Memory distortion during acute and chronic pain recalling.

AIM: The aim of this study was to evaluate the presence of pain memory distorsion using different quantitative pain scales. METHODS: A retrospective study on 2333 patients treated in a Pain Therapy Centre from 1994 to 2000 was carried out. VAS and NRS scores have been evaluated, as referred by patients, at the beginning and at the end of treatment. Moreover pain relief has been evaluated by means of correlation between initial and final pain. RESULTS: Patients do not remember initial pain correctly, using both VAS and NRS. CONCLUSION: Pain memory distorsion is related to pain intensity variation during treatment rather than present pain, and it is inversely related to the initial pain intensity. For this reason, it is not correct to evaluate pain relief at the end of treatment since this procedure can under- or over-estimate the initial pain.

Cost analysis of an Italian ICU.

BACKGROUND: Cost reduction is an important issue in medicine today, especially when considering ICUs, since they account for a large percentage of all hospital expenditure. Through a retrospective analysis of the data regarding the expenses incurred during the years 1996-97, we have been able to evaluate the total costs of our ICU and the influence that each component had on the final costs, thus gathering the necessary information for the improvement of the unit itself. METHODS: Retrospective analysis of a 5-bedded multidisciplinary ICU activity over a two-year period (1996-1997). Cost-related data have been supplied by the Hospital Administration as to wages, infrastructures, equipment buying and maintenance; by Hospital Pharmacy as to drugs and devices supplies; and by Laboratory and Radiology as to diagnostic investigations. RESULTS: According to our experience, physicians and non-medical staff account for more than 50% of the total expenditure--the latter slightly prevailing. Furthermore, we have assessed that the cost distribution is hardly comparable to that reported by other authors. CONCLUSIONS: It is useful to analyse the total distribution and to evaluate their nature only to gain the necessary data that will lead to a more effective management of the unit. Nevertheless, this methodology is valid within the cost analysis of our ICUs but the ICUs of other countries show great differences in the way they are structured and some of the use more reliable activity-based costing methodology.

[Increase in capillary permeability induced by endotoxin: protection with antioxidants and glutathione]. / Aumento della permeabilità capillare provocato dall'endotossina: protezione con antiossidanti e glutatione.

Endotoxin administration increases capillary permeability in experimental animals and this is one of the most relevant events in the pathophysiology of endotoxin shock; the aim of the present experiment was to demonstrate that the action of endotoxin on capillary permeability is due to oxygen-free radicals generation. Experiments were performed on the mesocecum of male Wistar rats; fluorescent labeled bovine albumin (FITC-BSA) was injected intra-arterially to evaluate the capillary permeability; the mesocecum microcirculation was observed by fluorescent light. Permeability was quantified by changes in the number of leaky sites at 10 minute intervals for an hour. The effects of Endotoxin (DIFCO 0111:B4, 30 mg/kg i.a.) were assessed in rats receiving 1) saline, 2) reduced glutathione (250 or 500 mg/kg i.p.), 3) three different nitrones (PBN, DMPO, POBN) (6.25 mg/kg i.p.) whose action is to "trap" oxygen radicals. Capillary permeability largely increased in a few minutes in control rats but it was quite unaffected in rats receiving glutathione or nitrones. As a conclusion the increased capillary permeability observed after endotoxin injection in rats may be due to an oxygen-radicals generation.