Recenti progressi in medicina
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Comparative Study
[Usefulness of pulse oximetry in respiratory diseases].
The aim of the present study was to verify the usefulness and the limits of the pulse oximeter (po) in the management of patients with pulmonary disease. To this end oxyhemoglobin saturation measured with the po (SpO2) in 81 outpatients (mean age 67.7 +/- 12.7 years) was compared to oxyhemoglobin saturation calculated from a Radiometer computerized system (ScO2) and measured with a Co-oximeter (SaO2), considered as a reference value. Both SpO2 values and ScO2 values were, in average, significantly higher than SaO2 values (p < 0.001). ⋯ The relationship between SpO2 values and the arterial gas data revealed that a wide range of PaO2 and PaCO2 values could be related to a narrow range of SpO2 values showing a clear variability of PaO2 and PaCO2 for the same value of SpO2. These findings seem to indicate that the po can be regarded as a simple, non-invasive, and non-expensive method to measure the oxyhemoglobin saturation with a sufficient reliability. The SpO2 values could be used in the management and follow-up of patients with hypoxemia, but SpO2 values could be misleading in presence of hypercapnia and/or hemoglobinopathies.
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Review Comparative Study
[Levels of scientific evidence and strength of clinical recommendations. From trials to guidelines. The Italian Group on Medicine Based on Evidence--(GIMBE)].
Evidence-based medicine is a new paradigm of clinical practice that promotes the collection, interpretation and integration of valid, important and applicable to patients research-derived evidence, and it can improve the efficiency and the effectiveness of health care. Nevertheless research often fails to get in clinical practice, also because the traditional tools used by physicians to solve clinical problems are less reliable as the volume/complexity of medical information and biomedical technology have grown exponentially. New tools are emerging to help physicians: the systematic reviews of randomized controlled trials and the clinical practice guidelines that summarize a great volume of medical knowledge to improve health care. ⋯ These combine the strength and heterogeneity of the primary studies with magnitude and precision of the treatment effects as it relates to the minimal clinical benefit. The recommendation may suggest therapeutic intervention when the baseline risk is high or otherwise when the baseline risk is low. The Authors discuss principles of evidence-based medicine, measures of treatment effectiveness, systematic reviews and methods used by experts to graduate the strength of clinical recommendations in producing practice guidelines.
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The study about the adhesion molecules pointed out their pathogenetic role in a lot of diseases within cardiological, nephrological, oncological precincts and in a lot of infectious diseases. Their role was in fact pointed out in the ischemic heart disease and in the reperfusion damage, in the glomerulonephritis, in the tumoural metastatic processes, in the infectious and inflammatory chronic processes. The Authors considered the recent literature and emphasized the therapeutic possibilities that such an experimental approach seems to suggest.