Monfalcone

Researchers are conducting an observational, prospective, multicenter study in Italian cardiology centers to evaluate how well patients with Heart Failure with Reduced Ejection Fraction (HFrEF) follow guideline-recommended treatments. The study also aims to assess the safety of these treatments, monitor treatment patterns in patients with acute heart failure, and observe treatment approaches in all chronic heart failure patients regardless of their ejection fraction levels. The study involves two phases of educational interventions and data collection. Initially, healthcare providers will receive education on guideline recommendations and treatment patterns, followed by 3 months of patient data collection or up to 30 consecutive patients with chronic or acute heart failure. After 6 months, treatment modifications and outcomes will be evaluated. Then, a second educational session will highlight gaps between guidelines and practice, followed by another 3 months of data collection. Patients will be followed for 12 months total, with ongoing monitoring of treatment changes and outcomes. Participants will be assessed at enrollment and during the follow-up periods through clinical evaluations and data collection on treatment adherence and safety. The main outcome measured is adherence to guideline-directed medical therapies over 6 months. The study includes evaluations at 6 and 12 months after enrollment, with close monitoring of treatment patterns and patient health status throughout the study duration.

Researchers are evaluating patients who have experienced athero-thrombotic events such as coronary artery disease, cerebrovascular disease, or peripheral artery disease. The study aims to assess how well patients follow guideline recommendations, particularly focusing on improving cholesterol levels and other modifiable risk factors to reduce the chance of cardiovascular event recurrence. This observational and prospective study takes place across multiple cardiology centers in Italy to represent a broad patient population. The study includes several phases starting with an educational intervention to discuss guideline recommendations for secondary prevention. Following this, data is collected for three months or until 30 patients with documented cardiovascular conditions are enrolled, using a web-based case record form that identifies when guidelines are not followed and records reasons for non-adherence. After six months, primary and secondary outcomes are evaluated. A second educational intervention then shares findings from the first phase to highlight gaps in clinical practice, followed by another three-month data collection period and a further six-month outcome assessment. Finally, all patients are followed for 12 months to monitor longer-term results. Participants provide informed consent and are monitored through data collection forms that track adherence to guidelines and clinical outcomes. The main outcome measured is adherence to cholesterol management guidelines over six months. Additional assessments include adherence to recommendations for other cardiovascular risk factors. Throughout the study, researchers gather data to understand how guideline adherence affects patient health and to identify barriers to following best practices, with continuous follow-up over a year to evaluate sustained effects.

Researchers are evaluating the management of acute and chronic osteomyelitis in the forefoot of diabetic foot patients. This prospective multicenter randomized trial aims to compare the effectiveness and safety of S53P4 bioactive glass, a medical device used according to its CE mark and instructions, with standard surgical care. The study focuses on patients admitted to specialized centers for this condition who have not responded to systemic antibiotic therapy for 2 to 6 weeks and require surgical intervention. Participants are randomly assigned to one of two groups. Group A receives surgical removal of the affected bone, debridement of infected soft tissues, and targeted systemic antibiotic therapy, with or without bone substitutes except bioactive glasses. Group B undergoes debridement preserving the bone cortex while removing infected soft bone, which is then replaced with S53P4 bioactive glass. Both groups aim for primary wound closure, with vacuum drainage placed before closure and removed as needed by the surgeon. During the study, patients are evaluated biweekly up to 3 months or until complete healing, then followed at 6 and 12 months after surgery. Assessments include local wound conditions, complications, x-rays, histopathology of surgical samples, wound photographs, laboratory tests, and quality of life and foot function questionnaires. Healing is defined as full wound closure without drainage confirmed at two follow-up visits. The primary outcome is the healing rate at 6 months.

Spinal muscular atrophy (SMA) is a genetic disorder caused by the degeneration of motor neuron cells, leading to severe muscle weakness and infant mortality. Most cases result from deletions or mutations in the survival motor neuron 1 (SMN1) gene. Early treatment with gene therapy, nusinersen, or risdiplam can improve neurological outcomes, especially if started before symptoms appear. This research focuses on the importance of early detection through neonatal screening to enable timely treatment and better health results for affected newborns. The study evaluates a screening test for SMA using a small blood sample taken from a newborn's heel within the first 48-72 hours after birth. The test looks for the deletion of exon 7 in the SMN1 gene using a genetic technique called Real Time PCR. If the screening test is positive, the birth center is notified to perform a confirmatory second-level blood test. This neonatal screening is integrated with cystic fibrosis screening as part of the feasibility study. Participants are newborns born in the participating neonatology and pediatric centers. The study involves collecting and analyzing dried blood samples, with results monitored to determine the rate of newborns screened within the first 48-72 hours. Parents must provide consent for their babies to participate. The main outcome measured is how many newborns are successfully screened for SMA during the study period.