Comparison of diuretic strategies in diuretic-resistant acute heart failure: a systematic review and network meta-analysis.

OBJECTIVE: Up to 50% of patients hospitalized for acute heart failure (AHF) show resistance to diuretics. This condition contributes to a prolonged hospital length of stay and a higher risk of death. This review aimed to investigate whether a diuretic therapeutic approach more effective than furosemide alone exists for patients with diuretic-resistant AHF. MATERIALS AND METHODS: We identified all randomized controlled trials (RCTs) evaluating diuretic therapy in patients with diuretic-resistant AHF. We searched Pubmed, BioMed Central, and Cochrane CENTRAL databases. RESULTS: Six RCTs were identified, involving a total of 845 patients. The P-score ranges from 0.6663 for furosemide to 0.2294 for the tolvaptan-furosemide. We found no significant differences in efficacy for any drug comparison. CONCLUSIONS: None of the diuretics considered in RCTs performed to date (tolvaptan, metolazone, hydrochlorothiazide, indapamide) appear to be more effective than furosemide therapy alone for the treatment of patients with diuretic-resistant AHF.

Which regional anesthesia technique is the best for arthroscopic shoulder surgery in terms of postoperative outcomes? A comprehensive literature review.

OBJECTIVE: The literature offers numerous reviews and meta-analyses assessing the different regional anesthesia techniques employed for arthroscopic shoulder surgery (ATS) in terms of diverse outcome parameters. Most have focused on analgesic efficacy in the limited post-operative period as their primary outcome. Indeed, the most up-to-date guidelines are based on the results of comparisons that focus on analgesic efficacy and analgesic drug consumption. However, a correlation has yet to be demonstrated between post-operative analgesia and functional recovery; indeed, the latter has received relatively less research attention concerning the anesthetic technique despite its clinical importance. Here, we aimed to identify the best loco-regional anesthetic technique for ATS, considering all the evaluation parameters considered to date. MATERIALS AND METHODS: We performed a comprehensive literature review on ATS, searching for all the relative aspects of the regional anesthesia technique employed and the outcome parameters assessed. RESULTS: From the literature, it is not clear which technique is better than the others. No single technique was revealed as being the absolute best, independent of the outcome parameter considered, which included: post-operative analgesic effect, speed of functional recovery, ease, and safety of execution. CONCLUSIONS: The choice of anesthetic technique should be tailored to the patient and type of surgery. When comparing one type of loco-regional anesthesia against another, in addition to analgesic efficacy, a whole plethora of aspects need to be considered (i.e., feasibility, complications, contribution to functional recovery, etc.).

[Migration: some points of interest]. / Le migrazioni: che cosa interessa conoscere.

The concept of migration is defined and categories describing such movements are outlined. "The author proposes a category of migration movements...which would allow for internationally comparable classifications. The basic characteristics are: type of frontier crossed, length and/or recurrence, [and] intentionality of movement...." (SUMMARY IN ENG AND FRE)

[Difficulties and problems related to research on the foreign population in Italy]. / Difficolta e problemi di ricerche sul campo relative alla presenza straniera in Italia.

PIP: The author discusses difficulties involved in research concerning the foreign population residing in Italy. Aspects considered include organization, financing, and compiling and coordinating results from different agencies.^ieng

The status of women, population and development.

PIP: The relationships among the status of women, demographic trends, and development are examined separately for developed and developing regions. Aspects considered include nuptiality, fertility, morbidity and mortality, infant mortality, migration, and the family cycle.^ieng

[The characteristics of the foreign presence in Italy and the problems that arise from it]. / Le caratteristiche della presenza straniera in Italia e i problemi che ne derivano

PIP: A framework for the information needed to study adequately the phenomenon of foreign immigration in Italy is proposed. The research currently being carried out on this topic by the Italian Committee for the Study of Population is also described.^ieng

[Urban and rural differentials in health and their relationship to socioeconomic change]. / Roznice w stanie zdrowia ludnosci miejskiej i wiejskiej oraz ich zwaizek z przemianami spolecano-gospodarazymi

PIP: Differential mortality between rural and urban residents in Italy is analyzed for 1971 and 1972. Among the factors considered are age, sex, working conditions, level of education, diet, sanitary and ecological conditions, and the spatial distribution of the population (SUMMARY IN ENG, RUS)^ieng

[The population situation in Europe at the beginning of the next century: two possible alternatives]. / La demographie de l'Europe au debut du siecle prochain: deux alternatives possibles

PIP: The author examines possible future population trends in Europe. In particular, distinctions are made between the likely alternatives for population trends in Western, Northern, Southern, and Eastern Europe. The possibilities of stationary or declining populations are discussed^ieng