[Algometric approach in the diagnostic evaluation of chest pain]. / Approccio algometrico nella valutazione diagnostica del dolore toracico.

OBJECTIVE: To contribute to a global clinical evaluation of the patients with chest pain, giving a quantitative analysis of the painful experience in the sensory, emotional, value and mixed component and searching significant differences among the different causes of the symptom. MATERIALS AND METHODS: We have administered the "Questionario Italiano del Dolore" by De Benedictis et al. to 92 patients with chest pain, who were divided into 4 diagnostic groups (acute coronary syndrome, coronary artery disease, oesophagus-gastric disease and other) and compared for the quantitative-qualitative features of the associated pain. RESULTS: PRIrcE (Global Value Component) resulted higher in the group "other" (A) compared to the patients with acute ischemic heart disease (CIA), with a statistically significant difference (test U-Mann-Whitney; p = 0.04). This group shows statistically significant differences in the emotional component (PRIrcA; p = 0.01) even compared to pain associated with oesophagus-gastric disease (G). In regard to PRIrcA, the difference between G group and the group of patients with chronic ischemic heart disease (CIC), as well as the "double" category, resulted markedly significant (p = 0.03 and p = 0.01 respectively). We extrapolated the "describers" chosen by at least 50% of patients in every category and obtained the semantics configuration of chest pain for every diagnosis. CONCLUSIONS: PRIrcE resulted lower in CIA group. PRIrcE e PR-IrcA are more represented in CIC group. The same conclusion is valid in the differentiation of pain between CIA and G group and between CIA and A group (the most representative of chronic pain). We found higher values in emotional component compared to pain of new onset as pain becomes chronic.

Biochemical markers in glucocorticoid-induced osteoporosis.

Following the introduction of corticosteroids as therapeutic agents in the 1950s, their use has been expanded so that today glucocorticoids are widely used. There are few studies in the literature directly aimed at describing the changes of bone markers following glucocorticoid administration. The interpretation of some of these investigations may be hampered by a number of confounding factors, whose influence is not always taken into consideration. In general, the effects of glucocorticoid administration are represented by a reduction in bone formation markers (particularly considering serum osteocalcin levels) and a trend to an increase or no change in bone resorption markers. The inconsistency of this last finding may be related to the time at which the observation is carried out and to the marker employed.