Recenti progressi in medicina
-
Until recently, only therapy with docetaxel and prednisone has been shown to prolong survival in men with hormonorefractory metastatic prostate cancer. With approvals of sipuleucel-T, cabazitaxel, and abiraterone acetate, all based on improvement in overall survival, the scenary for management of men with metastatic prostate cancer has dramatically changed. ⋯ In the phase III, the trial treatment with abiraterone acetate plus prednisone prolongs overall survival relative to prednisone alone in patients with metastatic castration-resistant prostate cancer who have disease progression after treatment with docetaxel and associated with an acceptable tolerability profile, which was generally similar to that of the placebo plus prednisone group. However, adverse events resulting from elevated mineralocorticoid levels because of CYP17A1 inhibition, fluid retention and oedema, hypokalaemia, hypertension occurred in significantly more in abiraterone acetate plus prednisone than in placebo plus prednisone.
-
Case Reports Comparative Study
[Lung ultrasound imaging of H1N1 influenza].
We describe the case of a 8 year-old child with acute respiratory distress syndrome (ARDS) during H1N1 swine flu. Lung ultrasound performed at the time of admission showed a typical ARDS ultrasound pattern, with multiple sonographic signs of interstitial oedema (also known as B-lines or ultrasound lung comets), and diffuse bilateral sub-pleural lung consolidations. After five days of anti-viral therapy, lung ultrasound showed a reduction of the dimension of consolidations, not clearly visible at chest X-ray, helping in the management of the patient.
-
Primary health care represents an essential area in relation to health protection: its purposes are, on the one hand, health promotion, on the other hand the possibility to resort only if necessary to hospital care. In the novel National Collective Agreement, new teamwork forms of organization are introduced; for example, the obligatory Territorial Functional Aggregation: an organizational Unit which general practitioners and general paediatricians join to. The article by Scala et al. (see page 17), about an experience of primary health care, focuses the necessity to plan new organizational forms of work for teams oriented to realize efficient and effective answers to population needs: the phases of the activities in équipe are analysed, lingering on lights and shadows of the team.
-
The common hepatic artery aneurysms (HAA) are uncommon atherosclerotic lesions and often they are clinically silent. Their diagnosis is often difficult prior to rupture, due to nonspecific clinical presentation. ⋯ The presence of the lesion was confirmed with the use of spiral computed tomographic angiography. Hepatic artery aneurysm is a lesion that should be considered in cases of unexplained obstructive jaundice.
-
Physician-family communication in the Intensive Care Units. Suggestions for critical situations. The present paper originates from some critical situations in clinical practice. The aim is to give some suggestions on how to convey information to families of patients admitted to Intensive Care Units, considering also the recent contribution of the international literature on "family shared decision making", "family conferences" and family care-givers attitudes towards decision making process.