Lean Thinking to manage a national working group on physics aspects of Stereotactic Body Radiation Therapy.

Purpose: To report how the adoption of a Lean Thinking mindset in the management of a national working group (WG) on the physics of stereotactic body radiation therapy (SBRT) contributed to achieve SBRT standardization objectives.

Methods: Vision for the WG has been established as fragmentation reduction and process harmonization enhancement in SBRT for Italian centers. Two main research themes of the technical aspects of SBRT emerged as areas with major standardization improvement needs, small field dosimetry and SBRT planning comparisons, to be investigated through multi-institutional studies.

Diagnostic accuracy of anesthesiology evaluation timing: the 'One-Stop Anesthesia' in pediatric day-surgery.

Objective: Assessing timing efficacy of anesthetic evaluation in pediatric day-surgery by a diagnostic accuracy study.

Aim: Lowering hospital visits in patients with negative medical history.

Background: Pediatric patients scheduled for day-surgery procedures can be categorized, according to their history, in two groups.

Hypotensive anesthesia with propofol and remifentanil: protective effect of alpha-tocopherol on renal function.

Study Objective: To determine the effect of alpha-tocopherol in patients receiving hypotensive anesthesia with propofol-remifentanil.

Study Design: Prospective, randomized study.

Setting: University hospital.

[Postoperative metabolic acidosis: use of three different fluid therapy models].

Intraoperative fluid administration is considered an important factor in the management of metabolic acidosis following surgical procedures. The aim of this study was to compare three types of intraoperative infusional models in order to evaluate their effect on acid-base changes in the immediate postoperative period as calculated by both the Henderson-Hasselbach equation and the Stewart approach. Forty-seven patients undergoing left hemicolectomy were enrolled in the study and assigned randomly to receiving 0.

Apoptogenic effect of fentanyl on freshly isolated peripheral blood lymphocytes.

Background: Opioids may trigger the apoptotic death of widely ranging cell types, and apoptosis contributes to the immune deficiency of critically ill patients and subjects experiencing surgical trauma. There is evidence that an altered mitochondrial membrane potential constitutes an early and irreversible step in the death-signaling pathway of apoptosis. This study investigated whether fentanyl, a opioid widely used in the management of these patients, may induce apoptosis of T cells by altering their mitochondrial membrane potential.

Oxidative stress and mitochondrial glutathione in human lymphocytes exposed to clinically relevant anesthetic drug concentrations.

Study Objective: To evaluate the potential of compounds commonly used in anesthesia practice to affect the intracellular oxidant-antioxidant homeostasis of peripheral blood lymphocytes at clinically relevant concentrations; and to study the changes in reactive oxygen species production and measure the mitochondrial glutathione content.

Design: Prospective, in vitro study.

Setting: Experimental medical research laboratory at a University Hospital.