Recenti progressi in medicina
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The authors report a case of Horton's arteritis in a woman (aged 76) presented some peculiarities. The arteritis simultaneously interested both superficial temporal arteries; in a second time caused a bilateral "claudicatio masticationis"; induced a worsening of extrapyramidal symptoms from which the patient had been suffering for many years, due to the possible involvement also of the endocranial arteries. ⋯ Also this result differs from what most authors have observed: they maintain that Horton's arteritis has become rather resistant to the cortisone therapy and required high dosage for a very long time. The authors maintain that precocity of diagnosis and an immediate treatment can influence in a significant way the course of the disease.
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Captopril is widely used in severe hypertension. Oral administration takes one-two hours to achieve a maximum effect and is not useful in hypertensive crisis. Few reports describe a more rapid effect on blood pressure following sublingual administration. ⋯ This effect was maintained over two hours. There were no side effects. Sublingual captopril is highly effective in hypertensive crisis and its gradual hypotensive action avoid dangerous abrupt fall in blood pressure.
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It is well known that heroin overdose may cause rhabdomyolysis. Sometimes a myocardial involvement complicates its course. ⋯ We think that heroin has a direct myotoxic effect on both myocardium and skeletal muscle. Yet we cannot exclude that hypoxia, acidosis, vasoconstrictive substances released by muscle necrosis, or hypersensitivity reactions associated with heroin or some of its adulterants are involved in myocardial injury.
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The author describes the frequencies and characteristics of psychopathological disorders before and after open heart surgery. In addition to cognitive and anxious-depressive mood disorders in the preoperative time, anxiety and coping are prominent. ⋯ Conditions and causes of psychopathological disorders are discussed with the aid of the literature and present results. Therapeutic possibilities are outlined.
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This paper describes a case of "Red man's syndrome" in a patient with staphylococcal sepsis. The patient was initially treated with intravenous Vancomycin and afterwards with Teicoplanin. The adverse reaction appeared immediately after the start of pharmacological treatment.