Venous thromboembolism in patients hospitalized in internal medicine wards.

Venous thromboembolism (VTE) is one of the main causes of morbility and mortality in the ospedalized patients. Epidemiologist studies have also demonstrated that VTE is an important and frequent problems in medical patients. In surgical patients is done with greater frequency, but in medical patients prophylaxis is not completely codified and less often less practiced. This review shows epidemiological data, risk factors and classification of the risk of VTE in patients with medical pathologies. Then meta-analyses studies and main studies such as Medenox, Prevent and Artemis, that have examined the prophylaxis of VTE in medical patients are described and discussed, along with their results concerning morbility and mortality. The current problems of prophylaxis in medical patients are reviewed , such as duration of treatment, optimal dosage of the low molecular weight heparin (LMWH) and the correct risk assessment of VTE. EXCLAIM Study has showed the benefit of extended prophylaxis with statistically significant reduction in VTE events.

[Lipid metabolic disorders in obesity: their epidemiology, physiopathology and clinico-therapeutic implications]. / Le turbe del metabolismo lipidico nell'obesità: epidemiologia, fisiopatologia ed implicazioni clinico-terapeutiche.

The centralization of body fat, particularly in abdominal or visceral depots, is associated with qualitative and quantitative lipid abnormalities. Examples of these qualitative alterations include changes in low density lipoprotein composition, namely an increased number of small or dense low density lipoprotein particles, which seem to be prone to increased lipid oxidation. Oxidative modification of low density lipoproteins is involved in atherosclerotic development of the arterial wall. Alterations of lipid composition often arise in a context of insulin resistance with hyperinsulinism. Genetic features, such as apolipoprotein E polymorphism, also play a significant role in lipoprotein metabolism. The principle treatment of obesity and associated dyslipidemia is to reduce energy intake through diet. Moderate exercise is effective, especially in patients with insulin resistance. Drug therapy is considered primarily for patients who refuse to make behavioral changes.

T-tube drainage of infected penile corporeal chambers.

Insertion of semirigid penile prosthesis is a surgical option to correct male erectile dysfunction. Postoperative infection of penile prosthesis necessitates removal and drainage of corporeal chambers. We describe a technique to drain infected corporeal cavities with T-tubes.