- Research Article
2
- 10.7175/cmi.v14i1.1460
- Sep 15, 2020
- Clinical Management Issues
- Francesca Guidotti + 6 more
Myeloid sarcomas (MS) are rare extramedullary hematological tumors which generally occur during the natural course of acute myeloid leukemia or chronic myeloid leukemia. Rarely, their onset precedes peripheral blood and bone marrow manifestations of disease. Common sites of involvement are skin, bone, soft tissue, lymph nodes, reproductive or digestive organs, and central nervous system.Herein, we report the case of a 72-year-old man affected by JAK2 V617F mutated myeloproliferative neoplasm who developed MS involving collecting system of both kidneys. MS and MS-related obstructive nephropathy were the first signs of the acute evolution of a known chronic hematological malignancy, preceding by some weeks the onset of leukocytosis.
- Research Article
1
- 10.7175/cmi.v14i1.1474
- Jul 30, 2020
- Clinical Management Issues
- Alessandro Cicolin + 1 more
Insomnia is the most prevalent sleep disorder (10-40%). It is defined as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep and that results in some form of daytime impairment. Among the typical symptoms, there are fatigue, decreased mood or irritability, general malaise, and cognitive impairment. According to the International Classification of Sleep Disorders 3rd edition, ICSD-3, it has been defined as chronic (lasting more than three months) or short-term insomnia (less than three months).In clinical practice, the usual therapeutic approach is pharmacological (benzodiazepines, z drugs, slow wave sleep enhancers), even if the American Academy of Sleep Medicine (AASM), the American College of Physicians (ACP), and the European Sleep Research Society (ESRS) guidelines suggest that the first clinical choice should be non-pharmacological (cognitive behavioral therapy). A combined (non-pharmacological and pharmacological)approach could be considered in poor responders to manage drug dependence and to increase compliance to treatment and patients’ quality of life.
- Research Article
- 10.7175/cmi.v14i1.1477
- Jul 15, 2020
- Clinical Management Issues
- Roberto Infrasca
- Research Article
61
- 10.7175/cmi.v14i1.1467
- Apr 3, 2020
- Clinical Management Issues
- Domenico Lorenzo Urso
Severe acute respiratory syndrome (“SARS-CoV-2”, previously provisionally named “2019 novel coronavirus” or “2019-nCoV”) disease (COVID-19) in China, at the end of 2019, resulted in a large global outbreak.Among patients with pneumonia caused by SARS-CoV-2, fever is the most common symptom, followed by dry cough. Bilateral lung involvement with ground-glass opacities (GGOs) is the most common finding from computed tomography (CT) images of the chest.At present, there are no specific antiviral drugs against SARS-CoV-2 infection for potential therapy of humans. Current treatments are mainly focused on symptomatic and respiratory support in patients with COVID-19. Preventive measures are the current strategy to limit the spread of cases.The present report summarizes the point of the situation about this global emergency.
- Research Article
- 10.7175/cmi.v14i1.1463
- Mar 23, 2020
- Clinical Management Issues
- Stefano Cascinu
- Research Article
- 10.7175/cmi.v14i1.1459
- Feb 25, 2020
- Clinical Management Issues
- Agnese Raponi + 2 more
- Research Article
2
- 10.7175/cmi.v14i1.1448
- Jan 30, 2020
- Clinical Management Issues
- Ayisha Ayisha + 1 more
Plummer-Vinson syndrome (PVS), also called "Paterson-Brown-Kelly syndrome“, is a rare medical syndrome generally affecting middle-aged women. Iron deficiency anemia is the prime etiological factor and other probable factors include malnutrition, genetic predisposition, or autoimmune processes characterized by three distinctive features: iron deficiency anemia, dysphagia, and esophageal web. The dysphagia is generally painless and intermittent or progressive over years, restricted to solids, and associated with weight loss. The exact pathogenesis of PVS is still indistinguishable, but it is interconnected with iron deficiency anemia. Plummer-Vinson syndrome, if left untreated, carries an increased risk of developing squamous cell carcinoma of the upper alimentary tract.In this case report, a 40-year-old female patient presented long-standing dysphagia for months, which progressively developed to postcricoid squamous cell carcinoma by the time she approached to medical treatment. Diagnosis was confirmed through laboratory tests, showing iron deficiency anemia and whole-body positron emission tomography-computed tomography (PET-CT) presenting squamous cell carcinoma in postcricoid region (hypopharynx).
- Front Matter
- 10.7175/cmi.v13i1.1455
- Dec 19, 2019
- Clinical Management Issues
- Laura Fascio Pecetto
- Research Article
- 10.7175/cmi.v13i1.1456
- Dec 19, 2019
- Clinical Management Issues
- Laura Fascio Pecetto
- Research Article
1
- 10.7175/cmi.v13i1.1434
- Dec 12, 2019
- Clinical Management Issues
- Giuseppe Foti + 2 more
Current treatments for chronic hepatitis B are able to provide a sustained suppression of the viral replication (i.e., persistent undetectability of HBV DNA). This leads to improvement of liver fibrosis and reduction of clinical complications. However, hepatitis B surface antigen (HBsAg) persists in most patients, probably justifying a still increased risk of hepatocellular carcinoma. Indeed, obtaining a complete and sterilizing cure with elimination of the covalently closed circular DNA (cccDNA) or silencing its activity is still a holy grail. New molecules are under evaluation to suppress viral replication acting on multiple phases of the HBV cycle or improve specific immune response against HBV. Molecules acting on HBV cycle have already showed encouraging results, such as entry inhibitors, small interfering RNAs (siRNAs), capsid assembly modulators (CAMs), nucleic acid polymers (NAPs). Also, promising results have been observed with immune-modulators, therapeutic vaccines, and other immune-based approaches. Among these, toll-like (TLR) or anti-programmed receptor agonists antibody 1 of the cell death protein (PD1) (e.g., nivolumab) are most promising. This paper describes newer drugs appearing on the horizon, including antiviral drugs targeting different steps of the HBV life cycle and therapeutic approaches based on immune-modulation.