Recenti progressi in medicina最新文献

Integrating arts and humanities into medical education is a pragmatic approach that significantly enriches students’ learning experiences by enhancing their observational, interpretative, and empathetic skills. Engaging students in thoughtful dialogue become crucial at it not only enriches their understanding of human experiences and cultural contexts but also sharpens their communication skills – essential for effective patient interactions and collaborative healthcare environments. This article outlines twelve essential tips for medical teachers aimed at effectively facilitating discussions among students within the context of museum arts. These strategies are carefully designed to create a safe and inclusive learning environment, promote active and equitable participation, and encourage deep, reflective interpretation of artworks. By implementing these tips, educators can not only foster a more conducive educational landscape but also significantly enhance their own teaching practices by pushing the boundaries of traditional medical curricula with new ways to integrate empathy, critical thinking, and cultural awareness.

Actinic keratoses (AK) are common precancerous lesions usually arising on chronic sun-exposed areas. Field of cancerization (FC) is a chronically UV-exposed area in which subclinical multifocal AKs are found. Therapeutic choice is mainly made according to the Olsen grade of AKs. We report the case of a 76-year-old man with numerous AKs of the face and scalp. The patient had undergone numerous topical physical and medical therapies with poor results. On the left cheek, grade I and grade II AKs were found in a large FC, so he was prescribed topical therapy with tirbanibulin 1% ointment. After 10 days erythema and crusts were objectified and a burning sensation was reported on the area of application and on surrounding areas. At 8 weeks follow-up, the patient had total resolution of disease and no residual local side effects. Although tirbanibulin 1% ointment has indication for type I AKs of face and scalp, this case reported its efficacy and benefit also on type II AKs, demonstrating safety and a minimal and manageable degree of discomfort caused to the patient. Therefore, it fits fully among the treatments of grade I AKs but numerous still may be its indications as demonstrated in our case, where efficacy, safety and compliance were combined.

The standard treatment for venous thromboembolism (Vte) is anticoagulation. Drug selection and treatment duration will depend on the clinical presentation, the existence of provoking factors, bleeding risk, and the patient's preferences. Anticoagulation therapy is indicated for 3-6 months in all patients with acute Vte but may be extended, even indefinitely in some cases. The most severe side effect of anticoagulation is bleeding, with the highest risk occurring during the 1st months of therapy. Balancing the risk of bleeding and the risk of recurrence in patients with Vte remain a major issue. There are, currently, no simple and validated predictive scores to estimate the long-term bleeding risk in patients undergoing anticoagulant treatment and to safely select those patients with higher bleeding risk. In this review we will examine some of these scores, including the RIETE scores, the HAS-BLED SCORE, the VTE-BLEED score, the VTE- PREDICT and the ACCP guidelines and the timing for their application in the patient's population treated for Vte as well as the initial and long-term management and evaluation of thromboembolic disease.

Introduction Falls are the second leading cause of accidental or unintentional death worldwide. In hospital falls represent a relevant health problem, in particular after their increasing since Covid year 2020. The aim of this study is to evaluate correlation between falls and Covid infection.

Methods: Risk Management Unit at Mauriziano hospital analyzed in the present observational study possible correlation with Covid Pandemic and falls risk factors, through comparison of patients falls occurred during year 2021 in Covid and no-Covid wards. The primary outcome of the study is the evaluation of relationship between falls and Covid infection. The secondary outcome is identification of falls risk factors.

Results: No direct correlation between falls and Covid-19 infection was found. Among falls risk factors, the most interesting emerged is the fall itself that enhances the risk of relapse.

Discussion: Increasing in patients falls since 2020 could be affected indirectly by strong hospital organization modifications during Covid pandemic.