[A singular case of Blizzard syndrome diagnosed at the ICU].
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Biomedical subjects
Publications and source records attributed to C Praticò.
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After mentioning the botanic characteristics of mandragora, its territorial distribution, morphological characteristics and the toxicological properties of its alkaloids, a clinical case of accidental mandragora poisoning is reported. The case was successfully treated with atropinic block antagonists, namely cholinesterase inhibitors. Apart from its serious symptomatology, mandragora poisoning also involves considerable metabolic commitment of liver and kidney, which present evident signs of disturbance. Information about these and other insidious plants should be spread to prevent such cases of poisoning, whose gravity is enhanced by the fact that they are exceptional and not often encountered in clinical practice.
The Authors state their ideas and report their experience about diagnosis and treatment of Crohn's disease. After having treated risk and etiological factors, they discuss typical anatomo-pathological lesions. Then they explain clinical diagnostic and surgical choices extensively: they prefer laparotomic approach. The Author's conclude that timely diagnosis spare heavy complications.
The Authors discuss on anatomical and functional characteristics of ileum-colon junction, physiological narrowing in alimentary tract and often involved in benign obstruction. They report their series and analyze all inflammatory or not inflammatory diseases potentially involved, by describing them shortly and giving some information about their clinical features and imaging. The treatment of this obstruction will be done as soon as possible, before wall lesions force to make a larger resection.
We studied 22 patients undergoing total intravenous anaesthesia for both abdominal and superficial surgery. Anaesthesia has been induced and maintained with propofol (1 mg/kg in 20 seconds; 10 mg/kg/h for 10 minutes; 8 mg/kg/h for 10 minutes; 6 mg/kg/h until the end of the operation) and alfentanil (15 mg/kg before the induction and boli of 10-30 mg/kg in the presence of insufficient surgical analgesia). All the patients have been intubated after the administration of vecuronium 0.1 mg/kg, and artificially ventilated with air and oxygen (FiO2 0.4). We observed: 1) haemodynamic stability after the intubation and during surgery; 2) easy control of surgical analgesia; 3) early postoperative recovery, with no correlation with the doses of propofol and alfentanil; 4) absence of postoperative respiratory depression; 5) intraoperative amnesia; 6) low incidence of postoperative side effects. We conclude that, by virtue of the pharmacokinetic characteristics of propofol and alfentanil, most limitations of total intravenous anaesthesia have been overcome.
Sedation with propofol was achieved in 10 patients with COPD admitted into ICU because of acute respiratory insufficiency. Propofol dosage was 1-3 mg/kg-1/h and the testing period 30-144 h. Curarization was non required. Sedation with propofol, valued by means of Ramsay Score, was suitable in all tested patients. Bio-humoral and instrumental monitoring have not evidenced side effects.
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