Articles: treatment.
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Minerva anestesiologica · Nov 2024
ReviewMultimodal analgesic strategies in polytraumatized patients.
In recent years, the resuscitation of trauma patients has improved; however, pain related to trauma remains associated with systemic complications. In trauma patients, pain should be considered a vital sign, and its control is crucial for reducing complications, improving patient satisfaction, and enhancing the quality of life. ⋯ In this review, we offer the reader an updated general framework of the various approaches available for pain treatment in polytraumatized patients, with a focus on the opportunities presented by regional anesthesia. We will examine different types of locoregional anesthesia blocks and describe ultrasonographic execution techniques.
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Chronic wounds on the leg (below the knee) are called leg ulcers. They have many causes, and thus patients with leg ulcers are treated by many different kinds of medical specialist. Appproximately 80% of sufferers have chronic venous insufficiency (CVI) and/ or peripheral arterial occlusive disease (PAOD). Knowledge of the relevant differential diagnoses is important for appropriate treatment, particularly for patients with atypical findings or an intractable course. ⋯ A timely differential-diagnostic evaluation for the many diseases that can cause leg ulcers, which require treatment from representatives of many different medical specialties and health professions, is a prerequisite for their effective individualized treatment.
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To provide a nationwide description of postoperative outcomes and analysis of prognostic factors following adrenalectomy for metastases. ⋯ The number of patients who can receive local treatment for adrenal metastases is rising, and adrenalectomy is more often minimally invasive and has a low morbidity rate. Subsequent research should evaluate which patients would benefit from adrenal surgery.
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Review
Clinical characteristics and treatment of psychosis in Parkinson's disease: A narrative review.
Parkinson's disease (PD) is a chronic, progressive, neurodegenerative disorder whose clinical presentation consists of motor and non-motor signs and symptoms. Among the non-motor symptoms, psychosis can occur in the later stages of the disease. Psychosis in PD (PDP) is a common, complex, and significantly disabling disorder associated with poorer quality of life, accelerated cognitive decline, need for hospitalization or institutionalization, and mortality. ⋯ After the exclusion of comorbid conditions as a possible cause of psychosis, correction of antiparkinsonian therapy may be required, and if necessary, the introduction of antipsychotics. The latest therapeutic recommendations include the use of pimavanserin, if available, otherwise second-generation or atypical antipsychotics. Although PDP has long been recognized as a possible complication in the course of the disease, further clinical studies are needed to fully understand its etiopathogenesis and pathophysiological mechanisms.
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Multicenter Study Observational Study
The HSACAT Project: A Prospective Multicentre Observational Study of Spontaneous Subarachnoid Haemorrhage in Catalonia (Spain).
Incidence, clinical course, and fatality of spontaneous subarachnoid hemorrhage (SAH) are evolving, with prevalence of risk factors diminishing, implementation of early detection programs and strategies for priority aneurysm exclusion, technical refinement with less invasive procedures, and improvements in neurocritical care. Modern epidemiological and prognostic data are lacking, especially in southern European and Mediterranean populations. ⋯ Even when most patients received timely aneurysm treatment, case fatality rates were considerably high. Data provided by the HSACat project may have public health effects and be used to guide prevention programs and screening strategies.