La Clinica terapeutica
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La Clinica terapeutica · Jan 2000
Case Reports[Clonidine hallucinations: description of a clinical case].
Authors report a case of hallucinations related to clonidine treatment in an elderly man with hypertension and renal failure. The symptoms appeared shortly after treatment is starting. The hallucinations disappeared after clonidine withdrawal. Implications for clinical practice are evocated.
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The introduction of new didactic guidelines, for the graduate degrees in medicine and allied disciplines, is secondary to the new needs of the National Health Care System, and in part to the significant developments of science. It is not easy to meet this challenge. It is likewise not easy to channel coherently the required changes, with respect to the scientific, clinical and didactic goals. ⋯ The latter, is a prerequisite of an effective training directed toward the development of the concept of "team approach", whose ultimate goal is patient care. In Italy, at the Università Campus Biomedico, in Rome, one of the first of such centers of medical education has been developed. Its goal is to be both a learning organization, as well as a center for both research and clinical services.
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La Clinica terapeutica · Nov 1998
Review Comparative StudyAge related risk and prevention of postoperative complications.
Perioperative morbidity in elderly patients has decreased in last years, with the advent of newer surgical, anaesthetic and monitoring techniques, but is still important when compared with that of younger patients. Complications in the post-operative show different frequencies and mainly depend: a) on age-related conditions of pulmonary, cardiovascular and renal functions, of C. ⋯ S. and of nutritional status; b) on surgery and medication-related risk factors, inclusive of emergency, bedrest, analgesia and infusions, drugs and intensive care; c) on neoplastic or non-neoplastic disease, type of surgery and surgeon's experience. Appropriate surgical intervention, therefore, should not be deferred because the patient is elderly, but surgeon must look beyond measured indices to the qualities of vitality and motivation.
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La Clinica terapeutica · Jul 1998
Comparative Study[Transdermal route as an alternative to oral administration of opioids in cancer pain].
Fentanyl TTS, the only transdermal opioid, represents a real tool for a better quality of life in patients with cancer pain. In this paper we report a short description of the pharmacologic properties and administration procedures of this drug that is a useful alternative when other opioids recommended on the third step of the WHO analgesic ladder, are ineffective or present unbearable side effects (nausea and/or vomiting-severe mucosites and dysphagia). ⋯ In addition we report the results of a study carried out in our Pain Therapy Center on 49 patients with severe oncologic pain, previously treated with opioids and other drugs associations. Our results indicated a good control of continuous nociceptive cancer pain, with a better quality of life and lesser side effects to respect the previous regime of orally opioids.