Salvatore De Cosmo

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This study looked at the health and care of older adults in Italy with Type 1 Diabetes who are over 75 years old. It involved 2,443 participants, with an average age of nearly 80, finding that 33.3% had diabetic eye disease and 39% had chronic kidney disease, but only a small number faced severe complications. The results indicate that while the quality of care is good, improvements are needed in managing heart disease risks and using insulin pumps more effectively. Who this helps: This information benefits doctors and healthcare providers caring for older patients with Type 1 Diabetes.

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This study looked at how changes in kidney function, measured by glomerular filtration rate (GFR), affect the risk of death in people with type 2 diabetes. Researchers found that people whose kidney function declined had a higher risk of dying, with a mortality rate of 2.75 deaths per 100 people each year. Additionally, a part of the effect of tryptophan metabolism on death risk is linked to how kidney function changes—specifically, 24.3% of this effect is due to the decline in kidney function. Who this helps: This research benefits patients with type 2 diabetes by highlighting the importance of monitoring kidney health.

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This study looked at how inflammation affects the risk of death in people with type 2 diabetes and examined a specific connection with tryptophan metabolism. Researchers found that six inflammatory markers were linked to an increased risk of death, with their combined score indicating more than double the risk of death compared to those without high levels (2.13 to 2.20 times depending on the group). Understanding this relationship could lead to better ways to predict who is at higher risk and may guide new treatments for patients with these inflammatory issues. Who this helps: This helps patients with type 2 diabetes and their doctors.

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This study looked at how controlling blood sugar levels early on affects the risk of heart problems in people diagnosed with type 2 diabetes. Researchers found that achieving a target blood sugar level (HbA1c) below 5.7% in the first year after diagnosis reduced the risk of major cardiovascular events, with risks increasing by 24% to 56% for higher blood sugar levels. This is important because it highlights the benefits of strict blood sugar control early in diabetes management to help prevent serious heart issues. Who this helps: This helps patients with type 2 diabetes and their doctors.

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The study looked at how many patients with Type 2 diabetes and chronic kidney disease in Italy are eligible to receive the drug finerenone, which helps protect the kidneys and heart. Out of 343,037 patients analyzed, about 33% (or around 110,000 patients) qualified for treatment, indicating that a significant number could benefit from this drug. This is important because it shows a potential for reducing serious health issues among this patient group, with estimates of preventable events at around 22 per 1,000 patients for heart issues and 17 per 1,000 for kidney problems. Who this helps: This helps patients with Type 2 diabetes and chronic kidney disease.

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The PIONEER REAL Italy study looked at how effective a daily pill called oral semaglutide is for managing type 2 diabetes in adults who hadn’t previously used injectable treatments. Over about 40 weeks, participants saw their blood sugar levels drop by nearly 1% and lost an average of 3.8 kg (about 8.4 pounds), with 65% achieving their blood sugar goal of under 7%. These results show that oral semaglutide works well in everyday settings, similar to what was seen in clinical trials, making it a reliable option for patients. Who this helps: This benefits adults with type 2 diabetes looking for effective medication options.

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This study analyzed the quality of type 2 diabetes care in Italy, reviewing data from over 680,000 patients across 301 diabetes centers. The findings showed that 55.9% of patients achieved good blood sugar control, while only 26.5% managed their blood pressure effectively. There is a positive trend in the use of newer medications, with almost 42% of patients receiving innovative treatments, indicating overall progress in diabetes care despite an aging population. Who this helps: This benefits patients with type 2 diabetes by ensuring better care and treatment options.

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This study looked at how using a machine learning tool in electronic medical records can help doctors better manage type 2 diabetes care by predicting which patients are likely to develop serious complications. Researchers found that among over 138,000 patients, those whose diabetes risk was assessed had much better health outcomes: their blood sugar levels improved more significantly (9% compared to 4.5%), and they were more likely to start treatment for other related health issues. This matters because it can lead to better overall care for diabetes patients and potentially prevent complications before they occur. Who this helps: This benefits patients with type 2 diabetes and their doctors.

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This study looked at the early stage of type 2 diabetes (T2D) in Italy, focusing on how many people fit this category and how their treatment changed over time. Out of over 127,000 patients, only about 10,700 (8.39%) were identified with early T2D, generally younger and with lower disease-related health issues. Less than 10% of these patients received intensified treatment within a year, but there was a positive trend in using better-targeted drugs over time. Who this helps: This research benefits patients diagnosed with early type 2 diabetes and their healthcare providers.

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This study looked at how two types of diabetes medications, SGLT2 inhibitors and GLP-1 receptor agonists, are prescribed to adults with type 2 diabetes, focusing on their heart and kidney health risks. Researchers found that prescriptions for SGLT2 inhibitors were more aligned with patients' health risks, but women were less likely to receive them. In contrast, GLP-1 receptor agonists were mainly prescribed based on patients' body weight and age, rather than their actual health needs, which could lead to high-risk patients missing out on necessary treatments. Who this helps: This research benefits patients with type 2 diabetes, especially those at higher risk for heart and kidney issues.

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This study looked at the Fibrosis-4 index (FIB-4), a test used to evaluate liver health, and how it relates to the risk of dying in patients with high heart disease risk. Researchers followed 994 patients for about four years and found that those who later died had a higher initial FIB-4 score (1.71) compared to those who survived (1.38). For every point increase in the FIB-4 index, the chance of dying increased significantly (by more than double), and one-third of this increased risk was linked to kidney function decline. Who this helps: This research benefits doctors and patients with heart disease by providing a clearer tool to assess mortality risk.

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The study looked at the quality of care for people with type 1 and type 2 diabetes in Italy, using data from over 573,000 type 2 diabetes patients and nearly 43,000 type 1 diabetes patients. It found that while 56.3% of type 2 diabetes patients and 35.9% of type 1 diabetes patients had good blood sugar control (HbA1c of 7% or less), only a small percentage (6.6% for type 2 and 3.5% for type 1) managed to meet multiple important health targets all at once. This matters because many patients are not achieving optimal health outcomes, which can lead to increased risks of heart disease and other complications. Who this helps: This helps patients with diabetes and their healthcare providers.

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This study looked at patients with type 2 diabetes who had very high levels of triglycerides, which are fats in the blood that can lead to serious health issues. Among nearly 9,600 patients, 8,592 had triglyceride levels over 880 mg/dL, with these individuals typically being young men (average age 54) and having high blood sugar levels (an average of 9.4% for hemoglobin A1c). This matters because high triglyceride levels can increase the risk of severe complications like pancreatitis and heart disease. Who this helps: This helps patients with type 2 diabetes and their doctors by identifying those at risk for severe health problems.

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This study looked at how quickly kidney function declines in people who have just been diagnosed with type 2 diabetes. Among over 105,000 patients, nearly 13,600 (about 12.9%) experienced rapid declines in their kidney function, which can lead to serious health issues like end-stage kidney disease. Important factors that contributed to this rapid decline included older age, being female, higher blood sugar levels, smoking, and existing kidney damage. Who this helps: This research benefits patients with type 2 diabetes and their doctors by highlighting the importance of monitoring kidney function.

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This study looked at how the RCHADS-VASc score, which assesses cardiovascular risk, relates to severe coronary artery disease in over 1,000 patients at high risk. The researchers found that patients with three-vessel coronary disease had an average RCHADS-VASc score of 4.20 compared to 3.36 in those without it, and the risk of three-vessel disease increased by 21% for each additional point in the score. This matters because using the RCHADS-VASc score can help doctors identify patients who are at high risk of severe heart issues and target those who may need closer monitoring and intervention. Who this helps: This helps doctors and patients at high risk for heart disease.

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This study examined how effective transthoracic ultrasounds (TUS) are at diagnosing spontaneous pneumothorax (PNX) in emergency departments. Out of 637 patients who showed symptoms, TUS accurately identified PNX in 83 out of 93 cases, giving it a sensitivity of 89.2%. However, it also incorrectly suggested PNX in 306 patients who didn't actually have it, leading to a low specificity of 43.8%. This means while TUS is good at detecting PNX when it’s present, it often fails to rule it out when it’s not, so doctors should confirm findings with a chest X-ray or CT scan. Who this helps: This helps doctors in emergency departments make better diagnostic decisions for patients with chest pain.

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This study looked at how well newly diagnosed patients with type 2 diabetes managed their blood sugar levels and the risk of developing heart disease over time. Researchers found that patients with higher average blood sugar levels (HbA1c above 8%) faced a 33% greater risk of heart issues compared to those with better control (HbA1c ≤7%). However, starting treatment with a specific type of medication called SGLT-2 inhibitors in the first two years significantly reduced this risk, indicating that early use of these drugs can protect against long-term heart problems. Who this helps: This benefits patients with newly diagnosed type 2 diabetes by lowering their risk of developing heart disease.

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This study looked at using thoracic ultrasound (TUS) as an initial screening tool for people living in a highly polluted area of Taranto, Italy, to see if they had lung problems or cancer. Among 677 participants, 24.7% agreed to a follow-up scan, and out of those, 50.9% had lung abnormalities. This is important because it shows that combining TUS with low-dose CT scans can help detect early signs of lung diseases and cancers in people who are at high risk due to environmental pollution. Who this helps: This benefits patients living in polluted areas who may be at risk for lung issues.

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This study looked at how well a new scoring system, called Alb-RCHADS-VASc, predicts death in people at high risk for heart problems compared to the existing RCHADS-VASc score. It found that adding albuminuria, a protein in urine that indicates kidney issues, to the score significantly improves its accuracy. Specifically, a one-point increase in the Alb-RCHADS-VASc score raises the risk of death by about 1.5 times, and those in the highest risk group had a 9.5-fold increased chance of dying. Who this helps: This information benefits doctors and healthcare providers working with patients who have cardiovascular risk factors.

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This study looked at a patient suffering from abdominal pain, fever, fatigue, and weight loss, who turned out to have an abdominal mass. Imaging tests and laboratory results pointed towards an infection rather than cancer, specifically linking it to brucellosis in a patient with latent tuberculosis. After a team of specialists discussed the findings, the patient had surgery to remove the mass, and with treatment, their symptoms improved. Who this helps: This helps doctors by highlighting the importance of a collaborative approach for diagnosing complex abdominal issues.

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This study looked at how to predict which patients with sepsis are at a higher risk of dying or needing to be admitted to an intensive care unit. Researchers examined 148 patients and found that 25% faced severe outcomes. Key predictors included the SOFA score and alertness levels, with certain models showing high accuracy in predicting risk—some even achieving an accuracy rating of 0.978, indicating they were very effective. Who this helps: This research benefits doctors and healthcare providers who care for patients with sepsis, helping them better identify those at risk.

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This study looked at how certain substances in the blood, called metabolites, relate to the risk of dying in people with type 2 diabetes. Researchers analyzed data from 856 individuals and found that high levels of hexanoylcarnitine and kynurenine are linked to a greater risk of death, while higher levels of tryptophan seem to lower that risk. The findings could help improve existing models that predict mortality risks in diabetic patients, making them more accurate. Who this helps: This helps patients with type 2 diabetes and their doctors by providing better tools to identify those at higher risk of dying.

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The study looked at whether a web-based telemedicine system could help people with type 1 and type 2 diabetes better manage their blood sugar levels compared to traditional care. Researchers found that after 6 months, people using the telemedicine system had a significant drop in their average blood sugar levels (by 0.38%) while those in standard care actually saw a small increase. This is important because better blood sugar control can reduce the risk of complications from diabetes. Who this helps: Patients with type 1 and type 2 diabetes.

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This study looked at how rare genetic variants in specific diabetes-related genes may lead to early-onset type 2 diabetes (T2D) in people under 35. Among 600 participants, those with these rare variants had a 65% higher risk of developing early-onset T2D, and the effect was even stronger for very rare variants, increasing risk by over 600%. This research is important because it could help create tools to identify young individuals at high risk for developing diabetes, allowing for earlier intervention. Who this helps: Patients, particularly young adults at risk for early-onset type 2 diabetes.

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Researchers developed a model to predict kidney function decline over five years in patients with type 2 diabetes who currently have healthy kidneys. They analyzed data from over 504,000 diabetes patients and found that those with a score of 8 or higher on their risk scale faced a 55.9% greater chance of significant kidney function loss. This is important because it helps identify which patients need closer monitoring to prevent kidney problems. Who this helps: This benefits patients with type 2 diabetes and their healthcare providers.

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This study looked at how genetic changes related to the body's internal clock affect people with rare diseases caused by enzyme deficiencies in the heme production process, known as porphyrias. Researchers found that patients with these disorders had noticeable changes in the expression of key genes related to the circadian (24-hour) rhythm. Understanding these changes might help develop new treatments for porphyria, as they connect the body's biological clock to the symptoms experienced by patients. Who this helps: This helps patients with porphyrias and their doctors.

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This study looked at a new ultrasound technology called shear wave elastography (SWE) to see if it can help doctors understand subpleural lung lesions, which are found near the outer surface of the lungs. Researchers tested 190 patients with these lesions and found that SWE could not reliably tell the difference between cancer and pneumonia, with no significant differences in stiffness measurements (P=0.296). However, they did find that pneumonia showed higher stiffness than cancer when necrotic lesions were excluded, which could influence treatment choices. Who this helps: This research benefits doctors by providing clearer insights into using SWE for diagnosing lung conditions.

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This study looked at how kidney problems affect the risk of dying in patients who were undergoing a heart procedure called coronary arteriography. Out of 1,017 participants, 114 died over about 44 months. It found that individuals with low kidney function (eGFR under 60) were nearly three times more likely to die than those with normal kidney function, while those with albumin in their urine faced similar increased risks, highlighting the serious consequences of kidney issues in these patients. Who this helps: This helps patients undergoing heart procedures, especially those with kidney issues.

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This study looked at how three-vessel disease (3VD), a severe heart condition, affects the risk of death in patients with chronic kidney disease (CKD). Out of 1,017 patients analyzed, those with both 3VD and low kidney function had nearly four times the risk of death compared to those without these conditions. This finding emphasizes that poor kidney health significantly increases the mortality risk for heart patients, underscoring the importance of managing kidney disease to improve outcomes. Who this helps: This helps patients with heart disease and kidney problems, as well as their doctors.

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This study looked at how well the antiviral drug remdesivir reduces the amount of the COVID-19 virus in the noses of hospitalized patients. Researchers found that patients who received remdesivir had a viral load decrease of about 34.3, compared to 27.2 in those who did not receive the drug, showing that remdesivir significantly speeds up the reduction of the virus. This is important because lowering the viral load can lead to better outcomes for patients with COVID-19. Who this helps: This helps hospitalized COVID-19 patients.

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This study looked at 214 hospitalized patients with COVID-19 in Italy to understand how often delirium occurs and its effects on their health. It found that 22% of these patients, or 47 individuals, experienced delirium, which greatly increased their risk of dying or needing intensive care. Specifically, the study highlighted that those with hypoactive delirium faced a higher risk of serious outcomes compared to those with hyperactive delirium. Who this helps: This helps patients with COVID-19 and their doctors by identifying risk factors and prompting early interventions to reduce the likelihood of delirium and improve outcomes.

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This study looked at the heart health of heavy drinkers over six months to understand early signs of alcoholic cardiomyopathy (ACM), a heart condition caused by excessive alcohol use. Researchers examined 43 patients and found that nearly half (46.5%) reduced their alcohol consumption during treatment. Initially, some heart measurements were higher than normal, indicating potential issues, but those who cut back on drinking saw significant improvement in their heart function after six months. Who this helps: This helps patients struggling with alcohol dependence and their doctors.

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This study looked at two scoring systems, CHADS-VASc and RCHADS-VASc, to see how well they predict the risk of death in people with high heart disease risk. Researchers followed 1,017 patients who were at risk for heart problems and found that, for each point increase in either score, the risk of death increased by about 50%. The RCHADS-VASc score was shown to be better than the CHADS-VASc score in predicting mortality, making it a more reliable tool for doctors. Who this helps: This benefits doctors and healthcare providers who care for patients at high risk for heart disease.

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This study looked at hospitalized patients aged 35 to 85 in Italy to find out how many had hidden Hepatitis C virus (HCV) infections. It found that about 3% of patients tested positive for HCV antibodies, with the highest rates (around 4.8%) in those born between 1935 and 1944. Many of these patients were unaware of their infection, which highlights the need for targeted screening in older populations to help identify and treat hidden cases before they lead to serious health issues. Who this helps: This helps patients, particularly older adults who may be at risk for HCV.

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This study looked at whether a combination of two blood pressure medications—benazepril and valsartan—could prevent kidney problems (microalbuminuria) more effectively than using each drug alone in diabetic patients with high-normal kidney function. Out of 612 patients studied over about six years, 27% of those on the combination therapy developed microalbuminuria, compared to 28% on benazepril and 32% on valsartan. The findings indicate that using both drugs together did not significantly reduce the risk of developing this kidney issue compared to taking either medication alone, which is important information for managing kidney health in diabetic patients. Who this helps: This helps diabetic patients who may be at risk for kidney problems.

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This study looked at using intraoperative lung ultrasound (ILU) to help surgeons locate hard-to-see lung nodules during surgery. The results showed that ILU successfully identified all 131 lung nodules, while the traditional method of feeling for them by hand found about 95%. Importantly, in 95% of the cases, the ultrasound images matched the actual edges of the nodules found during the surgery, and there were no complications from using ILU. Who this helps: This benefits patients undergoing lung surgery by improving the chances of accurately locating and assessing lung nodules.

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This study looked at how well contrast-enhanced ultrasound (CEUS) works compared to regular transthoracic ultrasound (TUS) when taking needle samples from small lung lesions. In a group of 232 patients divided into two equal parts, both methods were found to have similar effectiveness in diagnosing lung conditions, with the CEUS showing no significant improvement over TUS (p=0.34). However, CEUS was better at detecting necrosis in the lesions, increasing from 8% to 31% as lesion size grew, indicating that while the new method doesn't enhance overall diagnosis for smaller lesions, it might have potential for larger ones. Who this helps: Patients with lung lesions, particularly those undergoing biopsies.

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This study looked at how sepsis, a serious infection, affects people with alcohol-related liver disease. Researchers found that patients with this condition have weakened immune systems and changes in gut bacteria, making them more prone to infections. Early and effective antibiotic treatment is crucial, as sepsis is particularly dangerous for these patients, and their chances of recovery are low. Who this helps: This helps patients with alcohol-related liver disease and their doctors.

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This study looked at how well lung ultrasound (LUS) works to diagnose COVID-19 pneumonia compared to the more reliable chest CT scans. Out of 260 patients, LUS detected lung issues in only about 57% of cases, while the reliance on chest CT found COVID-19 pneumonia in nearly 91% of patients. The findings suggest that while LUS can be helpful, it's not enough on its own for accurate diagnosis and may lead to misclassifying other conditions as COVID-19 pneumonia. Who this helps: This research benefits doctors and healthcare providers working with COVID-19 patients.

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This study examined the use of transthoracic ultrasound (TUS) to assist in taking biopsies from patients with infectious organizing pneumonia, a type of lung infection. Out of 36 patients, TUS was found to be less accurate than chest CT scans for identifying specific lung issues, but it was better at detecting fluid around the lungs. This matters because using TUS can help doctors safely perform biopsies, which can lead to accurate diagnoses and appropriate treatments for patients with lung infections. Who this helps: This helps doctors and patients needing lung biopsies for accurate diagnosis.

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This study looked at how well transthoracic ultrasound (TUS) can help doctors perform needle biopsies of lung lesions compared to traditional chest CT scans. Out of 762 patients who had TUS-guided biopsies, 82% had cancerous lesions, and the overall accuracy of the diagnosis was 93%. While TUS was effective and safe, it couldn't reliably distinguish between cancerous and non-cancerous lesions based on their appearance alone, which means CT scans are still important for accurate diagnosis. Who this helps: This research benefits patients with lung lesions by helping doctors choose the best methods for diagnosis.

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This study looked at a condition called pulmonary artery stump thrombosis (PAST), which can happen after lung surgery. Researchers reported on a 59-year-old man who developed PAST four years after having part of his lung removed due to cancer. After starting treatment with blood thinners, his symptoms improved significantly, and follow-up scans showed that the clot almost completely resolved. Understanding and deciding how to treat PAST is important because it can help prevent serious complications. Who this helps: This helps patients recovering from lung surgery and their doctors in deciding the best treatment approach.

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This study looked at how kidney function, specifically a measure called eGFR, affects the health of hospitalized COVID-19 patients. Out of 231 patients, 34% faced severe outcomes, including ICU admission or death, with a notably higher risk in those with low eGFR levels. Specifically, 27.7% of patients died, and low eGFR was linked to a 64% increase in risk for severe outcomes. This matters because identifying patients with poor kidney function can help ensure they receive urgent and appropriate medical care to improve their chances of recovery. Who this helps: Patients with COVID-19, especially those with pre-existing kidney conditions.