Abstract Book of the 39° SIGOT National Congress | Modena, May 21-23, 2025

The increased volume of the aged population, the complexity of patients, and the updates in the legislative aspects linked to older people constitute various challenges for geriatrics. Education and training of young geriatricians appear crucial to forming conscious medical professionals. This short communication highlights the role of the Italian Society of Geriatrics Hospital and Territory in promoting good clinical practices for the care of older people.

The proportion of older adults using medical cannabis is rising. Most of the cannabinoid research has focused on a healthy, younger population free from frailty and major comorbidity. In this case report, we describe an 82-year-old woman who was autonomous in basic and instrumental activities of daily living and who came to our geriatric department for marked weight loss over the past 2 months (about 10 kg) and anemia. After appropriate clinical and endoscopic checks, it was concluded that the weight loss was induced by the initiation of therapy with oral cannabis for the control of rheumatic pain.

This study aims to assess the relationship between nutritional status and cognitive decline in a population of non-institutionalized elderly patients evaluated in a geriatric outpatient setting. Data from 144 patients admitted to the general geriatric outpatient services of Luigi Vanvitelli University Hospital (Naples, Italy) and San Felice a Cancello Hospital (San Felice a Cancello, Italy) were collected between January 1 and December 31, 2017. Cognitive function was evaluated through the mini-mental state examination and nutritional status was assessed through mini nutritional assessment. Logistic regression was used to assess the association between clinical characteristics and nutritional status, and it is reported as unadjusted, adjusted for age and sex, and adjusted for other potential confounding factors. In the unadjusted model, poor nutritional status was associated with a worse cognitive deficit (odds ratio (OR)=2.36; 95% confidence interval (CI)=1.77-3.55). The association remained significant after adjusting for age and sex (OR=2.36; 95% CI=1.77-3.55) and in the fully adjusted model (OR=2.92; 95% CI=1.90-5.64). In patients with dementia, malnutrition represents a significant burden that grows heavier as the disease progresses.

Stewart-Treves syndrome (STS) is an angiosarcoma associated with lymphedema deriving more often from radical mastectomy and longstanding lymphedema, first described in 1948. Irradiation is also commonly associated with chronic lymphedema of extremities. It generally occurs about 10 years after the mastectomy and/or radiotherapy. The prognosis is very poor with a mean survival of 20 months from the diagnosis especially when radical surgery is not possible. We present the case of STS in an 89-year-old female who underwent left upper outer quadrantectomy for invasive ductal carcinoma in 2009 followed by axillary lymphadenectomy, radiotherapy, and hormonal therapy until 2014. She presented swollen upper left limb associated with hemorrhagic red papular lesions. Skin biopsy revealed the presence of lymphedema-associated angiosarcoma. Radical surgery was not possible, so she underwent conservative therapy with pazopanib, a tyrosine kinase inhibitor, with benefit. Long-term follow-up of these patients is crucial to intercept this condition at an early stage.

Primary Sjögren’s syndrome (pSS) is a systemic autoimmune rheumatic disease where xerophthalmia, xerostomia and presence of anti-SSA and anti-SSB antibodies are typical features. Its prevalence is higher in over-65 aged population than in other age groups. In the elderly, pSS diagnosis comes up against a whole series of critical points that may favor its misdiagnosis. The aim of our article is to discuss the most relevant of them: the frequent occurrence of a seronegative subset, the presence of systemic features not related to sicca syndrome, the sicca syndrome as iatrogenic manifestation and the possibility of a biopsy false negative of labial salivary glands.

Asthma is a chronic inflammatory disease of the lower airways, characterize by wheezing cough, chest tightness along with inflammation of airway and shortness of breath. Allergens like environmental substance are predispose asthmatics patients to allergy. Mast cells produced interleukin (IL)- 4 which either activate signal transducer and activator of transcription 6 (STAT-6) pathway that involved in differentiation of na ve T-cells to TH2 or activation of TH2 cells indirectly. The aim of the current context is to present role of IL-4 in asthma and effect as antagonist. IL-4 results in increased mucus production and involve in IgE synthesis from B cells. IL4 facilitate chemotaxis and aid in displaying of VCAM-1 which attract eosinophil basophils monocytes T-lymphocytes to blood vessel. IL4 inhibit apoptosis either by preventing decrease in BCL-2 level or binding of FasL to Fas (cd32) receptor which result in acute allergic response. Elevated level of IL-4 has greatly adverse impact on asthmatic patients so by decreasing the level of IL-4 will greatly reduce asthma phenotype.

We present an eighty-year old man with a one year history of progressive macroglossia, dysphagia and loss of weight. He had a medical history of arterial hypertension and prostatic hypertrophy which he had under good therapeutic control. The entire tongue was swollen, had hard solidity and was slightly painful upon palpation. A tongue biopsy revealed an amyloid deposition as it coloured bright orange-red on Congo Red staining and lead us subsequently to the diagnosis of amyloidosis; then a bone marrow biopsy confirmed the diagnosis of multiple myeloma. The case was further evaluated by a multidisciplinary team who considered it appropriate to start a lowdose melphalan treatment combined with supportive care. When macroglossia in the tongue is confirmed to be amyloidosis the differential diagnosis should include systemic amyloidosis deposition and multiple myeloma.

Hydroxychloroquine is an antimalarial drug also known for its anti-inflammatory and antiviral effects, which have raised the interest of many researchers for its potential use in COVID-19 patients. It is known that this drug, being able to influence the cardiac repolarization phase with QTc interval prolongation, can be potentially harmful, chiefly in elderly subjects with frailty syndrome, several comorbidities and polypharmacotherapy. Therefore, although electrocardiogram monitoring of QTc prolongation is the focal point for reducing the arrhythmic risk of these patients, in order to identify the most exposed patients, the traditional Comprehensive Geriatric Assessment should be combined with a multiparametric risk score for QTc prolongation.

To protect appropriate authorship, the International Committee of Medical Journal Editors (ICMJE) formulated a guideline on authorship. Researchers not fulfilling these criteria and still enlisted as author are seen as honorary authors (HA). The objective of this study is to assess authorship decision making and the proportion of HA in journals in the field of geriatrics and gerontology. Corresponding authors of six highimpact journals in geriatrics and gerontology were sent a survey. The survey consisted of three parts: i) demographics of the respondent; ii) awareness of authorship guidelines; and iii) authorship decisions made for the paper they are authors of. Respondents were also asked if one of their coauthors does not deserve authorship. This is defined as self-perceived HA. Furthermore, respondents were asked if any of their co-authors only performed tasks from a list of non-authorship tasks. This is defined as ICMJE-defined HA. Of the 1592 contacted authors, 528 filled in a survey (response rate 33.2%). 84.4% was aware of the ICMJE-guidelines, but 44.2% was unaware of the issue of HA. The proportion of self-perceived HA was 12.7%. Independent factors associated with more self-perceived HA were having a senior member automatically enlisted as coauthor [odds ratio (OR) 3.4, 95%confidence interval (CI) 1.8 to 6.4] and have gotten the suggestion to include an HA (OR 11.1, 95% CI 4.4 to 27.9). The proportion of ICMJE defined HA was 39.3%. The journal surveyed (OR 1.2, 1.0 to 1.3) was associated with more, and awareness of the ICMJE-guidelines (OR 0.5, 95% CI 0.3 to 0.9) was associated with less ICMJE-defined HA respectively. Having a senior member automatically enlisted as co-author (OR 2.1 95% CI 1.3 to 3.4) and having anyone suggest to include an HA (OR 4.8 95% CI 1.8 to 12.8) were also associated with more ICMJE-defined HA. More than one out of ten of the corresponding authors thinks that based on the ICMJE-guidelines, one or more of their coauthors did not deserve authorship. A stricter journal policy and more awareness of the ICMJE-guidelines could help reduce the proportion of HA.