Article info


Aslanidis Th.
Mouloudi E.
Papagianopoulou P.


The Greek E-Journal of Perioperative Medicine 2017; 16(b)




POSTED: 10/23/17 6:20 PM
ARCHIVED AS: 2017, 2017b, Letter from the Editors


DOI: The Greek E-Journal of Perioperative Medicine 2017; 16(b)

Within diversity (of publications), we gain.

Aslanidis T1, Papagianopoulou P2, Mouloudi E3.

1 National Center of Emergency Care, Thessaloniki, Greece
2Anesthesia Department, “G. Gennimatas” General Hospital, Thessaloniki, Greece
3Intensive Care Unit, “Hippokration” General Hospital, Thessaloniki, Greece


The vast advance in medical knowledge forces us to super specializations. Yet, as we get to know better the tree, we might lose the perspective of the forest. Team work and more specifically, diversity teams, keep us in touch with the different aspects of knowledge. And although diversity has potential to disrupt group functioning, in reality, in both in behavioral and psychological science and in business arena, diverse teams are proven smarter1-2.

A publication is a reflection of team work towards the same direction. Thus, if working in a team with different specialists give you another perspective of your expertise field, then keeping in touch with a wide range of their work (publications) could also have the same effect.

The present issue represents the inaugural work of the new editorial team of the journal. Based on the aforementioned concept, the articles selected (mostly presentations of original studies) cover a wide area of interests.

The only review included is focused on intracranial hypertension (ICH). Although the subject is present in more than 17000 publications in PubMed database3, the research still continues. New monitoring techniques as pupillometry4, ultrasound measured optic nerve sheath5 and near infrared spectroscopy6 are suggested as alternatives to ‘classical’ invasive techniques. Transcranial pulsatility7 index and substance-Ps’8 role is yet to be defined; new therapies for conditions like refractory idiopathic ICH9 are tested. As we wait for the results of the new trials, Schizodimos et all, summarize the already know facts about the management of ICH.

In the next article, Özler et all. present the results of a study examining the effects of head down and head up positions in patients undergoing elective Coronary Artery By-pass Grafting (CABG) surgery after anesthesia induction. The study comes as an addition to the recently published trials about cerebral hemodynamics in healthy subjects under different conditions10-11.

The following study focus in workload in Intensive Care Unit (ICU). Even though several reports investigate the relation between high workload with administrative problems or adverse effects12-13, Aslanidis et all, use a different percpective as they choose NASA –TLX workload index to assess the effects of the repetition (familiarization) of a complex monitoring task.

Kolonia et al. cover a completely different theme, as they focus on the anesthetic considerations and potential problems of a patient with Noonan’s syndrome. These patients have facial, cardiovascular and skeletal abnormalities which may cause severe perioperative problems. The whole anesthetic management should consider all the above anomalies and be designed to prevent further complications14.

The final article is a “crisis during anesthesia”-related case. While clinician worldwide try to establish a method to predict such adverse effects15, reporting of single cases such as Stergiouda et al. presents, only add the collective database.


  1. Why diverse teams are smarter. Harvard Business Review 2014. Available from: (accessed 10/10/2017).
  2. Galinsky A, Todd A, Homan A, et al. Maximizing the Gains and Minimizing the Pains of Diversity Perspect Psych Sci 2015, Vol. 10(6) 742 –748
  3. National Library of Medicine (US). PubMed [Internet] Intracranial hypertension-results by year. Available from: (accessed 10/10/2017)
  4. [Internet]. Bethesda (MD): National Library of Medicine (US). Identifier NCT03304314, Multifocal Chromatic Pupilloperimetry in Patients with Pseudotumor Cerebri and Healthy Subjects; 2017 Okt 10 [cited 2017 Okt 10]; [about 4 screens]. Available from:
  5. [Internet]. Bethesda (MD): National Library of Medicine (US). Identifier NCT02361671, Optic Nerve Sheath Diameter in Patients with Intracranial Pathology; 2017 Okt 10 [cited 2017 Okt 10]; [about 4 screens]. Available from:
  6. [Internet]. Bethesda (MD): National Library of Medicine (US). Identifier NCT02950181, Descriptive Analysis of Near Infrared Spectroscopy in Critically Ill and Injured Pediatric and Neonatal Patients (NIRSCI); 2017 Okt 10 [cited 2017 Okt 10]; [about 6 screens]. Available from:
  7. [Internet]. Bethesda (MD): National Library of Medicine (US). Identifier NCT03144219, Transcranial Doppler Pulsatility Index as a Marker of Impaired Cerebral Compliance; 2017 Okt 10 [cited 2017 Okt 10]; [about 6 screens]. Available from:
  8. [Internet]. Bethesda (MD): National Library of Medicine (US). Identifier NCT03035838, Importance of Substance P in Intracranial Pressure Elevation Following Traumatic Brain Injury (NK1); 2017 Okt 10 [cited 2017 Okt 10]; [about 6 screens]. Available from:
  9. [Internet]. Bethesda (MD): National Library of Medicine (US). Identifier NCT02143258, Stenting of Venous Sinus Stenosis for Medically Refractory Idiopathic Intracranial Hypertension; 2017 Okt 10 [cited 2017 Okt 10]; [about 6 screens]. Available from:
  10. Kurazumi T, Ogawa Y, Yanagida R, et al. Dynamic Cerebral autoregulation during the combination of mild hypercapnia and cephalad fluid shift. Aerosp Med Hum Perform. 2017;88(9):819-826.
  11. Laurie SS, Vizzeri G, Taibbi G, et al. Effects of short-term mild hypercapnia during head-down tilt on intracranial pressure and ocular structures in health human subjects. Physiol Rep. 2017;5(11). pii: e13302y
  12. Oliveira AC, Garcia PC, Nogueira LS. Nursing workload and occurrence of adverse events in intensive care: a systematic review. Rev Esc Enferm USP. 2016;50(4):683-694
  13. Serafim CTR, Dell’Acqua MCQ, Castro MCNE, et al. Severity and workload related to adverse events in the ICU. Rev Bras Enferm. 2017;70(5):942-948.
  14. Bajwa SJ, Gupta S, Kaur J, et al. Anesthetic considerations and difficult airway management in a case of Noonan syndrome. Saudi J Anaesth. 2011; 5(3):345-7.
  15. Subramanyam R, Yeramaneni S, Hossain MM, et al. Perioperative Respiratory Adverse Events in Pediatric Ambulatory Anesthesia: Development and Validation of a Risk Prediction Tool. Anesth Analg. 2016;122(5):1578-85.
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