Minerva anestesiologica
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Minerva anestesiologica · Jan 2010
Randomized Controlled Trial Comparative StudyComparison of intrathecal hyperbaric and isobaric levobupivacaine in urological surgery.
The aim of our study was to compare the efficacy of hyperbaric and isobaric solutions of intrathecal levobupivacaine for transurethral endoscopic surgery. ⋯ We concluded that the clinical efficacy of hyperbaric levobupivacaine was superior to the isobaric form in spinal anesthesia for transurethral resection.
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Minerva anestesiologica · Jan 2010
Case ReportsEfficacy and safety of quinine-artesunate in an HIV-positive patient with severe falciparum malaria.
Severe falciparum malaria is a medical emergency that is associated with a high rate of mortality, even when treated in an Intensive Care Unit. Until recently, intravenous quinine was the standard treatment; however, artemisin derivatives are now regarded as the first-line treatment for multidrug-resistant falciparum malaria. Although several studies have demonstrated the superiority of Artesunate, this drug is not licensed in many countries. ⋯ Parasite clearance was rapidly achieved; however, on day IV, the patient developed acute respiratory distress syndrome that required mechanical ventilation. The patient was extubated on day XIV and discharged on day XXV. Due to its rapid action, artesunate was likely responsible for the good clinical outcome in this case; however, in order to clarify the role of this new combination therapy, further studies are required.
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Some may consider anesthesia a risky endeavor. However, anesthesia is safer now than ever before, and compared to other disciplines, anesthesiology is still among the leading disciplines with regard to patient safety. ⋯ Given the facts that errors and adverse events associated with patient harm and deaths continue to occur and that the complexity of our health care system will steadily increase, it is clear that more needs to be done in order to make anesthesia safer. With its proposals for training on patient safety, the European Society of Anesthesiology (ESA) makes an important contribution thereto, which merits expeditious and efficient implementation both in academia and everyday practice.
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Minerva anestesiologica · Jan 2010
Etiology of respiratory failure is related to mortality in critically ill patients affected by a hematological malignancy: a retrospective study.
The outcomes of patients affected by hematologic malignancies (HM) admitted to Intensive Care Units (ICUs) because of life-threatening complications are still considered to be poor. The aim of this study was to assess the incidence and impact of cardiac dysfunction on the outcome of these patients. ⋯ ICU patients with HM have high mortality. Respiratory failure caused by cardiac dysfunction seems to be associated with a lower risk of death.