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Studi in Onore di Aristide Calderini e Roberto Paribeni
No full textGorteman Claire. Studi in Onore di Aristide Calderini e Roberto Paribeni. In: L'antiquité classique, Tome 27, fasc. 2, 1958. pp. 578-591
What are the current indications for noninvasive ventilation in children ?
No full textPURPOSE OF REVIEW:
The aims of this paper are to examine the physiological rationale for noninvasive respiratory support (NRS) in children older than 1 month with acute respiratory failure, to review clinical available data and to give some practical recommendations for the safe application of NRS.
RECENT FINDINGS:
NRS is the delivery of ventilatory support without the need for an invasive airway. Two types of NRS are commonly used in the pediatric population: noninvasive continuous positive airway pressure and noninvasive positive pressure ventilation. In general, the evidence to support the use of NRS in children with acute respiratory failure is scarce. However, two randomized studies have been recently published suggesting that noninvasive positive pressure ventilation ameliorates clinical signs and gas exchange while reducing the need for endotracheal intubation. Moreover, noninvasive continuous positive airway pressure and heliox may improve clinical scores and carbon dioxide washout in infants with severe bronchiolitis, without major complications. Data from noncontrolled studies show that NRS unloads the respiratory muscles and that the helmet can be a valid alternative to a facial and/or nasal mask when noninvasive continuous positive airway pressure is administered to children in the early stage of acute respiratory failure.
SUMMARY:
Preliminary clinical data show that NRS is safe and effective in children with acute respiratory failure
Treatment of acute hypoxemic respiratory failure with continuous positive airway pressure delivered by a new pediatric helmet in comparison with a standard full face mask: A prospective pilot study
No full textOBJECTIVES:
To evaluate the feasibility and efficacy of continuous positive airway pressure delivered by a new pediatric helmet in comparison with a standard facial mask in infants with acute hypoxemic respiratory failure.
DESIGN:
A single-center prospective case-control study.
SETTING:
Pediatric intensive care unit in a tertiary children hospital.
PATIENTS AND INTERVENTIONS:
Twenty consecutive infants treated with continuous positive airway pressure by a helmet matched with a control patient treated with continuous positive airway pressure by facial mask and selected by age, weight, PaO2:Fio2, and PaCO2 on pediatric intensive care unit admission.
MEASUREMENTS AND MAIN RESULTS:
Feasibility was defined as the incidence of continuous positive airway pressure protocol failure secondary to 1) failure to administer continuous positive airway pressure because of intolerance to the interface; 2) deterioration in gas exchange soon after continuous positive airway pressure institution; and 3) major clinical adverse events such as pneumothorax or any hemodynamic instability related to the continuous positive airway pressure safety system device's failure. Evaluation of feasibility included also the total application time of respiratory treatment, the number of continuous positive airway pressure discontinuations/first 24 hrs. Interface-related complications included air leaks, cutaneous pressure sores, eye irritation, inhalation, and gastric distension. The 20 patients and control subjects had similar matching characteristics. Continuous positive airway pressure delivered by a helmet compared with a facial mask reduced continuous positive airway pressure trial failure rate (p = .02), increased application time (p = .001) with less discontinuations (p = .001), and was not associated with an increased rate of major adverse events, resulting in decreased air leaks (p = .04) and pressure sores (p = .002). Both continuous positive airway pressure systems resulted in early and sustained improvement in oxygenation.
CONCLUSIONS:
The helmet might be considered a viable and safe alternative to a standard facial mask to deliver continuous positive airway pressure in hypoxemic infants in the pediatric intensive care unit setting. In our study, the helmet allowed more prolonged application of continuous positive airway pressure compared with a facial mask, ensuring similar improvement in oxygenation without any adverse events and clinical intolerance
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Ventilazione meccanica domiciliare (cap.26)
No full textIl capitolo descrive le principali indicazioni per l'indicazione e l'adozione della ventilazione meccanica domiciliare (VMD) nei pazienti affetti da sindrome da insufficienza respiratoria cronica
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Unreported deaths in pediatric surgery and anesthesia: A national, twenty year report
No full textIntroduction. Pediatric perioperative mortality is extremely low but it is underre-ported in peer-reviewed journals, making it difficult to understand the magnitude of the problem. The aim of this study was to identify pediatric deaths reported by the mass media over a 20- year period in pediatric and non-pediatric hospitals. Materials and methods. The international search engines Google, Yahoo, Bing, and the online archives of major newspapers were searched independently by 3 trained investigators (1st January 1995 to 1st January 2015) looking for children (<18 years old) who died in the perioperative period in Italy, excluding obstetrical or neonatal deaths. Results. A total of 51 fatal events were identified with 41 cases (80%) being elective procedures. Most fatal events (31 cases, 61%) occurred in non-specialized hospitals, 12 cases (23%) occurred in high-volume non-pediatric hospitals, and 8 cases (16%) in pediatric hospitals. The most frequently represented operations were head/ neck 21 cases (41%), abdominal 11 cases (21%), and orthopedic surgery 9 cases (18%). The reported causes of death were equally distributed between surgical (25 cases, 49%) and anesthesiological complications. The most common causes of death were hemorrhage (n=11), difficult airway management (n=10), infections (n=6), and allergic reactions (n=4). In 25% of cases (13 cases), the complication resulted in intraoperative death. Conclusion. Our findings suggest that most pediatric deaths reported by mass media occurred in non-pediatric centers during elective surgical procedures (e.g. adenotonsillectomy and appendicectomy), suggesting that referral to large-volume or pediatric hospitals should be preferred. Moreover, one of the most commonly reported complications was difficult airway management, confirming that this aspect should have a central role in physician training and practice
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