SIAARTI recommendations for analgo-sedation in intensive care unit.
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Biomedical subjects
Publications and source records attributed to F Ambrosio.
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Carbonic anhydrase (CA) III is very abundant in type I skeletal muscle, but its function is still debated. Our aims were to examine CA III expression during growth and determine whether the effects of CA inhibition previously observed in adult muscles could be seen in younger rats in which CA III levels are lower. CA III content and activity were measured in soleus muscles from 10- to 100-day-old rats, and the influence of CA inhibitor on fatigue and hexosemonophosphate content was quantified in vitro. CA III activity and content increased fivefold between 10 and 100 days of age. Data analysis revealed that the influence of CA inhibitor on fatigue was to some extent positively and linearly related to the level of CA III activity. Hexosemonophosphate accumulation with CA inhibition also became more significant with age. In conclusion, CA III level in soleus muscle does not stabilize before 3 mo after birth; data also confirm that the effects of CA inhibitors are due to inhibition of the CA III isoform.
The authors report their experience using a peridural catheter with a subcutaneous port. This was used to obtain 120 peridural anesthesia inductions during a program of surgical debridement in a 13-year-old girl. The authors advocate the use of epidural dexamethasone to treat the ineffective anesthetic injection through a long-lasting catheter.
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Alternative substrates other than glucose could be used by the brain. In this study we hypothesized that lactate and ketone bodies can provide a significant portion of oxidative brain substrates in insulin-dependent diabetes mellitus (IDDM). Six control (C) and six insulin-treated streptozotocin diabetic (IDDM) dogs were studied during euglycemia (EU) and acute insulin induced hypoglycemia (HYPO). During EU for similar plasma glucose concentration (5.5 +/- 0.4 v 5.2 +/- 0.2 mmol/L in IDDM dogs showed a higher baseline lactate concentration (1.5 +/- 0.25 v 0.74 +/- 0.10 mmol/L; P less than .05). The ketone body concentrations were also increased in IDDM dogs but this increase was not statistically significant. The brain glucose uptake was 6.9 +/- 0.6 mumol/kg/min in C and 5.4 +/- 0.7 in IDDM. Lactate was released by the brain both in IDDM dogs (11.36 +/- 1.8 mumol/kg/min) and in C dogs (3.87 +/- 0.9; P less than .05). The brain ketones rate of disappearance (Rd) was 0.3 +/- 0.05 mumol/kg/min in IDDM dogs and 0.19 +/- 0.08 in C dogs. During HYPO the glucose uptake across the brain was 2.88 +/- 0.7 mumol/kg/min in IDDM and 3.12 +/- 0.5 in C dogs. We observed an overall brain lactate release (3.21 +/- 1.7 mol/kg/min) in C dogs and a net uptake (13.44 +/- 1.1; P less than .01) in IDDM (P less than .01). The brain ketones Rd was 0.1 +/- 0.2 mumol/kg/min in IDDM and 0.1 +/- 0.1 in C dogs.(ABSTRACT TRUNCATED AT 250 WORDS)
We present a double-blind trial in which a pulsed infrared beam was compared with a placebo in the treatment of myofascial pain in the cervical region. The patients were submitted to 12 sessions on alternate days to a total energy dose of 5 J each. At each session, the four most painful muscular trigger points and five bilateral homometameric acupuncture points were irradiated. Those in the placebo group submitted to the same number of sessions following an identical procedure, the only difference being that the laser apparatus was nonoperational. Pain was monitored using the Italian version of the McGill pain questionnaire and the Scott-Huskisson visual analogue scale. The results show a pain attenuation in the treated group and a statistically significant difference between the two groups of patients, both at the end of therapy and at the 3-month follow-up examination.
Tritiated imipramine binding to whole platelets was measured in 16 chronic pain patients not suffering from major depression and in a control group. Maximum binding was significantly lower in chronic pain patients than in the control group, whereas the binding affinity was not significantly different.
Tritiated imipramine binding to whole platelets was measured in sixteen chronic pain patients not suffering from major depression and in a control group. Maximum binding was significantly lower in chronic pain patients than in the control group, whereas the binding affinity was not significantly different.
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The authors studied the effects of acupuncture and pentazocine on post-operative respiratory function and pain management on patients hysterectomized by means of a subumbilical midline incision. The acupunctural technique consisted of GB-26, St-36, Sp-6 and auricular Shen-Men bilateral electrostimulation for 40 minutes. The analgesic effect of acupuncture was equivalent to that of 30 mg pentazocine, yet the most important effect of acupuncture consisted in a net increase of vital capacity during the period of acupuncture analgesia that lasted for 3-4 hr after stimulation; contrariwise, pentazocine did not cause any vital capacity increment and vital capacity remained at the levels observed prior to narcotic administration.
The Authors have investigated the antihallucinogenic and sedative effects of auricular points R and shen menn during surgery under ketamine anesthesia. The results demonstrate that the insertion of the needle in point R is very efficient in reducing hallucinations of ketamine emergence, while the insertion of needle in auricular point shen menn causes only a brief period of sedation in the beginning of the emergence period. The acupunctural technique employed by the Authors has been shown to increase considerably approbation of ketamine anesthesia.
The Authors report their experience with the placebo, an essential step in the clinical study of reflexotherapy. They assert that also in this branch of medicine it is possible to carry out a "double blind" clinical experimentation by means of placebo, that is, an essential condition in order to develop a scientific assessment of both the limits and the potentialities of reflexotherapy.
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