Gambling pathology is associated with dampened cortisol response among men and women.

Pathological gambling has many similarities to pharmacological addiction. Notably, both pathological gambling and drug addiction are characterized by aberrations in hypothalamic-pituitary-adrenal (HPA) axis responding. As well, there are indications that gender differences may play a role in these processes. Whether gender and/or HPA response are associated with pathological gambling was of interest. Recreational and pathological gamblers (15 men and 6 women per group) had the HPA factor, cortisol, assessed in saliva before and after watching a video of their preferred mode of gambling (slot machines, horse race betting, scratch-off tickets, blackjack, video poker, craps, sports betting, online casino games, or lottery tickets), and a video of neutral stimuli (a rollercoaster ride). Basal levels of salivary cortisol did not significantly differ among recreational and pathological gamblers. However, recreational gamblers demonstrated significantly increased salivary cortisol levels after the gambling and rollercoaster videos, whereas pathological gamblers demonstrated no salivary cortisol increase in response to either video stimulus. There was also a non-significant trend for women to have a greater cortisol response to video stimuli compared to men. These data suggest that pathological gambling is associated with hypoactive HPA response to gambling stimuli, similar to chronic drug exposure, and gender may contribute to this effect.

[General anesthesia without nitrogen monoxide. Its use in abdominal surgery]. / Anestesia generale senza protossido d'azoto. Impiego in chirurgia addominale.

In view of the problems relating to the routine use of nitrogen monoxide in general anesthesia, the authors drew up an anesthesiological protocol excluding the use of N2O and replacing its analgesic effect with higher doses of fentanyl and a higher inspired percentage of isoflurane. Twenty-three patients due to undergo abdominal surgery were included in the study. The established anesthetic protocol was evaluated by the constant measurement of PAOS/D and heart rate, as well as lacrimation and sweating. Satisfactory results were achieved using this protocol in almost all patients, although further modifications to the protocol are planned to make the technique more stable and manageable.

[Subarachnoid anesthesia and peridural anesthesia: which are the causes of total failure? A clinical case]. / Anestesia sub-aracnoidea e anestesia peridurale: quali le cause di un completo insuccesso? Caso clinico.

The paper reports the case of patient undergoing cystoscopy and subsequently radical cystectomy suffering from BPCO and pulmonary emphysema who received sub-arachnoid anesthesia during the first operation and peridural anesthesia during the second, with total failure both times. The techniques were correctly performed and on both occasions it was necessary to resort to general anesthesia in order to perform the operation.

[Congenital deficiency of metahemoglobin-reductases (diaphorases). A case of cyanosis during general anesthesia]. / Deficit congenito di metaemoglobin-reduttasi (diaforasi). Un caso di cianosi in corso di anestesia generale.

A case of cyanosis during general anaesthesia in a patient suffering from congenital deficiency of metahaemoglobin-reductase (diaphorase) is reported. The anaesthesiological technique and the probable triggering cause are analysed. The investigation carried out in members of the family to obtain confirmation of the genetic origin of the enzymatic deficiency is also reported.