La Clinica terapeutica
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La Clinica terapeutica · Jan 2011
Comparative Study[Effectiveness of antipsychotics in schizophrenia and related disorders. Results of a naturalistic study].
The present study aims to evaluate effectiveness of antipsychotics in a cohort of chronic outpatients affected by schizophrenia and related disorders. ⋯ Rates of all cause discontinuation of antipsychotics appear to be somewhat lower than expected on the basis of pragmatic studied published in the last years; similarly overall duration of treatment seems to be longer. Clozapine is associated to a higher overall effectiveness respect to any other atypical antipsychotic.
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La Clinica terapeutica · Jan 2011
[The syncope in Emergency Department: usual management vs guidelines].
The syncope is a common cause of admission to Emergency Departments, representing around 1-3% of all admissions to the service. However, elderly age and important comorbidities often hinder a definite etiologic diagnosis, with increasing requests for diagnostic tests and longer periods of hospitalization. ⋯ Management of patients with syncope, elderly people with important comorbidities in particular, is still a serious problem for the emergency physician. The creation of specialized units for the management of syncope, the so-called syncope units, through the implementation of a shared diagnostic and therapeutic protocol, aims at reducing inappropriate hospitalization and average length of stay.
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La Clinica terapeutica · Jan 2011
A world wide public health problem: the principal re-emerging infectious diseases.
The extraordinary progress in the knowledge of infectious disease, the discovery of antibiotics and effective vaccines are among the great achievement of the nineteenth and twentieth centuries. These achievement have led to a dramatic reduction in the levels of mortality from these diseases. According to the World Health Organization, the term "re-emerging infectious diseases" refers to infectious diseases, which although well known, have not been of recent public health importance. ⋯ A well organized monitoring system would enable the epidemiological characteristics of the infectious diseases to be analyzed and the success or otherwise of preventive interventions to be precisely evaluated. For this reason, the World Health Organization and the European Union have discussed the formation of a collaborative network for the monitoring and control of re-emerging diseases and has initiated special programmes. The battle between humanity and infectious disease has a history lasting thousands of years and is destined to continue in the future emphasizing the need to adopt combined policies for the prevention and control of re-emerging diseases.
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La Clinica terapeutica · Jan 2011
Review[The ketogenic diet: an underappreciated therapeutic option?].
Obesity is reaching epidemic proportions in Western countries and is a strong risk factor for cardiovascular disease. Despite the constant recommendations of health care organizations regarding the importance of weight control, this goal often fails. Although there is a common agreement about the concept that exercise and diet are two key factors for the control of body weight, the ideal amount and type of exercise and also the ideal diet for weight control are still under debate. ⋯ One of these strategies is the ketogenic diet or VLCKD (very low carbohydrate ketogenic diet) that has been widely studied in recent years. Most studies show that this diet has a solid physiological and biochemical basis which is able to induce effective weight loss and improvement of several parameters of cardiovascular risk. This review discusses the physiological basis of VLCKD and the main applications together with its strengths and weaknesses compared to common dietary recommendations.
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La Clinica terapeutica · Jan 2011
ReviewAcute adverse reactions to radiographic iodinated and gadolinium-based contrast media: incidence, risk factors and premedication: from published evidence to a practical approach.
Although relatively uncommon especially in their severe manifestations, adverse reactions (ARs) to radiographic contrast media (CM) may represent a source of concern to both physicians and patients because of the large number of CT and MR imaging procedures daily performed. In this paper the current literature is reviewed regarding incidence and risk factors for acute ARs to both iodinated and gadolinium-based CM, and about the usefulness of pharmacological premedication to reduce risk. A practical approach for everyday clinical practice is proposed.