2013

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Αγαπητοί συνάδελφοι,

Εκ μέρους της επιτροπής σύνταξης του περιοδικού σας ευχαριστούμε για τη μέχρι σήμερα εμπιστοσύνη και συνεργασία και προσδοκούμε στην περαιτέρω συνεισφορά σας ώστε να συνεχίσει την πορεία του στο χώρο τόσο του ελληνικού όσο και του διεθνούς ιατρικού τύπου.

Το ηλεκτρονικό Ελληνικό Περιοδικό Περιεγχειρητικής Ιατρικής είναι επιστημονικό έντυπο δημοσίευσης ερευνητικού και κλινικού υλικού από όλο το φάσμα της Αναισθησιολογίας, της Επείγουσας και της Εντατικής Ιατρικής, αναγνωρισμένο από το ΥΥΚΑ στα εθνικά περιοδικά (ΦΕΚ 964/20-7-2006) με επίσημο ISSN (1109-6888).

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Delirium, a serious and common manifestation of brain dysfunction in critically ill patients gained great attention over the last decade. Important risk factors such as use of benzodiazepines, coma, preexisting cognitive impairment, alcoholism and high severity of illness at ICU admission were i-dentified. Screening tools like the CAM-ICU and the ICDSC were extensively validated in many different ICU patient populations and are recommended for routine monitoring in everyday practice. Sedation with novel sedatives such as dexmedetomidine, implementation of non pharma-ceutical, preventive interventions and early mobilization of patients may reduce the incidence of this syndrome. The role of haloperidol and atypical antipsychotics in the prevention and treatment of ICU delirium is still under investigation.

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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 purpose of this study was to investigate the performance of the Pediatric Risk of Mortality (PRISM III–24) in a Greek pediatric intensive care unit (PICU). We prospectively followed 300 PICU patients in an observational cohort study. PRISM III-24 performance was assessed in the whole population and in 4 preselected groups (infants, patients with length of PICU stay > 4 days, patients with co-morbidities, ventilated patients) with standard discrimination and calibration me-thods.

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The study compares the efficacy of postoperative analgesia after the intravenous administration of opioids (nalbuphine, tramadol or morphine) in combination with ketamine in patients undergoing radical prostatectomy.Eighty eight patients scheduled for radical prostatectomy were randomly assigned in three groups. In Group A (n=31) Morphine was administered {bolus dose (BD) 0.05mg/Kg and continuous infusion (CI) at a dose [mg/24h =18-(agex0.15)]}, in Group B (n=28) Nalbuphine (BD 0.2mg/kg and CI at a rate 0.05mg/kg/h) and in Group C (n=29) Tramadol (BD 1.5mg/Kg and CI at a rate 0.15mg/Kg/h).

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The goal of this observesional study was to evaluate the improvement of the visual view of the la-rynx in neonates, infants and children with difficult airway using the Airtraq® Optical Laryngosco-pe, compared with visual views of the first conventional laryngoscopy with Macintosh blade. We studied clinical and/or laryngoscopic manifestations of difficult airway and advanced airway mana-gement of nine consecutive pediatric patients (2 neonates, 5 infants and 2 children) admitted from 1/1/2011 to 31/08/2012 for elective/emergency surgery or diagnostic procedure under general anes-thesia.

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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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