Comparison of A-mode ultrasound and computed tomography: detection of secretion in maxillary and frontal sinuses in ventilated patients.

OBJECTIVE: To study the accuracy of A-mode ultrasonography (A-MU) in detecting secretion in maxillary and frontal sinuses in critically ill, intubated patients undergoing mechanical ventilation. DESIGN: Open study in mechanically ventilated, comatose patients. SETTING: Medical-surgical intensive care unit in the General Hospital of Rovigo. PATIENTS: 50 consecutive, mechanically ventilated, critically ill patients. All patients were in a coma and needed cerebral computed tomography (CT) for a diagnosis. MEASUREMENTS AND RESULTS: The A-MU technique gave 100 images of maxillary and frontal sinuses. The images were read blindly and classified into five categories: definitely normal, definitely abnormal, probably normal, questionable, and probably abnormal. CT findings were considered to be the "gold standard". The specificity of echo images varied from 72 to 98% and the sensitivity from 63 to 86% for maxillary sinuses. For frontal sinuses, the specificity varied from 96 to 99% and the sensitivity from 14 to 57%. The area under the receiver-operating characteristic curve was found to be 0.89 and 0.76 for maxillary and frontal sinuses, respectively. CONCLUSIONS: The A-MU technique is an accurate tool for detecting secretion in the maxillary sinuses in intubated patients. More investigations are necessary in order to evaluate its usefulness in the frontal sinuses.

[Aneurysmectomy and aortocoronary bypass. Immediate and long-term results of 56 patients]. / Aneurismectomia e by-pass aorto-coronarico. Risultati immediati ed a distanza in 56 pazienti.

56 pts. who underwent left ventricular aneurismectomy were studied. Clinical improvement and lat post-operatory mortality rate have been evaluated. 39 pts. (II group) also had aortocoronary bypass and other surgical procedures performed at the time of the aneurismectomy. Group I (no other surgery beside the aneurismectomy) and group II did not significant differences in the pre-operatory period and were, therefore, comparable. The total operatory mortality has been of 14% (17.6% in group I and 12.8% in group II). By using myocardial protection the mortality dropped to 5.8%. A significant difference between deceased and survived pts. was noted in the following parameters: cardiac index, A-V oxygen difference, extracorporeal circulation time and the number of diseased coronary arteries (P < 0.001-0.005). Only 2 pts., both in group II, had a late death. After the operation 32 pts. became asymptomatic. Five pts. remained symptomatic: 3 continued to complain of angina and 2 to show signs of left ventricular failure; ventricular arrhythmias were still present in 6 pts. post-operatively (compared to 16 pts. pre-op.). The data suggested that aneurismectomy, associated with aorto-coronary bypass and myocardial protection, has an acceptable operatory risk, particulary in pts. with a good residual ventricular function. Except for ventricular arrhythmias clinical results are very good and late mortality rate is low

Influence of aromatic compounds in sugar chromatography on anion-exchange resins.

In sugar separations by partition chromatography on anion-exchange resins in aqueous ethanol, phenolic compounds are eluted within the same range as sugars and interfere when non-specific detectors are used. The simultaneous application of the orcinol method for sugars and an ultraviolet-detector for the aromatic compounds makes it possible to determine both types of compounds in the same chromatographic run.