Panminerva medica
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Randomized Controlled Trial Multicenter Study
Effect of neridronate in osteopenic patients after heart, liver or lung transplant: a multicenter, randomized, double-blind, placebo-controlled study.
Transplantation (Tx) is an effective therapeutic option in patients with end-stage organ failure and osteoporosis and related fractures are a recognized complication in these patients. Aim of this study was to evaluate the efficacy of neridronate in patients with reduced bone mass after Tx of the heart, liver or lung. ⋯ This is the first RCT that demonstrates the efficacy of neridronate in increasing bone density and reducing bone turnover in organ Tx recipients with significant skeletal morbidity.
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The present study aimed to analyze the litigation trends and ensuing compensatory damages brought about by the use of episiotomy, in order to outline a set of cautionary rules meant to limit the scope of legreal aftermath for both doctors and health care facilities. The authors have set out to gain an insight into the controversial practice of episiotomy, in light of available research data and official positions of various scientific and medical associations, with a close focus on the legal and medical viability of the procedure itself. ⋯ This review showed that most episiotomy-related lawsuits stemmed from a routine use of that procedure, which is almost universally advised against, and without valid informed consent having been gained. Ultimately, authors have seen fit to underscore the need for patients potentially eligible for an episiotomy (selective episiotomy) to receive thorough and understandable information in a timely fashion including the necessity and the effectiveness of the procedure as well as the risks involved, so that a well-informed decision can be made based on factual data.
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Review
Smoking cessation: strategies and effects in primary and secondary cardiovascular prevention.
Although smoking is seen as a major health problem by most clinicians, few are able to provide evidence based smoking cessation interventions to their patients. Most individuals who smoke actually want to quit. Unfortunately, smoking is still seen as a vice or lifestyle choice, when it is actually a chronic disease which often starts in adolescence. ⋯ Although classically tobacco dependence was seen in relation to smoking, since the early 2000s, new nicotine delivery systems have appeared on the market, which despite being marketed as "healthy" alternatives, can often complicate smoking cessation efforts and act as gateway devices for new generations of smokers. In this article we review the results of several large systematic reviews and meta-analyses, which have shown that many cessation strategies are effective. We also offer practical tips on providing brief cessation advice and how pharmacotherapy can be prescribed and incorporated into clinical practice in both primary and secondary cardiovascular prevention.
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Idiopathic pulmonary fibrosis (IPF) is the most common among idiopathic interstitial pneumonia. Life expectancy is estimated around 3-5 years at diagnosis. No reliable prognostic biomarker has been approved for routinary clinical practice of IPF. The aim of this study is to investigate the potential prognostic value of serum CD59 in a cohort of IPF patients. ⋯ CD59 levels were significantly increased in IPF patients, supporting the existence of epithelial damage in the pathogenesis of disease. Lower values of CD59 were associated with a significantly worse prognosis, suggesting a potential role of CD59 in the prognostic estimation of IPF patients.
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Review
Sleep apnoea, the ugly duckling of the Cinderellas in cardiovascular prevention and rehabilitation.
Cardiovascular diseases are the leading cause of death and account for the largest share of health expenditure worldwide, mainly invested in hospital and secondary care. Prevention and rehabilitation strategies are nearly neglected, therefore "the Cinderellas," in the health-care budget. The World Health Organization has proposed cost-effective interventions to reduce the impact of cardiovascular diseases that include polydrug treatment for hypertension and diabetes, counselling, diet, exercise, and others. ⋯ If obstructive sleep apnea plays a significant role in cardiovascular diseases, then screening and timely appropriate treatment could reduce morbidity and mortality. Thus, the public health and economic impact of these conditions could be included in the "best buy" list of interventions. This narrative review discusses the relationship between OSA and cardiovascular diseases and how neglected the link is.