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Two facts should be underlined before discussing this topic: (1) in recent years the anesthetist “went out” the operation theater to be more and more involved in post-operative care; (2) it doesn’t exist a “gold standard “ in anesthesia, but the possible options are many and varied. The term “anesthesia” usually includes general (intravenous, inhalatory, mixed) and loco-regional anesthesia, plus MAC (Monitored Anesthesia Care). In this paper, the three options are briefly analyzed in order to understand the implications and the pros vs cons of each, with the objective of offering some suggestions about the best choice in knee replacement surgery. The conclusions support regional anesthesia, fully integrated with MAC to minimize (or cancel) post-operative pain.

Background Cancer chemo- and radiotherapy are constantly associated with unwanted side effects at least partially ascribable to oxidative stress, an imbalance between pro-oxidant and antioxidant factors. However, the possible indication and efficacy of antioxidant supplementations — including glutathione-based formulas — aimed to restore the oxidative balance should be, respectively, evaluated and monitored carefully with reliable analytical tools.

We investigated the safety and efficacy of preoperative epoetin alfa used in conjunction with preoperative autologous blood donation (PAD) in 40 anemic orthopedic surgical patients undergoing hip replacement surgery [hematocrit (Hct) ≤39%]. Patients were randomized 25–35 days before surgery to twice weekly intravenous (i.v.) epoetin alfa (300, 150, or 75 IU/kg) or placebo treatments supplemented with 200 mg i.v. iron. Epoetin alfa facilitated dose-dependent increases in PAD (4.3 units, 300 IU/kg; 3.4 units, 150 IU/kg; 3.0 units, 75 IU/kg; 2.1 units, placebo), and minimized reductions in Hct associated with repeated phlebotomy. All epoetin alfa doses were well tolerated and safe. Our results indicate that preoperative epoetin alfa dose-dependently stimulates erythropoiesis and facilitates PAD in anemic orthopedic patients, which may benefit patients by reducing their exposure to the risks of allogeneic transfusion, hastening recovery and discharge from hospital.

The objective of this cross-sectional study was to compare the body composition and fat distribution measured by dual energy X-ray absorptiometry (DPX, Lunar) in different age decades of age-matched Danish and Italian women. The subjects comprised 133 healthy Italian women (age 20-60 years) age-matched to a representative sub-sample of healthy Danish women (n=375). Total and abdominal body fat tissue mass were measured by dual-energy X-ray absorptiometry. Italian women were shorter and fatter compared with age-matched Danish women, but in middle-age, had a less abdominal fat distribution. There was no difference in total body bone mineral density.