In patients undergoing hemodialysis, the initiation of treatment with rosuvastatin lowered the LDL cholesterol level but had no significant effect on the composite primary end point of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. (ClinicalTrials.gov number, NCT00240331.)

Background: Trigeminal neuralgia (TN) is a severe, disabling form of painful cranial neuropathy. Even though TN has a typical clinical picture, diagnosis it is often missed or delayed in clinical practice. In order to investigate the occurrence of diagnostic and therapeutic errors in TN, we studied 102 patients suffering from TN recruited through a multicentric survey. Methods: We performed a Pubmed database search on errors and pittfalls in TN diagnosis and management. Then, patients with TN were consecutively enrolled in the period from February 2017 to October 2019, by several European Headache Centers participating in the study, following a call of the Headache and Pain Scientific Panels of the European Academy of Neurology (EAN). Diagnosis of Classical Trigeminal Neuralgia (CTN) was made according to the International Headache Society (IHS) criteria (Tölle et al., Pain Pract 6:153-160, 2006). All the patients were evaluated using telephone/frontal interviews conducted by headache/pain specialists using an ad hoc questionnaire. Results: A number of 102 patients were recruited, mostly females (F:M ratio 2.64:1). Eighty-six percent of the patients consulted a physician at the time they experienced the first pain attacks. Specialists consulted before TN diagnosis were: primary care physicians (PCP) (43.1%), dentists (in 30.4%), otorhinolaryngologists (3.9%), neurosurgeons (3.9%), neurologists or headache specialists (14.7%), others (8%). The final diagnosis was made mainly by a neurologist or headache specialist (85.3%), and the mean interval between the disease onset and the diagnosis made by a specialist was 10.8 ± 21.2 months. The "diagnostic delay" was 7.2 ± 12.5 months, and misdiagnoses at first consultation were found in 42.1% of cases. Instrumental and laboratory investigations were carried out in 93.1% of the patients before the final diagnosis of TN. Conclusion: While TN has typical features and it is well defined by the available international diagnostic criteria, it is still frequently misdiagnosed and mistreated. There is a need to improve the neurological knowledge in order to promptly recognize the clinical picture of TN and properly adhere to the specific guidelines. This may result in a favorable outcome for patients, whose quality of life is usually severely impaired.

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Summary The study aimed to assess the inhalation technique of patients with bronchial asthma/chronic obstructive pulmonary disease (COPD) via an objective method and to evaluate the effect of training in patients with incorrect technique. Тhe inhalation technique of 120 patients with obstructive pulmonary disease was tested. The patients were divided into two groups: using metered dose inhalers (MDI) - 34 patients (28%) and dry powered inhalers (DPI) - 86 patients (72%). The most frequent mistakes in the MDIgroup were short duration of the inhalation (55.88%) and bad synchronization between activating the canister and the inhalation (29.41%). For the DPIgroup, the inhalation was not forceful enough (48.84%) and the short duration of the inhalation (12.79%). Patients claiming to have good inhalation technique accounted for 97%of those in the MDIgroup, and 96.5%of those in the DPIgroup. There were two patients (5.88%) with correct inhalation technique in the MDIgroup at their first attempt, and 31 patients (36.05%) in the DPIgroup. We found that in the MDIgroup there wasasignificant reduction in the number of mistakes (p<0.001). In the DPIgroup, such correlation was not found but during visit 2 there were no patients with more than 1 mistake. Correcting poor inhalation technique led to reduction of the number of mistakes during inhalation.