Despite stable background pain, most cancer patients suffer 3-4 episodes of breakthrough pain daily. Aim of the present study was the evaluation of potential correlation between effective doses of sublingual fentanyl citrate, administered for controlling breakthrough pain, with transdermal fentanyl used for background pain. Fifty-six cancer patients were prospectivelly recruited. All patients were suffering episodes of breakthrough pain and managed with transdermal fentanyl 25-300μg/h for their background pain.
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Posterior Reversible Encephalopathy Syndrome (PRES) is a newly recognised clinical entity, accompanied by characteristic depicted findings. Disturbance of consciousness levels, spasms, vomiting and cortical blindness are the clinical manifestations of the syndrome, while the main causes are hypertensive encephalopathy, renal failure, immunosuppressive and cytotoxic drugs. PRES may be displayed with reversible damage (white matter edema), while if infarcts happen, damage is considered irreversible or neuronal. Early MRI and Diffusion-Weighted MRI (DW-MRI) provide instant information, directly related to a prognosis, as DW-MRI can separate the vasogenic edema from the cytotoxic one, which is accompanied by early infarcts.
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- Letter from the Editor
- Analgesia and sedation in the paediatric Intensive Care Unit: Evidence based or extrapolation?
- Analgesia and sedation in the paediatric Intensive Care Unit
- Mechanical ventilation during anesthesia:Part I. Mechanisms of Lung Injury
- Mechanical ventilation during anesthesia:Part IΙ. Strategies for the protection of the lung
- Medical Emergency Teams based on anesthesiologists II
- From General ICU to dedicated Neuroscience Intensive Care Units
Αγαπητοί συνάδελφοι,
Μια νέα προσπάθεια ξεκίνησε από αυτό το τεύχος. Μια προσπάθεια να διασφαλίσουμε την υψηλή ποιότητα των κειμένων που δημοσιεύονται, απαλλαγμένα από προβλήματα ηθελημένης ή μη αντιγραφής, μεταφοράς, μετάφρασης ή οποιασδήποτε μορφής μη επεξεργασμένης ενσωμάτωσης αυτούσιων τμημάτων δημοσιευμένων κειμένων από άλλα περιοδικά ή βιβλία. Διεθνώς χρησιμοποιείται ο όρος «plagiarism» για να περιγράψει όλες της πιθανές μορφές αυτής της πρακτικής.
Αυτή διασφάλιση ξεκίνησε στο παρόν τεύχος με την χρήση προγραμμάτων που ευτυχώς υπάρχουν ελεύθερα στο διαδίκτυο και συγκρίνουν το υπό εξέταση κείμενο με την βάση δεδομένων τους. Το πρόγραμμα που χρησιμοποιήσαμε είναι το Duplichecker (http://www.duplichecker.com/) της εταιρείας Content Arcade (http://www.contentarcade.com/index.html). Υπάρχουν όμως τρία σημαντικά ζητήματα που πρέπει να ληφθούν υπ’ όψη.
Πρώτον, όπως γίνεται εύκολα αντιληπτό η διασφάλιση του αποτελέσματος εξαρτάται από την ευρήτητα της βάσης δεδομένων του συγκεκριμένου προγράμματος. Δυστυχώς η δύσκολη οικονομική συγκυρία δεν επιτρέπει την προμήθεια ακριβών και πιθανά πιο αξιόπιστων λύσεων λογισμικού.
Ένα δεύτερο ζήτημα προκύπτει με τα δημοσιευμένα ελληνικά κείμενα, όπου ο όγκος των δημοσιεύσεων είναι πολύ περιορισμένος και μεγάλο τμήμα του δεν είναι αναρτημένο στο διαδίκτυο με ικανοποιητική πρόσβαση.
Το θέμα των μεταφράσεων κατά λέξη (ή περίπου κατά λέξη) ξενόγλωσσων κειμένων ή τμημάτων τους είναι το τρίτο ζήτημα και είναι… Continue reading
Treating children in an intensive care unit aims at the reversal of physiologic derangement of their organism while caring for comfortable physical and psychological environment. Any correctable environmental and physical factors causing discomfort should be addressed before the introduction of effective analgesia and sedation by pharmacological means; a normal schedule for sleep is desirable, and attention should be paid to the provision of feeding and hydration, lighting, environmental noise and the temporal orientation of the patients.
Continue readingIn the field of paediatric critical care, there is considerable uncertainty and variation in the area of analgesia and sedation in critically ill children. Consensus guidelines on sedation and analgesia in critically ill children are available since 2006, although clinical practice reveals variations both in pharmacological agents and regimens used.
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Mechanical ventilation can have adverse effects on pulmonary function. The present review focuses on what has recently emerged as one of the most serious potential complications of mechanical ventilation, ventilation-induced lung injury (VILI). For the purposes of this review, the forms of lung injury will be discussed according to the following headings: barotrauma, volutrauma, atelectrauma, and biotrauma.
Continue readingMechanical ventilation can have adverse effects on pulmonary function. The present review focuses on the effects of perioperative mechanical ventilation and its role in ventilator-induced lung injury. For the purposes of this review, lung protective ventilatory strategies will be discussed.
Continue readingThe essential contribution of medical emergency teams (M.E.T) is to decrease the frequency of sudden deaths and the pointless transportation of patients in the intensive care units. The aim of the present study is to record the number and the type of emergency in-hospital calls, the clinical follow up and outcome, the departments and the staff of hospital that were covered by M.E.T (medical and/or nursing) that participated in them, the medications that were used, and the number of involved individuals per incident, as well as the type of monitoring and the fluids that were used. This study covered a 5 months period of emergency calls.
Continue readingThe review presents literature data and focuses on the acclaimed need for transition from general to dedicated Neurosurgical/Νeurological or Neuroscience Intensive Care Units (NSICU). There are solid data from well designed metanalyses showing that at least in the United States, the wider implementation of intensivists in the ICUs, led to significant reductions in ICU and hospital mortality and patient’s length of stay (LOS). Given the variation in ICU physician staffing plans and the potential for reduced mortality implied by these studies, a more rigorous evaluation of the optimal ICU organization is essential. Highly specialized vs. less specialized ICU physician staffing is associated with reduced hospital and ICU mortality and LOS.
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