Food anaphylaxis in the elderly: Analysis of allergy vigilance network data from 2002 to 2021.

Background: Few studies have focused on food allergies in the elderly, even though it may persist or appear de novo.

Methods: We reviewed data for all cases of food-induced anaphylaxis in people age ≥ 60 reported to the French "Allergy Vigilance Network" (RAV) between 2002 and 2021. RAV collates data reported by French-speaking allergists regarding cases of anaphylaxis graded II to IV according to the Ring and Messmer classification.

Does patient-controlled continuous interscalene block improve early functional rehabilitation after open shoulder surgery?

Background: Early mobilization after shoulder surgery plays a vital role in successful functional rehabilitation. However, postoperative pain often reduces, or even prevents, effective physiotherapy. We investigated the effect of analgesia via patient-controlled interscalene technique on early functional rehabilitation after open shoulder surgery.

Midlatency auditory evoked potentials in children: effect of age and general anaesthesia.

Background: Midlatency auditory evoked potentials (MLAEP) are a promising tool for monitoring suppression of sensory processing during anaesthesia and might help to avoid awareness. MLAEP in children are different to those in adults and the exact changes during general anaesthesia are unknown.

Methods: In 49 children of age between 2 and 12 yr, MLAEP were recorded before anaesthesia, during tracheal intubation, at steady-state balanced anaesthesia, and after extubation.

The influence of wavelets on multiscale analysis and parametrization of midlatency auditory evoked potentials.

This work shows methodological aspects of heuristic pattern recognition in auditory evoked potentials. A linear and a nonlinear transformation based on wavelet transform are presented. They result in a statistical error model and an entropy function related to the Gibbs function and describe changes in midlatency auditory evoked potentials induced by general anaesthesia.

Concurrent recording of AEP, SSEP and EEG parameters during anaesthesia: a factor analysis.

Background: Spontaneous EEG, mid-latency auditory evoked potentials (AEP) and somatosensory evoked potentials (SSEP) have been used to monitor anaesthesia. This poses the question as to whether or not EEG, AEP and SSEP vary in parallel with varying conditions during surgical anaesthesia.

Methods: A total of 81 variables (31 EEG, 22 SSEP, 28 AEP) were simultaneously recorded in 48 surgical patients during anaesthesia.

[Unwanted wakefulness during general anesthesia].

Intraoperative wakefulness ("awareness") is still a relevant problem. Different stages of wakefulness exist: conscious awareness with explicit recall of pain in 0.03% and with nonpainful explicit recall in 0.

Ropivacaine 7.5 mg/ml versus bupivacaine 5 mg/ml for interscalene brachial plexus block--a comparative study.

We investigated ropivacaine 75 mg/ml in comparison with bupivacaine 5 mg/ml in patients receiving interscalene brachial plexus block (ISB) and general anaesthesia. In this randomized, double-blind, prospective clinical trial, each patient received an ISB block according to the technique originally described by Winnie and a catheter technique as per Meier. The rapidity of onset and the quality of sensory and motor block were determined.

Ropivacaine 2 mg/mL vs. bupivacaine 1.25 mg/mL with sufentanil using patient-controlled epidural analgesia in labour.

Background: In recent studies, minimum local analgesic concentrations have been defined as 0.93 mg/mL for bupivacaine and 1.56 mg/mL for ropivacaine for epidural analgesia for the first stage of labour, resulting in an analgesic potency ratio of 1 : 0.

Discrimination of anesthetic states using mid-latency auditory evoked potential and artificial neural networks.

This study was undertaken to determine whether artificial neural network (ANN) processing of mid-latency auditory evoked potentials (MLAEPs) can identify different anesthetic states during propofol anesthesia, and to determine those parameters that are most useful in the identification process. Twenty-one patients undergoing elective abdominal surgery were studied. To maintain general anesthesia, the patients received propofol (3-5 mgkg(-1) h(-1) intravenously).

[Depth of anesthesia, awareness and EEG].

Inapparent adverse intraoperative wakefulness is still a relevant problem in modern anaesthetic routine. It can be associated with serious negative effects on the postoperative recovery of the patients. Several different procedures have been developed to monitor and therefore avoid intraoperative situations of wakefulness during general anaesthesia.

Activation of mu- and delta-opioid receptors causes presynaptic inhibition of glutamatergic excitation in neocortical neurons.

Background: The mechanism underlying the depressant effect of opioids on neuronal activity within the neocortex is still not clear. Three modes of action have been suggested: (1) inhibition by activation of postsynaptic potassium channels, (2) interaction with postsynaptic glutamate receptors, and (3) presynaptic inhibition of glutamate release. To address this issue, the authors investigated the effects of mu- and delta-receptor agonists on excitatory postsynaptic currents (EPSCs) and on membrane properties of neocortical neurons.

[Induction of anesthesia for a patient with sleep apnea syndrome].

Based on a case report, we offer brief guidelines on the perioperative management of patients with Sleep-Apnea-Syndrome (SAS) who present with a high incidence of a difficult airway and a high risk of respiratory depression during the perioperative period. A 39 year old male patient with a body mass index of 34.22 kg/m2 and receiving continuous-positive-airway-pressure-(CPAP) therapy for known SAS was scheduled for elective plastic surgery.

Improvement in the therapy of multiply injured patients by introduction of clinical management guidelines.

A trauma algorithm representing the guidelines for the management of emergency treatment of severe blunt trauma was implemented at our institution in 1994. By comparison of two prospectively recorded cohorts of multiply injured patients, the clinical efficacy of these guidelines was analysed. The algorithm cohort comprised 74 patients over the period January 1994 to June 1996, and the Control cohort 126 patients over the period April 1988 to December 1993.

Comparison of five sedation scoring systems by means of auditory evoked potentials.

Objective: To review five sedation scoring systems and to determine their correlation with an objective method for assessing the level of sedation by means of auditory evoked potentials (AEP) in critically ill patients.

Design: Prospective clinical study.

Setting: Multidisciplinary intensive care unit in a university hospital.

[Ambulatory anesthesia: which preoperative screening tests are required].

The volume of preoperative screening investigations for outpatient anaesthesia ranges from few, selectively ordered investigations to extensive routine diagnostic procedures. It seem appropriate to reevaluate benefit and efficacy of routine preoperative assessment programs. The purpose of preoperative diagnostic is to assess the risk of anaesthesia and surgery for the patient.

[Sevoflurane and the nervous system].

During sevoflurane anaesthesia cerebral blood flow is preserved or slightly decreased. Cerebral oxygen consumption is reduced to 50% under 1 MAC sevoflurane. Autoregulation of cerebral blood flow and responsiveness of cerebral blood flow to changes in Pa CO2 are widely preserved.

Power spectral analysis of the electroencephalogram during increasing end-expiratory concentrations of isoflurane, desflurane and sevoflurane.

We studied the effects of increasing end-expiratory concentrations of isoflurane (0.3, 0.6, 0.

Conscious awareness during general anaesthesia: patients' perceptions, emotions, cognition and reactions.

We interviewed 45 patients, who answered advertisements (n = 21) or were referred by colleagues (n = 24), about their experience of intraoperative awareness using a standardized questionnaire. Auditory perceptions, hearing sounds or voices were mentioned by all patients (45 of 45): 33 of 45 patients understood and recalled conversations; 21 of 45 patients had visual perceptions; 12 of 21 recognized things or faces; 29 of 45 patients felt being touched; three patients had the sensation of moderate pain; and eight patients were in severe pain. Patients' feelings were mostly related to paralysis (27 of 45), helplessness (28 of 45), anxiety and fear (22 of 45); 18 were in severe panic.

[Quality of pain management in preclinical care of acutely ill patients].

Unlabelled: The aim of this study was to evaluate the quality of pain management in prehospital emergency care and to get more information about the administration of analgesics in prehospital patients.

Methods: Patients with painful diseases or injuries who had been brought to Munich hospital's were included in the study. Immediately after having reached the hospitals' emergency department, they were evaluated using a 101-point visual analogue scale for the severity of pain at four predefined periods.

[Quality management in early clinical polytrauma management. II. Optimizing therapy by treatment guidelines].

To enhance the quality of treatment of patients with multiple injuries (blunt trauma), guidelines for the acute clinical management (trauma-algorithm) were implemented at our clinic in 1994. The impact of these guidelines was analysed, comparing two prospectively recorded collectives of polytraumatized patients 4/1988-12/1993 (A; n = 126) and 1/1994-6/1996 (B; n = 74). Nine specifically defined parameters were used to assess the therapeutic process of early clinical trauma management.

Midlatency auditory evoked potentials and motor signs of wakefulness during anaesthesia with midazolam.

We have studied midlatency auditory evoked potentials (MLAEP) and motor signs of wakefulness during anaesthesia with midazolam in 10 patients undergoing elective laparotomy under continuous extradural analgesia. Anaesthesia was induced with midazolam 0.3 mg kg-1 and maintained with midazolam 0.

Midlatency auditory evoked potentials predict movements during anesthesia with isoflurane or propofol.

To determine threshold values, sensitivity, and specificity of midlatency auditory evoked potentials (MLAEP) for prediction of spontaneous intraoperative movements, 40 patients undergoing elective laparotomy were studied. Continuous epidural analgesia was used in all patients. To maintain general anesthesia, the patients in Group 1 (n = 20) received isoflurane (0.