Hepatopulmonary syndrome: the anaesthetic considerations.

Hepatopulmonary syndrome (HPS) is a pulmonary complication observed in patients with chronic liver disease and/or portal hypertension, attributable to an intrapulmonary vascular dilatation that induces severe hypoxaemia. Considering the favourable long-term survival of HPS patients as well as the reversal of the syndrome with a functional liver graft, HPS is now an indication for orthotopic liver transplantation (OLT). Consequently, blood gas analysis and imaging techniques should be performed when cirrhotic patients present with shortness of breath as well as when OLT candidates are placed on the transplant waiting list.

Complications of elective liver resections in a center with low mortality: a simple score to predict morbidity.

Objective: To develop a score predicting the morbidity of liver resections in a center with low mortality.

Design, Setting, And Patients: The study was based on a prospective database of all liver resections performed at the Geneva University Hospitals between January 1, 1991, and October 30, 2009 (a total of 726 elective liver resections in 689 patients). Perioperative complications and their severity were graded according to the original classification by Clavien et al.

Laparoscopic colon surgery: unreliability of end-tidal CO2 monitoring.

Background: The relatively good haemodynamic and respiratory tolerance to abdominal CO(2) insufflation has mostly been observed in healthy patients during short-lasting laparoscopic procedures. End-tidal CO(2) pressure (PetCO(2)) has been shown to be a reliable method to assess arterial CO(2) (PaCO(2)) in the absence of cardio-respiratory disease in this setting. However, no study has investigated whether PetCO(2) is accurately related to PaCO(2) during laparoscopic colon surgery.

Low-dose sufentanil does not potentiate intrathecal morphine for perioperative analgesia after major colorectal surgery.

Purpose: Both intrathecal sufentanil (ITS) and intrathecal morphine (ITM) improve analgesia in obstetrical or cardiac procedures. From a pharmacokinetic standpoint, combining these two opioids may improve perioperative analgesia. We performed a prospective randomized double-blind study to compare the analgesic efficacy of ITM alone vs a mixture of a low dose of ITS plus ITM for perioperative pain relief in colorectal surgery.

Hepatopulmonary syndrome increases the postoperative mortality rate following liver transplantation: a prospective study in 90 patients.

Hepatopulmonary syndrome (HPS) is a frequent pulmonary complication of patients with end-stage liver diseases. HPS is diagnosed by hypoxemia and pulmonary vascular dilatation and is an independent risk factor of mortality. Orthotopic liver transplantation (OLT) is the only factor that modifies the natural course of HPS.

Isolation of an atypical strain of Actinobacillus pleuropneumoniae serotype 1 with a truncated lipopolysaccharide outer core and no O-antigen.

A field isolate of Actinobacillus pleuropneumoniae, the causative agent of porcine fibrinohemorrhagic necrotizing pleuropneumonia, was sent to the diagnostic laboratory for serotyping. The isolate presented a clear reaction, with both polyclonal antibodies against serotype 1 and monoclonal antibodies against the capsular polysaccharide of serotype 1. It also exhibited a PCR profile of Apx toxins expected for serotype 1.

Assessment of the efficacy of tilmicosin phosphate to eliminate Actinobacillus pleuropneumoniae from carrier pigs.

The aim of this study was to evaluate the efficacy of in-feed medication with tilmicosin phosphate in order to eliminate or reduce the carriage of Actinobacillus pleuropneumoniae in the tonsils of carrier pigs. Two groups of 6 carrier animals received either a non-medicated feed (control group) or feed medicated with 400 ppm of tilmicosin phosphate (treated group) for 30 d. Three sentinel pigs were then introduced in each group and left for 29 d.

The quantitative distinction between train-of-four "counts of 2" and posttetanic "counts of 2" evidenced by a stable paralysis/stable infusion rate method in anesthetized patients receiving mivacurium.

In this study we quantitatively evaluated, by a stable paralysis/stable infusion rate method, the difference between two standardized paralysis levels--train-of-four (TOF) count of 2 responses and posttetanic count (PTC) of 2. Ten ASA physical status I-II consenting adult patients scheduled for elective surgery were anesthetized (sufentanil/propofol), tracheally intubated, mechanically normoventilated with a fixed O(2)/air mixture, and normothermic; oropharynx and thenar temperatures were maintained above 36 degrees and 32.5 degrees C, respectively.

Antitumor activity of wheats with high orthophenolic content.

The purpose of the present study is to develop in vitro assays for rapid screening of a large number of food samples that contain components that prevent tumor formation in vivo and to identify the components that contribute to this antitumor effect. Wheat samples representing numerous strains and cultivars were screened for their in vitro ability to kill a human colon cancer cell, CaCo2, in culture by trypan blue dye exclusion assay. Wheat samples were assayed for orthophenolic acid content by use of a colorimetric assay using a bathochromatic shift at 350 nm.

Are there reliable predictors of postoperative pain?

Background: The purpose of this study was to identify the preoperative determinants of severe postoperative pain.

Methods: Potential predictors were assessed using a questionnaire submitted on the day before surgery. Pain at rest, and pain during coughing/mobilization, were measured using visual analog scales on the day of surgery and on the following 2 days.

Abdominal skin temperature variation in healthy broiler chickens as determined by thermography.

Abdominal skin temperature of healthy broiler chickens was determined by thermography to estimate the normal range of between- and within-bird temperature variation. Effects of potential confounding factors, such as bird's contention duration, abdominal side, age, and time of day, were also estimated. Mean skin temperature was estimated from thermogram pictures by computer image analysis of a predetermined abdominal area.

Hip fracture surgery: is the pre-operative American Society of Anesthesiologists (ASA) score a predictor of functional outcome?

Background And Aims: Many studies have identified specific demographic, social, health or life-style pre-operative indicators of long-term outcome among older hip fracture patients who underwent surgical treatment. The purpose of this study was to determine the predictive value of peri- and intra-operative factors, and more specifically of the pre-operative American Society of Anesthesiologists (ASA) score on functional outcome in these patients.

Methods: A questionnaire designed to assess pre-fracture functional and health status was administered to surgically treated hip fracture patients.

Quasi-model-independent search for new high p(T) physics at D0.

We apply a quasi-model-independent strategy ("Sleuth") to search for new high p(T) physics in approximately 100 pb(-1) of pp collisions at square root of (s) = 1.8 TeV collected by the D0 experiment during 1992-1996 at the Fermilab Tevatron. We systematically analyze many exclusive final states and demonstrate sensitivity to a variety of models predicting new phenomena at the electroweak scale.

Inclusive jet production in pp(macro) collisions.

We report a new measurement of the pseudorapidity (eta) and transverse-energy ( E(T)) dependence of the inclusive jet production cross section in pp(macro) collisions at square root of s = 1.8 TeV using 95 pb(-1) of data collected with the D0 detector at the Fermilab Tevatron. The differential cross section d(2)sigma/(dE(T)d eta) is presented up to eta = 3, significantly extending previous measurements.

Ratio of jet cross sections at square root of s = 630 GeV and 1800 GeV.

The D0 Collaboration has measured the inclusive jet cross section in barpp collisions at square root of s = 630 GeV. The results for pseudorapidities (eta)<0.5 are combined with our previous results at square root of s = 1800 GeV to form a ratio of cross sections with smaller uncertainties than either individual measurement.

Ratios of multijet Cross Sections in p p collisions at radical(s) = 1.8 TeV.

We report on a study of the ratio of inclusive three-jet to inclusive two-jet production cross sections as a function of total transverse energy in p&pmacr; collisions at a center-of-mass energy sqrt[s] = 1.8 TeV, using data collected with the D0 detector during the 1992-1993 run of the Fermilab Tevatron Collider. The measurements are used to deduce preferred renormalization scales in perturbative O(alpha(3)(s)) QCD calculations in modeling soft-jet emission.

Search for large extra dimensions in dielectron and diphoton production.

We report a search for effects of large extra spatial dimensions in pp collisions at a center-of-mass energy of 1.8 TeV with the D0 detector, using events containing a pair of electrons or photons. The data are in good agreement with the expected background and do not exhibit evidence for large extra dimensions.

Treatment efficacy is not an index of pain intensity.

Purpose: To determine if the efficacy of pain treatment assessed by the patient is a valid indicator to evaluate pain management.

Methods: Three hundred and ninety one adult patients were investigated on the day of surgery and on the two following days after intraperitoneal or orthopedic surgery. Pain scores and efficacy of pain treatment were evaluated using ungraduated visual analog scales (VAS).

[Start of an adult living donor liver transplantation program in Switzerland].

The shortage of cadaver organs has prompted transplant centres to seek new sources of grafts. While living-donor left lobe transplantation (segments II and III) is an established procedure for children, living donor right liver transplantation (segments V, VI, VII, VIII), which can provide adequate liver mass for an average-sized adult patient, is technically more demanding and potentially associated with higher risks for the donor. In view of the permanent shortage of organs in Switzerland, we started an adult living donor liver transplantation programme in 1999 with the approval of the Clinical Ethics Committee of Geneva University Hospitals.

Prognosis of functional recovery 1 year after hip fracture: typical patient profiles through cluster analysis.

Background: Many investigators have identified distinct medical, demographic and psychosocial prefracture conditions that influence the functional outcome of patients surgically treated for a fracture of the hip. However, to design efficient intervention care programs addressing the needs of these patients, at optimal economic and social costs, more information is required on the typical combinations of prognostic determinants actually encountered.

Methods: Data on specific descriptors of the prefracture status and on mobility and functioning 1 year after surgical intervention were collected by interview from 253 consecutive patients hospitalized for a fracture of the proximal femur.

Probing Balitsky-Fadin-Kuraev-Lipatov dynamics in the dijet cross section at large rapidity intervals in pp collisions at sqrt[s]=1800 and 630 GeV.

Inclusive dijet production at large pseudorapidity intervals (Deltaeta) between the two jets has been suggested as a regime for observing Balitsky-Fadin-Kuraev-Lipatov (BFKL) dynamics. We have measured the dijet cross section for large Deltaeta in pp collisions at sqrt[s]=1800 and 630 GeV using the D0 detector. The partonic cross section increases strongly with the size of Deltaeta.

Measurement of the W-->taunu production cross section in pp collisions at square root s=1.8 TeV.

We report on a measurement of sigma(pp-->W+X)B(W-->taunu) in pp collisions at sqrt[s]=1.8 TeV at the Fermilab Tevatron. The measurement is based on an integrated luminosity (lum) of 18 pb-1 of data collected with the D0 detector during 1994-1995.

Anesthetic assessment in an outpatient consultation clinic reduces preoperative anxiety.

Purpose: Preoperative anxiety in relation to anesthesia remains for many patients a major subject of concern. The aim of the present study was to compare the level of preoperative anxiety in patients assessed in an outpatient consultation clinic with the anxiety level of those having been assessed by the anesthesiologist after entering the hospital.

Method: We studied two groups of 20 patients who underwent elective transurethral prostate or bladder resection: group A having the anesthetic assessment between one-two weeks before hospitalisation, group B having this assessment the evening before surgery, after entering the hospital.