To provide a clinically oriented synthesis of the epidemiology, pathophysiology, and management of bronchiectasis in patients with inflammatory bowel disease (IBD), and to clarify the key mechanisms underlying this association. Emerging evidence suggests a non-random association between IBD and bronchiectasis, with prevalence estimates varying widely according to study design and diagnostic approach. Mechanistic insights support a role for gut–lung axis dysfunction, including loss of mucosal tolerance, microbial dysbiosis, and immune cell trafficking. Clinically, bronchiectasis in IBD appears heterogeneous and may occur independently of intestinal disease activity. The increasing use of biologic therapies further complicates management, particularly regarding infection risk. Bronchiectasis should be recognised as a relevant extra-intestinal manifestation of IBD with important implications for diagnosis and management. A pragmatic, multidisciplinary approach is required, and further research is needed to define optimal screening strategies and tailored therapeutic pathways. Bronchiectasis is a frequent but under-recognized extra-intestinal manifestation of IBD. Awareness of the gut–lung axis and early multidisciplinary management are essential to balance inflammation control, infection risk, and respiratory outcomes in the era of biologic therapies.
This study compares anthropometric, metabolic, cardiovascular, and liver parameters in people living with HIV (PLWH) on antiretroviral therapy (ART), and men on pre-exposure prophylaxis (PrEP) in the same age group. This was a single-center, cross-sectional study of males aged 18–50 years, receiving ART for HIV or PrEP for at least 6 months, consecutively enrolled at Policlinico Hospital, Milan. Lifestyle factors were assessed using the International Physical Activity Questionnaire and a food diary. Anthropometric measurements included body mass index (BMI), waist circumference, and bioimpedance analysis. Blood samples were analyzed for glycemic parameters, lipid profile, hepatic enzymes, and adipokines, including leptin. Hepatic steatosis and fibrosis were evaluated using FibroScan®. Group differences were assessed using chi-squared, t tests, and Mann–Whitney tests, while logistic regression determined associations with HIV status. Eighty-two participants were enrolled: 53 PLWH and 29 PrEP users. PLWH had significantly higher BMI, waist circumference, total fat mass, and triglycerides, as well as total and LDL cholesterol. PrEP users engaged in more vigorous-intensity activity, with no differences in dietary habits. Among PLWH, higher physical activity was associated with lower HOMA index. Leptin levels were significantly higher in PLWH compared to PrEP users. Multivariate analysis identified LDL cholesterol as independently associated with HIV status. PLWH exhibited greater adiposity and dyslipidemia than PrEP users, with leptin emerging as a potential marker of metabolic dysfunction. Higher physical activity was linked to improved insulin sensitivity, underscoring the role of exercise in mitigating HIV-related metabolic dysregulation.
Receiving a positive expanded newborn screening result is highly stressful for parents. This study aimed to examine parent–clinician concordance in perceived severity, to investigate its association with parental emotional distress at baseline and six months after communication, and to explore the interdependence between perceived severity and perceived control within parental dyads. A total of. 171 mothers and 168 fathers reported parental distress and completed the Impact of Event Scale–Revised and the Emotion Thermometers. Perceived severity and control were measured using single-item Likert scales reflecting subjective appraisals at the time of disclosure. For 147 parents (74 mothers and 73 fathers), a clinician-rated severity score was available. An Actor–Partner Interdependence Model with indistinguishable dyads was applied to 115 parental couples. Most parents (61.9
BACKGROUND:Epidermolysis bullosa (EB) is a rare inherited disorder characterized by skin and mucosal fragility, with severe implications for physical, psychological, and social well-being. Research on quality of life (QoL) in EB remains limited, particularly in Italy, where systematic patient-reported outcome measures are lacking. To address this gap, Fondazione REB ETS developed a patient-centered QoL questionnaire (QoL-REB) constructed directly by patients and caregivers, with support from clinicians and researchers. METHODS:We conducted a cross-sectional online survey between March and April 2024, recruiting Italian EB patients and caregivers through Fondazione REB and Debra Italia mailing lists. Participants completed the QoL-REB questionnaire, which assesses seven dimensions of QoL: physical health, autonomy, emotional well-being, family dynamics, social interactions, work/school life, and care experience. Responses were rated on a 4-point scale, with overall QoL assessed on a 0-10 scale. RESULTS:Forty-seven individuals with EB (38 adults, 9 minors; 55% female) participated, representing multiple EB subtypes, predominantly dystrophic EB (62.4%). Mean overall QoL was rated 6/10. Pain, itching, and reduced mobility emerged as the most frequent physical challenges. Over 70% of adults reported limited autonomy in daily activities, while children experienced difficulties with walking, dressing, and sports participation. Emotional distress was common, with patients expressing concerns about future prospects, body image, and dependence on others; 43% reported a need for psychological support. Family burden was evident, with both adults and minors perceiving themselves as a strain on relatives. Social limitations, workplace and school difficulties, and dissatisfaction with healthcare services-particularly a lack of EB-specific expertise in non-reference centers-were also reported. CONCLUSIONS:This first Italian patient-led assessment highlights the pervasive and multidimensional burden of EB on QoL. Findings underscore the need for integrated, patient-centered care models that combine medical, psychological, and social support. The QoL-REB questionnaire provides a novel, comprehensive tool to capture the lived experience of EB and may serve as a framework for international adaptation and implementation.
L’osteoporosi associata a gravidanza e allattamento (PLAO) è una condizione di fragilità scheletrica che si manifesta tipicamente con multiple fratture vertebrali nel terzo trimestre o durante l’allattamento. La sua incidenza è probabilmente sottostimata. L’inquadramento clinico richiede l’esclusione di cause secondarie e la valutazione della massa ossea. La gestione iniziale prevede l’ottimizzazione dell’intake di calcio, la supplementazione di vitamina D e la sospensione dell’allattamento. La farmacoterapia (off-label) è controversa; viene consigliato, infatti, di attendere il recupero spontaneo e riservare gli agenti anabolici ai casi più gravi o con insufficiente recupero.
