Minerva medica
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Case Reports
[Usefulness of plasmapheresis in the treatment of Blackfan-Diamond erythroid aplasia. Presentation of a case].
Plasmapheresis was attempted in a case where all other treatment had failed. As widely reported in the literature plasmapheresis is outstandingly effective in cases where antibodies are suspected and even in the absence of any such suspicion, its use is justified by the good results obtained. It is suggested that plasmapheresis is essential in the treatment of the particular pathology considered.
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Case Reports
[Diabetes insipidus after selective pituitary adenomectomy. A case with late appearance].
Diabetes insipidus is a well-known complication of hypophyseal surgery. The case is described of a women presenting with evident polyuropolydipsic syndrome arising 9 years after transphenoidal hypophyseal adenectomy. The diagnosis insipidus diabetes was secondary to intrasellar scars revealed by a hypophyseal CAT scan. The unusually long interval between surgery and the onset of the syndrome is emphasised.
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Comparative Study
[Endoscopic evaluation of the effects of diacerhein and naproxen on the gastroduodenal mucosa].
The potential capacity of diacerheine (DAR), a new drug known to have no anti-prostaglandin effect and therefore a different action mechanism from the standard non-steroid anti-inflammatory drugs, to cause damage to the gastroduodenal mucosa was compared with that of a well-known NSAID, naproxene. Gastroscopic examination of 10 + 10 patients before and 4 weeks after treatment showed that DAR produced endoscopic lesions without subjective symptoms in 10% of the patients whereas naproxene produced lesions of varying size in 50%, with or without symptoms.
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Clinical Trial Controlled Clinical Trial
[Diacereine: an original approach in the treatment of degenerative and/or extra-articular rheumatism].
71 patients with variously located osteoarthrosis or primary fibromyalgic syndrome were treated with oral diacereine (DAR). The case series was accumulated in successive periods and may be divided into three groups. An "open" test on DAR (100 mg/die for 4 weeks) was conducted on the first group of 31 arthrosis patients. ⋯ In the third group, a positive therapeutic effect was noted in 68.4% of the patients with fibromyalgia with a 15% incidence of side effects consisting of slight abdominal pain (diarrhea caused suspension of treatment in 1 case only). Blood chemical parameters were studied in all three groups and no alterations attributable to the treatment were found. The obtained result suggests that the new drug is effective and well tolerated in the envisaged indications.
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Blood gas and haemodynamic changes caused by chronic respiratory insufficiency affect the right ventricle and produce chronic cor pulmonale. Equally important but less well known modifications affect the left ventricle and the general circulation and are the subject of the present report. Hypoxemia, hypercapnia and acidosis caused by severe hypoxia create functional disturbances in both ventricles that are manifested in a volume overload that added to other major malfunctions provoke congestive heart failure. ⋯ Cardiac failure is reflected in other organs like the kidney and the central nervous system and also contributes to tissue and cerebral hypoxia. The later depresses the respiratory centres and develops into often irreversible coma. A better knowledge of these elements may contribute to the development of appropriate treatment.