BACKGROUND:Differently from the structured network for ST-elevation myocardial infarction (STEMI), which is characterized by standardized transfer protocols and well-defined pathways and is well-established in most Italian regions and provinces, the management of non-STEMI (NSTEMI) still presents organizational gaps, as it lacks a dedicated network in nearly all areas. METHODS:An ANMCO 15-item survey was conducted among hospital cardiologists to assess logistics, decision-making, and timing of invasive coronary angiography (ICA). A total of 539 questionnaires were collected from Hub (65.1%) and Spoke (34.9%) centers. RESULTS:ECG tele-transmission is available in 90.9% of settings; transfers mainly occur via advanced life-support ambulances. ICA timing is primarily driven by hemodynamic instability and ST-T changes, while the GRACE score is not systematically used. Overall, 80.3% of patients are transferred within 24-48 h. Significant regional differences were observed in 24/7 cath lab availability, presence of cardiac surgery, transport models, and early return to Spoke practices. CONCLUSIONS:The survey highlights good technological resources but marked heterogeneity in NSTEMI management. Findings support the need for shared protocols, interoperable telecardiology platforms, and uniform criteria for risk stratification and patient transfers.
Purpose: The relationship between bone mineral density (BMD) and muscle performance is little investigated in the context of eating disorders. The aim of the present study was to evaluate the association between BMD and lower-limb muscle power in patients with anorexia nervosa (AN). Methods: 44 female patients (aged 12 to 40 years) with AN were included in the study. The 5-repetition sit-to-stand test was conducted to assess physical functionality, and both absolute and relative muscle power were calculated. Body composition, appendicular lean mass (ALM), and BMD were measured using dual-energy X-ray absorptiometry. Results: A significant association was observed between lower-limb absolute muscle power and lumbar BMD. This association was still significant after adjustment for ALM. Conclusions: Our results show a positive relationship between lumbar BMD and lower-limb muscle power in patients with AN, which cannot be solely accounted for by ALM. KEY WORDS: Bone mineral density, anorexia nervosa, functional test, eating disorder.
Janus kinase (JAK) inhibitors are effective systemic treatments for moderate-to-severe atopic dermatitis (AD), rapidly controlling symptoms and improving quality of life. However, the impact of body mass index (BMI) on therapeutic response remains unclear. This multicenter retrospective study analyzed data from 388 adult AD patients treated with upadacitinib, abrocitinib, or baricitinib across 25 Italian dermatology centers between May 2022 and July 2024. Patients were classified as overweight (BMI ≥ 25) or non-overweight (BMI < 25), with disease severity assessed using EASI, IGA, and Numerical Rating Scales (NRS) for pruritus and sleep disturbance over 104 weeks. The effect of different treatment dosages was also evaluated. No significant BMI-related differences in clinical outcomes were noted at most timepoints. However, in the upadacitinib 15 mg group, non-overweight patients showed greater EASI and pruritus improvements at Week 4 (p = 0.037, p = 0.039), although these differences resolved subsequently. At Week 104, higher BMI modestly reduced EASI improvement (p = 0.045) in multivariable analysis. Treatment dosage consistently influenced clinical improvement regardless of BMI. These findings confirm the efficacy of JAK inhibitors across BMI categories, suggesting minimal short-term BMI influence but highlighting potential long-term considerations in overweight patients, emphasizing personalized dosing strategies and prolonged monitoring.
The development of idiopathic adult-onset dystonia (IAOD) in different body parts is associated with specific demographic and clinical characteristics, as well as with specific risk factors. To investigate whether specific occupations are associated with specific forms of IAOD at onset, namely blepharospasm (BSP), cervical dystonia (CD), and task-specific upper limb dystonia (TS-ULD). Data from 905 IAOD patients enrolled in the Italian Dystonia Registry were analysed. Each patient was assigned to the corresponding occupational category by specialists in occupational medicine according to the classification of the Italian National Institute of Statistics. Logistic regression models (adjusted for sex, year of birth, Italian geographical areas, and age at dystonia onset) were computed to assess the association between occupation and specific dystonia at onset, using patients who developed focal dystonia in other body parts as controls. Compared to other occupations, trades workers exhibited an increased risk for BSP at onset (OR = 2.6, 95
Cognitive dysfunction is increasingly recognised as a potential non-motor feature of the idiopathic adult-onset dystonia (IAOD) phenotype. However, evidence from large cohort studies is lacking, as previous research has been limited to small samples, leaving several questions unanswered. To investigate whether cognitive performance in IAOD is related to or independent of clinical and demographic factors. A total of 297 patients with IAOD from the Italian Dystonia Registry, unselected with respect to cognitive status, were assessed using the Montreal Cognitive Assessment (MoCA). Dystonia severity was expressed using the Global Dystonia Severity Rating Scale (GDRS), while anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Linear regression models were computed to explore the associations between MoCA scores and clinical and demographic variables. The mean raw total MoCA score was 22.8 ± 5.0, while the mean age- and education-adjusted MoCA score was 23.6 ± 4.0. Older age, fewer years of schooling, longer dystonia duration, segmental or multifocal dystonia distribution, higher HADS-depression score, and family history of dystonia were significant independent predictors of lower MoCA scores. No independent associations were found between MoCA score and sex, GDRS total score, presence of sensory trick, or HADS-anxiety score. In patients with focal dystonia, MoCA scores were not related to the specific site of dystonia. Our findings provide novel evidence supporting cognitive dysfunction as an intrinsic feature of the IAOD phenotype and suggest a possible pathophysiological link between dystonia and cognition.
