Acta bio-medica : Atenei Parmensis
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Historical Article
Lithographic lecture notes. A tool of forensic medicine teaching. Observation on the lessons of Paolo Pellacani (1884-1885), forensic physician at the University of Pavia.
We focus our attention on the use of lithographed lecture notes written by professors, or more often by students, in the teaching of medicine and surgery courses, between the late 19th and early 20th centuries, a period in which, to better understand the phenomena underlying life and death, collaboration between medical professionals and natural science researchers was intense (1). In particular, we analyzed the lithographed lecture notes of Professor Paolo Pellacani at the University of Pavia for the course of legal medicine.
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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which can be considered a late-onset allergic reaction, can cause serious long-term sequelae. SJS/TEN are considered a spectrum of life-threatening adverse drug reactions. They have the same clinical manifestations and the only difference is in the extent of epidermal detachment. ⋯ The usual treatment is mainly founded on the withdrawal of the suspected causative agent and supportive therapy. In pediatric patients, the specific therapeutic strategies are controversial and comprise systemic corticosteroids and the use of intravenous immunoglobulin (IVIG). More recently, new therapeutic approaches have been used, such as immunosuppressive therapies, including cyclosporine and TNF-α inhibitors.
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A case of a 71-year-old man with femoral and tibial osteolysis and severe metallosis of the knee, resulting from abrasive wears of the metal components of a unicompartmental knee arthroplasty, that leaded to the rupture of the femoral component of the prosthesis is reported. An unicompartmental prosthesis, in a varus knee, was implanted in 2007. In March 2017, the patient felt that his knee was becoming increasingly unstable with pain and increasing disability. ⋯ According to the literature, metallosis and rupture of the prosthetic components due to polyethylene wear after UKA is a common complication. In our case report the elevated BMI and varus knee accelerated the wear of the polyethylene. The aim of this case report is to enhance how an appropriate diagnosis (clinical and radiographic) and early treatment can lead to a successful result.
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Multicenter Study
A first contribution to the validation of the Italian version of the Behavioral Pain Scale in sedated, intubated, and mechanically ventilated paediatric patients.
Numerous negative outcomes of inadequate pain management among children have been cited in the literature. Inadequate pain management may be particularly detrimental to children and adolescents facing life-threatening injury or illness on a Paediatric Intensive Care Unit (PICU). It is therefore absolutely necessary that professionals utilize effective and efficient tools in order to evaluate a person's sensations of pain in the most objective way possible. The COMFORT-B scale is recognised as the gold standard in such patients. However, the use of this instrument in the clinical PICU setting is disputed. It requires long periods of observation to ensure an adequate utilization. Boerlage et al. noted that nurses are often impatient and do not always observe the patient for the recommended 2 minutes period. The Behavioral Pain Scale (BPS), instead, is considered to be the gold standard for pain assessment in deeply sedated, mechanically ventilated adult patients. This observational pain scale requires shorter observation time compared to the COMFORT-B. Moreover, BPS three subscales are included in other observational pain scales for paediatric patients. Therefore, the objective of this study was to assess the applicability of the BPS for use with paediatric patients. ⋯ Although the current study is based on a small sample of participants, these first results encourage us to continue working in the validation of the BPS in paediatric patients.
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Foreword.