[Optimization of PEEP levels in the treatment of ARDS by means of monitoring the atrial mixed venous oxygen saturation].
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Biomedical subjects
Publications and source records attributed to E Casadei.
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A large epidemic of spastic paraparesis in Mozambique during a drought was attributed to cyanide exposure from cassava. Active surveillance in one of the villages most affected by the epidemic detected four new cases in the first year after the epidemic, and none in the second year. In apparently healthy schoolchildren in the same village, surveillance of urinary thiocyanate concentration, an indicator of cyanide exposure, showed high peak values of 1175 and 673 mumols l-1 in succeeding years, with a gradual return to near-normal values in the third year. A marked seasonal variation in thiocyanate concentration was present, with the highest value coinciding with the dry season, the period of the epidemic, and the cassava harvest. Lower values were found in the neighbouring unaffected semi-urban centre. As cassava cultivation increases in many drought-affected countries, we recommend monitoring urinary thiocyanate concentration to estimate cyanide exposure and identify populations at risk for spastic paraparesis epidemics.
The increasing use of the atomic absorption technique makes it possible to study man's trace-element requirements with a very accurate methodology. Some of these elements are present in the daily diet in minute quantities of micrograms which are, however, indispensable for the proper functioning of the body. But apart from such trace quantities present in conditions which are not affected by abnormal environmental concentration, there may be situations in which trace-element levels in foods and diets reach very high values. If very high, the levels may expose a population to the risk of toxicity; on the other hand, they may lead to wrong interpretations of trace-element requirements because they may lead the nutritionist to regard some high values as normal levels and therefore appropriate for meeting man's requirements. Inversely, they may also induce the nutritionist to regard lower values as unsatisfactory. Therefore, since these environmental factors, which are not always identifiable, can induce erroneous judgements due to overestimation of the requirements, it would seem appropriate, if figures on the total supplies of the diet are to be used, to refer to the tabled values of the individual foods of the diet, rather than to analyses of the whole diet ready for consumption. In fact, an abnormally high or low value of a trace element of any single food of a food composition table would have little influence on the calculation of the total supply of the diet, whereas the use of values obtained from meals which have been exposed to contamination during technological processes(e.g., through the cooking water of foods or cooking utensils) may result in overestimation. However, the analysis of global diets seems to be the method of choice in toxicological research, because in this type of investigations the basic elements of an evaluation often derive indeed from abnormal conditions identified at consumer level. Regarding the importance of copper and iron in haematopoiesis, the following hypotheses can be put forward: (a) In the haematopoietic phenomena occurring in intrauterine life, copper seems to play a role equal to that of iron, and perhaps even more important. (b) This role does not seem to be an autonomous one, but is mediated by availability of serum globulin to the child. In other words, this hypothesis relates the problem more generally to the protein nutrition of mother and foetus...
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The paper reports the authors' experience regarding the rationalisation of transfusional therapy. The high risks of infection or damage to the immune system have highlighted the need to review the approach used by the anesthetist, surgeon or hematologist resulting in major cultural changes and the development of methods for the use of autologous blood. The study was carried out by comparing 2 similar periods of surgical activity in which the sole variant was the different attitude of the anesthetist who utilised blood transfusion on the basis of pre, intra and postoperative hematocrit values; in addition, the Authors report the results obtained in a group of patients enrolled for EIN. They observed that by using simple rationalisation a 30% saving, equivalent to 101 blood units, was achieved; EIN was performed in 20 patients out of the 32 enrolled with an effective 20% saving equivalent to 40 units; calculating the theoretical saving which could be obtained by total EIN and rationalisation, a saving of as much as 58% equivalent to 198 units could be achieved. Even if many aspects still require definition, good rationalisation, even using simple techniques, coupled with the availability of autologous blood certainly makes blood transfusion safer and less expensive.