117,729 research outputs found
Education as a practice of freedom. Prato and the School of Fight 8x5.Per un’educazione come pratica di libertà. Prato e la Scuola della Lotta 8x5
No full textIl contributo intende valorizzare il potenziale trasformativo della pedagogia engaged -
impegnata (hooks, 2020; Freire, 1970; Bianchi, 2019), attraverso una ricerca situata, che vede
come campo di riferimento la Scuola della Lotta 8x5 di Prato, nella quale il ricercatore è
immerso.
Si vuole restituire in questo modo un esempio di buona prassi, cui si riconosce il merito di unire
riflessione e azione, all’interno di un distretto dominato da uno sfruttamento brutale. In
particolare, si vuole sostenere che tale esperienza risponde al modello di educazione come
pratica di libertà di cui parlano Paulo Freire e bell hooks. Ed è proprio il dialogo con i due
grandi pedagogisti che fa da cornice a tutto il testo
Induction of general anaesthesia by rapid injection of propofol and dexmedetomidine or propofol and buthorphanol: cardiopulmonary and echocardiographic parameters in unpremedicated dogs
No full text2011 The Authors. Veterinary Anaesthesia and Analgesia
20 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists, 38, 1–35 Induction of general anaesthesia by rapid
injection of propofol and dexmedetomidine
or propofol and butorphanol:
cardiopulmonary and echocardiographic
parameters in unpremedicated dogs
G Ravasio, L Borghi, D Fonda, P Brambilla, V Bronzo,
J Cincotti & C Locatelli
Universita` degli Studi di Milano, Facolta` di Medicina
Veterinaria di Milano, via Celoria 10, 20133 (MI) Italy
The aim was to compare quality of induction,
echocardiographic and cardiopulmonary effects of
two different general anaesthesia induction protocols.
Twelve dogs (ASA I-II) were assigned randomly
into two groups. Both groups received a rapid bolus
of propofol (2.2 mg kg)1 IV) immediately followed
by a rapid bolus of dexmedetomidine 3 lg kg)1 IV
(group A) or butorphanol 0MAP, SAP (NIBP) were recorded and 2, 5, 10, 15,
20 minutes after drug administration. Induction
quality, intubation time, additional propofol dose to
achieve intubation, sedation score (Fernandez et al.
2005) and adverse effects were recorded. Echocardiogram
was performed at baseline and immediately
after tracheal intubation. Data were analyzed using
repeated measures ANOVA and Wilcoxon test
(p < 0.05).
Induction quality, intubation time (A: 75 ± 25,
B: 145 ± 66.8 seconds) were statistically different
between groups, HR was statistically lower in group
A compared to baseline (62 ± 23; 101 ± 23), fR
was not statistically different between groups but
lower than baseline in group A, NIBP was statistically
higher in group A and lower in group B
compared to baseline. Body temperature, SpO2,
PE¢CO2 were not statistically different. No apnoea
(>30 seconds) or emesis were recorded. Five group
B dogs required additional propofol (1.1 ± 0.7
mg kg)1 IV) to achieve tracheal intubation. Left
ventricular end-diastolic diameter was statistically
lower in group B and statistically higher in group A
compared to baseline. Cardiac output decrease was
18.5% in group A and 24.4% in group B.
Quality of induction was better in group A.
Echocardiographic parameters varied compared to
baseline in both groups but remained within normal
ranges for adult dogs (Cornell et al. 2004).
References: Fernandez JG, Parodi E, Garcia P et al.
(2005) Clinical action of subarachnoid sevoflurane
in vivo: a study in dogs. Brit J Anaesth 95(4), 530–
534.
Cornell CC, Kittleson MD, Della Torre P et al.
(2004) Allometric scaling of M-Mode cardiac measurements
in normal adult dogs. J Vet Intern med
18(3), 311–321..4 mg kg)1 IV (group B)
administered by a blinded operator. Baseline HR
Three dexmedetomidine constant rate infusion (CRI) in feline ovariectomized patients: sedative and analgesic effects
No full textThree dexmedetomidine constant rate infusion (CRI) regimens in feline ovariectomized patients: sedative and analgesic effects.
A.M. Carotenuto, G. Ravasio, L. Borghi, S Boveri, M. Beccaglia, D. Fonda
Università degli Studi di Milano, Facoltà di Medicina Veterinaria di Milano, via Celoria 10, 20133 (MI) Italy
In cats, few studies have investigated the clinical effect of dexmedetomidine (DMED) CRI during perioperative period. Our aim was to evaluate the analgesic and sedative effects of three rates of DMED CRI in feline patients undergoing ovariectomy, postoperatively monitored for 24 hours. Eighteen female cats were enrolled. After premedication (5 μg kg-1 DMED IM; 0.2 mg kg-1 meloxicam SC), patients were induced with propofol and randomly allocated into three groups (D1-D2-D3) to receive 0.5 (n=6), 1.5 (n=6) and 2.5 (n=6) μg kg-1 h-1 DMED CRI respectively. Anaesthesia was maintained with isoflurane in oxygen and respiration was mechanically controlled using intermittent positive pressure ventilation to maintain normocapnia. Intraoperative hemodynamic parameters and end tidal isoflurane concentration were recorded every 5 minutes. Rescue anaesthesia was provided by means of 0.5 mg kg-1 of propofol in response to acute increases in HR or MAP (20% or more). Postoperatively, sedation, analgesia, muscular relaxation and quality of recovery were evaluated using three postoperative scales (Ansah et al. 2002; Shaffran et al. 2008; Belda et al. 2008). Buprenorphine (10 μg kg-1) was provided as rescue postoperative analgesic drug. Data were analyzed by ANOVA and Kruskal-Wallis test (P<0.05). Intraoperatively, significant differences among groups were not found and any cat did not required rescue propofol, showing stable hemodynamic state. Isoflurane sparing effect of 40% was obtained in D1 and around 48% in D2 and D3. Postoperative analgesia and muscular relaxation showed to be significantly increased in D3 patients than in D1 and D2, while sedative effects resulted to be decreased. Although none patient in three groups required rescue analgesia, D3 showed the most favourable results. DMED infusion, used as part of a balanced anaesthesia, seemed to be safe, useful and effective to obtain adequate intra and postoperative analgesia in feline patients undergoing ovariectomy.
References: Arora S (2008) Combining ketamine and propofol (“Ketofol”) for emergency department procedural sedation and analgesia: a review. WestJEM 9, 20-23.
Ilkiw JE, Pascoe PJ (2003) Cardiovascular effects of propofol alone and in combination with ketamine for total intravenous anesthesia in cat. AJVR 64, 913-91
Total intravenous anaesthesia with “ketofol” (ketamine/propofol combination) in cats undergoing ovariectomy: intra and post-operative evaluation
No full textTotal intravenous anaesthesia with “ketofol” in cats undergoing ovariectomy: intra and post-operative evaluation
G. Ravasio, D. Fonda, G. De Carli, Beccaglia M., L. Borghi, A.M. Carotenuto, M. Gallo, A. Zonca
Università degli Studi di Milano, Facoltà di Medicina Veterinaria di Milano, via Celoria 10, 20133 (MI) Italy
Ketamine (K) and propofol (P) combination CRI is intravenous (IV) association used in humans and veterinary medicine (Arora 2008, Ilkiw & Pascoe 2003). Intraoperative anaesthetic variables and postoperative analgesic and sedative effects were evaluated. Fifteen female cats undergoing ovariectomy received IV loading dose of K plus P (2 mg kg-1 each) (n=8) mixed in the same syringe (ketofol) or ketofol added of dexmedetomidine (0.003 mg kg-1 IV) (n=7), followed by IV infusion of the ketofol mixture (10 mg kg-1 h-1 each). Physiological parameters and venous emogasanalysis were monitored during surgery and the count in the Heinz bodies formation was investigated. Blood concentrations of ketamine, norketamine and propofol were quantified by HPLC analysis. Sedation degree, the quality of recovery and pain assessment were also evaluated in the postoperative period. The intraoperative HR was significantly higher and the time of extubation was significantly shorter in the group receiving ketofol without dexmedetomidine. Blood emogasanalyses were not substantial different among groups and the infusion of propofol did not significantly increase oxidative damage to the red blood cells. The pharmacokinetic profile was similar for propofol and ketamine. During recovery the animals in both groups appeared restful, without pain. The total intravenous anaesthesia (TIVA) with ketofol appeared to be safe in cats, with fast and smooth recovery and adequate analgesia during postoperative period. Decrease HR in dexmedetomidine group resulted in a more stable haemodynamic state, but prolonged recovery time. The infusion of ketofol could represent a useful protocol for TIVA in cats undergoing moderately painful surgery.
References: Arora S (2008) Combining ketamine and propofol (“Ketofol”) for emergency department procedural sedation and analgesia: a review. WestJEM 9, 20-23.
Ilkiw JE, Pascoe PJ (2003) Cardiovascular effects of propofol alone and in combination with ketamine for total intravenous anesthesia in cat. AJVR 64, 913-91
INTERACTION OF MOLECULAR-OXYGEN WITH AMINOPHENOLS MEDIATED BY COPPER METAL AND COPPER-COMPOUNDS
No full textSeveral copper compounds (Cu, Cu2O, CuO, CuCl and CuCl2) have been used as catalysts for the oxidation of 2-, 3- and 4-aminophenol with O2 at 25-degrees-C; a comparison of their activities was made through kinetic determinations. The oxidation of 2-aminophenol selectively produced 2-amino-phenoxazin-3-one (1), whereas the oxidation products of 3- and 4-aminophenol were two new compounds, 2-amino-5 [(3-hydroxyphenyl)amino]-2,5-cyclohexadiene-1,4-dione (3) and 3-[(4-hydroxyphenyl)amino]-4-[(2-amino-5-hydroxy)phenyl]-6-[(4-hydroxyphenyl)imino]-2, 4-cyclohexadien-1-one (2)
Giant congenital nevi of the scalp and forehead treated by skin expansion
No full textCongenital giant melanocytic nevi of the scalp and forehead are rare lesions present at birth. These lesions are associated with risk of malignant transformation, but they primarily represent a psychological problem to both patient and parents and merit early excision and reconstruction. In this study we report our own experience: seven patients, aged 8 months to 9 years, with congenital pigmented nevi involving forehead and scalp, and a 4-year old patient with congenital pigmented nevus of periorbital region and nose were treated successfully with excision and expanded skin flap reconstructions. The mean expansion procedures were 2 (range, 1 to 3), with an average of 8,8 injections for each expansion procedure (range, 6 to 11). In only one patient simultaneous expanders were placed in the scalp and forehead. Follow-up ranged from 4 months to 15 years. We had no rupture, extrusion or infection of the skin expanders. Complications included eyebrow ptosis and asymmetry in two patients underwent correction at a final procedure. In our opinion tissue expansion is an excellent technique for the treatment of giant nevi of the scalp and forehead because it offers the best aesthetic and functional outcomes
I costi di trattamento del disturbo bipolare
No full textIntroduction: Bipolar disorder (BPD) is an affective condition, during which an individual experiences phases of excitement (mania or hypomania) and depression. Type I BPD is characterised by one or more maniac episodes and one or few depressive episodes, whereas type II by different depressive episodes and at least one hypomaniac episode. Bipolar disorder affects approximately 1% of the adult population. There are few studies on treatment costs of BPD in Europe and none in Italy. Objective: This article examines the costs of a sample of 107 BP patients (>18 years) on treatment after an acute episode, for a period of 24 months. The main purpose is to quantify the treatment costs and to explain the causes of variation. Methods: Data on patient profiles and consumption of psychiatric services were collected retrospectively in 12 Italian centres. The costs per patient were calculated by applying unit costs, derived from a previous study on 10 psychiatric departments in Lombardy, to services used. Only direct costs of public psychiatric services (SSN) are considered. Results: The mean age is 46.2 years and was 32.5 years at first BPD diagnosis. About 2/3 of patients are affected by type I BPD, 19% by type II and 10% by unspecified BPD. Out of total, 93.5% reported a new episode, 44% of which was depression, 27% hypomania and 27% mania. All patients were prescribed class N drugs and had a psychiatric visit, while 42% were also hospitalised. The drug treatment covered an average period of 624 days. The mean cost per BP patient is € 9,681 (SD 8,825); hospitalisation is 45% of all costs, whereas drugs are 20% and psychiatric visits 19%. Costs increase according to intensity of care and setting: from € 3,521 for patients treated in community services to € 13,200 in hospitals and to € 28,853 in residential facilities. Treatment costs are not related to age, gender, diagnosis, years since first diagnosis, number and length of acute episodes, but vary significantly with location of psychiatric centres (r = -0,21 from North to South) and type of care pathways (r=0,61). Why different treatment paths, for similar patients, are chosen remains to be explained
Activation of small molecules by copper. Part I: selective oxidation of organic substrates
No full textPersistence, switch rates, drug consumption and costs of biological treatment of rheumatoid arthritis: an observational study in Italy
No full textLuca Degli Esposti,1 Ennio Giulio Favalli,2 Diego Sangiorgi,1 Roberta Di Turi,3 Giuseppina Farina,4 Marco Gambera,5 Roberto Ravasio,6 1CliCon S.r.l. – Health, Economics & Outcomes Research, Ravenna, 2Department of Rheumatology, Istituto Ortopedico Gaetano Pini, Milan, 3Local Pharmaceutical and Supplementary Assistance Unit, Roma Local Health Authority D, Rome, 4Internal Management Control Unit – Pharmaceutical Spending Control Sector, Caserta Local Health Authority, Caserta, 5Local Pharmaceutical Service, Bergamo Local Health Authority, Bergamo, 6Health Publishing & Services Srl, Milan, Italy Objectives: The aim of this analysis was to provide an estimate of drug utilization indicators (persistence, switch rate and drug consumption) on biologics and the corresponding costs (drugs, admissions and specialist care) incurred by the Italian National Health Service in the management of adult patients with rheumatoid arthritis (RA).Methods: We conducted an observational retrospective cohort analysis using the administrative databases of three local health units. We considered all patients aged ≥18 years with a diagnosis of RA and at least one biologic drug prescription between January 2010 and December 2012 (recruitment period). Persistence was defined as maintenance over the last 3 months of the follow-up period of the same biological therapy administered at the index date. A switch was defined as the presence of a biological therapy other than that administered at the index date during the last 3 months of the follow-up period. Hospital admissions (with a diagnosis of RA or other RA-related diagnoses), specialist outpatient services, instrumental diagnostics and pharmaceutical consumption were assessed.Results: The drug utilization analysis took into account only biologics with at least 90 patients on treatment at baseline (adalimumab n=144, etanercept n=236 and infliximab n=94). In each year, etanercept showed better persistence with initial treatment than adalimumab or infliximab. Etanercept was characterized by the lowest number of patients increasing the initial drug consumption (2.6%) and by the highest number of patients reducing the initial drug consumption (10.5%). The mean cost of treatment for a patient persisting with the initial treatment was €12,388 (€14,182 for adalimumab, €12,103 for etanercept and €11,002 for infliximab). The treatment costs for patients switching from initial treatment during the first year of follow-up were higher than for patients who did not switch (€12,710 vs. €11,332).Conclusion: Persistence, switch rate and drug consumption seem to directly influence treatment costs. In subjects not persisting with initial treatment, other health care costs were approximately three times higher than for persistent patients. This difference could suggest a positive effect on the quality of life for persistent patients. Etanercept showed the highest persistence with treatment. Keywords: rheumatoid arthritis, biologic drugs, real-life clinical condition
Supplemental_Material – Supplemental material for Cost-effectiveness analysis of alectinib versus crizotinib in first-line treatment of anaplastic lymphoma kinase-positive advanced non-small cell lung cancer
No full textSupplemental material, Supplemental_Material for Cost-effectiveness analysis of alectinib versus crizotinib in first-line treatment of anaplastic lymphoma kinase-positive advanced non-small cell lung cancer by R Ravasio, M Tiseo, L Pradelli, M Bellone, A Gervasi and M Coffani in Global & Regional Health Technology Assessment</p
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