Correction to: A case of intracoronary and endovenous levosimendan as a rescue therapy for refractory cardiac arrest.

After publication of this supplement [1], it was brought to our attention that the author 'L. Vegnuti' has been erroneously omitted from the author list of the following abstract.

Optic chiasm involvement secondary to herpetic encephalitis. A case report.

Herpes simplex (HSV) encephalitis is one of the most common central nervous system (CNS) viral infections in adults. Early diagnosis is essential for treatment. We describe the case of a 70-year-old man who reported sudden bilateral reduction of visus. Four days after admission the patient showed high fever, followed the next day by a generalised convulsive crisis and coma. A first magnetic resonance imaging (MRI) showed no alterations, whereas the second showed the usual patterns of HSV encephalitis. With a clinical suspicion of herpetic encephalitis an intravenous therapy with acyclovir was established. The diagnosis of herpetic encephalitis was confirmed by cerebrospinal fluid (CSF) detection of herpes simplex DNA sequences. A further ten days later we performed a third MRI, demonstrating the typical pattern of HSV encephalitis and an increase in size and signal of the optic chiasm.

Nasopharyngeal electrode recording of somatosensory evoked potentials as an indicator in brain death.

Median nerve somatosensory evoked potentials were recorded in 28 comatose patients, eight of whom were progressing from coma to eventual brain death and in 11 brain dead patients using electrodes over the scalp, neck and nasopharynx (nasopharyngeal electrode). This recording technique was used to assess the different derivation of brainstem P14 wave activity. It showed that in the midfrontal scalp to the nasopharynx derivation a clear P14 was present in all comatose patients. This component disappeared during the passage from coma to brain death. In a separate group, simultaneous direct recordings in the vicinity of the dorsal column nuclei and with a nasopharyngeal electrode were made in five patients undergoing neurosurgical procedures at the craniocervical junction with the same somatosensory evoked potential monitor. We found that the P14 recorded with the nasopharyngeal electrode in the neurosurgical patients corresponded in latency and morphology with the P14 recorded directly on the surface of the craniocervical junction and more specifically in the vicinity of the nucleus cuneatus. The nasopharyngeal electrode provides non-invasive access to the ventral brainstem at the medullo-pontine level and the disappearance of the P14 shows a clear sign of involvement of the craniocervical junction in brain dead patients. Our study showed that with a simple montage the nasopharyngeal electrode is an effective non-invasive monitor for brainstem activity and can be used as an early diagnostic indicator of brainstem death.

[Efficiency of utilization of resources used at a polyvalent intensive care and resuscitation center]. / Efficienza di utilizzo delle risorse impiegate in un centro di rianimazione e terapia intensiva polivalente.

Along the lunes of a survey by GIRTI of 2,710 patients hospitalized in the 14 costituing CRTI, a parallel research has been carried out 350 patients in a polyvalent CRTI in order to compare the results. Omega score has been calculated to evaluate the intensity of the supplied treatment and consequently to settle efficiency of the resources. The results show a greater number of treated patients compared to those only monitored for intensive examination and a majority of patients from medical and surgical departments, compared to those from traumatological dpts. This proves that the intensity of treatment depends significantly and progressively on the diagnosis, seriousness and, above all, duration of hospitalization, with the only difference that more resources were needed for those patients who died than for those survived. Despite the coincidence of the quality of the results, this survey diverges from that of GIRTI as far as the quantity of utilized resources, which were about a half of those reported in their survey. This is probably due to the lack of medical and particularly nursing personnel as well as instruments especially monitoring ones, which prevented CRTI from working at its maximum. Then it has been pointed out that some pathologies (extrahospital cardiac arrest and pulmonary embolism) which caused losses of the utilized resources, could improve by creating Emergency and Urgency Departments.(ABSTRACT TRUNCATED AT 250 WORDS)

[Malignant hyperthermia in Tuscany: a study of a five year period from 1986 to 1990]. / L'ipertermia maligna in Toscana: una indagine per il quinquennio 1986-1990.

The authors report the results of a survey on M. H. in Tuscany during five years from 1986 to 1990, in order to ascertain frequency, to point out the system of evaluation of the reported cases, to pick out risk-subjects, to find out the presence of dantrolene in various hospitals and to contribute to the surveys held all over the nation. That is the reason why all the persons responsible for Anaesthesiology Depts. and their collaborators were interested in this survey, through a questionnaire which, where necessary, was further developed. The great number of participants, who supplied their data, allowed is to establish trustworthy values of the set objectives. The number of MH cases was coincident with national and international data: the necessity emerged of an only collecting center and of a sale system of classification of data in order to record and compare them in an homogenous way. Detection of subjects was made possible, in most cases, by personal and familiar anamnesis, and it allowed the very few suspect cases to be sent to the specific centers. We recommend that dantrolene, even though present in most hospitals, be available more widespreadly.

[Plasmapheresis and high-dose immunoglobulins in the treatment of acute demyelinating polyneuropathy]. / Plasmaferesi ed immunoglobuline ad alte dosi nel trattamento della polineuropatia acuta demielinizzante.

The authors report two clinical cases of Guillain-Barré syndrome, treated with contemporaneous use of plasmapheresis and high dose gammaglobulin. An early diagnosis and immediate application of such a therapeutic association, are of paramount importance in order to obtain remission of the neurologic symptomatology within a short time. They report the therapies carried out to avoid complications connected with this syndrome as well as cause which led to quit steroid use in these patients.

[Multiorgan damage in exertion heatstroke]. / Danno multiorgano nel colpo di calore da sforzo.

The paper reports a fatal case of exertion heat stroke. The etiopathogenetic, clinical and therapeutic aspects of the case are described; although rarely observed, this pathology must be taken into account by the intensive care unit in order to ensure rapid aid and treatment in an attempt to modify the severe prognosis due to multiorgan damage which increases with the intensity and duration of hyperthermia.

[The effect of propofol on somatosensory potentials evoked by stimulation of the lower limbs]. / L'effeto del propofol sui potenziali evocati somatosensoriali da stimolazione degli arti inferiori.

The Authors point out that during anaesthesia with propofol, latencies of early cortical waves after SEP of the posterior tibial nerve do not suffer significant variations: this may turn out to be useful during intraoperative monitoring when having to watch the integrity of nervous structures of spinal cords undergoing handling or possible indirect damage.