Endogenous Agents That Contribute to Generate or Prevent Ischemic Damage

Ornella Piazza and Giuliana Scarpati (2012). Endogenous Agents That Contribute to Generate or Prevent Ischemic Damage, Advances in the Preclinical Study of Ischemic Stroke, Dr. Maurizio Balestrino (Ed.), ISBN: 978-953-51-0290-8, InTech, Available from: http://www.intechopen.com/books/advances-in-the-preclinical-study-of-ischemic-stroke/endogenous-neuroprotective-compounds-in-strok

Update on transfusion solutions during surgery: review of hydroxyethyl starches 130/0.4

Ornella Piazza , Giuliana Scarpati , Rosalba TufanoAnaesthesia and Intensive Care, University of Naples Federico II, School of Medicine, Naples, Italy Objectives: Restoration of circulation is crucial in the surgical patient management. Colloids and crystalloids are widely used for blood volume therapy. We reviewed recent trials to evaluate efficacy and safety of hydroxyethyl starch (HES) 130/0.4 during surgery.Material and methods: A subjective, not systematic, review of literature was performed. Papers were searched to answer questions about efficacy of HES, its impact on coagulation and inflammation and its effects on pulmonary mechanics and renal function.Conclusions: HES 130/0.4 is effective for volume therapy and is less expensive than human albumin. Its effects on coagulation and renal function are manageable; it may ameliorate pulmonary permeability and reduce inflammation.Keywords: HES, colloids, volume loading, coagulation, inflammation, surgery, renal function, pulmonary mechanic

Soccer, neurotrauma and amyotrophic lateral sclerosis: is there a connection?

Curr Med Res Opin. 2004 Apr;20(4):505-8

Effects of dopamine infusion on forearm blood flow in critical patients.

Piazza O, Zito G, Valente A, Tufano R. Effects of dopamine infusion on forearm blood flow in critical patients. Med Sci Monit. 2006 Feb;12(2):CR90-3. Epub 2006 Jan 26

Sepsis-associated encephalopathy

Sepsis-associated encephalopathy (SAE) is defined as a diffuse or multifocal cerebral dysfunction induced by the systemic response to the infection without clinical or laboratory evidence of direct brain infection. Its pathogenesis is multifactorial. SAE generally occurs early during severe sepsis and precedes multiple-organ failure. The most common clinical feature of SAE is the consciousness alteration which ranges from mildly reduced awareness to unresponsiveness and coma. Diagnosis of SAE is primarily clinical and depends on the exclusion of other possible causes of brain deterioration. Electroencephalography (EEG) is almost sensitive, but it is not specific for SAE. Computed Tomography (CT) head scan generally is negative in case of SAE, while Magnetic Resonance Imaging (MRI) can show brain abnormalities in case of SAE, but they are not specific for this condition. Somatosensitive Evoked Potentials (SEPs) are sensitive markers of developing cerebral dysfunction in sepsis. Cerebrospinal fluid (CBF) analysis is generally normal, a part an inconstant elevation of proteins concentration. S100B and NSE have been proposed like biomarkers for diagnosis of SAE, but the existing data are controversial. SAE is reversible even if survivors of severe sepsis have often long lasting or irreversible cognitive and behavioral sequel; however the presence of SAE can have a negative influence on survival. A specific therapy of SAE does not exist and the outcome depends on a prompt and appropriate treatment of sepsis as whole

Thrombin antithrombin complex and IL-18 serum levels in stroke patients

The complex picture of inflammation and coagulation alterations comes to life in acute stroke phases. Increasing evidence points to a strong interaction and extensive crosstalk between the inflammation and coagulation systems: the interest towards this relationship has increased since recent experimental research showed that the early administration of antithrombin III (ATIII) decreases the volume of ischemia in mice and might be neuroprotective, playing an antiinflammatory role