Medea Pintaudi

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder characterized by recurrent nodules, abscesses, and sinus tracts in apocrine gland-bearing areas. Surgery plays a key role in moderate-to-severe disease. As patients increasingly rely on the internet for decision-making, the quality of online information on HS surgery requires critical evaluation. Previous studies have shown poor quality and limited coverage of surgical aspects. This study systematically assesses publicly available websites on the surgical and reconstructive management of HS, quantifies their quality using the modified Ensuring Quality Information for Patients (mEQIP) tool, and identifies areas needing improvement to support informed decisions. Methods: Google, Bing, and Yahoo were searched using five HS surgery-related keywords. The first 50 results per keyword and engine were collected (n = 750), and 214 websites met the inclusion criteria. Sites were categorized by provenance (practitioners, hospitals, healthcare portals, professional societies, encyclopedias) and assessed using the 36-item mEQIP checklist. High quality was defined as ≥23/36 (75th percentile). Comparisons were made by publication era (pre-/post-COVID-19) and source type. Results: The mean mEQIP score was 21.7; only 51 websites (23.8%) met the high-quality threshold. No significant difference emerged between pre- and post-COVID publications. Healthcare portals scored highest (22.8), followed by practitioners (21.5) and hospital sites (21.2); professional societies (19.7) and encyclopedias (17.3) performed worst. Major deficiencies included limited discussion of surgical risks, quality-of-life outcomes, and postoperative care. Conclusions: Online resources on HS surgery are frequently incomplete and omit essential details on risks, recurrence, and reconstructive options. Surgeons should direct patients toward vetted sources, and professional societies should develop accessible, evidence-based patient guidelines.

Peripheral artery disease (PAD) is an atherosclerotic condition commonly complicating type 2 diabetes (T2D), leading to poor quality of life and increased risk of major adverse lower-limb (MALE) and cardiovascular (CV) events (MACE). Therapeutic management of PAD in T2D patients is much more arduous, often due to bilateral, multi-vessel, and distal vascular involvement, in addition to increased systemic polyvascular atherosclerotic burden. On the other hand, the pathophysiological link between PAD and T2D is very complex, involving mechanisms such as endothelial dysfunction and increased subclinical inflammation in addition to chronic hyperglycemia. Therefore, the clinical approach should not ignore vascular protection with the aim of reducing limb and overall CV events besides a mere glucose-lowering effect. However, the choice of the best medications in this setting is challenging due to low-grade evidence or lacking targeted studies in PAD patients. The present review highlighted the strong relationship between T2D and PAD, focusing on the best treatment strategy to reduce CV risk and prevent PAD occurrence and worsening in patients with T2D. The Medline databases were searched for studies including T2D and PAD up to June 2024 and reporting the CV effectiveness and safety of the most used glucose-lowering agents, with no restriction on PAD definition, study design, or country. The main outcomes considered were MACE—including nonfatal acute myocardial infarction, nonfatal stroke, and CV death—and MALE—defined as lower-limb complications, amputations, or need for revascularization. To the best of our current knowledge, GLP-1 receptor agonists and SGLT2 inhibitors represent the best choice to reduce CV risk in T2D and PAD settings, but a personalized approach should be considered. GLP-1 receptor agonists should be preferred in subjects with prevalent atherosclerotic burden and a history of previous MALE, while SGLT2 inhibitors should be used in those with heart failure if overall CV benefits outweigh the risk of lower-limb complications.