Minerva anestesiologica
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Minerva anestesiologica · Mar 2010
Case ReportsAnesthetic management of an adult patient with Cornelia de Lange Syndrome.
Cornelia de Lange Syndrome is a well-known congenital disease characterized by multiple malformations that make anesthetic management a challenge. Since few individuals survive the earliest stage of life, papers describing the details of anesthetic management are mainly reported in the pediatric population. These individuals who move into adulthood develop physical changes that should be taken into consideration. ⋯ Fiber optic intubation was performed under slight sedation after three unsuccessful attempts. Dental crowding, prominent upper central incisors that were more pronounced than in most children, a short and stiff neck, and poor patient cooperation due to mental retardation and occasional autistic behavior made airway management difficult. This case should alert anesthesiologists to the greater difficulties of managing patients with Cornelia de Lange Syndrome when they become adults.
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Minerva anestesiologica · Mar 2010
Effects of tracheal intubation on ventilation with LMA classic for percutaneous dilation tracheostomy.
The classic laryngeal mask airway (cLMATM) can be used in place of an endotracheal tube (ETT) as the ventilatory device during percutaneous dilational tracheostomy (PDT). We aimed to investigate the possible loss of efficacy of cLMATM after tracheal intubation. ⋯ Efficacy of cLMATM was maintained after short tracheal intubation and decreased after long intubation.
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Minerva anestesiologica · Feb 2010
Case ReportsThe Hutchinson-Gilford Progeria Syndrome: a case report.
The HGPS (Hutchinson Gilford Progeria Syndrome) is a rare genetic disorder with an incidence of 1 per 8 million live births. Originally described in 1886, less than 100 cases have been reported. ⋯ The diagnosis is usually made by age 2, the mean survival age is 13.4 years and the most common cause of death is myocardial infarction. Recent genetic advances have identified the cause as a defect in the LMNA gene of chromosome 1.
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Postoperative urinary retention (POUR) occurs after lower joint arthroplasty with an incidence between 0% and 75%. This vast range reflects the differences in diagnosis and management of POUR. At present, clinical practice includes either preoperative insertion of an indwelling catheter to be removed after 24-48 postoperative hours or postoperative intermittent in-and-out catheterization performed either at scheduled times (every 6-8 hours) or as necessary. ⋯ The purpose of the present article is to review the published data on the effects of analgesia techniques on the development of POUR after hip and knee arthroplasty. General and regional anesthesia are implicated in the etiology of POUR; however, type and duration do not correlate with its incidence. Of the different postoperative analgesic techniques currently used, continuous peripheral nerve block has the least impact on POUR.