Diagnostic delay in rare diseases in the Campania region: addressing ageing, gender disparities, and the "postcode lottery effect" to reduce the patient odyssey.

Our study assessed the time to diagnosis of rare diseases (RDs) in Campania and whether there are determinants of diagnostic delay (DD). Demographic characteristics, date of first medical contact and diagnosis, disease macro-groups, and area of residence of patients were recorded. DD was calculated as the time elapsed (in years) from the onset of symptoms to the RD diagnosis date.

[Rare Diseases and epidemiology: an overlook at data from the Campania Region Rare Disease Registry (Southern Italy)].

Objectives: to provide the epidemiological framework of those affected by rare diseases resident in the Campania Region (Southern Italy), using the data entered in the Campania Region Rare Disease Registry, acquiring information potentially useful for regional planning.

Design: observational retrospective cohort study on patients with rare diseases included in the Regione Campania Rare Disease Registry from 01.01.

Trend in the use of biological drugs in pediatric patients with immune-mediated inflammatory diseases: Insight from the large-scale Italian VALORE project.

Real-world data on biological drug use in pediatric patients with immune-mediated inflammatory diseases (IMIDs) are scarce. This retrospective, population-based, cohort study aimed to provide an overview of biological drug use among children and adolescents with IMIDs from 2010 to 2023 using the Italian VALORE distributed database network. As secondary aim, potential of such a network for evaluating the risk of serious infections related to biological drugs in pediatrics was investigated.

Low LDL-Cholesterol and Hemorrhagic Risk: Mechanistic Insights and Clinical Perspectives.

Low-density lipoprotein cholesterol (LDL-C) plays a central role in lipid metabolism and is a well-established therapeutic target for the prevention of atherosclerotic cardiovascular diseases (CVDs). In recent years, increasingly aggressive lipid-lowering strategies have been adopted to achieve ultra-low LDL-C concentrations (<55 mg/dL or even <30 mg/dL) in high-risk patients. While the benefits of LDL-C reduction in lowering the incidence of myocardial infarction and ischemic stroke are well documented, emerging clinical evidence has raised concerns about a potential association between very low LDL-C levels and an increased risk of bleeding, particularly hemorrhagic stroke and gastrointestinal hemorrhage.

Type 2 diabetic disease and current drug treatments: clinical and governance aspects.

Aims: Type 2 diabetes mellitus (T2D) is recognized as one of the most pressing global health issues of our time. In Italy, its prevalence has grown significantly, currently affecting an estimated 4 million individuals. Moreover, it is believed that an additional 1 million people may be living with the condition without a formal diagnosis, underscoring the critical need for enhanced awareness, screening, and preventive measures.

Disproportionality analysis of European safety reports on autoimmune and rheumatic diseases following COVID-19 vaccination.

The safety profile of COVID-19 vaccines is well-established, yet the widespread immunization campaign has led to an increase in reported cases of Immune-Mediated and Rheumatic Diseases (IMDRs). This study aimed to assess the reporting of Adverse Events Following Immunization (AEFIs) related to IMDRs after COVID-19 vaccination. We analyzed all individual case safety reports (ICSRs) related to COVID-19 vaccines authorized in the European Union (i.

Hypogammaglobulinemia in patients with multiple sclerosis receiving disease modifying therapies: disproportionality analysis using the EudraVigilance database.

Background: Monoclonal antibodies targeting CD20, such as rituximab, ocrelizumab, and ofatumumab, are crucial in managing multiple sclerosis (MS). However, they can cause hypogammaglobulinemia, increasing the risk of infections and autoimmune disorders.

Research Design And Methods: This study describes cases of hypogammaglobulinemia in MS patients receiving anti-CD20 monoclonal antibodies, using data from the European spontaneous reporting system database, EudraVigilance.

Consumption and expenditure of drugs used for the treatment of hypercholesterolemia: a governance analysis.

Background: Elevated cholesterol levels are a significant contributor to cardiovascular disease risk. While statins have long been the cornerstone for lowering LDL cholesterol, their associated side effects have prompted the exploration of alternative treatments, including ezetimibe, bempedoic acid, PCSK9 inhibitors and inclisiran.f.

The structural and organizational aspects of human papillomavirus vaccine affecting immunization coverage in Europe: a systematic review.

The introduction of HPV vaccinations, that can prevent most prevalent HPV-related cancers of various body districts, is a public health milestone. Despite broad immunization programs, European Health Systems face structural and organizational difficulties that hinder care. This study examined structural and organizational elements that may affect HPV vaccine coverage.

Synergistic Effects of a Novel Combination of Natural Compounds Prevent HO-Induced Oxidative Stress in Red Blood Cells.

Novel strategies to prevent the "storage lesions" of red blood cells (RBCs) are needed to prevent the risk of adverse effects after blood transfusion. One option could be the supplementation of stored blood bags with natural compounds that may increase the basal load of antioxidant protection and the shelf life of RBCs. In this pilot study, we investigated for the first time potential synergistic effects of a triple combination of well-known anti-oxidant compounds curcumin (curc), vitamin E (vit E), and vitamin C (vit C).

Considerations on the sustainability of hypercholesterolemia treatment in the context of new drugs on the market: data from Campania, Italy.

Hypercholesterolemia is a major risk factor in the development of cardiovascular diseases. Statins have been the primary treatment for reducing LDL cholesterol for years; however, adverse events related to their use have led to the development of alternative therapies, such as ezetimibe, bempedoic acid, and PCSK9 inhibitors, including alirocumab, evolocumab, and inclisiran. The study is aimed at comparing the consumption and costs of lipid-lowering drugs in the first half of 2023 (21,446,011.

Analysis of prescriptive monitoring regarding the current therapeutic landscape of rheumatoid arthritis: the experience of an Italian local health authority.

Introduction: Rheumatoid Arthritis (RA) is among the most prevalent chronic inflammatory diseases affecting millions of people with a significant expenditure of resources by National Healthcare Systems. This study aimed to analyze all available treatments exclusively for RA to highlight the costs of each treatment type and raise awareness of the use of biosimilar drugs.

Methods: In an Italian healthcare authority, all prescriptions made for the diagnosis of RA were extracted to verify consumption expressed in Defined Daily Dose (DDD) and the expenditure incurred expressed in euros.

Late Hepatocellular Carcinoma Occurrence in Patients Achieving Sustained Virological Response After Direct-Acting Antiviral Therapy: A Matter of Follow-Up or Something Else?

: Despite achieving a sustained virological response (SVR) with direct-acting antivirals (DAAs), an unexpected increase in the occurrence rate of hepatocellular carcinoma (HCC) has been observed among HCV-treated patients. This study aims to assess the long-term follow-up of HCV patients treated with DAAs who achieved an SVR to investigate the potential for late-onset HCC. : In this prospective multicenter study, we enrolled consecutive HCV patients treated with DAAs following Italian ministerial guidelines between 2015 and 2018.

Bacterial Porins and Their Procoagulant Role: Implication in the Pathophysiology of Several Thrombotic Complications during Sepsis.

The association between sepsis and thrombotic complications is still not well known. Different mechanisms have been shown to be involved in the sepsis-induced prothrombotic state, but clinical scenarios may differ. In this review, we have summarized the role that bacterial products such as porins and toxins can have in the induction of the prothrombotic state during sepsis and the interaction that they can have with each other.

An Analysis of the Distribution of Direct Cost of Diabetes Care in Selected Districts in Italy.

Introduction: This study aims to define the distribution of direct healthcare costs for people with diabetes treated in two healthcare regions in Italy, based on number of comorbidities and treatment regimen.

Methods: This was a retrospective analysis using data from two local health authority administrative databases (Campania and Umbria) in Italy for the years 2014-2018. Data on hospital care, pharmaceutical and specialist outpatient and laboratory assistance were collected.

Covid-19 psychological distress: Analysis of antipsychotic drugs' use in an Italian population sample.

Background: The current pandemic, in addition to putting a strain on healthcare systems and global economies, has exacerbated psychiatric problems and undermined the mental health of many individuals. In an Italian cohort, this phenomenon has been assessed through a retrospective study aimed at evaluating the consumption and costs of antipsychotic drugs between 2020 and 2022.

Methods: All dispensations made in local pharmacies accessible to the public have been extracted from a database called 'Sistema Tessera Sanitaria', which covers a population of approximately one million people residents in the ASL Napoli 3 Sud.

Incidence of new-onset hypertension before, during, and after the COVID-19 pandemic: a 7-year longitudinal cohort study in a large population.

Background: While the augmented incidence of diabetes after COVID-19 has been widely confirmed, controversial results are available on the risk of developing hypertension during the COVID-19 pandemic.

Methods: We designed a longitudinal cohort study to analyze a closed cohort followed up over a 7-year period, i.e.

Comparison and Analysis of Antibiotic Consumption in Two Italian Hospital Settings in Relation to the Fight of Antimicrobial Resistance.

: The emergence and spread of drug-resistant pathogens due to the improper use of antibiotics have become increasingly apparent in recent years. : This retrospective comparative analysis aimed to assess and compare antibiotic prescription trends in Italy across two different regions based on geographic area and healthcare structure. One region represents a large hospital institution, while the other represents a populous local Italian health agency.