Recenti progressi in medicina
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In this paper we summarize present trends and controversies in the use of beta-blockers in cardiovascular diseases. Beta-blockers are catecolamine competitive inhibitors and act through alpha and beta adrenergic receptors blockade. Different agents have a dose-dependent affinity for different beta adrenergic receptors (beta 1, beta 2, beta 3) which is less with higher doses. ⋯ Different metabolic effects of selective and non-selective beta-blockers are actually debated. In conclusion, beta-blockers have indication in the treatment of many cardiovascular diseases. Further studies are needed for better understanding the differences in cardiac and peripheral beta-blockers effects depending on their selectivity.
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Case Reports
[Intestinal intussusception in adult. Abdominal ultrasound is useful as diagnostic method, if correctly assessed].
We report a case of adult intestinal intussusception. The patient had complained of intermittent nonspecific abdominal pain and nausea for two weeks, when acute abdomen appeared and required a segmental small bowell resection. During hospitalization in our Department three abdominal ultrasound examinations were performed, but only one of which was useful in making the diagnosis. We stress the role of ultrasound imaging in the diagnosis of intussusception in adults.
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Comparative Study
[Patients' satisfaction with pain management: the italian version of the Patient Outcome Questionnaire of the American Pain Society].
According to American Pain Society (APS), assessment of quality of pain management must consider not only improvement of symptoms but also patients' satisfaction with care. To this purpose, Patient Outcome Questionnaire (APS-POQ) was made. ⋯ The tool was administered to 322 hospitalized adults. Results showed positive psychometric properties of the Italian version of APS-POQ, particularly for the sections assessing intensity and interference of pain, and satisfaction with pain management.
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Case Reports
[Acute myocardial infarction following persistent atrial fibrillation. Consequence, common etiology or a case?].
We describe the case of a patient with persistent atrial fibrillation who subsequently developed an acute myocardial infarction. We discuss the hypothetical reasons that can explain the correlation between the two events: coronary embolism, inflammation, endothelial dysfunction.
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Acute dyspnea as a presenting symptom is a frequent challenge for physicians. Difficulties in establishing a correct diagnosis may lead to late institution of appropriate medical therapy. The authors describe the case of a 77 year-old man with both chronic obstructive pulmonary disease and cardiac insufficiency, presenting with episodes of acute dyspnea, whose ethiology has been revealed by lung ultrasound.