Pain symptomatology is present in 60% - 80% of patients affected by advanced cancer, but in most cases it is not adequately treated. Our series, composed of 45 patients affected by cancer in an advanced stage, demonstrates how the application of common concepts of pharmacotherapy, standardized according to a sequential scheme proposed by the WHO, makes it possible to reach total control (in 24.4% of our cases) or only slight residual persistence (in 68.8% of our cases) of pain from cancer, with scarce side effects that are easily controlled with symptomatic therapy. According to the type of pain, its behavior in relation to the therapy effected and any previous pharmacologic treatment, the proposed pharmacologic scheme foresees, as the first step, the use of non-narcotic drugs, eventually associated or substituted with weak narcotics or finally with strong narcotics. Attention is given to modulation of the administration, to guarantee an analgesic effect throughout the day, thus preventing the pain. Irrespective of the analgesic scheme employed, it is more effective if patients affected by chronic oncologic pain (who present an important emotional component) are treated contemporaneously with anxiolytic and antidepressive drugs and those in which nerve structures are involved are treated with steroids. In conclusion, pain of an oncologic patient in an advanced stage can almost always be alleviated or often eliminated by the rigorous application of therapeutic concepts well known by physicians but for various reasons often neglected in clinical practice.
A case of Reed-Sternberg (R-S) leukaemia is described, and the results of the morphological, cytochemical and cytokinetic studies on the circulating neoplastic cells are reported. Detailed data are given for each of the 3 types of abnormal circulating cells: abnormal mononuclear (AM) cells, Hodgkin's (H) cells and R-S cells. Our results cannot discriminate whether R-S cells derive from monocyte-macrophages or from B-cell lineage. However, some data suggest that H and R-S cells may likely originate from AM cells. The unfavourable clinical significance of the appearance of circulating R-S cells is discussed taking into account the other few cases reported in literature.
Background: From November 2016 to the summer of 2021, some U.S. diplomats and their family members residing in Havana and other locations, including China, Russia, Colombia, Switzerland, and France, reported the sudden onset of auditory, vestibular, and neurological symptoms. The aim of this study is to define enrollment criteria for patients with a possible diagnosis of Havana Syndrome. Methods: This study, through a review of the scientific literature, proposes the definition of criteria for proper enrollment of patients with a possible diagnosis of "Havana Syndrome" Results: In view of the increasing number of cases, their wide geographic distribution, and the lack of certainty regarding etiopathogenesis, it is essential to propose a strategy for sharing case histories Conclusions: A correct enrollment of patients is crucial since specialists can then disclose new strategies for the study of case histories and for a clear definition of the diagnosis. This way, it will be possible to have a wide discussion of clinical and epidemiological results among specialists in different medical, engineering, and intelligence disciplines.
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