Recenti progressi in medicina
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The traumatic lesions during surgical interventions often turn into a persistent pain. Pain persists in the location of surgical intervention for a long time, beyond the usual course of natural healing of an acute pain and it is different from that suffered preoperatively. It is usually a chronic pain and it is associated to lesions of the central or peripheral nervous system. ⋯ The post-surgical neuropathic pain is often resistant to the pharmacologic treatment; for this reason the spinal cord neuromodulation can be applied only after careful selection of the patients according to the international guidelines. The incidence of post-surgical neuropathic pain in the Pain Units is approximately 20% of the patients admitted to hospital. Therefore it is necessary a greater attention for the post-surgical analgesia, adopting appropriate surgical techniques in order to avoid the onset of the post-surgical neuropathic pain.
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Acute respiratory failure (ARF) is one of the most common and severe urgencies of the modern medicine which may require the application of mechanical ventilation and a careful monitoring of the patient's conditions. With the popularity of non-invasive ventilation and the interest of the pulmonologist for the care of the respiratory critical patient, in Italy there has been the spreading of Respiratory Intensive Care Units (RICU), which are as intermediate specialist structures in terms of intensity of care between the General Intensive Care Unit and the ordinary ward. In this article, the author analysed the cultural, scientific and organizational aspects of the central role played by the pulmonologist who's working in the RICU in the complex intra-hospital multi-disciplinary management of ARF.
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Hemp (Cannabis sativa L.) has been used since remotes ages as a herbal remedy. Only recently the medical community highlighted the pharmacological scientific bases of its effects. The most important active principle, Delta-9-tetrahydrocannabinol, was identified in the second half of the last century, and subsequently two receptors were identified and cloned: CB1 that is primarily present in the central nervous system, and CB2 that is present on the cells of the immune system. ⋯ Furthermore, parallels exist between opioid and cannabinoid receptors, and evidence is accumulating that the two systems sometimes may operate synergistically. The interest of the pharmaceutical companies led to the production of various drugs, whether synthetic or natural derived. The good ratio between the polyunsatured fatty acids omega-3 and omega-6 of the oil of Cannabis seeds led to reduction of the phlogosis and an improvement of the pain symptoms in patients with chronic musculo-skeletal inflammation.
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In literature, there is not an unanimous agreement on the definition of hypertension in pregnancy. The most severe complications are pre-eclampsia and eclampsia which need an early diagnosis to be avoided. ⋯ Among calcium-antagonist drugs, the efficacy of nifedipine is proved; and in the pre-eclampsia, metil dopa, beta blockers and idralazine. Many questions are anyway still unsolved needing more studies.
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Bruxism is a para-function with tooth clenching and grinding. Particularly, the sleep bruxism is a frequent phenomenon that causes cephalalgia and muscular/joint pains to the awakening, besides an increased dental abrasion and sensibility. The etiology of sleep bruxism is uncertain: while the occlusal discrepancies and the anatomy of the bony structures of the orofacial region play only a minor role, others factors, like smoking, alcohol, drugs, systemic diseases, stress, trauma and heredity, appear to have an important role in the sleep bruxism genesis. ⋯ Besides the sleep bruxism appears to be an disturbance in the dopaminergic system. Further psychological factors (like stress, anxiety) are implicated in the aetiology of sleep bruxism as well. The aim of this paper is to review the literature on the aetiology of bruxism.