The Mediterranean Diet (MD), first conceptualized by Ancel Keys in the 1950s, is widely acknowledged as a dietary pattern associated with significant health benefits. It is also a cultural heritage, recognized by UNESCO in 2010. Despite its relevance, the MD has been variably defined through descriptive models, food pyramids, and adherence scoring systems. This heterogeneity limits comparability across research and practice. This paper describes the development of a standardized, evidence-based, and multidimensional definition of the MD within the Italian National Guidelines "La Dieta Mediterranea." Importantly, the proposed definition integrates both nutritional components and sociocultural dimensions, including lifestyle practices, conviviality, and sustainability. The guideline development process followed internationally recognized standards, involving a multidisciplinary panel and systematic evidence synthesis. The MD was defined conceptually through an operational approach based on the analysis of existing adherence scores available in the literature. Thirty-three eligible studies and fifteen Mediterranean Diet Scoring Systems were analyzed to identify common food groups, nutrients, and lifestyle components. The proposed definition emphasizes high consumption of plant-based foods, olive oil as the primary fat source, moderate intake of fish, dairy, and white meat, and limited consumption of red meat and processed products. Beyond nutrition, the MD is conceptualized as a multidimensional lifestyle encompassing physical activity, conviviality, and sustainability principles. This integrated approach aligns with contemporary evidence on chronic disease prevention and health promotion. The resulting definition provides a conceptual framework for healthcare professionals, researchers, and policymakers, supporting harmonized interventions and policy strategies that extend "beyond the plate."
Paracetamol (also known as acetaminophen or N-acetyl-p-aminophenol, APAP) is the most widely used antipyretic and analgesic during pregnancy and early childhood, although its exact mechanism of action remains not fully understood. Several publications have suggested a potential association with adverse neurological or behavioural outcomes in foetal or neonatal development; however, these studies were limited by significant confounding factors. More recently, a nationwide sibling-controlled study has definitively refuted this hypothesis. Similarly, some evidence supports both the safety and the efficacy of paracetamol use in early childhood. Based on the available literature and their own clinical experience, a multidisciplinary panel of Italian experts developed a position paper addressing the safety of paracetamol exposure during pregnancy, the neonatal period and the first 1,000 days of life. Current evidence and the board’s clinical experience indicate that paracetamol is safe and should be considered the first-choice treatment in these stages of life, as highlighted and endorsed by the guidelines of leading scientific societies.
Hospital discharge is a crucial moment in the continuity of care, acting as a bridge between the acute phase and the treatment pathway that follows. Far from being a simple administrative act, it is a complex process requiring careful planning, effective communication, and the active involvement of all the stakeholders of the healthcare system, including the patient. Poor discharge management can have a negative impact on clinical outcomes, resulting in a higher risk of hospital readmission and inefficient use of healthcare resources. Taking into account the increasingly old, fragile population showing a high prevalence of comorbidities and complex care needs, it is essential to consider discharge as a comprehensive and integrated approach to the care continuum. This document arises from the necessity to share an updated and practical model for the management of hospital discharge, based on the latest scientific evidence and multidisciplinary experience, its aim being to promote continuity of care and personalized treatment as well as to improve health outcomes. The authors intend to provide clinical cardiologists with a unified tool for the management of patient discharge, offering concrete proposals to improve communication between physicians and patients, optimize therapies, and positively impact health outcomes.
Chronic obstructive pulmonary disease (COPD) is the fourth most important cause of death in high-income countries. Inappropriate use of COPD inhaled therapy, including the low adherence (only 10 %-40 % of patients reporting an adequate compliance) may shrink or even nullify the proven benefits of these medications. As such, an accurate prediction algorithm to assess at national level the risk of COPD exacerbation might be relevant for general practictioners (GPs) to improve patient's therapy.
