Contemporary changes in medical science and scientific publishing practices are hard to understand and even harder to follow. In the past it was enough to talk about “medicine” and “announces”/papers written by an author-researcher-doctor. Today one can easily claim that there are constellations of medical fields and publishing practices and still, not describe the reality.

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Trend towards noninvasive, easy to use monitor was always a challenge. Numerous indices have been used to monitor the progress of patients on positive pressure ventilation. The present study compares different indices in a mixed larger intensive care unit (ICU) population. In a prospective observational study Arterial blood gases (ABG) analyses were obtained from 225 patients under mechanical ventilation in a polyvalent adult ICU. Values of ideal body weight (IBW), Body mass index (BMI), PAO2, PaO2/FiO2 ratio (PFr), SpO2/FiO2 ratio (SFr), SpO2/PEEP ratio (SPr), SpO2/PaCO­2 ratio (SPCr), Oxygenation index (OI) and Ventillatory ratio (VR) were calculated; and further correlation analysis was conducted. In Pressure control ventilation mode a relative strong relation between PFr and SFr and OI was found; yet further regression analysis implies that no direct replacement of PFr with SFr can be made without limitations, in clinical setting. In Volume control ventilation mode moderate relation was found between SFr and PFr. In the present study a moderate relation was found between SFr and PFr. The results agree with previous published studies; the differences among them lie in the different design of each one of them. The authors believe that- given the fact that one still considers using broadly PFr as index of oxygenation- SFr can be used safely as a surrogate for PFr only for certain disease states. Larger series are needed in order to define those patients groups and these pathophysiological conditions.

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Dear colleagues,

Traditional publishing is an ex cathedra affair, top down, hierarchical. Electronic publishing is essentially egalitarian1. That’s why the present journal had never adopted printed form.

Here, we would like to underline some of the changes that occurred in the journal. These changes were designed to maintain excellence while improving the efficiency of the review process and taking advantage of new technology. Thus, new features have been added in the article section and feedback surveys are planned to be performed in regular basis. New sections for bibliographic information and editorial board / reviewers’ panel have been added. Organizational changes for a better workflow are also en route. The journal is already accepted in several electronic databases (see “indexing” section), while application for inclusion in several others is also under way. For all the changes, every website visitor is invited to explore these new features.

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Clinical evaluation of pupils is considered as an essential part of neurological examination. The pupillary response to light is controlled by the autonomic nervous system. Numerous factors affect pupils dynamics, like e.g. luminance, visual field area, pain, drug administration, age, the functional integrity of anatomical structures involved, e.t.c. Moreover, pupillometry card method and examination of pupil reaction with the use of a penlight is subjective to a lot of bias. Portable infrared pupillometry allows a more objective and detail evaluation of pupil’s dynamics. That’s why it has already found applications in various clinical areas, like e.g. neurology, psychology, ophthalmology, endocrinology, anesthesia, pain management, intensive care, emergency medicine. This review focuses on physiology of pupil’s dynamics and on applications of infrared pupillometry in perioperative setting.

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The Fontan procedure and its modifications is the definitive therapy for a number of congenital heart diseases. Anesthesia for semi-elective Caeserian section in a pregnant woman with a history of such surgery history can be a real challenge due to probability of high perioperative morbidity and mortality. We present the anesthetic management of a young parturient with a history of a partially repaired complex cyanotic congenital heart disease and perform a literature review.

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The incidence of pre-eclampsia in the western countries is estimated to range from 2% to 6% in healthy, nulliparous women. In developing nations, the incidence of the disease is reported to be 4- 18%,with hypertensive disorders being the second most common obstetric cause of stillbirths and early neonatal deaths in these countries Etiology of the disease is multifactorial, with risk factors like maternal age, oxidative stress, angiotensin T-235 homozygote having a different role in every case. Moreover, the disease its self is a multisystem expression of a complicated pathophysiology. Many attempts to explain the latter have been made with often controversial results. In the present article we explore the hypothesis of intra-abdominal pressure as possible causative factor of pre-eclampsia and the role ofthe maternal venous compartment and rennin-angiotensin-anldosterin system in this hypothesis.

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The application of statistical methods in order to extract safer conclusions from samples of medical data has become a key methodology for synthesis and evaluation in any medical research. This study makes a retrospective overview of statistical methods used for oral presentations in the summaries of Greek anesthesia conferences and tries to “capture” the change in the use of statistics in recent years. Nine hundred and twenty five oral presentations from seven Greek anesthesia conferences were included for further analysis.

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The 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.

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Despite of great interest in understanding the pain mechanisms and pain management, and the foundation of acute pain services; numbers of patients still suffer unacceptable pain even today. Surveys show that there are not many improvements in this area. So, it is quite clear that the solution to post operative pain is not just developing a single technique.

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Early tracheal extubation has been safely performed after large operative procedures, questioning the need for routine postoperative ventilation. Because immediate postoperative tracheal extubation of liver transplanted patients has not been previously reported in Greece, we announce the first case report.

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