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Prospettive storiche sulla metafora del ponte che separa e unisce. Le colonie d'America e la Gran Bretagna: riflessioni su fattori di continuità e di rotture tra colonie e madrepatria
No full textL'articolo affronta il tema del rapporto delle Colonie statunitensi con il Regno Unito, alla luce di fattori di continuità e/o conflitt
Impiego clinico dei miorilassanti in pazienti con malattie neurologiche muscolari e neuromuscolari
No full textviene discusso il ruolo e le criticità dell'impiego dei farmaci miorilassanti nei pazienti portatori di patologie neuromuscolari che possono risentire soprattutto nella fase di recupero dell'autonomia motoria dell'effetto clinico dei bloccanti la placca muscolare
Coscienza mitico-religiosa greca. Riflessioni simboliche.
No full textIn this discussion we will address of the image of the wolf in the mythical-religious consciousness of the Greeks, starting from the reading of some sources. Our discussion begins with the narration of the myth of Lykaon, taken from the Description of Greece by Pausania, Greek writer and geographer, who lived in the second century B.C.. We have extended our thoughts focusing on sources and ancient authors who have dealt directly and indirectly with the characteristics of the wolf, seizing common and recurring features. This work has enabled us to build a clear picture of the representation of the wolf, elaborated by the Greek people and by pastoral peoples in general. Our curiosity, also resulted from the mystery and charm of the theme, has allowed us to develop some reflections on lycanthropy in ancient and medieval times. We considered how the mythical legend of Lykaon, built by Greek consciousness, so far away from us, has continued through the ages to exercise such a fascination that the popularity of the phenomenon of werewolves in movies and in literature is still present. In fact, the wolf is the character that arouses fear par excellence, so much that it is considered a sort of bogeyman in this fairy-tale literature, which depicts him as a negative presence to avoid and possibly kill
Muscle relaxants for outpatient otorhinolaryngeal surgery pattern and home-rediness
No full textBackground and Goal of Study: The use of muscle relaxants in outpatient anaesthesia is controversial, some authors recommend an induction regimen including propofol and opioids without muscle relaxants (1). This study evaluated the intubating conditioning in otorhinolaryngeal (ORL) ambulatory surgery with and without muscle relaxant and the immediate and intermediate post operrative recovery.
Methods: We examined in three groups (n = 20 for each) of ASA I-II patients the intubating conditions four minutes after induction of anesthesia with remifentanil 0.5 mcg/kg/min, propofol 2 mg/kg without muscle relaxant (A) or with rocuronium 0.6 mg/kg (B) or with cisatracurium 0.15 mg/kg (C). The time course of neuromuscolar block was determined by TOF Guard® using train of four stimulation (TOF). Anaesthesia was maintained with remifentanil 0.25mcg/kg/min and propofol 6-8mg/kg/h. Residual block was antagonized at T1 recovery of 25% with neostigmine 50mcg/kg and atropine 15mcg/kg. We have evaluated the intubating conditions with and without muscle relaxant; the onset time as maximal suppression of T1; time to 25% T1 recovery (duration of action), TOF ratio ≥0.9 recovery, postoperative recovery in phase I (Aldrete's score ≥9) and II (PADDS ≥ 9) (2,3).
Results: Intubating conditions were good or excellent in group B and C, in group A they were good only in 50% of patients because of cough and movements after orotracheal tube positioning.
Conclusions: Rocuronium and cisatracurium do not influence the discharge times in ambulatory surgery. The post anesthetic discharge scoring system (PADDS) show that the use of non depolarizing muscle relaxant has no influence on the recovery and home-readiness. 70% of patients were discharged 2 h and 3% 3 h after surgery.
References:
1 Schlaich N, Mertzlufft M, Soltész S et al. Acta Anaesth. Scand 2000; 44: 720-726.
2 Chung F et al. Anesth. Analg 1995; 80: 896-902.
3 Aldrete JS et al. Anesth. Analg 1970; 49: 924-934
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
Comparison of different concentration of ropivacaine in spinal anesthesia for vascular surgery
No full textBackground and Goal of Study: Plain ropivacaine 0,5% vial has been recentely introduced and recommended for intrathecal use. The aim of this randomized study was to compare clinical efficacy and safety of 15 mg plain ropivacaine in different concentration given intrathecally in patients scheduled for vascular surgery (saphenectomies, femoro‐popliteal by‐pass and peripheral aneurysms).Materials and Methods: 38 ASA III patients (mean age 65.5±8.0 years) were scheduled after obtaining written informed consent. All patients had a history of arterial hypertension and other cardiovascular disorders pharmacologically treated. They were divided into two groups A(19 patients) and B (19 patients) receiving respectively ropivacaine 0,75 % 15 mg in a bolus of 2 ml and ropivacaine 0,5 % 15 mg in a bolus of 3 ml. Profile of spinal block (onset and recovery times) and quality of anesthesia (Bromage 0–3 score and pinprick test) were recorded (1). Pulse rate (HR), mean arterial pressure (MAP), cardiac output (CO), left ventricular contractility (dP/dt), systemic vascular resistance (SVR) and global end‐diastolic volume (GEDV) were monitored by the PiCCO System Pulsion in order to evaluate their variations (2). ANOVA test was applied for statistical analysis.Results and Discussion: The median times to onset of complete regression of sensory (140 vs 240 sec; p<0.001) and motor block (175 vs 320 sec; p<0.001) were longer in group B. The quality of sensory and motor block was superior in the group A. The prinpick test at S2 level was similar in both groups. The Bromage scale showed a profile of 2–3 score in group A compared to 1–2 score in group B. 5 patients of group B received additional anesthesia with continuous infusion of propofol 3mg/kg/h because of the poor efficacy of the spinal block. Cardiovascular parameters were not influenced in both groups.Conclusion(s): Spinal anesthesia produced with 15 mg plain ropivacaine 0,75% in a volume of 2 ml is effective and safe in ASA III patients. The concentration of 0,75% gives a complete spinal block in high risk patients without side effects and cardiovascular modifications. A concentration of 0,5% fails to determine an adequate anesthesia level required for vascular surgery and did not offer any advantage in terms of comfort, safety and rapid recovery.
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References:
1 Camorcia M, Capogna G, Lyons G et al. Anesth and Analg 2004; 98: 1779-84.
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2 Buhre W, Weyland A, Kazmaier S et al. J Cardiothorac Vasc Anesth 1999; 13: 437-440.
Cited Here... | PubMed | CrossRe
Jejunoileal bypass in a 20 years woman affected by Gilles de la Tourette syndrome treated with tetrabenazine. Case Report.
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