TMT Peer reviews
type: channel
description: Ticino Medical Tribune is the official publication of the Ordine dei medici del Cantone Ticino (OMCT). The Institute of Family Medicine collaborates and ensures the scientific quality of the contributions published in the peer-reviewed section.
publisher: Tribuna Medica Ticinese
language: en
publication name: TMT Peer reviews
issn: 1421-1009
items: Multidisciplinary medicine: integration, leadership, and the challenge of fragmentation
items: Is there a need to improve information provided to gynecologists in Ticino regarding vaccinations during pregnancy?
items: Anastomic leaks treated with dual endo-sponges following rectal cancer surgery
items: The active involvement ofpatients in clinical oncologyresearch
items: Navigating plurality: A patient’sperspective on his care journey
items: Interdisciplinary Approach in Complex Oncological Clinical Cases
items: Malattia Leventinese: A Non-Age-Related Macular Degeneration
items: When it’s not necrotizing fasciitis: a case of benign subcutaneous emphysema
items: Arnold’s reflex: when the earmakes you cough
items: The Use of Artificial Intelligencein the Diagnosis of Cutaneous Melanoma
items: Lipedema: an overlooked clinicalchallenge in women’s health -fromearly diagnosis to multidisciplinary management
items: Chronic Fatigue Syndrome:A Challenge in Family Medicine
items: Endogenous Brewery Syndrome: A Rare Cause of Alcohol Intoxication
items: A case of refractory severe hypomagnesemia
items: Solitary extramedullary plasmacytoma
items: A Case of Lemierre Syndrome
items: Beyond the Surface: Clinical and DiagnosticAspects of Acquired Perforating Dermatosis
items: Preventing acute radiodermatitiswith photobiomodulation therapy:a literature review
items: Polypharmacy in general internalmedicine in italian-speaking Switzerland: an analysis of SWICOS data
items: Anterior cruciate ligament injury: surgical techniques and possible conservative treatment
items: Carbon monoxide poisoning: emerging and overlooked causes
items: Cefepime and Neurotoxicity: An Underestimated Complication in the Geriatric Population
items: Hypertension - prevalence andmanagement efficacy in Southern Switzerland
items: Suprascapular nerve entrapment syndrome
items: Young athletes’ and parents’knowledge of sports-related concussionin Italian-speakingSwitzerland: a pilot study
items: Parsonage-Turner syndrome, a (notso) rare cause of shoulder pain
items: Renal damage and Mycoplasma pneumoniae infection: a guide toclinical reasoning and literature review

Multidisciplinary medicine: integration, leadership, and the challenge of fragmentation
type: item
description: No abstract
subject: Articles
  topic: section
subject: Multidisciplinary care
  topic: keywords
subject: clinical integration
  topic: keywords
subject: healthcare fragmentation
  topic: keywords
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-04-17
publication date: 2026-04-17
doi: 10.63648/hz1t3s68

Is there a need to improve information provided to gynecologists in Ticino regarding vaccinations during pregnancy?
type: item
description: In Switzerland, influenza vaccination during pregnancy has been recommended since 2010, and pertussis vaccination since 2017. This cross-sectional pilot study conducted in the Canton of Ticino analyzed, through questionnaires and interviews, the practices of 43 gynecologists regarding the recommendation and administration of the two vaccines. All participants recommend pertussis vaccination and 95% administer it, whereas the influenza vaccine is systematically recommended by 74% and regularly administered by 65%. The specialists perceive pertussis vaccination as more effective in protecting the newborn, while they tend to underestimate the risks of influenza during pregnancy and show some uncertainty in communicating with patients. Overall, adherence to recommendations is good, but there is a clear need to strengthen training and awareness, particularly regarding influenza and infant protection.
subject: Articles
  topic: section
subject: Maternal vaccination
  topic: keywords
subject: Pertussis and influenza vaccines
  topic: keywords
subject: Gynecologists’ practices and perceptions
  topic: keywords
subject: Vaccine counseling during pregnancy
  topic: keywords
subject: vaccinology
  topic: disciplines
subject: ginecology
  topic: disciplines
subject: internal medicine
  topic: disciplines
subject: pediatrics
  topic: disciplines
subject: pubblic health
  topic: disciplines
creator: Aleksandra Nobile
creator: Mario Lazzaro
creator: Martine Bouvier Gallacchi
creator: Giorgio Merlani
creator: Ottavio Beretta
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-04-17
publication date: 2026-04-17
doi: 10.63648/ty56v688

Anastomic leaks treated with dual endo-sponges following rectal cancer surgery
type: item
description: We describe a case of dual anastomotic leaks following a lower anterior rectal resection for a low-grade rectal adenocarcinoma diagnosed during a routine colonoscopy. The anastomotic defect was complex, characterized by two coexisting leaks located on the same anastomosis, resulting in an open circumference exceeding 300°. Dual Endo-SPONGEs ® were positioned via recto- igmoidoscopy and replaced every 3 to 4 days for 40 days. This approach achieved complete healing of both anastomotic leaks, being one of the first documented cases of complete closure of very large, dual, circumferential anastomotic leaks successfully managed with endoluminal vacuum therapy alone.
subject: Articles
  topic: section
subject: Endo-SPONGE®
  topic: keywords
subject: dual anastomotic leakage
  topic: keywords
subject: rectal cancer
  topic: keywords
subject: anterior rectal resection
  topic: keywords
subject: case report
  topic: keywords
subject: insufficienza anastomotica doppia
  topic: disciplines
subject: Endo-SPONGE
  topic: disciplines
subject: tumore rettale
  topic: disciplines
subject: resezione rettale anteriore
  topic: disciplines
creator: Marc-Emilio El-Nachef
creator: Alfred Kuhrmeier
creator: Davide Lanza
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-04-17
publication date: 2026-04-17
doi: 10.63648/21e14b75

The active involvement ofpatients in clinical oncologyresearch
type: item
description: Patient and community engagement across all stages of clinical research development is now widely recognized as an essential component. This activity, referred to as Patient and Public Involvement (PPI), is distinct from participating as a study subject. Since 2006, the European Medicines Agency (EMA) has acknowledged the importance of the interaction between patients, consumers, and those involved in the research and development of new therapies. Patients can contribute to clinical research by identifying their needs, helping to shape study design and assessment schedules, thus improving feasibility and acceptability. They are also involved in the preparation of the information materials for patients, informed-consent documents, patient diaries, quality-of-life questionnaires, and the lay summary that must be uploaded on the national clinical-trial portal within twelve months after study completion. The article describes ongoing and planned initiatives at the Istituto Oncologico della Svizzera Italiana in the field of PPI. These include a training course for patients on the fundamentals of clinical research, a public patient forum to promote Patient and Public Involvement, and a training program for healthcare professionals on patient engagement in research. The Area Formazione Medica e Ricerca and the Clinical Trial Unit actively promote PP and are working to extend these activities to other areas of biomedical research.
subject: Articles
  topic: section
subject: Patient and Public Involvement (PPI)
  topic: keywords
subject: Oncology Clinical Research
  topic: keywords
subject: Patient Engagement
  topic: keywords
subject: Patient-Centered Research
  topic: keywords
subject: Patient Advocacy and Empowerment
  topic: keywords
subject: Oncologia
  topic: disciplines
subject: Collaborazione con pazienti
  topic: disciplines
subject: Ricerca clinica
  topic: disciplines
creator: Cristiana Sessa
creator: Marco Cefalì
creator: Alessandro Ceschi
creator: Paola Cestari
creator: Matteo Oleggini
creator: Angela Tolotti
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-03-17
publication date: 2026-03-17
doi: 10.63648/j1db5568

Navigating plurality: A patient’sperspective on his care journey
type: item
description: This illustrative case describes the experience of an 80-year-old man in the Ticino healthcare system, highlighting how communication, continuity, and interprofessionality determine the perceived quality of care. Through a semi-structured interview and thematic analysis followed by participant validation, key passages emerge: from the feeling of a “rocking boat” to engagement as a team member thanks to visible clinical direction; from monitoring “parameters” to requesting trajectories with verifiable objectives and timelines. The plurality of professionals appears both salvific and disorienting. The case shows how focusing on relational and biographical dimensions, including extra-clinical narrative spaces, helps to support agency, trust, and coordination along the way.
subject: Articles
  topic: section
subject: clinical communication
  topic: keywords
subject: continuity of care
  topic: keywords
subject: interprofessionality
  topic: keywords
subject: person-centeredness
  topic: keywords
subject: biographical narrative
  topic: keywords
creator: Marta Fadda
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-03-17
publication date: 2026-03-17
doi: 10.63648/ewn8ga84

Interdisciplinary Approach in Complex Oncological Clinical Cases
type: item
description: We report a complex case of a patient with multiple comorbidities managed through a multidisciplinary approach involving oncologists, cardiologists, and clinical pharmacologists. This integrated collaboration enabled an evidence-based therapeutic decision, tailored to the patient’s elevated cardiovascular risk profile. Clinical pharmacology played a pivotal role in personalizing and safely monitoring the therapeutic strategy, which was defined by oncologists in close coordination with cardiologists to optimize outcomes and minimize adverse effects.
subject: Articles
  topic: section
subject: clinical pharmacology
  topic: keywords
subject: oncology
  topic: keywords
subject: cardiology
  topic: keywords
subject: interdisciplinarity
  topic: keywords
subject: precision medicine
  topic: keywords
subject: oncology
  topic: disciplines
subject: pharmacology
  topic: disciplines
subject: cardiology
  topic: disciplines
creator: Francesca Capitanini
creator: Vittoria Espeli
creator: Alice Schianchi
creator: Francesca Bedussi
creator: Giulio Conte
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-01-07
publication date: 2026-01-07
doi: 10.63648/5x31nw28

Malattia Leventinese: A Non-Age-Related Macular Degeneration
type: item
description: Malattia Leventinese, also known as Doyne honeycomb retinal dystrophy, was first described in patients living in the Leventine Valley in Canton Ticino of southern Switzerland in 1925. It is an hereditary retinal dystrophy characterized by an autosomal dominant mutation in the EFEMP1 gene. This pathology was initially described by Doyne in 1899 in England. Later, in 1925, Vogt described a similar phenotipic picture in the Leventine Valley. A particular contribute to the investigation of Malattia Leventinese was due to a Swiss ophthalmologist, Forni, who described the ophthalmoscopic features adding histological images. The suspect that the two separately described clinical entities corresponded to the same disease arose as early as 1962, but the confirm went only in 1999 as a result of genetic studies. This rare disease shows many aspects very similar to the more frequent age-related macular degeneration. The similarities include the history and symptoms, as both condition may have an insidious onset of mild visual disturbances, with an age-related increasing loss of visual acuity. Drusen are typical found in early stages, but later neovascularization and subsequent scarring may form, and in advanced stages geographic atrophy may occur, and severe central vision loss may result. Imaging, in particular optical coherence tomography, is the main diagnostic method for diagnosis and follow- up of both diseases. For Malattia Leventinese the only risk factor is genetic. Therefore any patient suspected of having in his ancestry a case of hereditary dystrophy of the retina should be referred to an ophthalmologist for examination.
subject: Articles
  topic: section
subject: age-related macular degeneration
  topic: keywords
subject: malattia leventinese
  topic: keywords
subject: OCT
  topic: keywords
subject: Oftalmologia
  topic: disciplines
creator: Elisabetta Luisa Teresa De Felice
creator: Gabriela Grimaldi
creator: Moreno Menghini
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-01-07
publication date: 2026-01-07
doi: 10.63648/26thtf88

When it’s not necrotizing fasciitis: a case of benign subcutaneous emphysema
type: item
description: A 54-year-old woman presented with hand swelling 15 hours after sustaining a superficial incision between her fingers with a letter opener. She was afebrile and reported minimal pain. Examination revealed crepitus extending from the dorsum of the hand to the forearm, without inflammatory signs. Radiographs showed subcutaneous emphysema without fascial involvement, and inflammatory markers were normal. Infectious causes such as necrotizing fasciitis were excluded, and a diagnosis of benign subcutaneous emphysema was made. The patient recovered fully with immobilization and prophylactic antibiotics.
subject: Articles
  topic: section
subject: subcutaneous emphysema
  topic: keywords
subject: necrotizing fasciitis
  topic: keywords
subject: gas gangrene
  topic: keywords
subject: medicina d'urgenza
  topic: disciplines
creator: Gabriel Bronz
creator: Adam Ogna
creator: Carlo Zamarra
creator: Michael Llamas
creator: María José Navarrete Dättwyler
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-01-07
publication date: 2026-01-07
doi: 10.63648/6mqybf02

Arnold’s reflex: when the earmakes you cough
type: item
description: Coughing is the mechanical response to stimulation of certain anatomical structures linked to the innervation of the vagus nerve and frequently leads to consulting the physicians. Understanding the origin of cough is crucial in many cases, as treatment options differ significantly depending on the underlying cause. The diagnostic process can lead to expensive and unnecessary exams. Among these is Arnold’s reflex, which is nothing more than a physiological response to mechanical stimulation of the ear, discovered two centuries ago. It is a rare condition, the frequency of which increases in people with chronic cough. A comprehensive medical history, in addition to an otoscopic examination, are simple and sufficient tools for diagnosing Arnold’s reflex.
subject: Articles
  topic: section
subject: Arnold’reflex
  topic: keywords
subject: cough
  topic: keywords
subject: vagus reflex
  topic: keywords
subject: ear-cough
  topic: keywords
subject: vagal hypersensitivity
  topic: keywords
creator: Simone Janett
creator: Giovanni Galbiati
creator: Gregorio P. Milani
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-01-07
publication date: 2026-01-07
doi: 10.63648/pdvc0771

The Use of Artificial Intelligencein the Diagnosis of Cutaneous Melanoma
type: item
description: Artificial intelligence (AI) is reshaping melanoma diagnosis through convolutional neural networks (CNNs), achieving accuracy comparable to, and sometimes exceeding, that of expert dermatologists. Prospective studies and systematic reviews highlight the benefits of Augmented Intelligence, combining algorithmic output with clinical judgment to enhance sensitivity and specificity. Nonetheless, important limitations persist, including dataset bias, underrepresentation of darker skin types, and insufficient external validation. Ethical, regulatory, and trust-related issues remain critical. Overall, AI represents a promising support tool in dermatology, but requires transparency, robust clinical validation, and specialist supervision to ensure safe and responsible integration into clinical practice.
subject: Articles
  topic: section
subject: Artificial Intelligence (AI)
  topic: keywords
subject: Melanoma Diagnosis
  topic: keywords
subject: Convolutional Neural Networks (CNNs)
  topic: keywords
subject: Augmented Intelligence
  topic: keywords
subject: Clinical Validation / Dataset Bias
  topic: keywords
creator: Ylenia Micca
creator: Matteo Calegari
creator: Helmut Beltraminelli
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-01-07
publication date: 2026-01-07
doi: 10.63648/0dcr8h73

Lipedema: an overlooked clinicalchallenge in women’s health -fromearly diagnosis to multidisciplinary management
type: item
description: Lipedema is a chronic, progressive, and painful disorder characterised by symmetrical accumulation of subcutaneous adipose tissue in the limbs, with typical sparing of the hands and feet, and a marked predominance in females. Onset most frequently occurs during hormonal transitions such as puberty, pregnancy, and menopause, and may be associated with a hereditary predisposition. The pathophysiology involves the interaction of genetic and hormonal factors, in association with microvascular and lymphatic dysfunction, adipocyte hyperplasia and hypertrophy, and chronic inflammatory processes. The clinical picture includes spontaneous or pressure- induced pain, hypersensitivity, easy bruising, and functional limitations, with a significant psychosocial impact. Diagnosis is clinical, based on positive criteria and the exclusion of conditions with similar presentations such as obesity, lymphoedema, lipo-hypertrophy, and Dercum’s disease. Management is primarily conservative and includes regular physical exercise, compression therapy, and complex decongestive lymphatic therapy. In refractory cases, liposuction is a surgical option with low risk and excellent outcomes. Poor awareness of the condition and the absence of specific biomarkers contribute to substantial underdiagnosis. Early recognition by general practitioners is crucial for timely referral to an angiologist, who serves as a reference figure for excluding vascular comorbidities and defining a multidisciplinary diagnostic and therapeutic pathway involving nutritionists, psychologists, and physiotherapists, with the aim of preventing disease progression and improving quality of life.
subject: Articles
  topic: section
subject: Lipedema
  topic: keywords
subject: Chronic pain
  topic: keywords
subject: Microangiopathy
  topic: keywords
subject: Lymphangiopathy
  topic: keywords
subject: Chronic inflammation
  topic: keywords
subject: Therapeutic liposuction
  topic: keywords
subject: vascular medicine
  topic: disciplines
creator: Rosaria Del Giorno
creator: Daniel Schmauss
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-01-07
publication date: 2026-01-07
doi: 10.63648/4kzy9677

Chronic Fatigue Syndrome:A Challenge in Family Medicine
type: item
description: Chronic fatigue syndrome, also termed myalgic encephalomyelitis, is a disabling condition that remains underdiagnosed in primary care. We report a 53-year-old woman who developed persistent exhaustion, cognitive impairment, and social withdrawal after postoperative sepsis, leading to the diagnosis of chronic fatigue syndrome. The condition is characterized by post-exertional worsening of symptoms, unrefreshing sleep, and cognitive dysfunction, with multifactorial pathophysiology involving immune, neurological, metabolic, and endocrine pathways. No curative therapy exists; management relies on multidisciplinary care and energy management strategies. Greater awareness in family medicine is essential for timely diagnosis, advocacy, and social and professional reintegration.
subject: Articles
  topic: section
subject: chronic fatigue syndrome
  topic: keywords
subject: myalgic encephalomyelitis
  topic: keywords
subject: primary care
  topic: keywords
creator: Mirjam Rodella
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-10-21
publication date: 2025-10-21
doi: 10.63648/dy8k8x15

Endogenous Brewery Syndrome: A Rare Cause of Alcohol Intoxication
type: item
description: Endogenous brewery syndrome, also known as “auto-brewery syndrome,” is a very rare condition in which the intestinal microbiota ferments ingested carbohydrates into ethanol, leading to episodes of alcohol intoxication in the absence of alcohol consumption. To date, only about one hundred cases have been reported, with clinical manifestations ranging from dizziness and ataxia to overt intoxication and medicolegal complications. Even rarer is urinary fermentation, characterized by ethanol presence in urine without corresponding blood elevation. Predisposing factors include dysbiosis, high-carbohydrate diets, diabetes, and immunosuppression. Diagnosis relies on a thorough medical history, carbohydrate challenge tests, and microbiological investigations. Treatment involves carbohydrate restriction, antifungal (or antibiotic) therapy, and microbiota-balancing strategies. This syndrome highlights the metabolic role of the microbiota and its clinical and legal implications.
subject: Articles
  topic: section
subject: Auto-brewery syndrome
  topic: keywords
subject: Gut microbiota
  topic: keywords
subject: Ethanol intoxication
  topic: keywords
subject: malattie metaboliche
  topic: disciplines
creator: Gregorio Milani
creator: Ilaria Alberti
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-10-21
publication date: 2025-10-21
doi: 10.63648/yhdxgp97

A case of refractory severe hypomagnesemia
type: item
description: A 90-year-old male patient was hospitalized following syncope without prodromal symptoms. Clinical examination revealed a positive Chvostek sign and brisk deep tendon reflexes. Laboratory tests demonstrated severe hypomagnesemia (0.21 mmol/L), hypokalemia (2.8 mmol/L), and hypocalcemia (corrected calcium 1.81 mmol/L), along with a prolonged QTc interval (510 msec) on electrocardiography. Initial management included intravenous electrolytes replacement, discontinuation of metformin and, especially, of pantoprazole. After an initial improvement, we switched from intravenous to oral magnesium supplementation, but magnesium levels declined again. Further history-taking revealed that the patient consumed exclusively soft-drinks (such as cola- based beverages). These drinks contain phosphoric acid, which acts as a chelating agent, binding magnesium and inhibiting its intestinal absorption. Discontinuation of this beverage intake led to normalization of magnesium levels. Finally, the syncope of our patient is most likely attributable to an arrhythmia secondary to electrolyte disturbances. The most severely altered electrolyte is magnesium, which has contributed to the development of both hypokalemia and hypocalcemia. The origin of this disturbance is probably multifactorial, involving the use of proton pump inhibitors (and possibly metformin), the malnutrition commonly seen in elderly patients, and the exclusive consumption of soft-drinks, resulting in a chelating effect.
subject: Articles
  topic: section
subject: hypomagnesemia
  topic: keywords
subject: magnesium
  topic: keywords
subject: soft drinks
  topic: keywords
subject: soda
  topic: keywords
subject: nefrologia
  topic: disciplines
creator: Gabriel Bronz
creator: Adam Ogna
creator: Valentina Forni Ogna
creator: Abdelhamid Achrit
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-10-21
publication date: 2025-10-21
doi: 10.63648/szfyq222

Solitary extramedullary plasmacytoma
type: item
description: A 70-year-old man presented with nasal airway obstruction due to a pedunculated pharyngeal mass. Histopathological examination confirmed the diagnosis of a solitary extramedullary plasmacytoma, with no evidence of multiple myeloma on diagnostic work-up. Plasma cell neoplasms typically manifest either as solitary plasmacytomas (5–10% of cases) or as multiple myeloma (90–95%). Solitary plasmacytomas, characterized by localized clonal proliferation of plasma cells without systemic involvement, most commonly arise within bone but may also occur in extramedullary sites. In these cases, symptoms are primarily related to the local mass effect. The standard treatment for solitary extramedullary plasmacytoma is complete surgical excision when feasible, or curative radiotherapy, which may also serve as complementary therapy in cases of incomplete resection. Compared with osseous plasmacytoma, the extramedullary variant generally has a more favorable prognosis. Following local therapy, only a minority of patients develop local recurrence, while 10–20% progress to multiple myeloma. The five-year overall survival rate ranges from 40% to 85%, highlighting the importance of close follow-up for at least five years. In our patient, given a radical surgical resection, no additional therapy was administered. Subsequent follow-up (currently nine years after diagnosis) has shown no evidence of local recurrence or progression to multiple myeloma.
subject: Articles
  topic: section
subject: Solitary extramedullary plasmacytoma
  topic: keywords
subject: Multiple myeloma
  topic: keywords
subject: Oncologia
  topic: disciplines
subject: Ematologia
  topic: disciplines
subject: medicina di famiglia
  topic: disciplines
creator: Sandro Bonetti
creator: Erika Lerch
creator: Andrea Ferrazzini
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-01-07
publication date: 2026-01-07
doi: 10.63648/q4dc7c57

A Case of Lemierre Syndrome
type: item
description: Lemierre syndrome is a rare but potentially life-threatening septic condition, most commonly caused by Fusobacterium necrophorum. We report the case of a 36-yearold man presenting with high fever, cervical lymphadenopathy, and respiratory manifestations shortly after a recent dental extraction. Imaging revealed thrombophlebitis of the internal jugular vein and septic pulmonary emboli, and microbiological investigations identified Fusobacterium necrophorum. Early recognition of the syndrome and initiation of empiric intravenous antibiotic therapy resulted in a favorable clinical outcome. This case underscores the importance of considering Lemierre syndrome in patients with oropharyngeal infection and signs of sepsis.
subject: Articles
  topic: section
subject: Lemierre Syndrome
  topic: keywords
subject: Fusobacterium necrophorum
  topic: keywords
creator: Matteo Badini
rights: Copyright (c) 2026 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2026-03-17
publication date: 2026-03-17
doi: 10.63648/92xgnj27

Beyond the Surface: Clinical and DiagnosticAspects of Acquired Perforating Dermatosis
type: item
description: Acquired perforating dermatosis is a rare condition characterized by transepidermal elimination of dermal material, often associated with systemic diseases such as diabetes and chronic kidney disease. We report a 77-year-old man with type II diabetes, chronic kidney disease, and amiodarone-induced hypothyroidism who developed generalized pruritus and papular skin lesions. Histopathological findings confirmed the diagnosis of acquired perforating dermatosis. Secondary bacterial infection was treated with systemic antibiotics. Management focused on discontinuation of potent topical corticosteroids and initiation of targeted therapy for underlying atopic diathesis, underscoring the importance of individualized multidisciplinary care.
subject: Articles
  topic: section
subject: Acquired perforating dermatosis
  topic: keywords
subject: Diabetes mellitus
  topic: keywords
subject: Chronic kidney disease
  topic: keywords
subject: medicina di famiglia
  topic: disciplines
subject: dermatologia
  topic: disciplines
creator: Sandro Bonetti
creator: Gionata Marazza
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-10-21
publication date: 2025-10-21
doi: 10.63648/mraspf36

Preventing acute radiodermatitiswith photobiomodulation therapy:a literature review
type: item
description: Radiation-induced dermatitis (RID) is one of the most common acute toxicities associated with external beam radiotherapy, particularly in breast cancer patients. In general patients develop mild to moderate RID, however it can affect quality of life, and few effective preventive strategies are currently available. The aim of this narrative review is to examine the current evidence supporting the use of photobiomodulation therapy (PBM) for the prevention of acute RID in breast cancer patients, focusing on mechanisms of action and its integration into standard care. Emphasis was placed on studies involving breast cancer radiotherapy and on evidence from major clinical trials. PBM, a non-invasive light-based intervention, has been shown to reduce the incidence and severity of grade ≥2 RID in multiple trials. Treatment protocols typically involve near-infrared light (808–905 nm) applied 1–2 times weekly during radiotherapy. All reviewed studies reported high patient tolerability and no negative oncologic outcomes. PBM was one of the few modalities endorsed in recent international guidelines for RID prevention. PBM is a safe and effective option for preventing acute RID in breast cancer patients undergoing curative radiotherapy. With growing clinical support and guideline endorsement, PBM is well positioned for broader adoption as part of routine supportive cancer care. Future research should focus on protocol standardization and expanding its use to other cancer populations.
subject: Articles
  topic: section
subject: radiation-induced dermatitis
  topic: keywords
subject: breast cancer
  topic: keywords
subject: radiotherapy
  topic: keywords
subject: photobiomodulation therapy
  topic: keywords
subject: skin toxicity
  topic: keywords
subject: Radiation Oncology
  topic: disciplines
subject: Radio-Oncologia
  topic: disciplines
creator: Letizia Deantonio
creator: Layal Barjoud
creator: Thomas Zilli
creator: Rossella Cavicchiolo
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-10-21
publication date: 2025-10-21
doi: 10.63648/kvdgkn23

Polypharmacy in general internalmedicine in italian-speaking Switzerland: an analysis of SWICOS data
type: item
description: Polypharmacy, defined as the concurrent daily use of five or more distinct medications, represents an increasingly relevant challenge in clinical practice. Although the term has existed since the 19th century, its clinical significance has grown substantially over recent decades. Using data from the Swiss Cohort Study (SWICOS) - a prospective, population-based investigation conducted between 2015 and 2018 - we assessed the prevalence and determinants of polypharmacy in the Mesolcina valley. Data collection included demographic characteristics, lifestyle factors, comorbidities, and pharmacological treatments. Polypharmacy prevalence was evaluated in 474 participants aged 18 years or older (268 [56%] women and 206 [44%] men). The most frequently used drug classes, listed in decreasing order of frequency, were: analgesics and anti-inflammatory agents (N=108), vitamins (N=86), cardiovascular medications (N=81), proton pump inhibitors (N=44), lipid-lowering agents (N=40), antiplatelet agents (N=33), psychotropic drugs (N=28), oral contraceptives (N=18), antidiabetic agents (N=14), and anticoagulants (N=8). Prevalence of polypharmacy increased significantly with age: it was observed in 10 of 236 individuals (4.2%) aged 18–49 years, in 23 of 180 (13%) aged 50–69 years, and in 24 of 58 (41%) aged ≥70 years. Prevalence was similar between sexes. In conclusion, polypharmacy increases with advancing age in Mesolcina valley, mirroring demographic and clinical trends observed in aging societies.
subject: Articles
  topic: section
subject: age
  topic: keywords
subject: general internal medicine
  topic: keywords
subject: polypharmacy
  topic: keywords
subject: medicina interna
  topic: disciplines
subject: medicina di famiglia
  topic: disciplines
subject: epidemiologia
  topic: disciplines
subject: farmacologia
  topic: disciplines
creator: Lisa Ponti
creator: Pia A. Härvelid
creator: Dragana Dragana
creator: Augusto Gallino
creator: Franco Muggli
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-08-04
publication date: 2025-08-04
doi: 10.63648/c6y1jg35

Anterior cruciate ligament injury: surgical techniques and possible conservative treatment
type: item
description: Anterior cruciate ligament (ACL) injury is the most common ligament injury of the knee joint, frequently affecting both professional and amateur athletes. Surgical options—such as ligament reconstruction, reinsertion, or augmentation— are widely adopted; however, conservative management remains a valid alternative in selected cases. This narrative review aims to synthesize the most recent evidence on ACL injury treatment strategies, highlighting the factors that guide clinical decision-making. Recent literature increasingly emphasizes that patient age alone should no longer be the primary determinant of treatment choice. Instead, the individual’s activity level and functional demands play a more significant role in selecting the most appropriate therapeutic approach. Moreover, targeted rehabilitation programs that include muscle strengthening and proprioceptive exercises have shown to improve outcomes across both surgical and non-surgical pathways. These interventions contribute to joint stability, functional recovery, and overall patient satisfaction. Importantly, the presence of associated meniscal injuries often shifts the balance in favor of surgical intervention due to the increased risk of long-term joint degeneration. Further research is needed to refine patient selection criteria and optimize individualized treatment protocols.
subject: Articles
  topic: section
subject: ACL
  topic: keywords
subject: reconstruction
  topic: keywords
subject: conservative treatment
  topic: keywords
subject: clinical outcomes
  topic: keywords
creator: Arturo Comba
creator: Niccolò Marelli
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-08-04
publication date: 2025-08-04
doi: 10.63648/yxhya965

Carbon monoxide poisoning: emerging and overlooked causes
type: item
description: Carbon monoxide poisoning is a subtle and insidious medical emergency. Due to its ability to mimic other conditions such as influenza, food poisoning, vestibular disorders, acute coronary syndrome, or epileptic seizures, it has been referred to as the “chameleon of emergencies”. While fires are a well-recognized source of carbon monoxide exposure, cases in which the origin remains unknown to both physicians and patients are increasingly reported. To enhance awareness of emerging and overlooked sources of carbon monoxide poisoning and summarize its pathophysiology, we conducted a comprehensive review in the National Library of Medicine. The toxicity of carbon monoxide relies on impaired blood oxygen transport and inhibition of the mitochondrial respiratory chain in the tissues. Less recognized sources include domestic combustion appliances (boilers, water heaters, stoves, ovens, and fireplaces), external heating sources (heating mushrooms), motor vehicle exhaust (cars, motorcycles, scooters, lawnmowers), sports-related activities (mud bogging, ice resurfacing machines), misuse of barbecues, portable power generators, and the use of narghile and cigarettes. Given the nonspecific presentation of carbon monoxide poisoning, improving recognition and diagnostic strategies is essential. Greater awareness among healthcare professionals, along with the integration of advanced diagnostic tools such as pulse oximeters capable of measuring carboxyhemoglobin levels, could facilitate earlier diagnosis and improve patient outcomes.
subject: Articles
  topic: section
subject: carbon monoxide poisoning
  topic: keywords
subject: occult carbon monoxide
  topic: keywords
subject: hidden carbon monoxide
  topic: keywords
subject: urgency medicine
  topic: disciplines
subject: intensive medicine
  topic: disciplines
subject: internal medicine
  topic: disciplines
creator: Gabriel Bronz
creator: Fabio Lanzi
creator: Michael Llamas
creator: Adam Ogna
rights: Copyright (c) 2025 Authors
date: 2025-06-26
publication date: 2025-06-26
doi: 10.63648/sfcpyb66

Cefepime and Neurotoxicity: An Underestimated Complication in the Geriatric Population
type: item
description: Cefepime is a widely used fourth-generation cephalosporin for the treatment of nosocomial infections but is known for its potential neurotoxicity, particularly in elderly and frail patients. This condition, characterized by cognitive impairment and confusion, occurs more frequently in the presence of renal insufficiency and/or suboptimal dosing. This paper presents two cases of geriatric patients, who developed cefepime-associated neurotoxicity.
subject: Articles
  topic: section
subject: cefepime
  topic: keywords
subject: neurotoxicity
  topic: keywords
subject: adverse effect
  topic: keywords
subject: older patients
  topic: keywords
subject: geriatrics
  topic: keywords
subject: Geriatrics
  topic: disciplines
subject: internal medicine
  topic: disciplines
creator: Luca Barelli
creator: Milagros Altagracia Carela Mora
creator: Rosambra Leo
creator: Olivier Giannini
creator: Anna Acchini
rights: Copyright (c) 2025 Author
date: 2025-06-26
publication date: 2025-06-26
doi: 10.63648/sgs6vf29

Hypertension - prevalence andmanagement efficacy in Southern Switzerland
type: item
description: Hypertension is a major public health concern worldwide, significantly contributing to cardiovascular morbidity and mortality. This study investigates the prevalence, management, and treatment outcomes of hypertension in the Italian- speaking region of Switzerland. A total of 1,202 individuals participated in the study, undergoing office blood pressure measurements and 24-hour ambulatory blood pressure monitoring. Results indicate that over 40% of the examined population exhibited hypertensive blood pressure levels according to the 2024 ESC and 2023 ESH guidelines. A key finding is that one in four individuals with office hypertension experienced stress-induced hypertension, highlighting the importance of ambulatory blood pressure monitoring in distinguishing context related elevations from sustained hypertension. Additionally, three-quarters of those diagnosed with office hypertension presented with Grade 1 hypertension, underscoring the need for early intervention through lifestyle modifications and pharmacological treatment when necessary. Alarmingly, a significant proportion of hypertensive individuals did not receive adequate treatment. Among hypertensive patients, 74% were untreated, and among those undergoing treatment, 80% failed to reach target blood pressure levels. The study found that 85% of patients on monotherapy remained hypertensive, indicating the potential need for combination therapy and treatment optimization. These findings emphasize the essential role of primary care physicians in diagnosing and managing hypertension effectively. Physicians must ensure accurate blood pressure assessment, promote lifestyle changes, and tailor pharmacological interventions to individual needs. A comprehensive, multifaceted approach incorporating patient education, regular monitoring, and evidencebased treatment strategies is crucial to improving hypertension control and reducing the associated cardiovascular risks. This study highlights the urgent need for enhanc…
subject: Articles
  topic: section
subject: Hypertension
  topic: keywords
subject: Prevalence
  topic: keywords
subject: Management
  topic: keywords
subject: Treatment efficacy
  topic: keywords
subject: Switzerland
  topic: keywords
subject: internal medicine
  topic: disciplines
subject: nephrology
  topic: disciplines
creator: Martina Zandonà
creator: Francesca Cinieri
creator: Sébastien Sare
creator: Franco Muggli
creator: Rosaria Del Giorno
creator: Luca Gabutti
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-06-26
publication date: 2025-06-26
doi: 10.63648/zj52tm66

Suprascapular nerve entrapment syndrome
type: item
description: Suprascapular nerve entrapment syndrome is a neuropathy with shoulder pain (due to involvement of sensory fibers from the glenohumeral and acromioclavicular joints) and weakness of supraspinatus and infraspinatus muscles. We show a 40-year-old female patient with a didactic clinical and ultrasound-imaging presentation.
subject: Articles
  topic: section
subject: suprascapular nerve entrapment syndrome
  topic: keywords
subject: shoulder neuropathy
  topic: keywords
subject: muscle atrophy
  topic: keywords
creator: Sandro Bonetti
creator: Francesco Maulucci
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-08-04
publication date: 2025-08-04
doi: 10.63648/3c7sh998

Young athletes’ and parents’knowledge of sports-related concussionin Italian-speakingSwitzerland: a pilot study
type: item
description: Knowledge about sport-related concussion symptoms, prevention and management is critical to minimise severe consequences in paediatric patients, yet evidence on sport-related concussion knowledge among young athletes and their parents in the European context is scarce. This pilot study aims to test the feasibility and acceptability of populationbased study on sport-related concussion knowledge and associated factors in the Italian-speaking part of Switzerland. The CKBBQ was translated and adapted to fit the cultural context. Linguistic and face validity were assured before collecting pilot data. participants were recruited in early 2024 through sports coaches of high-risk team sports. descriptive statistics, t-tests, and bivariate correlations were performed to evaluate sport-related concussion knowledge levels in young athletes and parents and how it might differ based on socio-demographic and information-related factors. Data from 61 parents and 45 young athletes revealed that sociodemographic factors are not associated with sport-related concussion knowledge, but having received sport-related concussion information in the past year is a significant and positive predictor. Also, using dyadic data, a significant positive correlation was found between parents’ and adolescents’ sport-related concussion knowledge. Sport-related concussion information is crucial in improving knowledge about it. A large-scale population- ased prevalence study is needed to corroborate these findings and inform future sport-related concussion information interventions adapted to the specific cultural context. The study highlights the importance of reducing barriers to questionnaire access and involving key stakeholders including the sports doctor catering for this population.
subject: Articles
  topic: section
subject: Concussion
  topic: keywords
subject: sport
  topic: keywords
subject: knowledge
  topic: keywords
subject: young athletes
  topic: keywords
subject: parents
  topic: keywords
creator: Giovanna Pedroni
creator: Marta Fadda
creator: Anne-Linda Camerini
creator: Andrea Castiglioni
creator: Jacopo Calciolari
creator: Davide Bassi
creator: Barbara Goeggel Simonetti
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-04-28
publication date: 2025-04-28
doi: 10.63648/byxvx240

Parsonage-Turner syndrome, a (notso) rare cause of shoulder pain
type: item
description: Parsonage-Turner syndrome is a pathology that mainly affects the brachial plexus in its upper or middle part and the peripheral nerves that originate from it. In the past, it was considered a rare disease, but recent studies show an annual incidence of about 1/1000. The clinical presentation has a characteristic course with a relatively rapid, often nocturnal onset of pain, most often localized in the proximal region of the arm and the trapezius muscle. The pain is usually not elicited by shoulder movements and is particularly severe at night. In the days following the onset of the first symptoms, there is a progressive paresis of part of the muscles of the shoulder. The diagnosis is based on the formulation of a clinical suspicion and subsequent confirmation by electro neuro-myography and imaging studies. While the main pain resolves spontaneously after 3–4 weeks, the motor disorder and a duller pain persist much longer and usually resolve within 1–3 years. While Parsonage-Turner syndrome was considered a benign disease in the past, there is now increasing evidence that a significant proportion of patients develop a chronic course characterized by persistent pain, weakness and fatigue in the affected extremity. Better clinical courses, however, appear to be favored by early treatment. It is therefore crucial to make the diagnosis as early as possible.
subject: Articles
  topic: section
subject: acute brachial neuropathy
  topic: keywords
subject: hepatitis E
  topic: keywords
subject: neuralgic amyotrophy
  topic: keywords
subject: Parsonage-Turner syndrome
  topic: keywords
subject: severe acute respiratory syndrome coronavirus 2
  topic: keywords
creator: Sandro Bonetti
creator: Matteo Dell'Era
rights: Copyright (c) 2025 All content published in Tribuna Medica Ticinese is protected by copyright. The authors retain the copyright to their works and grant the journal a license for publication. Unauthorized reproduction, distribution, or use of the published content is prohibited, except as permitted by law or with the written permission of the authors and the publisher. Respecting copyright ensures the integrity and protection of scientific work.
date: 2025-04-28
publication date: 2025-04-28
doi: 10.63648/hh0aqm80

Renal damage and Mycoplasma pneumoniae infection: a guide toclinical reasoning and literature review
type: item
description: Mycoplasma pneumoniae is a well-recognized pathogen responsible for community-acquired respiratory infections, particularly atypical pneumonia. Beyond its respiratory involvement, this microorganism is often associated with extra-respiratory manifestations. However, available reviews only marginally address the potential occurrence of kidney injury. The aim of this study was to investigate the relationship between Mycoplasma pneumoniae and kidney disease through expert analysis and a comprehensive literature review. Four possible mechanisms underlying kidney injury were identified: cardiorenal syndrome; pigment nephropathy resulting from hemolysis or rhabdomyolysis; “direct” kidney injury including interstitial nephritis, IgA mediated nephropathy, or hemolytic uremic syndrome; nephrotoxicity caused by medications used to treat Mycoplasma pneumoniae infection or to relieve symptoms. Renal impairment associated with Mycoplasma pneumoniae predominantly occurs during the infection rather than as a post-infectious complication. This renal impairment is probably caused directly by Mycoplasma pneumoniae, cytokines, or by immunologically mediated mechanisms characteristic of the early immune response. This study highlights the need for clinicians to consider renal complications in patients with Mycoplasma pneumoniae, particularly those presenting with systemic symptoms.
subject: Articles
  topic: section
subject: Mycoplasma pneumoniae
  topic: keywords
subject: renal injury
  topic: keywords
subject: hemolysis
  topic: keywords
subject: rhabdomyolysis
  topic: keywords
subject: Schönlein-Henoch vasculitis
  topic: keywords
creator: Pietro B. Faré
creator: Giorgia D'Angelo
creator: Sebastiano A.G. Lava
rights: Copyright (c) 2025 Author
date: 2025-02-20
publication date: 2025-02-20
doi: 10.63648/uhgd6681