Recenti progressi in medicina
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Editorial Historical Article
[History of medicine, medicine in history].
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Basic investigation in industrial laboratories are mainly addressed to widespread diseases. It follows that: 1) basic research is addressed chiefly to the well known and largely diffuse diseases; 2) rare diseases are not usually studied and therefore little chance is given to their physiopathological or therapeutic knowledge. Hence the name of orphan diseases. ⋯ Therefore we suggest starting from a study plane, classification and estimation of rare diseases, shared for apparatus. These studies may be undertaken on a vigorous rationale (more than studies on orphan drugs) and therefore they may bring about to the definition of a national (government) planning for addressing consistent financial resources to the study of pathophysiology and therapy (or prevention) of the major orphan diseases. Adequate studies within the European Community may be planned in the near future, since most rare diseases are presumed to have a common distribution within the Community.
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Treatment of acute myocardial infarction with intravenous thrombolytic agents improves survival and limits the infarct's size. Despite its proved efficacy, thrombolytic therapy is currently used for only a minority of patients with acute myocardial infarction. Because of the possibility of significant haemorrhagic complications, certain groups of patients traditionally have been excluded from receiving this therapy. ⋯ The literature on thrombolytic therapy in acute myocardial infarction following cardiopulmonary resuscitation is reviewed. Recent (< 2 w) prolonged (< 1 min.) cardiopulmonary resuscitation, per se, should not be regarded as absolute contraindication for thrombolytic therapy in patients with acute myocardial infarction if gross trauma and oldest age are absent. Prospective controlled studies are necessary to remove definitively this contraindication for thrombolysis.
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Letter Case Reports
[Vancomycin at the very lowest infusion rate and red man's syndrome].
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A case of vascular purpura of the lower limbs in a 67 year old man is described. A diagnosis of scurvy was made in consideration of the absence of signs of vasculitis on skin biopsy, the history of a diet extremely poor in vitamin C and the prompt resolution of clinical picture with administration of vitamin C. The authors emphasize the importance of taking into consideration scurvy in the differential diagnosis of vascular purpura: this may spare expensive investigations and a dangerous delay in appropriate therapy.