Recenti progressi in medicina
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The Emergency Medical Service in Italy is based on operating exchanges, distributed on all the national territory. The operating exchange coordinates the help means sending in relation to the event severity. The telephone calls of request for help are sent to the operating exchange through a single telephone number (118). ⋯ In the April 1996 the National Guide Lines, which provide the information on the organizational and functional emergency requirements, have been given off. Requirements have been furthermore identified for the Emergency Departments of first and second level. After ten years from the Emergency Department activation, the main critical states are represented by the heterogeneous organization on the national territory and medical and nursing staff's formation.
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The importance of this case, an episode of anaphylactic reaction for Argas reflexus, the pigeon tick, is due to the ever-increasing presence in urban areas of the pigeon. The knowledge of existence of this parasite and of his biological characteristics is essential to make a correct and timely diagnosis, to avoid the frequent relapse of symptoms, to take the necessary therapeutical and preventive measures.
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Comparative Study
[The Italian law on termination of pregnancy (194/1978). Should it be revised? The palliative care option].
The section of the Italian law on the termination of pregnancy (no. 194/1978) regarding late termination is revised and discussed in the light of the various options that could be offered to parents. Besides recent suggestions to apply time limits, the author reviews an alternative therapeutic option, considered the only feasible revision of the law which calls for strong involvement by the neonatologist and close collaboration with the obstetrician: the offer of palliative care for foetus/neonate and parents.
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Review
[Use of positive end-expiratory pressure in acute respiratory distress syndrome: current views].
Despite its wide application during mechanical ventilation of patients with acute respiratory distress syndrome, the correct setting of positive end-expiratory pressure is still an unsolved issue. We have recently observed that PEEP response is strictly correlated to the amount of the potentially recruitable lung, which is in turn associated to the overall severity of lung injury. Assessment of the potential for lung recruitment is therefore necessary for the correct setting of PEEP: a high PEEP level should be limited only to patients with a higher amount of potentially recruitable lung. At present, computed tomography represents the most accurate technique for its measurement.
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In the recent years, we have witnessed a new revolution in the field of communication through Internet. Web 2.0, whose contents are provided by the collaboration, discussion, and sharing between more users, is replacing the traditional web (the web 1.0). The use of podcasts, wikis, and blogs is rapidly increasing, and today they are proposed as educational tools for health professionals, physicians, and medical students. ⋯ This could make the contents unreliable and inaccurate, and could introduce risks for a correct medical education and for the health of those patients deciding to follow the medical advice included. Studies are needed to evaluate limits, benefits, and efficacy of these tools when used in the contexts of medical education and clinical practice. Other studies are needed to evaluate the reliability and the accuracy of the medical contents posted online through the web 2.0 services.