Biomedical subjects
Publications and source records attributed to D Di Piazza.
A pilot program of general training in Cardio-Pulmonary Resuscitation (C P R) and Basic Life Support (BLS) sponsored by Sicily Regional Administration is illustrated. A practical training in Basic C P R and Emergency Care is offerec to many categories of population and High School students (aged 14-16 years).
This study evaluated the analgesic efficacy of baclofen in relation to specific pain stimuli in 83 women (27 nulliparas and 56 multiparas) undergoing voluntary abortion (clamping of the cervix and dilatation and curettage). The patient population was divided into five treatment groups as follows: group 1, placebo; group 2, baclofen, 0.3 mg/kg, administered intravenously (IV); group 3, baclofen, 0.6 mg/kg IV; group 4, baclofen, 0.3 mg/kg IV, and fentanyl, 1.5 mg IV; and group 5, baclofen, 0.3 mg/kg IV, and diazepam, 5 mg given orally and 5 mg IV. In each case the surgical intervention was started using analgesia only. When the first sensation of pain was recorded, a paracervical anesthetic block was performed to provide pain relief for completion of the operation. The results showed that baclofen had significantly better analgesic properties than did placebo, with no important side effects. Its analgesic action seemed to be dose-dependent, since better results were obtained with the higher dose. The analgesic effect was slightly potentiated when baclofen was combined with fentanyl, but not when it was combined with diazepam. Factors independent of the pain stimuli and drugs used--the most important being parity--influenced the results.
A previously described method was used to induce haemorrhagic shock in the rabbit by removing 40% of the circulating mass. This had been previously established as 2.6 +/- 0.5 kg-1 by a radioisotopic technique. Survivals were determined 1 and 2 weeks later after treatment with 40 mg/kg-1 6-MPD and vascular refilling with 3.5% gelatine equal to the amount removed. The blood gas analysis and EAB findings suggested that haemorrhagic shock includes both a fast and a slow physiopathological stage, and that the results of treatment are strictly linked to the time of its commencement. Metabolic acidaemia and respiratory alkalosis was constant, and all the controls died within 2 days, 6-MPD was not able to normalise the EAB, but ensured 100% survival at 2 weeks. Gelatin brought the lab data close to normal, but only ensured 100% survival at 2 weeks if given immediately after the removal of blood.
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The description of neuro-endocrine effects due to surgical stress and certain anaesthetic products led the authors to look for the action of alfadione and enflurane on the hypothalamic-hypophyseal-thyroidian-adrenal axis. Taking 20 subjects who were divided into three groups of 10, the authors measured the plasma levels of T3, T4, TSH, cortisol and ACTH during anaesthesia with alfadione (without surgery). This was group I. Group II were patients during surgery under alfadione. Group III was during surgery under enflurane. The results show the absence of significant changes in the plasma levels of the hormones measured. The authors conclude that alfadione changes the levels of T3, T4, TSH and cortisol even less than does enflurane, whether the anaesthesia is isolated or in a patient undergoing surgery.
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A pre-, intra- and post-operative determination of thyroid hormone in values in the peripheral and thyroid vein reflux blood of patients with thyroid disorders requiring surgery showed that the so-called intraoperative squeezing of the gland either does not place or is of little importance when delicate surgical movements are commenced. A low incidence of intraoperative arrhythmia was also noted. Prevention of the latter is not indicated, since it is often dependent on surgical movements and/or unorthodox anaesthesiological management.