La popolazione anziana, rispetto alla popolazione generale, ha una maggiore prevalenza di problemi orali e dentali. Questo è dovuto non tanto all’invecchiamento fisiologico in sé, quanto alla maggiore incidenza di alcune patologie che interessano direttamente il cavo orale. In età geriatrica sono frequenti la perdita di denti, le lesioni della mucosa di natura neoplastica o infettiva e i sanguinamenti. A queste condizioni si aggiungono gli effetti cumulativi delle malattie sistemiche tipiche dell’anziano che, oltre ad avere una propria azione diretta sul cavo orale, predispongono anche agli effetti secondari della polifarmacoterapia, di cui il cavo orale è un bersaglio frequente (xerostomia, infezioni da Candida).
Nonostante l’evidenza dell’importanza della salute orale nell’anziano, spesso i problemi del cavo orale sono sottovalutati sia dal personale sanitario sia dagli anziani e dai loro famigliari. Ciò accade principalmente per due ordini di motivi che gli autori analizzano: la scarsa conoscenza del problema e la difficoltà di accesso a servizi.

(1) UO Geriatria, Policlinico S. Orsola-Malpighi, Bologna

Aim of our report is to present and discuss a paradigmatic case report of a patient followed for HIV infection for over twenty years, who, despite the initial diagnosis of AIDS presenter (due to the diagnosis of three episodes of cryptococcal meningo-encephalities, and one episode of pneumocystosis), showed a little or a complete lack of compliance to all the therapeutic regimens, including antiretrovirals, and primary and secondary antimicrobial chemoprophylaxis. Despite the non-compliance during the last three years of follow-up (from poor adherence to voluntary and complete discontinuation of all the therapies) an unexpected clinical-laboratory stabilisation was observed, with progressive increase of CD4+ T-lymphocyte count (range 410 to 825 cells/μl), and HIV viraemia under control (range 5,970-24,000 HIV-RNA copies/ml). This case report arises a number of open questions, concerning the anomalous course of the illness in this patient and the management of non-compliance.

(1) Dipartimento di Medicina Interna, dell’Invecchiamento e delle Malattie Nefrologiche, Divisione di Malattie Infettive. “Alma Mater Studiorum” Università degli Studi di Bologna. Policlinico S. Orsola-Malpighi, Bologna

We report the case of a 22-year-old woman from Albania, with thalassaemia major, in severe clinical condition who could no longer be transfused due to the occurrence of severe, acute, post-transfusional reactions. After 10 years of treatment, she failed to respond to hydroxyurea.
When she received thalidomide, haemoglobin levels increased from 3.7 g/dl to 9 g/dl. Since then, at 22 months of follow-up, the therapy is still effective and well tolerated. The case gives the opportunity to describe the clinical use of thalidomide, and its potential in the management of beta-thalassaemia.

(1) Clinica pediatrica, Università di Milano-Bicocca, Ospedale San Gerardo, Monza
(2) Centro Immunotrasfusionale, Ospedale San Gerardo, Monza

Post-menopausal osteoporosis is a skeletal disease that can be asymptomatic and is sometimes underdiagnosed and undertreated. Post-menopausal osteoporosis can be associated with fractures and consequent impaired quality of life and increase of health care costs. Bisphosphonates are a
therapeutic choice, because they proved to be effective in preventing bone loss. The current case report shows the efficacy of six-month risedronate administration in a post-menopausal woman affected by osteoporosis and inflammatory bowel disease in reducing biochemical bone turnover markers and increasing bone mineral density.

(1) Cattedra di Ginecologia e Ostetricia. Università degli Studi di Catanzaro “Magna Graecia”

Neurologic side effects related to cancer therapy are a common problem in oncology practice. These complications can negatively affect the management of the patient, because they can inhibit treatment and diminish quality of life. Therefore specific skills are required to recognise symptoms and clinical manifestations. This review focuses on the most common neurologic complications to improve physician’s familiarity in determining the aetiology of these symptoms.

(1) Dipartimento di Neuroscienze, Istituto Nazionale Tumori “Regina Elena”, Roma