Recenti progressi in medicina
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Case Reports
[A rare case of hypokalemic thyrotoxic periodic paralysis in a Caucasian patient with Basedow's disease].
Thyrotoxicosis periodic paralysis is a very rare complication of thyrotoxicosis in whites, but is more frequently reported in oriental and latin american populations and associates the clinical picture of hyperthyroidism with bouts of paralysis due to hypokalemia. The hypokalemia is due to a massive shift of potassium from the extra- to the intracellular compartment. ⋯ The restoration of a euthyroid state with methimazole and propranolol was effective in preventing further episodes of paralysis. It is suggested that the mechanism for the development of the hypokalemic periodic paralysis is the intracellular blockade of potassium by the surplus of thyroid hormones.
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A case of long-lasting chronic asbestos pleuritis is described. Radiological picture was initially that of an exudative pleuritis and subsequently that of pleural thickening associated to chronic pleural effusion. ⋯ Diagnosis was made only at autopsy. In absence of a sure histological diagnosis, the differential diagnosis of the two diseases (chronic asbestos pleuritis and malignant pleural mesothelioma) is not easy, so that necropsy retains a fundamental role in patients without a certain diagnosis in vita.
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This article outlines the project entitled "Towards a Pain Free Hospital" which aims to make both citizens and health sector workers more aware of the problem of pain in hospitalised patients. The project is already under way in some countries and is being implemented in others. It has been introduced into the local Health Authority Hospital of Vicenza for the first time in Italy and will later be introduced into other Italian hospitals. The article deals with the various initiatives which make up the project and the methods used to involve those assisting the patient in pain.