Rays
-
Degeneration of the intervertebral disk complex begins early in life and is a consequence of a variety of environmental factors as well as of normal aging. Degeneration of bone and soft tissue spinal elements is the most common cause of spinal stenosis. ⋯ Computed tomography and myelography have long been used for diagnosing the effects of degenerative diseases' of the lumbar spine. Despite the continuous improvement in magnetic resonance scanning for this purpose, computed tomography can provide excellent screening for disk herniation and spinal stenosis.
-
The differentiation between normal sequelae and complications of any surgical treatment of the lumbar spine is of the utmost importance. Clinical and radiological diagnosis is often difficult. ⋯ For example, the frequent resort in vertebral surgery to metal implants which may limit or even prevent the interpretation of CT or MR images, should be kept in mind. The main types of surgical procedures involving the lumbar spine are briefly reviewed, focusing on CT and MRI appearance of normal sequelae of early or late complications and the recurrence of the lesion that necessitated the first procedure.
-
An overview of the complex Italian situation and the consequences of the European integration, which puts an emphasis on the role of research and education involving the universities and the specific faculties, is given. Attention is then focused on the characteristics of the evolution of the medical activity and health services as for prevention, health education, more extensive knowledge and the need for continuing education. Different problems are tackled and pertinent suggestions are offered. ⋯ For better health care medical education and training should be updated with respect to the doctor-patient relationship as well as to the technological advances and team-work in medicine. The ethical aspects of the medical profession should be evidenced to be able to tackle the involved problems. The main features of the doctor of the future are the need and the difficulty of updating and life-long learning.