Minerva medica
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Patent foramen ovale (PFO) is a common finding in healthy subjects and has not been associated with increased risk of ischemic stroke in population-based cohort studies. Nevertheless, case-control studies have consistently shown an increased prevalence of PFO in cryptogenic stroke, suggesting that PFO might be a cause of stroke. The risk of stroke recurrence in patients with cryptogenic stroke and PFO is low under aspirin therapy but may be substantially higher in patients with an associated atrial septal aneurysm (ASA). ⋯ The optimal treatment for secondary prevention in patients with cryptogenic stroke and PFO is still uncertain and debated. A randomized controlled trial failed to demonstrate the superiority of transcatheter PFO closure over medical therapy. Whether anticoagulation is superior to aspirin should be tested in a randomized controlled trial.
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Randomized Controlled Trial
Eperisone versus tizanidine for treatment of chronic low back pain.
Many therapies exist for treatment of chronic low-back pain (LBP) including the use of muscle relaxant and analgesic drugs. The aim of this paper was to compare efficacy and tolerability of eperisone and tizanidine in combination treatment with tramadol in chronic LBP. ⋯ Both associations assumed for one month, have shown effective for LBP at rest and with effort. Eperisone/tramadol, reducing discontinuation and allowing a better adherence to the therapy, may be considered a viable option for the treatment of chronic LBP.
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Comparative Study
[Study of codeine-paracetamol combination treatment compared with tramadol-paracetamol in the control of moderate-to-severe low back pain].
The objective of this study was to compare the analgesic efficacy and tolerability of tramadol hydrochloride compared with codeine phosphate in combination with paracetamol in patients with moderate-to-severe low back pain caused by osteoarthritis. In fact, while paracetamol is the analgesic of choice for this disease, in cases where this treatment may be ineffective, the therapeutic choice involves the addition of weak opioids. Due to the chronic nature of the disease, these drugs represent a safer alternative compared to anti-inflammatory drugs (NSAIDs) and selective inhibitors of cyclooxygenase 2 (COX-2). ⋯ The study, although conducted on a limited number of patients and for a relatively short time, demonstrates the greater efficacy and tolerability of the association codeine-paracetamol compared to tramadol-paracetamol.
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The aim of the study was to investigate the concentration of PGRN and other inflammatory cytokines TNF-α, IL-1β, IL-4, IL-6, IL-10, IL-13 and IL-17 in osteopenic and non-osteopenic obese subjects. Bone mineral density in subjects with different PGRN levels were compared to the appraisal of our hypothesis. ⋯ Based on the pathway of effect of TNFα on bone metabolism, it appears that PGRN acts on the bone with mechanisms involving TNFR signaling, disturbance and TNFα performance, similar to the results that have been found in animal model study.