ABSTRACT
AIM: This study was carried out to evaluate the outcome of patients in different hospitals with the aim to plan future structural and management changes. METHODS: All the anaesthesiological and surgical procedures were observed for a 2 weeks period in a major teaching hospital (A), in a major nonteaching hospital (B) and in a minor nonteaching hospital (C) in all the patients requiring anaesthesia. The main and the co-existing diseases and the surgical and anaesthesiological treatments they received were evaluated to determine the outcome. The ASA class, the duration of the procedure, the length of staying in hospital, the transfusions of blood or derivatives, the adverse events for each patient were also observed. RESULTS: The results showed that the patients admitted to the teaching hospital were classified in higher ASA risk classes and had surgery of longer duration, with a higher ratio of major surgery. The outcome was satisfactory in all the 3 hospitals, with a 2 days length of stay respectively in 30% (A and B) and 50% (C) of the patients. The rate of mortality was low: only 3 patients in hospital A and no patient in B and C died in a period of 2 days following surgery. Hospitals B and C showed a large use of modern techniques such as autologous blood transfusion and central and peripheral anaesthetic blocks, with a better cost-benefit ratio than the major teaching hospital. CONCLUSIONS: This study showed good results, but it should be repeated in a few years in order to evaluate any change and possible improvement in the management and outcome of the patients.
Subject(s)
Anesthesia , Health Facility Size , Hospitals, Teaching , Surgical Procedures, Operative , Adult , Aged , Anesthesia/adverse effects , Female , Humans , Length of Stay , Male , Middle Aged , Postoperative Complications/epidemiology , Quality of Health Care , Surgical Procedures, Operative/adverse effects , Treatment OutcomeABSTRACT
We report a case of thrombotic thrombocytopenic purpura evaluated by MR. Multiple hyperintense foci on the T2-weighted images, observed principally in the brain stem and in the region of the basal nuclei, and neurologic signs disappeared after 15 days of therapy.
Subject(s)
Brain/pathology , Cerebral Infarction/diagnosis , Magnetic Resonance Imaging , Purpura, Thrombotic Thrombocytopenic/complications , Adult , Cerebral Infarction/etiology , Cerebral Infarction/therapy , Female , Humans , Purpura, Thrombotic Thrombocytopenic/therapyABSTRACT
We report the clinical case of a patient operated for a right extracerebral haematoma. In the immediate post-operative period, although no clinical signs were present, a BAEP examination (showing the lack of the V) warned of a pathological condition which was ascertained by CT. A second haematoma was observed, contralateral to the first, and immediately removed. In this case, therapy was based on the neuroelectrophysiological findings.
Subject(s)
Cerebral Hemorrhage/diagnosis , Evoked Potentials, Auditory, Brain Stem , Hematoma/diagnosis , Adult , Brain Injuries/complications , Cerebral Hemorrhage/etiology , Hematoma/etiology , Humans , MaleSubject(s)
Eclampsia/complications , Adolescent , Adult , Eclampsia/diagnostic imaging , Female , Humans , Pregnancy , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
The authors used plasmapheresis to treat 8 patients with myasthenia gravis and 26 with polyradiculoneuropathy. In myasthenia the treatment was effective in 85% of the cases, as reported in other studies. Good results occurred in some 80% of the cases with acute and relapsing polyradiculoneuropathy. In all cases plasma-exchange was started in the early stage. In chronic polyradiculoneuropathy the treatment was less effective. The authors discuss the advantages, disadvantages and prospects of this kind of therapy.
