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This paper explores the relations between nocturnal practices, their negative impacts and the regulation, design and planning of public spaces. Focusing on the case of Montpellier and Bologna, two cities that have experienced the rise of several nightlife-related problems, it analyzes the variety of measures and regulations adopted by local administrations and their impacts. It suggests that the “disciplinary” approach adopted by these cities, that consider nightlife-related conflicts a problem of public order connected to excessive behaviors, often associated to alcohol consumption in the public space, has limited or even counterproductive results. A more structural action that takes into account the urban night in both urban policies and planning is needed to effectively tackle the night-time economy’s negative impacts. This implies to fully consider how the physical, social and cultural dimensions of public spaces influence night-time practices.

The last two decades have witnessed the emergence of a growing interest in the evolution of the urban night. However, the touristification of the urban night has received only limited attention in contemporary social sciences. Until now, academic research has explored night tourism mainly in relation to specific contexts or events: tourist resorts or springbreaks.The focus was placed on the health and safety risks associated with excessive drinking, recreational drug use and casual sex. More recently, researchers have begun to theorize these forms of holiday as a form of temporary departures from the participants' daily lives. While this vision of night tourism as a temporary departure is still dominant, recent studies have revealed a more complex reality. For this reason, this paper proposes the development of a new research agenda aimed at questioning the progressive diversification of tourist practices during the night in the city and the urban issues that these dynamics produce.

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Purpose: To compare spectral analysis of the electrocardiogram (ECG) with mean arterial pressure (MAP) and heart rate (HR) monitoring in the detection of autonomic hyperreflexia (AHR) induced by sacral root stimulation., Methods: Ten spinal cord injured patients scheduled for implantation of a sacral root stimulator for bladder retention were included. Under target controlled anesthesia with propofol 4 micro g*mL(-1) and remifentanil 4 ng*mL(-1), the patients were placed in the knee chest position. The sacral roots were exposed by laminectomy (L2-S1) and their function assessed by electrostimulation under urodynamic and cardiovascular monitoring. Online power spectrum densities were calculated from the ECG R-R interval by the MemCalc(TM) software using the maximum entropy method. Low frequency (LF: 0.04-0.15 Hz) and high frequency (HF: 0.15-0.4 Hz) spectra were associated with sympathetic and parasympathetic activities respectively. The most extreme value of each variable was noted before and during each stimulation. A difference ( triangle up ) of more than 10% signified AHR. The comparison ( triangle up LF vs triangle up MAP and triangle up HF vs triangle up HR) was done by a concordance test with a kappa coefficient (k): -1 = total discordance to 1 = total concordance., Results: AHR was detected in six patients as an increase in LF and MAP (n = 4); an increase in LF, HF, MAP with a decrease in HR (n = 2). The detection delay was 5.3 +/- 1 sec (LF, HF) and 10.4 +/- 1.2 sec (MAP and HR). Concordance was 85% (LF vs MAP: k = 0.7) and 90% (HF vs HR: k = 0.8)., Conclusion: AHR induced by sacral root stimulation is detected by spectral analysis of the ECG earlier than MAP and HR. Other studies are needed to confirm these results.

The symptomatic treatment of hydrocephalus remains cerebrospinal fluid (CSF) drainage to an external reservoir (external CSF drainage) or to an internal cavity mainly the peritoneum or the right atrium via a unidirectional valve (internal CSF drainage) and finally by endoscopic ventriculocisternostomy. Local anaesthesia is adequate for external CSF drainage in adults and children above 10 years while general anaesthesia is required in all other cases. The main problems encountered in these patients are difficult intubation and full stomach associated with increased intracranial pressure. The anaesthetic approach should favour homeostasis. With the exception of ketamine and enflurane, the majority of anaesthetic drugs can be used. Anti-epileptic drug are mandatory. Antibioprophylaxis mainly against staphylococcus is systematic in internal CSF drainage. Rapid emergence from anaesthesia and extubation should be encouraged. Complications (infectious, mechanical and bleeding kinds) are frequent and are often the cause of reinterventions or revisions of the device, exposing the patients to iterative anaesthesia. Furthermore, patients with shunts are at risk of malfunction of the device when exposed to situations like pregnancy, magnetic resonance imaging, or laparoscopy. Under these circumstances, it is recommended to associate the neurosurgical team in the management of these patients and to verify that the shunt is working well before and after the procedure or event.

Among the techniques of cerebral protection, the use of controlled arterial hypertension is based on the following arguments: 1) Cerebral ischaemia is the final common pathway of any insult to the brain, particularly through secondary lesions. Causes of secondary cerebral lesions include pressure under the brain retractors, temporary clipping, arterial hypotension, hypoxaemia, anaemia and hypercapnia. 2) In the brain, the critical lower value for cerebral blood flow is around 25 mL.100g-1.min-1, under which two types of ischaemic areas can be defined: the penlucida type where cerebral function is abolished, without permanent cerebral lesion and the penumbra type where cerebral tissue recovers only if flow is rapidly restored. In the latter case the duration of ischaemia is very important. 3) Cerebral blood flow is maintained stable within a large range of variations of mean arterial pressure through the autoregulation mechanisms, which is based on vasomotricity of the cerebral circulation, which implies major variations in cerebral blood volume. However, autoregulation needs several dozens of seconds to be achieved. Therefore, sudden variations in mean arterial pressure are associated with short lasting but major variations in cerebral blood volume. 4) In case of increased intracranial pressure, a decrease in cerebral perfusion pressure causes cerebral vasodilation through the autoregulation mechanism, with an increase in cerebral blood volume which will, in turn, increase intracranial pressure and thus decrease cerebral perfusion pressure, and so on. This is the vasodilatory cascade. The therapeutical increase in mean arterial pressure will correct this phenomenon and decrease intracranial pressure. This is called the vasoconstrictive cascade.(ABSTRACT TRUNCATED AT 250 WORDS)

Eleven male patients undergoing endoscopic resection for prostatic adenoma and bladder tumours under spinal anaesthesia received intrathecal pethidine 1 mg X kg-1. Plasma concentration and its evolution with time were assessed; pethidine plasma concentrations were determined by high performance liquid chromatography. Pethidine was rapidly and extensively absorbed. The peak plasma concentration of pethidine was 176 +/- 66 ng X ml-1 (range: 84-208) and the time to peak concentration was 2.3 +/- 1.4 h (range: 0.5-6 h). The terminal elimination half-life was 7.2 +/- 2.2 h (range: 4-11.5 h). The plasma concentrations of pethidine remained below 500-700 ng X ml-1, the minimum concentration necessary to obtain a systemic analgesic effect. Two patients required noramidopyrine as a complement at the 8th and 12th h respectively. No respiratory depression was observed. Intrathecal pethidine (1 mg X kg-1) was an effective agent for spinal anaesthesia: the prolonged postoperative analgesia was due to the drug acting on opioid receptors in the spinal cord. This led to the necessity of postoperative monitoring during 24 h after intrathecal pethidine administration.