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IntroductionThe use of Information and Communication Technology (ICT) for assessing and treating cognitive and motor disorders is promoting home-based telerehabilitation. This approach involves ongoing monitoring within a motivating context to help patients generalize their skills. It can also reduce healthcare costs and geographic barriers by minimizing hospitalization. This systematic review focuses on investigating key aspects of telerehabilitation protocols for children with neurodevelopmental or neurological disorders, including technology used, outcomes, caregiver involvement, and dosage, to guide clinical practice and future research.MethodThis systematic review adhered to PRISMA guidelines and was registered in PROSPERO. The PICO framework was followed to define the search strategy for technology-based telerehabilitation interventions targeting the pediatric population (aged 0–18) with neurological or neurodevelopmental disorders. The search encompassed Medline/PubMed, EMBASE, and Web of Science databases. Independent reviewers were responsible for selecting relevant papers and extracting data, while data harmonization and analysis were conducted centrally.ResultsA heterogeneous and evolving situation emerged from our data. Our findings reported that most of the technologies adopted for telerehabilitation are commercial devices; however, research prototypes and clinical software were also employed with a high potential for personalization and treatment efficacy. The efficacy of these protocols on health or health-related domains was also explored by categorizing the outcome measures according to the International Classification of Functioning, Disability, and Health (ICF). Most studies targeted motor and neuropsychological functions, while only a minority of papers explored language or multi-domain protocols. Finally, although caregivers were rarely the direct target of intervention, their role was diffusely highlighted as a critical element of the home-based rehabilitation setting.DiscussionThis systematic review offers insights into the integration of technological devices into telerehabilitation programs for pediatric neurologic and neurodevelopmental disorders. It highlights factors contributing to the effectiveness of these interventions and suggests the need for further development, particularly in creating dynamic and multi-domain rehabilitation protocols. Additionally, it emphasizes the importance of promoting home-based and family-centered care, which could involve caregivers more actively in the treatment, potentially leading to improved clinical outcomes for children with neurological or neurodevelopmental conditions.Systematic review registrationPROSPERO (CRD42020210663).

The history of sodium-glucose cotransporter 2 inhibitors (SGLT2i) is so long and started in 1835 when Petersen extracted a compound called phlorizin from apple tree bark. About fifty years later, von Mering discovered its glucosuric properties. In the 1980s, it was discovered that the glucosuria resulted from inhibition by phlorizin of glucose reabsorption by the renal tubules, which lowered blood glucose levels in diabetic rats. Nowadays, beyond their glucose-lowering effects, growing evidence suggests significant cardiorenal benefits associated with SGLT2i therapy. Indeed, several clinical trials, including landmark studies such as EMPA-REG OUTCOME, CANVAS Program, and DECLARE-TIMI 58, have demonstrated robust reductions in cardiovascular events, particularly heart failure hospitalizations and cardiovascular mortality, among patients treated with SGLT2i. However, subsequent trials showed that SGLT2i benefits extend beyond the diabetic population, encompassing individuals with and without diabetes. Additionally, SGLT2i exhibit nephroprotective effects, manifesting as a slowing of the progression of chronic kidney disease and a reduction in the risk of end-stage kidney disease. The mechanisms underlying the cardiorenal benefits of SGLT2i are multifactorial and include improvements in glycemic control, reduction in arterial stiffness, modulation of inflammation and oxidative stress, reduction of intraglomerular pression and promotion of natriuresis and diuresis through inhibition of SGLT2 in the luminal brush border of the first segments of the proximal kidney tubule. This narrative review aims to explore the cardiorenal outcomes of SGLT2i, encompassing their mechanisms of action, clinical evidence, safety profile, and implications for clinical practice.

This paper illustrates the activities proposed by the Department of Modern Languages and Cultures (DLCM) of the University of Genoa, carried out within the framework of the POT (Plans for Orientation and Tutoring) and PCTO (Pathways for Transversal Competences and Orientation) projects promoted by MIUR, starting from 2017 and addressed to students of secondary schools. The described workshop experiences focus on two macro-areas in particular: on the one hand, an experiential pathway on the profession of interpreter; on the other, the enhancement of language skills. In conclusion, future objectives are described in the perspective of a more inclusive university.

Luogo di snodo e di possibile riannodamento, recupero, rianimazione, orientamento di una domanda di ascolto troppo spesso mortificata o misconosciuta, servizio di libero accesso, senza intermediazioni, gratuito ma altamente professionale per co-costruire insieme un nuovo sistema, efficace ed efficiente, che condivida come fine ultimo il benessere dell’essere umano ferito. Il servizio di Urgenza Psicologica è una delle molteplici risposte nate dalla cooperativa CREA, la quale si occupa da circa trent’anni di riabilitazione e inclusione sociale, nel campo del disagio psicologico e psichiatrico grave, con una logica di mantenimento di un dialogo fra servizi riabilitativi, città e società civile.[...]

Myocarditis is a potentially fatal complication of coronavirus disease 2019 (COVID‐19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) virus. COVID‐19 myocarditis appears to have distinct inflammatory characteristics that distinguish it from other viral etiologies. COVID‐19 myocarditis can present with symptoms ranging from dyspnea and chest pain to acute heart failure and death. It is critical to detect any cases of myocarditis, especially fulminant myocarditis, which can be characterized by signs of heart failure and arrhythmias. Serial troponins, echocardiography, and electrocardiograms should be performed as part of the initial workup for suspected myocarditis. The second step in detecting myocarditis is cardiac magnetic resonance imaging and endomyocardial biopsy. Treatment for COVID‐19 myocarditis is still debatable; however, combining intravenous immunoglobulins and corticosteroids may be effective, especially in cases of fulminant myocarditis. Overall, more research is needed to determine the incidence of COVID‐19 myocarditis , and the use of intravenous immunoglobulins and corticosteroids in combination requires large randomized controlled trials to determine efficacy. The purpose of this review is to summarize current evidence on the subject. This review aims to summarise current evidence on this topic.

We report the case of a 62-year-old man who was admitted to the Cardiac Department for TakoTsubo and ACC by torsades de point, secondary to acute kidney disease. We decide to discharge with a portable defibrillator. One month after cardiac magnetic resonance showed a complete recovery of left ventricular function.

This essay is an account of the development and implementation of the ‘English Project’ at the University of Genoa, aimed at establishing a language standard at B1 level, assessing freshers, and providing a structured path if such proficiency is not met. The discussion covers the rationale behind defining a language standard, its alignment with local and national requirements, and includes statistical analysis of the assessment test results from over 10,000 students. The study concludes by exploring future developments, including raising the standard to B2, fostering internationalization efforts, and aligning with Erasmus requirements.

La papilomatosis laríngea (PL) es una enfermedad en donde se desarrollan tumores benignos en las vías respiratorias causados por el virus del papiloma humano, principalmente VPH-6 y VPH-11. Aunque el VPH se clasifica como un virus de transmisión sexual, la papilomatosis laríngea no necesariamente, ya que cuenta con múltiples formas de transmisión. Esta enfermedad no posee cura definitiva y todo paciente con este diagnóstico debe llevar un seguimiento regular para evitar posible diseminación, transformación maligna y complicaciones que amenazan la vida. El objetivo de esta revisión de tema es reunir la información más reciente y relevante sobre la patología de interés para así ayudar a cualquier profesional de medicina interesado en obtener un diagnóstico correcto y temprano con el que se mejorará tratamiento, calidad de vida y mortalidad del paciente.

Aims: To investigate the effect of sodium‐glucose co‐transporter 2 inhibitor [SGLT‐2i] therapy on renal haemodynamics in T2D patients with glomerular hyperfiltration. Materials and Methods: Sixty T2D patients with elevated [HYPER] and normal [NORMO] GFR were randomized to dapagliflozin 10 mg/day [DAPA/HYPER, n = 15; DAPA/NORMO, n = 15] or to metformin/glipizide [CONTROL/HYPER, n = 15; CONTROL/NORMO, n = 15] to reach similar glycaemic control after 4 months. GFR was measured with Iohexol and hyperfiltration was empirically defined as >125 mL/min/1.73 m2. GFR, renal plasma flow [RPF], mean arterial pressure [MAP], filtration fraction [FF], and renal vascular resistance [RVR] were determined before/after therapy. Results: HbA1c decreased similarly in all 4 groups. GFR declined by ~18% in DAPA/HYPER and by ~7% in DAPA/NORMO and did not change in CONTROLS (p < 0.05 vs. DAPA). RPF remained unchanged in all four groups. Thus, FF (%) declined from 0.23 ± 0.01 to 0.18 ± 0.01 in DAPA/HYPER and from 0.17 ± 0.01 to 0.15 ± 0.01 in DAPA/NORMO and remained unchanged in CONTROLS (p < 0.05 vs. DAPA). MAP (mmHg) decreased from 95.4 ± 1.4 to 88.1 ± 1.3 in DAPA/HYPER and from 95.6 ± 1.3 to 91.8 ± 0.8 in DAPA/NORMO and remained unchanged in CONTROLS (p < 0.05 vs. DAPA). RVR [mmHg/L/min] declined in DAPA/HYPER (92.7 ± 7.8 to 80.4 ± 6.1) and DAPA/NORMO (90.1 ± 3.0 to 81.4 ± 2.1) but not in CONTROLS (p < 0.05 vs. DAPA). Conclusions: Despite comparable glycaemic control, dapagliflozin treatment, but not metformin and /or glipizide, reduced glomerular hyperfiltration in T2D patients and decreased both filtration fraction and renal vascular resistance. These findings suggest that a post‐glomerular vasodilatory action of SGLT2 inhibitors contributes to their renal protective effect in T2D. [ABSTRACT FROM AUTHOR]

Metaphor comprehension has been investigated in neurodevelopmental disorders, but studies devoted to adults with dyslexia are few and present inconsistent results. The present study sought to investigate how adults with dyslexia process novel metaphors. Individual differences in vocabulary, working memory, and Theory of Mind were also assessed. An online metaphor comprehension task based on the Visual World Paradigm was carried out with eye-tracking. Metaphors and corresponding literal sentences were aurally presented in isolation, and participants were asked to select a picture that best corresponded to the sentence they heard. Our results indicated that participants with dyslexia chose metaphor interpretations at a similar rate as did the control group. However, online processing data indicated generally slower response times, with a particular delay in processing metaphorical utterances. Eye movement analyses provided further insights into the underlying nature of the processing slowdowns, highlighting specific challenges encountered by individuals with dyslexia when interpreting figurative language. [ABSTRACT FROM AUTHOR]

We examined the effect of increased levels of plasma ketones on left ventricular (LV) function, myocardial glucose uptake (MGU), and myocardial blood flow (MBF) in patients with type 2 diabetes (T2DM) with heart failure. Three groups of patients with T2DM (n = 12 per group) with an LV ejection fraction (EF) ≤50% received incremental infusions of β-hydroxybutyrate (β-OH-B) for 3–6 h to increase the plasma β-OH-B concentration throughout the physiologic (groups I and II) and pharmacologic (group III) range. Cardiac MRI was performed at baseline and after each β-OH-B infusion to provide measures of cardiac function. On a separate day, group II also received a sodium bicarbonate (NaHCO3) infusion, thus serving as their own control for time, volume, and pH. Additionally, group II underwent positron emission tomography study with 18F-fluoro-2-deoxyglucose to examine effect of hyperketonemia on MGU. Groups I, II, and III achieved plasma β-OH-B levels (mean ± SEM) of 0.7 ± 0.3, 1.6 ± 0.2, 3.2 ± 0.2 mmol/L, respectively. Cardiac output (CO), LVEF, and stroke volume (SV) increased significantly during β-OH-B infusion in groups II (CO, from 4.54 to 5.30; EF, 39.9 to 43.8; SV, 70.3 to 80.0) and III (CO, from 5.93 to 7.16; EF, 41.1 to 47.5; SV, 89.0 to 108.4), and did not change with NaHCO3 infusion in group II. The increase in LVEF was greatest in group III (P < 0.001 vs. group II). MGU and MBF were not altered by β-OH-B. In patients with T2DM and LVEF ≤50%, increased plasma β-OH-B level significantly increased LV function dose dependently. Because MGU did not change, the myocardial benefit of β-OH-B resulted from providing an additional fuel for the heart without inhibiting MGU. Article Highlights: Sodium–glucose cotransporter 2 inhibitor (SGLT2i) therapy is associated with an increase in plasma ketone concentration. In patients with type 2 diabetes and heart failure with reduced ejection fraction, we examined the effect of β-hydroxybutyrate (β-OH-B) infusion, spanning the physiologic and pharmacologic ranges of plasma β-OH-B concentrations (0.7, 1.6, and 3.2 mmol/L) on myocardial function (using MRI), myocardial blood flow (measured with positron emission tomography [PET]/15O-labeled water), and myocardial glucose uptake (PET/18F-FDG). β-OH-B caused a dose-response increase in left ventricular ejection fraction and myocardial blood flow without altering myocardial glucose uptake. These results suggest that the SGLT2i-induced increase in plasma ketone concentration may contribute to its beneficial effects on myocardial function. [ABSTRACT FROM AUTHOR]

This study explores the transformative role of families in addressing and educating regarding gender differences and sexual orientations. Through qualitative research involving 32 families across Italy, the research examines parents' awareness and challenges in navigating traditional and emerging gender norms within a contemporary society. Using creative digital diaries from children and interviews with parents, the study highlights the generational and cultural gaps that shape perceptions and practices around gender roles, identity, and equality. Key findings reveal that while parents recognize the importance of fostering inclusive and egalitarian attitudes, many feel unprepared to address these changes effectively. The recurring sentiment, "We are not ready". underscores a collective need for rethinking educational approaches within families and institutions to better support younger generations in a fluid and technologically interconnected world. In conclusion, the study emphasizes the need for a systemic rethinking of family dynamics and educational models to address entrenched gender biases. By integrating gender education into family and institutional practices, families can be empowered to foster resilience, equality, and mutual understanding. This approach repositions families as active agents of a cultural transformation, capable of shaping more inclusive and equitable intergenerational relationships. [ABSTRACT FROM AUTHOR]

Introduction Type 2 diabetes mellitus (T2DM) is a powerful risk factor for cardiovascular disease (CVD), conferring a greater relative risk in women than men. We sought to examine sex differences in cardiometabolic risk factors and management in the contemporary cohort represented by the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE).Research design and methods GRADE enrolled 5047 participants (1837 women, 3210 men) with T2DM on metformin monotherapy at baseline. The current report is a cross-sectional analysis of baseline data collected July 2013 to August 2017.Results Compared with men, women had a higher mean body mass index (BMI), greater prevalence of severe obesity (BMI≥40 kg/m2), higher mean LDL cholesterol, greater prevalence of low HDL cholesterol, and were less likely to receive statin treatment and achieve target LDL, with a generally greater prevalence of these risk factors in younger women. Women with hypertension were equally likely to achieve blood pressure targets as men; however, women were less likely to receive ACE inhibitors or angiotensin receptor blockers. Women were more likely to be divorced, separated or widowed, and had fewer years of education and lower incomes.Conclusions This contemporary cohort demonstrates that women with T2DM continue to have a greater burden of cardiometabolic and socioeconomic risk factors than men, particularly younger women. Attention to these persisting disparities is needed to reduce the burden of CVD in women.Trial registration number ClinicalTrials.gov (NCT01794143)

Severe aortic stenosis (AS) is the most common valvular heart disease with a prevalence rate of more than 4% in 75-year-old people or older. Similarly, cardiac amyloidosis (CA), especially “wild-type transthyretin” (wTTR), has shown a prevalence rate ranging from 22% to 25% in people older than 80 years. The detection of the concomitant presence of CA and AS is challenging primarily because of the similar type of changes in the left ventricle caused by AS and CA, which share some morphological characteristics. The aim of this review is to identify the imaging triggers in order to recognize occult wtATTR-CA in patients with AS, clarifying the crucial step of the diagnostic process. Multimodality imaging methods such as echocardiography, cardiac magnetic resonance, cardiac computed tomography, and DPD scintigraphy will be analyzed as part of the available diagnostic workup to identify wtATTR-CA early in patients with AS.

The study discusses the potential of e-Pharmacies and the new digital skills of pharmacists in the aftermath of the Sars-Cov2 pandemic. From this perspective, a sociological analysis of the digital role-set of pharmacists isdeveloped, in order to highlight the opportunities and risks of the spreading of online pharmacies and their potential contribution to the delivery of new digitalservices for addressin Covid-19.The paper ends with some considerations on the importance of the sociological studies of “e-pharmacy encounters” in the current phase of Covid Age in Italy.