A forgotten life-threatening medical emergency: myxedema coma

Nowadays myxedema coma is a rare medical emergency but, sometimes, it still remains a fatal condition even if appropriate therapy is soon administered. Although physical presentation is very non-specific and diversified, physicians should pay attention when patients present with low body temperature and alteration of neurological status; the presence of precipitating events in past medical history can help in making a diagnosis. Here we discuss one such case: an 83-year-old female presented with abdominal pain since few days. Laboratory tests and abdomen computed tomography scan demonstrated alithiasic cholecystitis; she was properly treated but, during the Emergency Department stay she experienced a cardiac arrest. Physicians immediately started advance cardiovascular life support algorithm and she survived. Later on, she was admitted to the Intensive Care Unit where doctors discovered she was affected by severe hypothyroidism. Straightway they started the right therapy but, unfortunately, the patient died in a few hours

Development and Metrological Characterization of a Multi-sensor Device for Indoor Environmental Quality (IEQ) monitoring

Indoor Environmental Quality (IEQ), which affects people's health, comfort, well-being and productivity, combines thermal, visual, acoustic and air quality conditions. This work deals with design, development and metrological characterization of a low-cost multi-sensor device that is able to detect the quality conditions of indoor environments for IEQ purposes. The device, hereafter referred as PROMET&O (PROactive Monitoring for indoor EnvironmenTal quality & cOmfort) embeds a set of low-cost sensors that measure air temperature and relative humidity, illuminance, sound pressure level, carbon monoxide, carbon dioxide, particulate matter, formaldehyde, and nitrogen dioxide. The basic architecture of the device is described and the design criteria that are related to the measurement requirements are highlighted. Particular attention has been paid towards the traceability assurance of the measurements provided by PROMET&O by means of specifically conceived calibration procedures, which have been tailored to the requirements of each measurement quantity. The calibration is based on the comparison to reference standards following commonly employed or ad-hoc developed technical procedures. The defined calibration procedures can be applied both for the single sensors and for the set of sensors integrated in the multi-sensor case. For the latter, the effects of the percentage of permeable case surface and the sensors allocation are also investigated. A preliminary uncertainty evaluation of the proposed multi-sensor device is reported for the carbon dioxide and the illuminance sensors taking the defined calibration procedures into account

Oral Hypoglycemic Drugs: Pathophysiological Basis of Their Mechanism of ActionOral Hypoglycemic Drugs: Pathophysiological Basis of Their Mechanism of Action

Type 2 diabetes is a syndrome characterized by relative insulin deficiency, insulin resistance and increased hepatic glucose output. Medications used to treat the disease are designed to correct one or more of these metabolic abnormalities. Current recommendations of the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) include diet and exercise as first-line therapy plus hypoglycemic drugs. Actually there are seven distinct classes of anti-hyperglicemic agents, each of them displaying unique pharmacologic properties. The aim of this review is to describe the pathophysiological basis of their mechanism of action, a necessary step to individualize treatment of diabetic people, taking into proper consideration potential benefits and secondary effects of drugs