In this second issue of the Greek e-journal of Perioperative Medicine for 2018 a wide area of interests is covered.
The review article of Gortsou D, et al summarizes the nursing interventions for patients with Myasthenia Gravis (MG) undergoing surgical removal of the thymus gland. They concluded that prompt identification of the symptoms and signs of common MG complications combined with aggressive nurse interventions are the keys to ensure the best possible outcomes.
Dubey A assessed the line of action that forty anesthetic specialists would follow in case of an iatrogenic tooth avulsion during intubation and laryngoscopy. The author observed that few anesthetists knew the correct protocol in handling the avulsed tooth and also proposes measures like immediate reimplantation and stabilization of a permanent avulsed tooth.
The following retrospective study of Ioannidis R, et al compares the level of sensory block in parturients with different body height, after spinal anesthesia with local anesthetic of fixed volume and consistence. Authors concluded that body height of parturients and level of sensory block after spinal anesthesia with a fixed intrathecal solution, for elective caesarean section, seems to be two independent variables.
Next, Lolakos K, et al described the intraoperative use of… Continue reading
One half of cortical thymoma patients develop myasthenia gravis (MG), an autoimmune disease affecting the voluntary muscles, while 15% of MG patients have thymomas. Thymectomy has been a mainstay in the treatment of myasthenia gravis and the management of such surgical patients is extremely demanding both at the physician’s and at the nurse’s level. In this paper we review some of the nursing interventions for patients with MG undergoing surgical removal of the thymus gland. Continue reading
Anesthesiologist always works around the oral and peri oral soft and hard tissue. Oral/nasal intubation might injure hard tissue or “knock out” the tooth. The present study was conducted among anesthetic specialist to assess the measures that they would take to manage an avulsed tooth that might occur during intubation & laryngoscopy. The present study involved 40 anesthetists working in private hospitals. They were asked to answer a questionnaire designed to evaluate the line of action that an anesthetist would follow in case of an iatrogenic tooth avulsion... Continue reading
The aim of this study was to compare the level of sensory block in parturients with different body height, after spinal anesthesia with local anesthetic of fixed volume and consistence. This retrospective study was conducted on 107 women, which underwent caesarean section under spinal anesthesia. It was hypothesized that maternal height was not associated with level of sensory block. Parturients were divided into two groups, based on their body height. Group A (n=65) included those with height ≤165 cm and group B (n=42) those with height of ≥166 cm. Subarachnoid space was reached with a 25G needle through the L3-L4 spinal space. Then, ropivacaine 20mg and 10mcg fentanyl (in solution of 2.8 ml) was given... Continue reading
Η βελτίωση των χειρουργικών τεχνικών αλλά κυρίως των χημειοθεραπευτικών σχημάτων αύξησε κατά πολύ την επιβίωση των ασθενών με κακοήθη νόσο των πνευμόνων. Οι ασθενείς που έχουν υποβληθεί σε θωρακοχειρουργική επέμβαση για κακοήθη νόσο πνευμόνων, έχουν αυξημένη πιθανότητα να υποβληθούν σε μια νέα διαγνωστική ή θεραπευτικήεπέμβαση, λόγω υποτροπής της αρχικής νόσου, ή εμφάνισης ενός δεύτερου πρωτοπαθούς όγκου του πνεύμονα. Continue reading
Adamantinomas are rare primary low grade malignant bone tumors’ (<1% of all bone cancers), which are usually located in tibial diaphysis. We present a case of lung metastasis in a 45 year old female who underwent left knee amputation because of tibial adamantinoma. Continue reading
In this first issue of the Greek e-journal of Perioperative Medicine for 2018 we are very honored to present -throughout our Editorial- an invitation from the organizing and scientific committee of the ANAESTHESIA 2018 for ANAESTHESIA 2018 – 15th Congress of Anesthesiology and Ιntensive Medicine which is to be held in Thessaloniki, on the 20th to the 23rd of September, 2018.
The present issue, also, covers a wide area of interests. The review article of Schizodimos et al summarizes the classification, epidemiology and management of Bloodstream infections (BSIs). They refer to the therapeutic strategy of Bloodstream infections that should be based on international guidelines in combination with local microbiology and local antibiotic resistance data.
Next, Grosomanidis V et al present an experimental study in order to record the effect of increased intra-abdominal pressure on the cardiovascular system of pigs, with or without additional sepsis. Their results showed that the increase in intra-abdominal pressure was well tolerated by the laboratory animals without septic condition, while in septic animals the increase in intra-abdominal pressure had an unfavorable effect on the cardiovascular system.
The following study of Mouloudi E et al. presents data that showed that relative eosinophilia may be… Continue reading
Certainly, nobody during the autumn of 1990, when the 1st Congress of Anesthesiology & Intensive Medicine was first inaugurated, had any idea of the impact and the influence this new institution would gain in the years to come. This very first congress was under the organizational presidency of Dr. Nikos Balamoutsos, respectable teacher and skillful director in the field.
But this was not a surprise; Thessaloniki had already experienced pioneering in Anesthesiology. Dr. Spyros Makris (1926-1978) was the first ever Professor of Anesthesiology in Greece (1974) at the Aristotle University of Thessaloniki. He wrote the very first textbooks of Anesthesiology in Greek and published more than one hundred papers, in Science, Anaesthesia and Analgesia, and other journals. This is the reason why during the opening ceremony, the honorary lecture has his name and is assigned to an academic with a broader scientific flair, normally from the local medical community. Continue reading
Bloodstream infections (BSIs) are a frequent and life threatening condition in hospital settings. The case fatality rate associated with BSI reaches 35-50% when associated with admission to intensive care unit (ICU). The extensive use of intravascular catheters, however, is recognized as the most important factor contributing to the occurrence of BSI. Catheter-related BSIs (CR-BSIs) are the most common types of BSI in ICU. Bacteraemias that occur in the ICU are classified as Community Onset BSI and Hospital Acquired (HA) BSI. They are also distinguished in primary and secondary. Community-onset BSIs are those that occur in outpatients or are first identified 48 h after admission to hospital/ICU, and they may be sub classified further as health care associated (HCA), when they occur in patients with significant prior health care exposure, or community associated, in other cases. Hospital Acquired (HA) and / or ICU-acquired BSIs are defined as those occurring more than 48 hours after the patient's admission into the hospital or ICU or within 48 hours of leaving the hospital or the ICU. Community acquired BSIs usually due to susceptible bacteria should be clearly differentiated from HCA and HA BSIs frequently due to resistant hospital strains. A bedridden status, presence of indwelling devices, recent hospitalization or contact with health care facilities and recent antibiotic therapy may represent the most important risk factors for the development of emerging multi drug resistant (MDR) GN infections. The basic components of the treatment of a bacteraemia in the ICU are determining the type of bacteraemia in order to target potential pathogens, the initiation of empirical antimicrobial therapy based on the guidelines, and the source control if it is a secondary bacteremia. These goals become difficult to achieve in case of BSI due to multi-drug resistant pathogens with high MICs to antimicrobials. The main mechanisms which have put in danger the marvelous antibiotic weapon are the production of ESBL (several different subtypes), the production of carbapenemases and metallo-betalactamases, with consequent spread of multi or pan-resistant organism and the emerging growing resistance in colistin. The targeted treatment should be applied immediately after receiving the susceptibility test from the cultures. Targeted treatment essentially consists in redefining antibiotic treatment, in de-escalation in order to decrease the antibiotic selection pressure, and in determining the duration of treatment. Source control is recognized as an important part of the therapy of BSIs and has been recently shown to be independently related with outcome. Depending on the source of the infection (pneumonia, CRBSIs, urinary tract infections, intra-abdominal infections), the therapeutic strategy should be based on international guidelines in combination with local microbiology and local antibiotic resistance data. Continue reading