Hypotensive anesthesia and recovery of cognitive function in long-term craniofacial surgery.

The aim of our study was to compare three different anesthesiological techniques with regard to hemodynamics, recovery, and postoperative morbidity, for craniofacial surgery. One hundred twenty patients with American Society of Anesthesiologists (ASA) classification of I or II patients, 18 to 32 years old, and undergoing maxillary and mandibular osteotomies were randomly assigned to receive anesthesia with propofol-remifentanil (group P), desflurane-remifentanil (group D), or sevoflurane-remifentanil (group S). All patients were given premedication: midazolam 0.03 mg/kg, atropine 0.007 mg/kg, desametasone 0.1 mg/kg, NaCl 0.9% 100 mL + 2 mg/kg ketoprofene + 1.5 mg/kg ranitidine + 1 µg/kg clonidine. Anesthesia was induced by O2/air (FiO2 0.5), remifentanil 0.5 µg/kg/min, propofol 2 mg/kg, rocuronium 0.6 mg/kg. Maintenance group P received O2/air (FiO2 0.5), remifentanil 0.25 to 1.5 µg/kg/min, propofol 6 to 10 mg/kg/h; groups D and S received O2/air (FiO2 0.5), remifentanil 0.25 to 1.5 µg/kg/min, and respectively, sevoflurane or desflurane 0.5 minimum alveolar anesthetic concentration. The dosage of propofol, desflurane, and sevoflurane, obtained with a value of bispectral index (BIS) 40, was kept unchanged throughout the course, and remifentanil was titrated to maintain controlled hypotension: systolic arterial blood pressure 70 to 90 mmHg and mean arterial blood pressure 50 to 65 mmHg. A 24-hour elastomeric infusion system (ketoprofene 320 mg) was started 60 minutes before induction and cloridrat ondansetron 0.1 mg/kg was administered 30 minutes before the end of surgery. Hypotension was successfully obtained in all three groups with a bloodless surgical field, and there was no need for additional use of a potent hypotensive agent. Early and late recovery were faster and more complete in the D group; P 0.05. Postoperative morbidity (nausea, vomiting, shivering, pain, and edema) was slight and did not significantly differ among the groups

Epilessia e morbo di Wilson: discussione di un caso clinico e revisione della letteratura = Epilepsy and Wilson's disease: case report and literature review

We describe the case of a 26 years old patient, with neuro-psychiatric onset of Wilson's disease, who developed severe generalized dystonia, dysphagia and dysphonia, two weeks after introducing Penicillamine treatment. Brain MRI showed extensive damage of cerebral white matter and cortex in temporal lobes, basal ganglia, thalamus and brainsteam. Despite of treatment was shifted to Trientine and Zinc Acetate, there was not clinical improvement and a month later the patient presented a status epilepticus. In addition a new MRI showed an important extension of temporal lesions

FAN COMPRISING AN ACOUSTIC ATTENUATION ELEMENT

The present invention relates to a fan (300) comprising an impeller (301) and a housing (302) encasing the impeller (301), wherein the housing (302) comprises at least one inlet (303) for fluid to the impeller (301) and at least one outlet (304) for fluid from the impeller (301). The housing (302) further comprises at least one acoustic attenuation element (305) associated with the at least one inlet (303), the acoustic attenuation element (305) comprising at least one hollow lateral expansion (306; 307) arranged around the at least one inlet (303). The at least one hollow lateral expansion (306; 307) is open towards the at least one inlet (303) and is closed towards a periphery of the at least one acoustic attenuation element (305), so as to be configured as an acoustic resonant cavity for noise generated by the impeller (301). The acoustic attenuation element (305) further comprises at least one separation element (308; 309) in the at least one hollow lateral expansion (306; 307) configured for defining at least one second separated volume (310; 311) within the at least one hollow lateral expansion (306; 307), the at least one separation element (308; 309) being configured for dissipating an acoustic field within the at least one hollow lateral expansion (306; 307)

Indagine sulle caratteristiche igienico-sanitarie degli allevamenti ovini della regione Marche che trasformano latte crudo.

Nel sistema agro-alimentare italiano il settore lattiero- caseario occupa attualmente una posizione di primaria importanza. La filiera latte è stata oggetto nel tempo di un crescente interesse da parte del consumatore, soprattutto per quanto concerne i prodotti tradizionali a latte crudo, tipicamente percepiti come genuini e “salutistici”. Tra questi, particolare attenzione viene rivolta alle produzioni ovicaprine, poiché particolarmente apprezzate per le peculiari caratteristiche organolettiche e di digeribilità. Tuttavia, a causa dei rischi sanitari legati alla produzione di formaggi a latte crudo, è necessaria una maggiore attenzione da parte degli operatori nel management aziendale e nelle fasi di lavorazione del prodotto. Nel seguente lavoro vengono presentati i risultati di una indagine preliminare finalizzata alla valutazione dei fattori di rischio relativi alla salubrità del latte di massa ovino. In particolare sono stati sottoposti a studio gli allevamenti della regione Marche che trasformano direttamente latte crudo

Colloque sur l'offre d'éducation: Dijon, 25-26 octobre 1979

International audienc