Reporterskie zmagania z obrazami pamięci : wokół "podróży do Włoch" Jarosława Iwaszkiewicza

Jarosław Iwaszkiewicz's Italian travels are the record of the real journey to Apennine Peninsula in the form of reportages. The important fact is that each report constitutes a particular collection of impressions and observations of not the very journey as such but they constitute a compilation of author's encounters with the place he described. As a subject of description the author chose places less known because he wanted to depart from run-of-the-mill description of the Italian space. The form of a reportage allows Iwaszkiewicz to connect freely the description of urban spaces with reflections on history of art and observations on political and economic situation of Italy. Moreover, he allows certain textual polyphony, justifies subjectivity, selectivity of observation and justifies the lack of interest in the chronology of events or the cause and effect relationship of the plots taken. At the same time Italian travels are Iwaszkiewicz's reflections on his own life and work. The text devoted to Sicily (which is one out of seven reportages in the volume) is analysed in detail

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

A Rare Cause of Acute Renal Failure: Leriche Syndrome

A Rare Cause of Acute Renal Failure: Leriche SyndromeAkut Böbrek Yetmezliginin Nadir Bir Sebebi: Leriche SendromuSeydahmet Akın 1, Sinan Kazan 1, Bilge Kalkan 2, Mehmet Aliustaoğlu 1&nbsp;ABSTRACTLeriche Syndrome is characterized with occ-lusive atherom plaques at aortic bifurcation obs-tructing iliac arteries. Renal arteries are involvedin only 10% of patients. Renal artery involvementmay be a rare cause of renal impairment. We reporta Leriche sydrome case presenting with acute renalfailure.Key Words: atherosclerosis, Leriche syndrome, Re-nal insufficiency.&nbsp;</div