Minerva anestesiologica
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Minerva anestesiologica · Nov 2005
Informed consent to proposed course of medical treatment: recent case law stances.
Developments in ethics, deontology and case law, along with the related increasing demand for patient autonomy in decision-making in health care, led the President of SIAARTI in 2000 to request the Bioethics Commission to revise the documentation on informed content the Study Group on Anesthesia Safety had issued. In response to the request, a multidisciplinary study group was called to examine the ethical, psychological, clinical, legal and medicolegal issues related to informed consent and to draw up a document that would provide for the implementation of the procedure for information and consent proposed in the model of disclosed information and consent for anesthesia approved by the SIAARTI Advisory Board. ⋯ Since 1992, the failure to obtain consent has become part of case law, an exemplary instance of which is the case of a surgeon that was closed in 2002 with the judgment of the Corte di Cassazione (Italian Supreme Court), section I, of 29/05/2002. The judgment found that, in the absence of express implementation of the Oviedo Convention, a physician is always legitimated to performed therapeutic treatment deemed necessary for preserving the life of a patient in his or her care, even in the absence of explicit consent, with the sole but significant exception of unequivocal refusal of treatment.
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Minerva anestesiologica · Nov 2005
Randomized Controlled Trial Comparative StudyComparison of sequential combined spinal-epidural anesthesia and spinal anesthesia for cesarean section.
The aim of our study was to prove that by using sequential combined spinal-epidural (CSE) anesthesia it is possible to overcome the limits connected to the use of spinal anesthesia (SA) alone for elective cesarean section. ⋯ In our opinion sequential CSE can be considered an important step forward in the regional anesthesia used for elective cesarean section.
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Minerva anestesiologica · Nov 2005
Correlation between hyperglycemia and mortality in a medical and surgical intensive care unit.
The aim of this study was to assess the correlation between hyperglycemia and mortality in a group of patients admitted to a medical and surgical ICU and to evaluate if the association between hyperglycemia and reason of ICU admission significantly worsens patients' outcomes. ⋯ A strict blood glucose control seems to be crucial, even in a medical and surgical ICU. The need for intensive insulin therapy, even by means of continuous infusion of insulin, to obtain the normalization of blood glucose levels, appears essential.