La Clinica terapeutica
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The aim of this retrospective study is to indicate the correlation between the grade of the extent of the aortic pathology, the presence of complications, the evolution of the pathology value of the D-dimer in all the patients with aortic dissection in order to know a prognostic role a short-long time of this test. ⋯ The D-dimer is considered a diagnostic marker by the clinicians during the acute setting of the aortic dissection. A lot of points of view should be valued and cleared, its possible to attribute a prognostic role at the D-dimer during the acute aortic dissection.
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General concepts and about medical disasters, public health and triage are outlined. Ethical values at stake are summarized. ⋯ Three attitudes are suggested: protection of human dignity, precaution, solidarity. A personalistic perspective is suggested to deepen solidarity as a pillar both of clinical and public health ethics.
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La Clinica terapeutica · Jan 2010
Review[Near Infrared Spectroscopy for cerebral monitoring during cardiovascular surgery].
Near-infrared spectroscopy (NIRS) is an optical imaging technique for medical applications, able to monitor the variation of hemoglobin saturation into the tissues. The NIR photon passes through the biological tissue following a path similar to a more or less complex split. The NIR absorption of photons is proportional to the concentration of chromophores (pigments that absorb the light in the spectral region of interest). ⋯ The NIRS may represent an added value in those patients. The NIRS is also applied during surgery performed with cardiopulmonary bypass, including aortic arch surgery with cardiocirculatory arrest. Continuous monitoring of any changes in cerebral rSO2 allows a rapid treatment in the aim to improve the psycho-neurological outcome of patients undergoing this type of surgery.
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La Clinica terapeutica · Jan 2010
Review Historical Article[The psychopathology of delirium. Evolution of the research from Jaspers to Kapur].
Delirium represents a symptom of a thought disorder in which a belief is strongly held in spite of invalidating evidence. Many varieties of delirium have been described and this symptom is common in psychotic disorders (schizophrenia, brief psychotic disorder, chronic delusional disorders, etc.), affective disorders (major depressive disorder, psychotic depression, melancholic depression, bipolar disorder, etc.), organic illnesses and psychotropic substance abuse. Delirium has been deeply studied by psychopathology. Our work offers an overview of the most relevant psychopathological descriptions of delirium in the last century, from Jaspers to Kapur.
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La Clinica terapeutica · Jan 2010
Comparative Study[Obesity and outcomes in the ICU: an observational study].
We examined the relationships among Body Mass Index (BMI) with or without Metabolic Syndrome (MetS), ICU length of stay (ICU-LOS), duration of mechanical ventilation and mortality among ICU patients. ⋯ In our study, a BMI >25 with MetS was significantly associated with increased morbidity and mortality in ICU patients.