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Law no. 38 of 2010 introduces for the first time protection for access to Palliative Care and Pain Management. It was interesting to evaluate the level of knowledge among health care workers at the Policlinico Tor Vergata, procedures relating to such access through the administration of a questionnaire. The questionnaire divided into a general part and the two sections (A and B) The general part concerns the health operator respect to age, gender, profession, and his role within the operating unit of the hospital. The section A and B, is to understand if the operator knows Palliative Care, and Pain Therapy, as he became aware of the two arguments, and if they have been addressed during the university courses he attended. The analysis of the data examined show a general confusion distributed evenly among all professionals. Is greater knowledge of pain therapy compared to Palliative Care.

Multinodular goitre is a very common pathology among people especially female adult and represents more than 90% of the thyroid surgery. We analyzed 37 patients, demonstrating that the whole gland is progressively affected by an incessant nodulogenesis and we confirm the necessity of total thyroidectomy in order to eliminate any persistent pathology.

Patients with homocystinuria have an increased risk for both venous and artherial thrombosis but it has been found that even moderate increase in homocysteine levels are associated with heightened risk of thromboembolism. The Authors report a case of juvenile vasculopathy in a patient with hyperomocysteinemia. In this case the patient presented both venous and artherial thromboembolism in the absence of the most important risk factors. The opportunity is stressed to perform clinical tests for the correct diagnosis of hyperhomocysteinemia because it is possible, with the use of folic acid and vitamin B12, to correct the elevated levels of homocysteine.

Objective: To evaluate if parenteral gold-therapy with Sodium gold thiosulfate is effective and safe for the treatment of rheumatoid arthritis we began an open, multicenter trial., Methods: 126 rheumatoid arthritis patients were treated with Sodium gold thiosulfate for two years. Efficacy, quality of life, progression of joint damage, inflammatory parameters and side effects were evaluated., Results: Gold salts reduced joint inflammation and improved subjective and objective symptoms, quality of life and activity of illness within 6 months. Side effects appeared in 13,8% of all cases and regressed, promptly, when gold therapy stopped. The poor efficacy caused the interruption and the change from the gold therapy to others disease-modifying anti-rheumatic drugs (DMRDs) in 17,8 % of the patients., Conclusions: The follow-up showed Sodium gold thiosulfate was effective in Rheumatoid Arthritis and the survival in therapy was of 77,8% to one year and of 68,4% to two years.

The Authors report their experience in the treatment of soft tissue necrotizing infections. The correct "timing" of the association of surgery, antibiotics and hyperbaric oxygen therapy is stressed. The good clinical results obtained in the patients examined confirm the usefulness of an early treatment modulated according to the needs of each single patient.

At INT of Milan between 1964 and 1990, 204 consecutive native patients suffering from penile cancer have been treated. 101 (59%) patients out of 171 with invasive cancer (23 affected with Tis were excluded) have been classified T1N0M0. 74 patients have been treated with penis conserving methods, such as circumcision, radiotherapy, laser excision and primary chemotherapy + conserving surgery. Overall local failure and/or nodal relapses occurred in 27% (20/74). Relapses are significantly related with grading but there isn't any relationship with macroscopical aspect or size of the tumor. The conservative treatment had been possible in 80% of patients. In our experience T1N0 clinical stage conservative therapy does not worsen the prognosis.

The research has been executed on a sample embracing 253 patients affected with rheumatid arthritis (ARA criteria), 177 patients affected with osteoarthritis and 104 healthy subjects forming the standard sample. On the serum of every subject we have used a series of five different tests in order to find the rheumatoid factor. The results we obtained have been weighed with biometrical criteria of various kinds in order to single out any possible common behaviour-pattern and to determine the tests diagnostic value as regards the considered disease. We have noticed a different result of single tests as regards the same diagnosis so we can exclude an absolute equivalence of the five tests, though for some of them there is a high mutual relation.

A series of clinical cases very rarely observed in rheumatology is presented. These cases consist of osteoid-osteoma, osteogenesis imperfecta, pachydermo-periostosis, multiple chondromatosis, osteopecilia, Camurati-Engelmann disease. The caracteristics of the patients examined are appropriate and well adapted to the typical clinical studies of these diseases, and are considered current with the contributions concerning rheumatology appeared in the most recent literature.

The rheumatoid factor research restricted to only a test finds evident limitation not only in clinical field, but also on epidemiological investigations. The problem may find a solution by contemporary employment of a tests pool both in epidemiology and in the different physiopathological conditions present in rheumatology. Such kind of proposal has been verified on rheumatic diseases (rheumatoid arthritis classic or probable, polyarthritic syndrome, polyarthritis, spondylitis, psoriatic arthritis) and not rheumatic ones and in control group population (2901 subjects controlled). The results obtained emphasize the eventual presence of rheumatoid factor in the control group population, usually documented by the isolate positivity of three or more tests is preponderant for the same occurrence. By the statistical analysis applied to the conditions with equivalent number in the positive tests, is resulted that the possibility to discriminate the population, apparently health from the sick one is realized in a significative way of the positive tests, and starting from the positivity of two or more tests at least. It can be concluded confirming the already historical datum that the rheumatoid factor research with a test only has a limited orientation power to the diagnosis purpose.

The tolerance and effectiveness of Ibuproxam were investigated in 54 patients with arthrosis, R.A., ankylosing spondylitis, and fibrositis. Statistically significant reduction of pain at the end of the treatment was accompanied by decreased limitation of joint movement and morning stiffness. Simultaneous investigation of clinical and biological tolerance showed that the drug is infrequently responsible for side-effects that are always of negligible importance. Oesophagogastroduodenoscopy in subjects with a prior history and/or signs of active pathology of the upper digestive tract did not reveal exacerbation or recrudescence of lesions, nor the appearance of acute lesions.

The intermediates of metabolic cycle of pyridine compounds have been isolated in Ricinus communis seeds, at various stages of development, by reversed-phase HPLC with a linear gradient elution. NAm, NAc, QAc, NMN, des-NMN, des-NAD+, NAD+ and NADP+ were separated in less than 32 min. Pyridine compounds show typical behaviours during the considered periods (0-6th day). On the basis of the obtained results the metabolic availabilities of these vegetable tissues are discussed.

The frequency and significance of associated diseases and clinical problems in patients with nerve injuries in the recovery stage was statistically assessed. A variety of clinical situations are observed in practically all such patients. Half of the symptoms and diseases encountered relate to the nervous system and cardiocirculatory apparatus, while there is also a high incidence of skeletal muscle and urinary affections. The significance of these signs as far as rehabilitation is concerned can be seen in the fact that psychological and micturition disturbances are observed, along with muscle hypertonia, fibromyositis, cystitis and arthrosis. These form the more common obstacles to the regular execution of a rehabilitation programme, whereas no such significance is possessed by such serious diseases as valvular cardiopathy, hypertension and neoplasia of the neuraxis.