0000000000478851
AUTHOR
G Romano
Addition of either pioglitazone or a sulfonylurea in type 2 diabetic patients inadequately controlled with metformin alone: impact on cardiovascular events. A randomized controlled trial.
Abstract Background and aims Metformin is the first-line therapy in type 2 diabetes. In patients inadequately controlled with metformin, the addition of a sulfonylurea or pioglitazone are equally plausible options to improve glycemic control. However, these drugs have profound differences in their mechanism of action, side effects, and impact on cardiovascular risk factors. A formal comparison of these two therapies in terms of cardiovascular morbidity and mortality is lacking. The TOSCA.IT study was designed to explore the effects of adding pioglitazone or a sulfonylurea on cardiovascular events in type 2 diabetic patients inadequately controlled with metformin. Methods Multicentre, random…
Profili neuropsicologici nei bambini pretermine con basso peso alla nascita
AIM: Several studies focus on the psychic development of extremely low birth weight (ELBW) preterm infants and highlight the presence of neurological, cognitive and relating disorders. Several contributions have in fact shown that in these subjects in school age disturbances of cognitive functions may be encountered; in particular, disturbances of specific neuropsychological functions, such as attention defects, impaired visuo-spatial function, memory and language have been reported in subjects with a globally normal intelligence quotient. METHODS: Forty-three school-aged children were studied (21 males and 22 females). They had a low birth weight (weight between 1,050-2,450 g), the gestati…
MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE OUTCOME OF PATIENTS UNDERWENT TO PRIMARY PTCA
A New Prosthetic Implant for Inguinal Hernia Repair: Its Features in a Porcine Experimental Model
Even after more than 100 years of inguinal hernia repair, the rate of complications and recurrence remains unacceptably high. In the last decades, few effective advances in surgical technique and materials have been made. The authors see them as minor adjustments in the shape and materials of the prosthetic implants. Still, the underlying genesis of inguinal hernia remains undefined. Based upon this, it seems the surgical repair of inguinal protrusions cannot be based upon the pathogenesis because the etiology to date has not been addressed. Most hernia repairs are performed with some degree of point fixation (sutures/tacks) to stop the mesh from migrating and creating high recurrence rates…
MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE UTCOME OF PATIENTS UNDERWENT TO PRIMARY PTCA
Analisi della scarsa attitudine alla vaccinazione antinfluenzale dei medici italiani del futuro: risultati di uno studio multicentrico condotto in 18 Università Italiane.
Introduzione: Nel corso della stagione influenzale, gli Operatori Sanitari (OS) rappresentano una delle categorie lavorative maggiormente investite dalla responsabilità di limitare la diffusione della patologia influenzale tra i pazienti ospedalizzati e contemporaneamente di proteggere se stessi garantendo la continuità dell'assistenza sanitaria nei periodi di maggiore assenteismo lavorativo e sovraccarico delle attività assistenziali (picco influenzale stagionale). La vaccinazione antinfluenzale, ormai riconosciuta sicura ed efficace, rappresenta ancora oggi una argomento di dibattito tra gli OS, nonostante le raccomandazioni dei Center for Disease Control and Prevention Statunitense ed Eu…
Adrenal cavernous hemangioma: which correct decision making process?
Introduction: Cavernous hemangioma of the adrenal gland is a rare benign tumor characterized by the presence of blood-fil- led, dilated vascular spaces. These adrenal masses are usually non-functioning and the patients have no symptoms so the diagnosis is incidental. Methods: We performed a systematic literature review for all articles published until April 2015. The initial search identified 98 publications. We considered some characteristics: the mean age of the patients at diagnosis was 59 years (range 19 - 84); there were approximately 1.7 times more female patients than male patients; mean diameter of the lesions was 10.3 cm (range 2 - 25). Surgical treatment was more often open with m…
Ultrasound-guided port-a-cath positioning with the new one-shoot technique: thoracic complications.
Port-a-cath catheterization is often required for those patients who need long-term therapies (malnutrition, neoplasm, renal failure, other severe diseases). The use of ports for a wide range of indications is not exempt from complications. Ultrasound-guided central venous catheterization (CVC) is a safe and fast technique for the introduction of the catheter inside a central vein. This retrospective study reports our experience with US-guided CVC in patient eligible for port-a-cath implantation.From January 2007 to March 2017, 108 CVC (out of 770 procedures), were positioned using an ultrasound guide, with the new "one-shoot technique" (group 1) and the classic Seldinger technique (group 2…
Osgood-Schlatter syndrome and pelvic tilt: longitudinal screening on adolescent male soccer players
Aim and Methods. We realized a longitudinal screening on 258 adolescent male subjects practising agonistic soccer; during sport season, 10.47% of group (N=27) showed a tibial anterior apophysite (Osgood-Schlatter syndrome). Results. By statistical analysis we showed that 77.77% of diseases was related to presence of adolescent pelvic tilt; there more we showed that 83.33% of athletes with right Osgood- Schlatter syndrome presented a left pelvic tilt, 66.67% of athletes with left Osgood Schlatter syndrome showed a right pelvic tilt. Conclusion. The study shows that pelvic tilt can represent a risk factor to controlateral Osgood- Schlatter syndrome inducing a functional overload.
INCIDENZA DELL'INFLUENZA LIKE-ILLNESS TRA I MEDICI IN FORMAZIONE SPECIALISTICA ITALIANI: RISULTATI DI UNO STUDIO MULTICENTRICO
Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial
Background The best treatment option for patients with type 2 diabetes in whom treatment with metformin alone fails to achieve adequate glycaemic control is debated. We aimed to compare the long-term effects of pioglitazone versus sulfonylureas, given in addition to metformin, on cardiovascular events in patients with type 2 diabetes. Methods TOSCA.IT was a multicentre, randomised, pragmatic clinical trial, in which patients aged 50â75 years with type 2 diabetes inadequately controlled with metformin monotherapy (2â3 g per day) were recruited from 57 diabetes clinics in Italy. Patients were randomly assigned (1:1), by permuted blocks randomisation (block size 10), stratified by site and…