[Reconstructive surgery in a case of aneurysm of the ascending aorta and aortic valve insufficiency]. / Chirurgia ricostruttiva in un caso di aneurisma dell'aorta ascendente ed insufficienza valvolare aortica.

The authors report the case of a young patient with an aneurysm of the ascending aorta and moderate aortic incompetence, who underwent a conservative operation at our institution. Dilatation of the sinotubular junction, particularly at the level of the non-coronary sinus of the aortic valve with loss of coaptation between the corresponding leaflet and the two coronary leaflets, was identified at the time of surgery as major cause of valve insufficiency. During surgery, the dilated ascending aorta and pathologic aortic sinus were replaced with a 26 Hemashield prosthesis tailored according to the David guidelines. An intraoperative post-repair transesophageal echo exam showed that the aortic valve appeared to be working competently. The post-operative course was uneventful and at one year, an echographic check of the aortic valve showed that it was fully competent, with normal leaflet motion. Conservative surgery can be a good option in selected patients with ascending aortic aneurysm and aortic valve insufficiency.

[Total parenteral nutrition in resuscitation. A study of 31 cases]. / Nutrizione parenterale totale in rianimazione. Studio di 31 casi.

The authors analyse the results obtained above study of 31 patients managed with total parenteral nutrition for a period variant from 3 to 18 days. From these dates result importance of caloric and nitrogen administration both qualitatively and quantitatively. The authors analyse the nutritional requirements in the seriously patients, particularly with renal insufficiency.

[Chemical rhizotomy using phenol in the treatment of perineal pain of neoplastic origin]. / Rizotomia chimica con fenolo nel trattamento delle algie perineali di origine neoplastica.

The Authors report the results obtained in 53 patients treated with intrathecal injections of 5% phenol in glycerin for the control of serve pain caused by rectal and genital cancer. The method used for determining the sensory roots to be blocked and the technique of drug administration are described. The effects of subarachnoid phenol blockade have been evaluated on the basis of pain relief (measured by the visual analogue test) and improved general well being. The observed results indicate that this is one of the most effective and safest procedures in the management of perineal cancer cancer pain.

[Clinical experience with etomidate]. / Esperienza clinica con l'etomidate.

The effects of Etomidate, a new intravenous anaesthetic agent, were studied in 138 cases which underwent different procedures of variable duration under general anaesthesia. The effects on different organs and systems of this drug, alone or in association with other anaesthetics or adjuvants, were analyzed in this series. Clinical signs, plethysmography and electroencephalography were the main parameters studied. It was shown that Etomidate has a rapid, transient action and a high therapeutic index without any cumulative effects. In conclusion this drug is recommended as an excellent induction agent which could also be advantageously employed for short surgical procedures.

[Althesin-induced EEG changes in patients with central nervous system lesions]. / Modificazioni EEG indotte dall'althesin nei pazienti con lesioni del sistema nervoso centrale.

The EEG changes produced by Althesin (75 microliter/kg intravenously administered over 60 sec) were evaluated in 18 unpremedicated patients wih CNS diseases who were scheduled for cerebral angiography. Three parameters were analyzed: the EEG patterns of anaesthesia, the appearance of a fast activity during stabilized burst suppression (Level V), and enhancement of the registered epileptiform abnormalities. The EEG depth of anaesthesia was correlated with the EEG pattern at rest and the preexisting neurological signs. The 15 Hz fast activity which occurred during the suppression phase of Level V was recorded unilaterally over the healthy hemisphere, while it was observed bilaterally in a case involving lesion of the midline structures. The exaltation of the epileptiform EEG discharges following Althesin administration suggests that this agent might be utilized as a convenient provocative test in the diagnosis of epilepsy.