Recenti progressi in medicina
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During the last months of 2003, outbreaks of avian flu caused by influenza A (H5N1) virus were described in eight Asian countries, and has paralleled an epidemic of human influenza caused by the same avian virus A (H5N1). Between December 26, 2003 and October 13, 2005, there had been 117 documented human infections and 60 deaths (mortality, 51%) in four Asian countries: Vietnam, Thailand, Cambodia and Indonesia. ⋯ Human-to-human transmission of H5N1 virus has been suggested in several household clusters, but it seems very uncommon at present. All the viral genes of human H5N1 isolates were of avian influenza origin, which indicates absence of reassortment with human influenza viruses, but H5N1 continue to evolve and persistent monitoring is requested to identify any increase in viral adaptation to man, which could lead to a human pandemic.
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Inhaled bronchodilators are considered one of the principal treatments for chronic obstructive pulmonary disease (COPD). In the GOLD guidelines inhaled long acting bronchodilators are raccommended in patients witch moderate and severe COPD (VEMS/FVC < 70% predicted and VEMS < 80% predicted).
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Erectile dysfunction is often associated with diabetes mellitus and athero-thrombotic diseases, such as coronary heart disease, stroke, peripheral vascular disease. An association between erectile dysfunction and asymptomatic coronary artery disease angiographically verified has been recently shown in diabetic patients. ⋯ The strong association between erectile dysfunction and athero-thrombosis may have some important clinical implications. In particular, erectile dysfunction may be used as a predictor of silent or early athero-thrombotic diseases, especially in diabetic patients.
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Blood Doping has recently obtained a large diffusion between professional and nonprofessional athletes, in particular for endurance sports it has almost become a necessary way to warrant best performance. Seven years after the publication of our article "Blood Doping", this second installment was born to emphasize the way the biomedical research supplies (often unintentionally) new drugs and new technology to improve athletic performance and, on the other hand, to underline the antidoping strategies.
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The authors had experienced the telediagnosis on digital snapshots of standard radiology imaging (chest, abdomen, and bones), sent by e-mailing, to support the medical doctors working in remote areas of developing countries. In order to validate the overall procedure, the authors have set up a simulating model and estimated some parameters of accuracy of the diagnosis on digital snapshots against the golden standard of the diagnosis by direct look. The study concerned the standard X-ray tests of one hundred randomly-selected patients out of a hospital archive. ⋯ The chest test shows a specificity and predictive value of positives of 100.0%. Although the number of cases is low, the abdomen test apparently shows a sensibility and predictive value of negatives as high as 100%, but a lower specificity and predictive value of negatives (85.7 and 87.5%). Though this data is supportive to the validation of the procedure, even better results are supposedly achieved by increasing the quality of the snapshots and by improving the skills of using the software.