Evidence of the correlation between a city's air pollution and human health through soft computing.

Huge quantities of pollutants are released into the atmosphere of many cities every day. These emissions, due to physicochemical conditions, can interact with each other, resulting in additional pollutants such as ozone. The resulting accumulation of pollutants can be dangerous for human health. To date, urban pollution is recognized as one of the main environmental risk factors. This research aims to correlate, through soft computing techniques, namely Artificial Neural Networks and Genetic Programming, the data of the tumours recorded by the Local Health Authority of the city of Benevento, in Italy, with those of the pollutants detected in the air monitoring stations. Such stations can monitor many pollutants, i.e. NO2, CO, PM10, PM2.5, O3 and Benzene (C6H6). Assuming possible effects on human health in the medium term, in this work we treat the data relating to pollutants from the 2012-2014 period while, the tumour data, provided by local hospitals, refer to the time interval 2016-2018. The results show a high correlation between the cases of lung tumours and the exceedance of atmospheric particulate matter and ozone. The explicit genetic programming knowledge representation allows also to measure the relevance of each considered pollutant on human health, evidencing the major role of PM10, NO2 and O3.

Safety and effectiveness of coadministration of intrathecal sufentanil and morphine in hyperbaric bupivacaine-based spinal anesthesia for cesarean section.

Subarachnoid block is a widely used technique for cesarean section. Opioids adding to the local anesthetics can improve its quality. In this prospective, randomized, double blind, controlled trial, we compared the effects of coadministration of intrathecal sufentanil and morphine with intrathecal sufentanil and a single administration of subcutaneous morphine. Sixty-four pregnant women scheduled for elective cesarean section under spinal anesthesia were assigned to two groups according to the way of administration of morphine: intrathecal sufentanil (5 microg) plus intrathecal morphine (150 microg) (ITM group), and intrathecal sufentanil (5 microg) plus single administration of 10 mg subcutaneous morphine (SCM group). In both groups, the local anesthetic used was hyperbaric bupivacaine 0.5 percent (10 mg). Both groups received 1 g acetaminophen every 6 hours. In the postoperative period, pain was recorded on a 0-100 visual analog scale (VAS) and intravenous tramadol (100 mg) was administered if VAS score was >40 mm. Collateral effects, such as nausea, itching, respiratory depression, and sedation were assessed. VAS scores at rest and on coughing were significantly higher in the SCM group than in the ITM group between 3 and 24 hours. The mean titrated dose of tramadol consumed was also significantly greater in the SCM group than in the ITM group (p < 0.05). The time to first administration of tramadol was lower in the SCM group versus the ITM group (p < 0.05). The incidence of nausea was significantly lower in the SCM group than in the ITM group (p < 0.05). There was no significant group difference in the incidence of pruritus (p > 0.05). In conclusion, coadministration of sufentanil and morphine into the subarachnoid space was effective and provided longer pain relief than intrathecal sufentanil plus a single injection of subcutaneous morphine, despite a higher incidence of side effects such as nausea and vomiting.

Post-transfusional variation in urinary oxygen tension in surgical patients.

Prior studies have suggested urinary oxygen tension (P(u)O2) as a putative index of renal blood flow (RBF) and tissue oxygenation. In the present study, we collected intraoperative data from eight anaemic, bladder-catheterized patients who received erythrocyte transfusions during various surgical procedures under general anaesthesia. Urinary and arterial blood gas analysis and co-oximetry were performed before and after transfusion, during an interval in which RBF was assumed to be constant. Pre- and post-transfusion haematocrit levels were 23 +/- 4.8 and 27 +/- 6.4%, respectively, and arterial oxygen content (C(a)O2) was 10.5 +/- 2.5 and 12.4 +/- 3.1 mL/dL, respectively (P = 0.012). Pre- and post-transfusion P(u)O2 was 90 +/- 14 and 108 +/- 20 mmHg, respectively (P = 0.036). 4. These results, although limited, suggest that under conditions of stable haemodynamics, systemic oxygenation and renal function, intraoperative blood transfusion may increase P(u)O2 in anaemic anaesthetized patients. If confirmed by subsequent clinical and laboratory studies, P(u)O2 measurement could become a simple, non-invasive way to monitor renal medullary oxygenation and tissue oxygen availability and help determine whether red blood cells should be transfused.

Dreams recall and auditory evoked potentials during propofol anaesthesia.

It is unclear whether shorter wave latencies of middle-latency-auditory-evoked-potentials may be associated to cognitive function other than nondeclarative memory. We investigated the presence of declarative, nondeclarative and dreaming memory in propofol-anaesthetized patients and any relationship to intraoperatively registered middle-latency-auditory-evoked-potentials. An audiotape containing one of two stories was presented to patients during anaesthesia. Patients were interviewed on dream recall immediately upon emergence from anaesthesia. Declarative and nondeclarative memories for intraoperative listening were assessed 24 h after awakening without pointing out positive findings. Six patients who reported dream recall showed an intraoperative Pa latency less than that of patients who were unable to remember any dreams (P<0.001). A high responsiveness degree of primary cortex was associated to dream recall formation during anaesthesia.

Effects of dopamine infusion on forearm blood flow in critical patients.

BACKGROUND: In critical care, dopamine is administered by infusion at low doses (or=5 microg/kg/min) for assessment of hemodynamics. The present study was conducted to explore the effects of dopamine infusion on the vast microvascular network of skeletal muscle in the early phases of sepsis. MATERIAL/METHODS: An observational study was performed which included twelve critically ill patients. Patients' response to dopamine infusion (3 microg/kg/min) was studied within 24 hours from admission to the ICU. The forearm blood flow (FBF) and vascular resistance (FVR) were measured by near-infrared spectroscopy (NIRS). RESULTS: Dopamine did not ameliorate forearm regional oxygenation. The infusion of dopamine caused an increase in MAP, while FBF decreased with the resistance increase (p>0.05). CONCLUSIONS: NIRS was suitable to measure bedside the vascular resistance and to test the effects of low doses of dopamine on forearm blood flow. A dopamine infusion of 3.0 microg/kg/min caused a reduction in forearm blood flow and an increase in vascular resistance in our patients.