RESUMO
We report three cases of external ventricular derivation infections caused by multidrug-resistant Gram-negative rods and treated successfully with intraventricular colistin. The intrathecal or intraventricular use of colistin have been reported in more than 100 cases without any consensus on dosage, duration and type (monotherapy or combination therapy) of treatment. Based on our comprehensive review of the relevant literature relating to both clinical and pharmacokinetic data, we conclude that the intrathecal/intraventricular administration of colistin is a safe and effective option to treat central nervous system infections caused by multidrug-resistant Gram-negative bacteria.
Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas do Sistema Nervoso Central/tratamento farmacológico , Colistina/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Farmacorresistência Bacteriana Múltipla , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Adolescente , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Antibacterianos/farmacologia , Infecções Bacterianas do Sistema Nervoso Central/microbiologia , Colistina/administração & dosagem , Colistina/efeitos adversos , Colistina/farmacologia , Infecção Hospitalar/microbiologia , Bacilos e Cocos Aeróbios Gram-Negativos/efeitos dos fármacos , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Injeções Intraventriculares/efeitos adversos , Injeções Espinhais/efeitos adversos , MasculinoAssuntos
Fármacos Anti-HIV/sangue , Estradiol/sangue , Oxazinas/sangue , Inibidores da Transcriptase Reversa/sangue , Alcinos , Fármacos Anti-HIV/uso terapêutico , Benzoxazinas , Ciclopropanos , Ensaio de Imunoadsorção Enzimática , Estradiol/urina , Reações Falso-Positivas , Infecções por HIV/sangue , Infecções por HIV/tratamento farmacológico , Infecções por HIV/urina , Humanos , Medições Luminescentes , Oxazinas/uso terapêutico , Radioimunoensaio , Inibidores da Transcriptase Reversa/uso terapêuticoRESUMO
In the article the Author drew an outline of the various approaches to the problem of alcoholism, starting from the classical psychiatric point of view and arriving at the present-day psychodynamic and psychosocial approaches. In conclusion he emphasized the complexity of this phenomenon, and therefore the need to apply a comprehensive, multimodal approach.
Assuntos
Alcoolismo/psicologia , Humanos , SociologiaRESUMO
The article begins by examining the position of psychotherapy in Italy's current cultural climate. This is followed by a brief review of an experiment in the training of National Health Service psychiatrists at National Health Unit 71 in Valenza Po (Piedmont). The experiment was designed and conducted as the first year of a "3-year Course in Psychotherapy" intended to offer training in the practice of psychotherapy within the National Health Service. It was therefore necessary to teach the correct approach both to relations with the patient and to the complex network of relations arising in team work in such cases.
Assuntos
Psicoterapia/educação , Currículo , Humanos , Itália , Psicanálise/educação , Saúde PúblicaRESUMO
The professional duties of the psychologist operating in the mother and baby sector are examined in the light of the cultural and operational prospects opened by the Health Service Reform Law. Within this framework a brief review is presented of the various models of the "psychologist's role" that have successively developed in Italy. Emphasis is then placed on the importance of preventive work in the modern sense, a role that combines the contributions of both clinical and community social psychology to create what amounts to an "extended" clinical practice.