1,721,008 research outputs found
Affinities and divergence of Aedes mosquitoes using bayesian relaxed clock and complex models of evolution
Full text linkKnowledge of Aedini genetic diversity is still scattered and incomplete (only two genomes sequenced so far, (Gasperi at al., 2015; Nane et al., 2007 ). In particular, the divergence time of Aedini has yet to be inferred using molecules. In order to improve our understanding of their evolution, we present the first multigene estimate of Aedini divergences based on Bayesian inference and fossil calibrations. Results are helpful to provide a paleo-biological background to understand present Aedini ecology and to ease genomic studies aimed at ameliorating their control
Ex utero intrapartum surgery (EXIT): Indications and anaesthetic management
No full textThe ex utero intrapartum treatment (EXIT) procedure is a technique for safely managing airway obstruction at birth, in which placental support is maintained until the airway is evaluated and secured. In addition to the usual considerations of anaesthesia in obstetrics there are special considerations relating to the EXIT procedure: maintaining fetoplacental circulation by profound uterine relaxation and achieving fetal anaesthesia for airway manipulations. This chapter focuses on the key issues involved in managing this procedure: the indications, preoperative concerns, organization of a multidisciplinary team, problems of maternal and fetal anaesthesia, maintenance of the uterine relaxation and control of fetal airway. © 2003 Elsevier Ltd. All rights reserved
Undetected central core disease myopathy in an infant presenting for clubfoot surgery
No full textA 1-year-old child was scheduled for two stage bilateral clubfoot surgery. Preoperative evaluation was normal and total intravenous anesthesia with a continuous sciatic nerve block was performed. Two months later, before the second clubfoot correction, a hip subluxation was evident suggesting a provisional diagnosis of neuromuscular disease. Anesthesia was identical, except that a femoral nerve block, necessary to permit a diagnostic muscle biopsy was performed. The perioperative course was uneventful but result of the muscular biopsy was surprising in that central core disease was diagnosed. Although congenital myopathies of all grades and severity exist, they are often mild and underestimated. Patients affected by central core disease are considered susceptible to malignant hyperthermia. Because a high prevalence of myopathic changes is reported in children undergoing clubfoot surgery, anesthesiologists must take precautions including a hightened awareness of these events and a high ..
Hangman's fracture in a paediatric patient: considerations for anaesthesia
No full textCervical spree injuries are quite uncommon in children. When occurring, these lesions are of particular concern for the anaesthesiologist. This case refers to an hangman's fracture diagnosed in a four-month-old female infant, which probably occurred at birth. We describe the anaesthetic management adopted in this infant undergoing diagnostic procedures and conservative treatment. The problems related to airway control and the anaesthetic management utilized to diagnose and treat this unusual paediatric pathology are highlighted
Use of benzodiazepines during pregnancy. A survey in a cohort of pregnant women in northern Italy
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Esox flaviae, population genomics revealed entangled origin and differentiation of the Italian populations
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Ex utero intrapartum technique
No full textUpper airway obstruction of a neonate constitutes an emergency. The ex utero intrapartum technique (EXIT) is a procedure for safely managing airway obstruction at birth, in which placental support is maintained until the airway is evaluated and secured. The anaesthetist is involved in preventing uterine contractions that impair oxygenation of the foetus and cause placental separation, in providing foetal anaesthesia to help airway manipulations, in maintaining foetal pattern of circulation, in preventing and treating maternal hypotension and in resuscitating the neonate. General anaesthesia with high concentration of inhalational agents is preferred as it provides surgical tocolysis and foetal anaesthesia. Additional uterine relaxation may be obtained using tocolytic drugs like nitroglycerin or β-adrenergic agonists. During EXIT the foetus is delivered only as far as the shoulders or thorax leaving the cord entirely in utero to maximize the duration of placental support and to minimize heat and water loss. In this position foetal airway is examined and secured, which may involve tracheal intubation, bronchoscopy or tracheostomy. The umbilical cord is divided and the neonate is completely delivered only after the airway has been secured. With EXIT, a potential life-threatening emergency at birth can be managed like an elective procedure that can improve the prognosis for foetuses with airway obstruction
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