Minerva anestesiologica
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Minerva anestesiologica · Apr 2022
Adjacent segment syndrome after failed back surgery: biomechanics, diagnosis, and treatment.
The adjacent segment syndrome is defined as the changes in the adjacent structures of an operated spinal level that produce symptoms of pain and disability, which worsen the quality of life of a patient. Pain management specialists must be aware of these biomechanical changes brought by spinal surgeries, as well as of the symptoms associated with pain after surgery, to reach an appropriate diagnosis and provide an adequate treatment. ⋯ It is necessary to perform studies with a population sample comprising patients with adjacent segment syndrome after spinal surgery, since almost all treatments applied in this group are extrapolated from those used in patients with pain originating in the same area but who have not previously undergone spine surgery. Therefore, we consider necessary for pain physicians to understand the underlying biomechanics, promote the diagnosis of this condition, and analyze possible treatments in patients with adjacent segment disease to alleviate their pain and improve their quality of life.
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Minerva anestesiologica · Apr 2022
Randomized Controlled TrialEffect of ultrasound angle for radial artery cannulation in adults: a randomized controlled trial.
Although the first attempt success rate of radial artery cannulation has been significantly improved by using dynamic needle tip positioning (DNTP) method, there are still problems with long cannulation time. We hereby observe the effect of ultrasound angle for radial artery cannulation in adult patients. ⋯ The usage of the U-P-needle approach could remarkably reduce radial arterial cannulation time at the first attempt as well as total puncture procedure duration, comparing with the U-P-artery approach.
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Minerva anestesiologica · Apr 2022
Multicenter StudyEarly procalcitonin to predict mortality in critically ill COVID-19 patients: a multicentric cohort study.
High levels of procalcitonin (PCT) have been associated with a higher risk of mortality in COVID-19 patients. We explored the prognostic role of early PCT assessment in critically ill COVID-19 patients and whether PCT predictive performance would be influenced by immunosuppression. ⋯ PCT values are not independent predictors of ICU mortality in COVID-19 patients. Acute immunosuppression significantly reduced PCT values, although not influencing its predictive value.
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Minerva anestesiologica · Apr 2022
Ten conditions where lung ultrasonography may fail: limits, pitfalls and lessons learned from a computer-aided algorithmic approach.
Lung ultrasonography provides relevant information on morphological and functional changes occurring in the lungs. However, it correlates weakly with pulmonary congestion and extra vascular lung water. Moreover, there is lack of consensus on scoring systems and acquisition protocols. The automation of this technique may provide promising easy-to-use clinical tools to reduce inter- and intra-observer variability and to standardize scores, allowing faster data collection without increased costs and patients risks.