Recenti progressi in medicina
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In this paper we try to define the future goals of the clinical research, with particular reference to methodological and policy issues. There is an increasing tension between the real drivers of clinical research and its scientific and ethical aims. To consumers the goal is to strengthen the relevance and usefulness of clinical research. ⋯ Finally the scientific community should reflect on its own conflicts of interests and analyse the causes of the ethical divide between the needs and the market. Scientists too often seem to loose sight of the original cumulative nature of research and of the idea of research as a collective good. More non-commercial research is needed, integrated with the health care systems, to support a transparent, more realistic and valid information useful for patient care, scientific information.
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Acute pancreatitis represents the 0.15-1.5% of all diagnoses in the Emergency Room. Biliary diseases and alcohol abuse are the two mainly etiological factors of this illness in Italy. ⋯ On the other hand, the identification of alcoholic origin of pancreatitis can prevent interventional procedures not useful in this kind of patients. In this paper we will assess the markers able to early identify the etiology of this acute illness such as the liver function tests and the lipase/amylase ratio.
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In head and neck district, major salivary gland diseases seem to have a considerable epidemiological and clinical impact, especially in obstructive disease. Major salivary glands, in fact, having a ductal system can develop several diseases: sialoadenitis, sialodochitis and sialoceles. Particularly, the obstructive sialoadenitis, with or without sialolithiasis, are the most frequent inflammatory disorder, especially for submandibular gland. ⋯ R. Since '90 years, lithotripsy and, later, sialendoscopy have been introduced as gold standard diagnostic procedures in case of obstructive sialoadenitis and also as therapeutic tool when possible. In this way, it has been possible to offer a valid alternative in place of traditional surgical techniques, with a less invasive and more efficacious approach.
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The malnourished cancer patients are at a higher risk of morbidity and mortality, when undergoing major surgical treatments. In comparison with patients affected with other cancers, the highest occurrence of malnutrition (78.9%) was found in those with esophageal cancer and is related with post-operative complications. ⋯ The enteral option is to be preferred, due to preservation of intestinal integrity, reduced risk of complications, and lesser expenses. The prevention or correction of nutrient depletion in several malnourished esophageal cancer patients remarkably reduce or eliminate malnutrition-related morbidity and mortality, therefore the level of malnutrition must be identified and treated.