Cytomegalovirus encephalitis: diagnosis with clinical approach, EEG and PCR techniques.

Cytomegalovirus (CMV) encephalitis is particularly evident in immunodepressed patients. Often diagnosis is difficult and time-consuming because of the complex basic clinical picture of these patients. We describe the diagnostic steps taken in a case of cytomegalovirus encephalitis affecting an elderly patient, classified as immunodepressed and deceased on the thirty-fifth day of hospitalisation in the intensive care unit due to acute myocardial infarction. Treatment with ganciclovir, 30 mg/kg per day, begun at the time of diagnosis, appears to have had a positive effect on the neurologic symptoms.

[Effects of somatostatin peridurally administered in the treatment of postoperative pain]. / Effetti della somministrazione della somatostatina per via peridurale nel trattamento del dolore post-operatorio.

Somatostatin (SMS), a hormone extensively found within the CNS, has shown to have a powerful analgesic effects administered either via the epidural or subdural route. The aim of the present study was to evaluate the efficacy of SMS administered epidurally compared with placebo, for the treatment of post-operative pain in patients receiving epidural anaesthesia for surgery. Of the 86 patients observed, 58 entered the study and were randomized to receive either SMS or placebo in a double blind fashion. They were also divided into 3 groups according to the site of the operation (group A: procto-anal; group B: inguino-crural; group C: other), 28 of them receiving SMS and 30 placebo. The post-operative pain evaluation was obtained via VAS at the moment of request of treatment (basal) and after an hour. Twenty-eight of the 86 observed (32.5%) didn't complain of pain that necessitated analgesic treatment. A statistically significant difference in reduction of intensity of pain was observed in the somatostatin treated group (6.42 +/- 0.37 vs 3.64 +/- 0.59) and in the somatostatin treated subgroup A and B (6.4 +/- 0.4 vs 3.8 +/- 0.7 and 6.3 +/- 0.8 vs 3.0 +/- 0.6 respectively). No adverse reactions of any kind were observed. SMS has shown to be a safe and effective drug, reducing by 50% the intensity of pain in patients undergone procto-anal or inguino-crural surgery.