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91.
92.
Volatile anesthesia in bariatric surgery 总被引:1,自引:0,他引:1
Sollazzi L Perilli V Modesti C Annetta MG Ranieri R Tacchino RM Proietti R 《Obesity surgery》2001,11(5):623-626
Background: Obesity causes anesthesiologists a broad variety of perioperative theoretical and practical problems. The aim
of this study was to compare two protocols of anesthesia employing Isoflurane and Sevoflurane and evaluate the cardiorespiratory
parameters, postoperative recovery and analgesia. Methods: 90 patients underwent biliopancreatic diversion. 60 patients (group
A) received Isoflurane and 30 patients (group B) were anesthetized with Sevoflurane. Intraoperative monitoring consisted of
EKG, invasive arterial pressure, Sp02, EtCO2, Etanest, Spirometry, urinary output and TOF. Cardiorespiratory parameters and end tidal expiratory concentrations of volatile agents
were collected during specific phases of surgery: 1) before induction of anesthesia, 2) after intubation, 3) after skin incision,
4) after positioning of costal retractors, 5) in the reverse Trendelenburg position, 6) end of surgery. During the postoperative
period the Aldrete test was carried out to evaluate the recovery from anesthesia. VAS was administered for 6 hours after the
end of surgery to set the quality of analgesia. Results: No statistically significant differences in cardiorespiratory parameters
were found between the two groups. Extubation time was significantly less in the Sevoflurane Group than in the Isoflurane
(15 ± 7 min vs 24 ± 5 min, p< 0.05). The Sevoflurane Group showed an Aldrete score significantly higher than the Isoflurane
(8.8 ± 0.3 vs 8.1 ± 0.4, p < 0.05). VAS values did not show statistical differences. Conclusion: The introduction of Sevoflurane,
a volatile agent with rapid pharmacokinetic properties, seems to offer an interesting application in these patients. 相似文献
93.
Segarra A Chacón P Martinez-Eyarre C Argelaguer X Vila J Ruiz P Fort J Bartolomé J Camps J Moliner E Pelegrí A Marco F Olmos A Piera L 《Journal of the American Society of Nephrology : JASN》2001,12(6):1255-1263
This study investigated the relationship between the circulating levels of the endothelial cell glycoproteins plasminogen activator inhibitor type 1 (PAI-1), tissue plasminogen activator (TPA), and thrombomodulin (TM) and the major vascular risk factors described in dialysis patients. In addition, the role of these endothelial cell products as independent predictors of coronary artery disease (CAD) was analyzed. Levels of TM, TPA antigen (Ag), TPA activity, PAI-1 Ag, PAI-1 activity, TPA/PAI complexes, thrombin-antithrombin complexes, fibrinopeptide A, C-reactive protein (CRP), interleukin-1beta and tumor necrosis factor-alpha, lipids, apoproteins A1 and B, and albumin were measured in a group of 200 nondiabetic dialysis patients and 100 healthy matched volunteers. When compared with healthy controls, dialysis patients showed increased levels of CRP, TM, TPA, and PAI-1 and evidence of increased thrombin-dependent fibrin formation. Increased levels of active PAI-1 were associated to a great extent with major classic vascular risk factors and to a lesser extent with CRP and serum triglycerides. Forty-six patients (23%) had evidence of CAD. Variables associated with CAD in the univariate analysis included age, time on dialysis, male gender, number of packs of cigarettes per year, high BP, fibrinogen, apolipoprotein B, albumin, PAI-1 activity, CRP, thrombin-antithrombin complexes, and fibrinopeptide A. Logistic regression analysis found age, high-density lipoprotein cholesterol, gender, high BP, CRP, time on dialysis, and PAI-1 activity to be independent predictors of CAD. This model classified correctly 85% of patients as having CAD and showed adequate goodness of fit for all risk categories. Our data support a pathogenic link among activated inflammatory response, endothelial injury, and CAD in hemodialysis patients and suggest that assessment of circulating PAI-1 levels could be an additional tool to identify dialysis patients who are at risk for developing atheromatous cardiovascular disease. 相似文献
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Piera Di Martino Christine Barthlmy Giovanni F. Palmieri Sante Martelli 《European journal of pharmaceutical sciences》2001,14(4):293-300
Naproxen sodium (NS) is a nonsteroidal anti-inflammatory drug used in painful and inflammatory diseases. By crystallization from water or by exposure to relative humidities over 43%, the anhydrate form can be hydrated to a dihydrate species. Different techniques have been used to characterize physically anhydrate naproxen sodium (ANS) and hydrate naproxen sodium (HNS): elemental analysis, atomic absorption, electron scanning microscopy, thermomicroscopy, differential scanning calorimetry, Karl Fisher’s titrimetry, thermogravimetry, spectrophotometric analysis and X-ray diffraction study. The hydration/dehydration mechanism, at different relative humidities, was investigated to evaluate their physical stability. When stored up to 43% relative humidity, ANS shows a good stability, whereas with an increase in relative humidity it is hydrated. HNS equilibrium solubility was determined at different temperatures (21, 26, 31, and 37°C). Due to the metastability and the quick phase changes in the water of ANS, its solubility was calculated from intrinsic dissolution measurements at the same temperatures, as solubility measurements of HNS. Water solubility of ANS is greater than HNS, but the solubility difference decreases when the temperature decreases. This is due to the fact that at higher temperatures the intrinsic dissolution rates (IDR) of ANS are considerably faster and decrease as the temperature falls. 相似文献
96.
V Di Lazzaro F Pilato M Dileone P Profice C Marra F Ranieri D Quaranta G Gainotti P A Tonali 《Clinical neurophysiology》2008,119(11):2494-2500
OBJECTIVE: Central cholinergic circuits of human brain can be tested non-invasively by coupling peripheral nerve stimulation with transcranial magnetic stimulation of motor cortex. This test, named short latency afferent inhibition (SAI) has been shown in healthy subjects to be sensitive to the blockage of muscarinic acetylcholine receptors and it is impaired in Alzheimer disease (AD) patients, a cholinergic form of dementia, while it is normal in non-cholinergic forms of dementia such as fronto-temporal dementia. The objective of present study was to evaluate central cholinergic circuits in patients with Vascular Dementia (VaD). METHODS: We evaluated SAI in a group of patients with VaD and compared the data with those from a group of AD patients and a control group of age-matched healthy individuals. RESULTS: Mean SAI was normal in VaD patients while it was significantly reduced in AD patients. The analysis of individual data showed abnormal SAI in 75% of AD and in only 25% of VaD. CONCLUSIONS: SAI is normal in most of VaD patients in contrast with AD patients. This test might be used for the functional evaluation of central cholinergic circuits in VaD patients. SIGNIFICANCE: SAI testing may represent a useful additional tool for the evaluation of patients with VaD however, further studies are required in order to evaluate whether this method can be used for the differential diagnosis between pure VaD and different forms of dementia. 相似文献
97.
De Simone Roberto Ranieri Angelo Bilo Leonilda Fiorillo Chiara Bonavita Vincenzo 《Neurological sciences》2008,29(1):69-78
Cranial neuralgias are paroxysmal painful disorders of the head characterised by some shared features such as unilaterality of symptoms, transience and recurrence of attacks, superficial and “shock-like” quality of pain and the presence of triggering factors. Although rare, these disorders must be promptly recognised as they harbour a relatively high risk for underlying compressive or inflammatory disease. Nevertheless, misdiagnosis is frequent. Trigeminal and glossopharyngeal neuralgias are sustained in most cases by a neurovascular conflict in the posterior fossa resulting in a hyperexcitability state of the trigeminal circuitry. If the aetiology of trigeminal neuralgia (TN) and other typical neuralgias must be brought back to the peripheral injury, their pathogenesis could involve central allodynic mechanisms, which, in patients with inter-critical pain, also engage the nociceptive neurons at the thalamic-cortical level. Currently available medical treatments for TN and other cranial neuralgias are reviewed. 相似文献
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100.
Giorgia Randi PhD Maida De Bortoli BSc Piera Mondellini BSc Carla Verri PhD Gabriella Sozzi PhD Marco A. Pierotti PhD Carlo La Vecchia MD Ugo Pastorino MD Italia Bongarzone PhD 《Cancer》2010,116(5):1326-1335