Search

Diabetes mellitus (DM) is a very common disease, encountered in nearly one third of patients admitted to Internal Medicine Units. The discharge from the hospital is a crucial moment for patients with chronic and complex diseases such as DM and also for the caregiver. After hospital admission, therapeutic modifications with respect to usual therapy might have occurred, and shift to insulin therapy during admission occurs in the majority of patients. Therefore, treatment with insulin needs education of the patient and/or the caregiver for the correct drug administration and treatment of related side effects, mainly hypoglycemia. We believe that a very practical and mnemonic approach can help the clinician in the management of the delicate phase of hospital discharge of the diabetic patient. [ABSTRACT FROM AUTHOR]

Sepsis is one of the leading causes of death in hospitalized patients and its management involves a lot of specialist. Internist is required to demonstrate his competence since the beginning when the diagnosis is not so easy to be clarified. A rapid clinical suspicion permits a prompt management of the patient that means important mortality reduction. However, it is essential to understand the source of infection and echography represents a rapid, economic, useful and widespread tool with whom Internist should become more and more confident. The following review is a practical guide to manage septic patients according to the most recent literature, underlining aspects of antibiotic therapy, hemodynamic stabilization and supportive therapy. To limit sepsis mortality, a valid Internist should be culturally prepared and especially able to cooperate with other specialists, because a strong enemy requires a strong team. [ABSTRACT FROM AUTHOR]

Severe sepsis and septic shock are leading causes of morbidity and mortality in critically ill patients in and outside Intensive Care Units. Early hemodynamic and respiratory support, along with prompt appropriate antimicrobial therapy and source control of the infectious process are cornerstone management strategies to improve survival. Antimicrobial therapy should be as much appropriate as possible, since inappropriate initial antimicrobial therapy is associated with poorer outcome in different clinical settings. When prescribing antibiotic therapy, drug's characteristics, along with dosing, pharmacokinetics, and pharmacodynamic properties related to the drug and to the clinical scenario should be well kept in mind in order to achieve maximal success. [ABSTRACT FROM AUTHOR]