Recenti progressi in medicina
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Interstitial lung diseases (ILD) are an heterogeneous group of inflammatory diseases characterized by an anatomical distortion of peripheral airways and interstitium, determined by a first stage of alveolitis and a following stage of fibrosis. Natural history of several ILD is characterized by slow and progressive destruction of alveolar-capillary functional units, often with respiratory failure and death. For their smoldering evolution and not specificity of symptoms (exertional dyspnea and cough) ILD may remain not diagnosed and not treated for a long time.
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Comparative Study
[A multidisciplinary organizational Emergency Department model for trauma patients in hypovolemic shock].
Hypovolemic shock in trauma patients causes high mortality because of exanguination, secondary brain damage, multiple organ disfunction. Good organization and operative protocols are vital to patients in need of a prompt and multidisciplinary treatment. ⋯ A valid internal organization can improve mortality of trauma patients without expenditure of extra resources.
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Comparative Study
[General practitioner and respiratory medicine specialist. A survey on the management of the asthmatic patient].
The relationship between the general practitioner (GP) and the respiratory medicine physician specialist in the management of the asthmatic patients was examined. Two-hundred sixty -two GPs from Brescia and province were enrolled into the study and underwent an appropriate questionnaire, focusing the survey on three aspects: the relationship among GP-respiratory medicine physician specialist and asthma patients, the training of GP, the appraisal of the socio-economic aspects of the management of bronchial asthma. The results have shown the requirement of a GP-respiratory medicine physician specialist relationship founded on the exchange of information and experiences, rather then of synthetic diagnoses and therapeutic directions, and the opportunity to establish outpatients' departments dedicated to the management of the asthmatic patients. Moreover, it has been shown an inadequate application of international guidelines and a not full appraisal of the socio-economic aspects of the management of the asthmatic patients.
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Review Comparative Study
[Nocturnal desaturation in chronic obstructive pulmonary disease].
Chronic obstructive pulmonary (COPD) patients with mild-moderate daytime hypoxia or normoxia (PaO2 > 60 mmHg) may also have transient oxygen desaturation during sleep. Revisiting literature, the authors consider various features of this condition: the prevalence, causes, diagnostic procedures, symptoms, predisposing factors, consequences and therapy. The conclusion is that isolated nocturnal oxygen desaturation in COPD patients is a pathologic condition not yet sufficiently cleared; it likely represents an intermediate step in the evolution of COPD to overt respiratory failure. Since negative outcomes are possible, nocturnal oxygen desaturation must be early put in evidence and then treated with suitable drugs, correct dietetic regimen, respiratory physiotherapy and nocturnal oxygen-therapy.