[Bilateral hydrothorax with hydromediastinum after cannulation of the left internal jugular vein]. / Idrotorace bilaterale con idromediastino dopo incannulamento della vena giugulare interna sinistra.

A rare case of combined bilateral hydrothorax and hydromediastinum was encountered during Total Parenteral Nutrition (TPN) via incannulation of the left internal jugular vein in a patient with advanced cancer of the portio. The possible anatomical and technical causes of this very serious complication were investigated in order to assess the importance of specific manual technique and to supply appropriate instrumental back-up that could prevent the recurrence of this sometimes fatal complication of TPN.

TSF, RBP and TBPA as nutritional indices in surgical patients with gynecological cancer.

The Authors investigated the usefulness of some biochemical markers of visceral protein synthesis (TSF, TBPA and RBP) in 24 patients affected with gynecological cancer and treated with Total Parenteral Nutrition in the perioperative period. The absence of an improving TSF and TBPA is related to increased morbidity and mortality.

A rare case of intramedullary lipoma associated with cyst.

Intramedullary lipomas are benign tumours of the spinal cord corresponding to 1% of all primitive intramedullary tumours. We report a rare case of "true" intramedullary lipoma associated with cyst. The patient underwent subtotal resection and the diagnosis was made by histopathological examination. There was postoperative neurological improvement.

[Clinical experience with althesin]. / Esperienza clinica con althesin.

On the basis of the clinical records of experiments on 110 patients treated with Althesin as induction and maintenance anaesthetic in association or otherwise with other anaesthetics, it is concluded that Althesin possesses good hypnotic power and is compatible with other anaesthetics. It also offers fair stability of cardiocirculatory and respiratory values with slight incidence of unwanted side-effects. Althesin is therefore classed among the safest anaesthetics.

[Comparison of the effect of premedication with diazepam and trazodone on anesthesia induced with althesin]. / Valutazioni comparative degli effetti della premedicazione con diazepam e con trazodone sulla narcosi da althesin.

Interference on the part of premedication with diazepam and trazodone with althesin anaesthesia was investigated and compared by means of variance analysis according to Fisher, and the X2c test according to Yates, in 150 patients aged 35-45 yr in three groups of 50 during examination of the uterine cavity. No marked difference between the effects of the two drugs were noted, with two exceptions: 1) trazodone was better able to potentiate the hypnotic action of althesin, so that less was needed for the induction of anaesthesia; 2) patients pretreated wih diazepam displayed a marked increase in postoperative somnolence, this being an expression of the drug's hypnotic effect.

The influence of thiopentone and alfathesin on succinylcholine-induced fasciculations and myalgias.

Thiopentone doses corresponding to 5.238 mg x kg-1, that is 2UD95 (UD95:unconsciousness dose 95) inhibit the intensity of succinylcholine-induced fasciculations compared with UD95. Alfathesin doses corresponding to 0.570 mg x kg-1, also 2UD95 (calculated as alphaxalone at a concentration of 9 mg/ml in alfathesin), do not have any greater effect on the degree of fasciculations compared to UD95. Furthermore, neither induction agent influences the incidence, distribution and duration of succinylcholine-induced myalgias. The inhibition of the degree of fasciculations caused by thiopentone is believed to be a consequence of a postsynaptic depressant effect of thiopentone at the neuromuscular junction. The evaluation of the degree of succinylcholine-induced fasciculations must take into consideration the dose of thiopentone administered at induction of anaesthesia.

[Althesin in cesarean section]. / L'althesin nel taglio cesareo.

The effects of Althesin (group A) and thiopentone (group B) in mother and newborn were compared after their use in the induction of narcosis in 80 patients undergoing Caesarean section. The mean doses of Althesin (0.072 ml/kg i.v.) and thiopentone (4.1 mg/kg i.v.) proved sufficient to guarantee rapid onset of sleep (about 20 seconds) in both groups. As of cardiovascular effects on the mother in the induction-extraction period, greater stability of cardiac frequency (c.f.) was noted with thiopentone, while Althesin produced rapid, frequent variations in c.f. The reverse phenomenon was observed with respect to arterial pressure variations. The clinical condition of the newborns at 1st, 3rd and 5th minutes after extraction, assessed by means of the Apgar index, was excellent in both groups of patients. Results obtained were assessed by analysing variance with the Fisher test.

Interaction between thiopentone and subhypnotic doses of ketamine.

The hypnotic effects of thiopentone and ketamine were studied in ASA Grade I female patients aged 20-30 without premedication. The dose-response curves of ketamine 0.4 mg kg-1 and thiopentone following ketamine 0.4 mg kg-1 were determined by probit analysis. The interaction between ketamine and thiopentone was found to be an antagonistic one. This effect can be interpreted as a consequence of the different neurophysiological spectra of action of the two drugs.