (BVC), created to support nursing assessment, showed good psychometric skills; a new version of the instrument (BVCrev), including sleep alterations, seems to improve the predictivity of sleep compared to the original scale but is not available in Italian. Aims: To evaluate the psychometric properties of the Italian version of the Brøset Violence Checklist revised (BVCita-rev). Materials and methods: This was a prospective, observational study. After back-translation and content validity assessment, the BVCita and BVCita-rev were used simultaneously for risk assessment on a sample of patients admitted to the psychiatric inpatient wards of two Italian hospitals. Sensitivity, specificity, positive predictive value, negative predictive value, and ROC curve were calculated for both BVCita and BVCita-rev. Results: 137 patients were enrolled, and 1117 evaluations were performed. Thirty-four subjects (24.82 %) engaged in aggressive actions during hospitalization, 24 of whom more than once. The predictivity of BVCita-rev was higher than that of BVCita (ROC = 0.9528 vs 0.8811). The S-CVI of the new version of the instrument was = 0.92. Conclusions: Including an item addressing sleep disturbances enhances the predictive capabilities of the BVCita-rev. This modified version of the BVC proves to be an effective tool for supporting nurses in the short-term assessment of violence risk within acute psychiatric inpatient settings. Keywords: Brøset Violence Checklist, violence, aggression, psychiatry, sleep, risk assessment
Ritratto di Nicolò Doria Jacopo Robusti detto Tintoretto
No full textUn dipinto eccezionalmente esposto di Tintoretto; novità sulle vicende collezionistiche e contestualizzazione fra i Ritratti del '500 in Venet
Accelerated Atherosclerosis in Autoimmune Diseases
No full textAtherosclerosis (AS) is a chronic inflammatory disease of arterial vessels, leading to chronic and acute ischemic damage or hemorrhages in virtually any organ. Atherosclerotic plaque formation is the result of inflammatory processes that mediate lymphocyte and macrophage infiltration, lipid intra- and inter-cellular deposition, and eventually smooth muscle cell migration/proliferation and fibrosis. Adaptive and innate immune responses against exogenous as well as self-antigens cooperate in triggering such processes. The atherogenic processes may be magnified and accelerated in patients with autoimmune rheumatic diseases (AIRDs) because of the underlying immune abnormalities, the consequent systemic inflammation and the effects of some concomitant chronic therapies. As a matter of fact, accelerated AS is responsible for increased mortality and morbidity in almost all AIRDs, nowadays. Diagnostic strategies to detect early atherosclerotic lesions and to apply preventive therapeutical approaches have been proposed in order to avoid complications related to accelerated AS in AIRDs. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2008, 2024
From Survival to Parenthood: The Fertility Journey After Childhood Cancer
No full textBackground: The advances in cancer diagnosis and treatment have significantly improved survival rates in pediatric patients, with five-year survival now exceeding 80% in many high-income countries. However, these life-saving therapies often carry long-term consequences, including impaired fertility. The reproductive health of childhood cancer survivors has emerged as a key issue in survivorship care. Objective: This narrative review aims to examine the gonadotoxic effects of cancer treatments on pediatric patients, evaluate fertility preservation strategies in both males and females, and provide guidance on the long-term monitoring of reproductive function post treatment. Methods: A comprehensive literature review was conducted using PubMed, including randomized trials, cohort studies, and clinical guidelines published up to March 2024. The keywords focused on pediatric oncology, fertility, and reproductive endocrinology. Studies were selected based on relevance to treatment-related gonadotoxicity, fertility preservation options, and follow-up care. Results: Radiotherapy and alkylating agents pose the highest risk to fertility. Postpubertal patients have access to standardized preservation techniques, while prepubertal options remain experimental. Long-term effects include premature ovarian insufficiency, azoospermia, hypogonadism, and uterine dysfunction. The psychosocial impacts, especially in female survivors, are profound and often overlooked. Conclusions: Fertility preservation should be discussed at diagnosis and integrated into treatment planning in pediatric patients with cancer. While options for postpubertal patients are established, more research is needed to validate safe and effective strategies for younger populations. A multidisciplinary approach and long-term surveillance are essential for safeguarding future reproductive potential in childhood cancer survivors
Comparative analysis of AI tools for disseminating CPR guidelines: Implications for cardiac arrest education
No full text
Anticorpo biparatopico diretto verso NG2/CSPG4 e i suoi usi
No full textLa presente invenzione riguarda un anticorpo o un frammento anticorpale biparatopico in grado di riconoscere e legare almeno una, preferibilmente almeno due, porzioni del proteoglicano transmembrana NG2/CSPG4, modulando di conseguenza i processi autofagici 5 cellulari. Inoltre, si riferisce all’uso dell’anticorpo, del frammento, o della composizione che li
comprende, per trattamento di un tumore, dove il tumore esprime preferibilmente elevati livelli di NG2/CSPG4 rispetto al tessuto sano
Artificial neural networks-driven modeling of semiconductor optical amplifiers
No full textThis paper presents the development of several multilayer feed-forward artificial neural network (ANN) models aimed at the simulation and parametrization of semiconductor optical amplifiers (SOAs). In the direct approach, it is assumed that the SOA physical parameters are known, and the ANNs can reproduce the results of detailed SOA models up to 20 times faster. In the inverse approach, it is assumed that the SOA is a grey-box with a known model but unknown parameters, and the ANNs infer the SOA model parameters from the input-output data. These results provide efficient surrogate models to represent SOAs in future digital twins for on-line optimization of ultra-wide band transmission systems that employ the SOA as the repeater element