Medical eponyms versus acronyms: what medical terminology is most beneficial to learn? A question of goals.

Appropriate use of medical terminology is one of the core conditions for successful communication in monolingual and multilingual healthcare communities. The modern scientific language is based on the descriptive terminology. However, it is often the case that the advantages of descriptive terminology are at odds with the ability to express complex concepts in just a few words. To solve this practicality problem it is customary to coin abbreviations and acronyms preferred to traditional eponyms. Today eponyms are considered ambiguous and non-descriptive, linked to the terminology of the past. The overview of this study demonstrates that the current habit of using acronyms can increase the scientific descriptive capacity compared to eponyms. On the other hand, acronyms remain ambiguous and more ephemeral than eponyms. Furthermore, eponyms are not as descriptive as acronyms, but they still carry important information for a medical student. If you truly believe in the importance of Medical Humanities in the medical curriculum, two aspects cannot be overlooked. First, eponyms bring students closer in an almost subliminal way to the history of medicine and the non-strictly technical-scientific field of medicine. Second, medicine is a complex science applied to humans and must strive to keep the patient at the center of its interests. Patients and their families preferably ask us to use eponyms. Which terminology to choose for medical students? The teachers have the last word.

Urgent ERCP performed with single-use duodenoscope (SUD) in patients with moderate-to-severe cholangitis: Single-center prospective study.

Background and study aims To assess the outcomes of urgent endoscopic retrograde cholangiopancreatography (ERCP) performed with a single-use duodenoscope (SUD) in patients with moderate-to-severe cholangitis. Patients and methods Between 2021 and 2022 consecutive patients with moderate-to-severe cholangitis were prospectively enrolled to undergo urgent ERCP with SUD. Technical success was defined as the completion of the planned procedure with SUD. Multivariate analysis was used to identify factors related to incidence of adverse events (AEs) and mortality. Results Thirty-five consecutive patients (15 female, age 81.4±6.7 years) were enrolled. Twelve (34.3%) had severe cholangitis; 26 (74.3%) had an American Society of Anesthesiologists (ASA) score ≥3. Twenty-eight patients (80.0%) had a naïve papilla. Biliary sphincterotomy and complete stone clearance were performed in 29 (82.9%) and 30 patients (85.7%), respectively; in three cases (8.6%), concomitant endoscopic ultrasound-gallbladder drainage was performed. Technical and clinical success rates were 100%. Thirty-day and 3-month mortality were 2.9% and 14.3%, respectively. One patient had mild post-ERCP pancreatitis and two had delayed bleeding. No patient or procedural variables were related to AEs. ASA score 4 and leucopenia were related to 3-month mortality; on multivariate analysis, leukopenia was the only variable independently related to 3-month mortality (odds ratio 12.8; 95% confidence interval 1.03-157.2; P =0.03). Conclusions The results of this "proof of concept" study suggest that SUD use could be considered safe and effective for urgent ERCP for acute cholangitis. This approach abolishes duodenoscope contamination from infected patients without impairing clinical outcomes.

The last battle of Alessandro Farnese (1545-1592).

BACKGROUND AND AIM: Alessandro Farnese (1545-1592), 3rd Duke of Parma and Piacenza, one of the most important generals and politicians of his age. He died after a rapid deterioration of his health. The available documents testify that the Duke suffered for a long time from various health problems, such as jaundice, intestinal disorders, gout, dropsy but very little is known about the cause(s) of his death. The aim of this article is to offer for the first time a complete clinical interpretation of Alessandro Farnese's last months of life Methods: A collection of descriptions of symptoms and signs described by his court physician and by the leading biographers of Farnese has been compiled. This collected medical evidence has been interpreted in the light of current medical knowledge, to obtain a final interpretation. RESULTS: The results led us to consider liver diseases, neoplastic diseases (especially pancres) and infectious diseases (including typhus and malaria) as causes or contributing causes of death. CONCLUSIONS: The accurate autopsy description, in association with the anamnestic information provided by the historical documents studied, suggests that Alessandro Farnese was a hepatopathic patient suffering from spontaneous bacterial peritonitis. In the pre-antibiotic era, the pathological organ alterations described certainly have at least contributed to making the infectious episode (that the autopsy describes of pulmonary origin) fatal.

Dante Alighieri (1265-1321): an "infernal" endocrinological observation.

The year 2021 marks the 700th anniversary of Dante's death. Is it appropriate to celebrate this anniversary in a journal of endocrinology? The answer is yes-the motivation for this being found in the giants that Dante, in his Divine Comedy, places around the well that divides Circle 8 from Circle 9 of Hell. The "Supreme Poet" describes one of the giants (Nimrod, a Biblical character) as having a large and elongated face with a body of gargantuan proportions. Such a description immediately calls to mind the characteristics of acromegalic prognathism, the huge stature being the most pathognomonic aspect. Is it possible that the sharp eye of Dante had observed such a feature in people affected by actual gigantism?

Dilation assisted stone extraction for complex biliary lithiasis: Technical aspects and practical principles.

Common bile duct stones are frequently diagnosed worldwide and are one of the main indications for endoscopic retrograde cholangio-pancreatography. Endoscopic sphincterotomy (EST) has been used for the removal of bile duct stones for the past 40 years, providing a wide opening to allow extraction. Up to 15% of patients present with complicated choledocholithiasis. In this context, additional therapeutic approaches have been proposed such as endoscopic mechanical lithotripsy, intraductal or extracorporeal lithotripsy, or endoscopic papillary large balloon dilation (EPLBD). EPLBD combined with EST was introduced in 2003 to facilitate the passage of large or multiple bile duct stones using a balloon greater than 12 mm in diameter. EPLBD without EST was introduced as a simplified technique in 2009. Dilation-assisted stone extraction (DASE) is the combination of two techniques: EPLBD and sub-maximal EST. Several studies have reported this technique as safe and effective in patients with large bile duct stones, without any increased risk of adverse events such as pancreatitis, bleeding, or perforation. Nevertheless, it is difficult to analyze the outcomes of DASE because there are no standard techniques and definitions between studies. The purpose of this paper is to provide technical guidance and specific information about the main issues regarding DASE, based on current literature and daily clinical experience in biliary referral centers.