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Mental Time Travel (MTT) allows us to remember past events and imagine future ones. According to previous literature, the Temporal Distance of events affects MTT: our ability to order events worsens for close, compared to far, events. However, those studies established distances a-priori, albeit the way we perceive events' temporal distance may subjectively differ from their objective distance. Thus, in the current study, we aimed to investigate the effects of Perceived Temporal Distance (PTD) on the MTT ability and the brain areas mediating this process. Thirty-three healthy volunteers took part in an fMRI MTT task. Participants were asked to project themselves into the past, present, or future, and to judge a series of events as relative-past or relative-future, in relation to the adopted time location. Outside the scanner, participants provided PTD estimates for each stimulus of the MTT task. Participants' performance and functional activity were analyzed as a function of these estimations. At the behavioural level, PTD predicts the modulation of the performance for relative-past and relative-future. Bilateral angular gyrus, retrosplenial cortex, temporo-parietal region and medial, middle and superior frontal gyri mediate the PTD effect. In addition to these areas, the closer the relative-future events are perceived, the higher the involvement of left parahippocampal and lingual gyri and right cerebellum. Thus, perceived proximity of events activates frontal and posterior parietal areas, which therefore might mediate the processing of PTD in the cognitive spatial representation of time. Future proximity also activates cerebellum and medial temporal areas, known to be involved in imaginative and constructive cognitive functions., (© 2024. The Author(s).)

Objectives: The ability to mental time travel (MTT) consists in moving along a cognitive and spatially oriented representation of time, that is, an ideal mental time line, where past and future events are, respectively, located on the left and on the right portion of such a line. A shift of spatial attention by prismatic adaptation (PA) influences this spatial coding of time, thus affecting MTT. Here, we investigated the neural correlates of such a spatial modulation on MTT in a functional Magnetic Resonance Imaging protocol., Method: To study MTT ability, participants were asked to indicate if a series of events took place before or after (Self-Reference component) an imagined self-location in time (Past, Present or Future; Self-Projection component), where they had to project themselves. The MTT task was performed before and after PA inducing a leftward shift of spatial attention, which is supposed to move toward the left portion of mental time line (MTL), where Past is represented., Results: Following PA, we observed a facilitation in responding to past as compared to future events when participants projected themselves to the Past projection. As a functional counterpart of this behavioral finding, we propose a model of the brain activity modulations following the PA effects on MTT., Conclusions: As a result of the shift of spatial attention toward the left, the facilitation in having access to past events is associated with the inhibition of superior frontal gyrus in the left hemisphere, whereas the facilitation in projecting toward the Past may result from the activity modulation in right and left inferior parietal lobule. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

In adolescence individuals enlarge their social relationships and peer groups acquire a strong importance for their identity. Moreover, adolescents can experiment negative relationships with peers, i.e., bullying/cyberbullying. The present study aims to investigate the relationship between the feeling of belonging to a specific group, social identification, the distance that adolescents maintain interacting with others, interpersonal distance, and bullying/cyberbullying behaviors. Adolescents (age range 10-15 years) completed online measures of group identification (social identification with classmates, friends and family), interpersonal distance, and bullying and cyberbullying (perpetration and victimization). Results showed that adolescents with low social identification with classmates and friends chose larger interpersonal distance. Additionally, low scores in social identification with classmates were associated with higher victimization in cyberbullying. In contrast, adolescents with low scores in social identification with family were more involved as bullies in bullying and as victims in cyberbullying. Male adolescents were more likely to be victimized in bullying than females. This study underlines how social identification with peers and family works as a buffer in interfacing strangers, adjusting the distance maintained with them, and as a protective factor against aggressive relationships in adolescence. This study provides new opportunities for psychologists in understanding the psychological dynamics that shape social interactions among adolescents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wei et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Previous studies show that the right hemisphere is involved in time processing, and that damage to the right hemisphere is associated with a tendency to perceive time intervals as shorter than they are, and to reproduce time intervals as longer than they are. Whether time processing deficits following right hemisphere damage are related and what is their neurocognitive basis is unclear. In this study, right brain damaged (RBD) patients, left brain damaged (LBD) patients, and healthy controls underwent a time bisection task and a time reproduction task involving time intervals varying between each other by milliseconds (short durations) or seconds (long durations). The results show that in the time bisection task RBD patients underestimated time intervals compared to LBD patients and healthy controls, while they reproduced time intervals as longer than they are. Time underestimation and over-reproduction in RBD patients applied to short but not long time intervals, and were correlated. Voxel-based lesion-symptom mapping (VLSM) showed that time underestimation was associated with lesions to a right cortico-subcortical network involving the insula and inferior frontal gyrus. A small portion of this network was also associated with time over-reproduction. Our findings are consistent with a slowdown of an 'internal clock' timing mechanism following right brain damage, which likely underlies both the underestimation and the over-reproduction of time intervals, and their (overlapping) neural bases., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The aim of the present study was to investigate the effects of home confinement/social isolation (i.e., lockdown), imposed to reduce large-scale spread of a disease in the population, on the mental health of individuals. Through an online survey during the lockdown ( DL ) related to COVID-19 (1085 respondents, 627 females, age range : 18-82) (Italy, 23 April-2 May 2020), we revealed that situational factors, i.e., the presence of children at home and female gender, and psychological factors, i.e., a greater sense of isolation, lower perception of safety outside the home and higher trait anxiety, predicted higher levels of state anxiety (R 2 = 0.58). The same factors, but with young age instead of the presence of children, predicted higher levels of perceived stress (R 2 = 0.63). Then, these data were compared with those collected after the lockdown ( AL ) (174 respondents, 128 females, age range : 19-78) (Italy, 1 July-31 October 2021). The results showed that along with a reduced sense of isolation ( DL = 2.90 vs. AL = 2.10) and an increased perception of safety outside the home ( DL = 2.63 vs. AL = 3.05), a reduction in state anxiety ( DL = 45.76 vs. AL = 40.88) and stress appeared ( DL = 18.84 vs. AL = 17.63). However, the situation was better for men than for women. Perceived self-efficacy emerged as a protective factor for mental health (R 2 range : 0.03-0.27). The results are discussed in light of the evidence on the effects of lockdown on individuals worldwide. These results may be used to make more educated decisions on targeted help for individuals who may be most adversely affected by the adoption of lockdowns in the future.

The ability to discriminate between one's own and others' body parts can be lost after brain damage, as in patients who misidentify someone else's hand as their own (pathological embodiment). Surprisingly, these patients do not use visual information to discriminate between the own and the alien hand. We asked whether this impaired visual discrimination emerges only in the ecological evaluation when the pathological embodiment is triggered by the physical alien hand (the examiner's one) or whether it emerges also when hand images are displayed on a screen. Forty right brain-damaged patients, with (E+ = 20) and without (E- = 20) pathological embodiment, and 24 healthy controls underwent two tasks in which stimuli depicting self and other hands was adopted. In the Implicit task, where participants judged which of two images matched a central target, the self-advantage (better performance with Self than Other stimuli) selectively emerges in controls, but not in patients. Moreover, E+ patients show a significantly lower performance with respect to both controls and E- patients, whereas E- patients were comparable to controls. In the Explicit task, where participants judged which stimuli belonged to themselves, both E- and E+ patients performed worst when compared to controls, but only E+ patients hyper-attributed others' hand to themselves (i.e., false alarms) as observed during the ecological evaluation. The VLSM revealed that SLF damage was significantly associated with the tendency of committing false alarm errors. We demonstrate that, in E+ patients, the ability to visually recognize the own body is lost, at both implicit and explicit level., (© 2022 The Authors. Journal of Neuroscience Research published by Wiley Periodicals LLC.)

In Winter 2020, Italy, and in particular the Lombardy region, was the first country in the Western hemisphere to be hit by the COVID-19 pandemic. Plasma from individuals recovered from COVID-19 (COVID-19 convalescent plasma, CCP) was the first therapeutic tool adopted to counteract the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this retrospective cohort study, we report the experience of the city hospital of Mantua, Lombardy region, on the compassionate use of CCP in patients hospitalized for severe COVID-19. Between April 2020 and April 2021, 405 consecutive COVID-19 patients received 657 CCP units with a median anti-SARS-CoV-2 neutralizing antibody (nAb) titer of 160 (interquartile range (IQR), 80−320). Their median age was 68 years (IQR, 56−78 years), and 62% were males. At enrollment, 55% of patients had an increased body mass index (BMI), and 25.6% had at least three comorbidities. The 28-day crude mortality rate was 12.6% (51/405). Young age (<68 years), mild disease (admission to low-intensity departments) and early treatment (<7 days from symptoms onset) with high nAb titer (≥320) CCP were found as independently associated with a favorable response to CCP treatment. No safety concerns were recorded, with a rate of CCP-related adverse reactions (all of mild intensity) of 1.3%. In our real-life experience, the first in the western world, early administration of high-titer CCP was a safe and effective treatment for hospitalized COVID-19 patients.

Prolonged periods of restrictions on people's freedom of movement during the first massive wave of the COVID-19 pandemic meant that most people engaged in all their daily activities at home. This suggested the need for the spatial features of the home and its occupants' perception of them to be investigated in terms of people's wellbeing. The present study was conducted on a large sample (N = 1354) drawn from different Italian regions. It examined the relationship between the "objective" and "subjective" dimensions of the home, measured in terms of objective home crowding and satisfaction with the space at home, in relation to perceived stress and the perceived risk of COVID-19 infection during the lockdown. The results showed that perceived stress is influenced by objective home crowding through the mediation of satisfaction with the space at home. These associations were more pronounced in younger generations. The negative association between satisfaction with the space at home and perceived stress was higher, the lower the perceived COVID-19 risk., (© 2021 Elsevier Ltd. All rights reserved.)

In this study, we explored the time and space relationship according to two different spatial codings, namely, the left/right extension and the reachability of stimulus along a near/far dimension. Four experiments were carried out in which healthy participants performed the time and spatial bisection tasks in near/far space, before and after short or long tool-use training. Stimuli were prebisected horizontal lines of different temporal durations in which the midpoint was manipulated according to the Muller-Lyer illusion. The perceptual illusory effects emerged in spatial but not temporal judgments. We revealed that temporal and spatial representations dynamically change according to the action potentialities of an individual: temporal duration was perceived as shorter and the perceived line's midpoint was shifted to the left in far than in near space. Crucially, this dissociation disappeared following a long but not short tool-use training. Finally, we observed age-related differences in spatial attention which may be crucial in building the memory temporal standard to categorize durations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Candini, D’Angelo and Frassinetti.)

Interpersonal space (IPS) is the area surrounding our own bodies in which we interact comfortably with other individuals. During the COVID-19 pandemic, keeping larger IPS than usual, along with wearing a face mask, is one of the most effective measures to slow down the COVID-19 outbreak. Here, we explore the contribution of actual and perceived risk of contagion and anxiety levels in regulating our preferred social distance from other people during the first wave of the COVID-19 pandemic in Italy. In this study, 1293 individuals from six Italian regions with different levels of actual risk of infection participated in an online survey assessing their perceived risk to be infected, level of anxiety and IPS. Two tasks were adopted as measures of interpersonal distance: the Interpersonal Visual Analogue Scale and a questionnaire evaluating interpersonal distance with and without face mask. The results showed that the IPS regulation was affected by how people subjectively perceived COVID-19 risk and the related level of anxiety, not by actual objective risk. This clarifies that the role of threat in prompting avoidant behaviors expressed in increased IPS does not merely reflect environmental events but rather how they are subjectively experienced and represented.

Previous research indicates that the size of interpersonal space at which the other is perceived as intrusive (permeability) and the ability to adapt interpersonal distance based on contextual factors (flexibility) are altered in Autism Spectrum Disorder (ASD). However, the neurophysiological basis of these alterations remains poorly understood. To fill this gap, we used fMRI and assessed interpersonal space preferences of individuals with ASD before and after engaging in cooperative and non-cooperative social interactions. Compared to matched controls, ASDs showed lower comfort in response to an approaching confederate, indicating preference for larger interpersonal space in autism (altered permeability). This preference was accompanied by reduced activity in bilateral dorsal intraparietal sulcus (dIPS) and left fusiform face area (FFA), regions previously shown to be involved in interpersonal space regulation. Furthermore, we observed differences in effective connectivity among dIPS, FFA, and amygdala in ASDs compared to controls, depending on the level of experienced comfort. No differences between groups were observed in interpersonal space regulation after an experienced social interaction (flexibility). Taken together, the present findings suggest that a dysregulation of the activity and connectivity of brain areas involved in interpersonal space processing may contribute to avoidance of physical proximity and social impairments in ASD., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Interpersonal space (IPS) is the area around the body that individuals maintain between themselves and others during social interactions. When others violate our IPS, feeling of discomfort rise up, urging us to move farther away and reinstate an appropriate interpersonal distance. Previous studies showed that when individuals are exposed to closeness of an unknown person (a confederate), the skin conductance response (SCR) increases. However, if the SCR is modulated according to participant's preferred IPS is still an open question. To test this hypothesis, we recorded the SCR in healthy participants when a confederate stood in front of them at various distances simulating either an approach or withdrawal movement (Experiment 1). Then, the comfort-distance task was adopted to measure IPS: participants stop the confederate, who moved either toward or away from them, when they felt comfortable with other's proximity (Experiment 2). We found higher SCR when the confederate stood closer to participants simulating an IPS intrusion, compared to when the confederate moved farther away. Crucially, we provide the first evidence that SCR, acting as a warning signal, contributes to interpersonal distance preference suggesting a functional link between behavioral components of IPS regulation and the underlying physiological processes.

In recent years, there has been a dramatic increase in research examining interpersonal space, i.e., the sector of space immediately around the body in which we interact with other people. These studies have consistently revealed impairments of interpersonal space regulation in psychopathological disorders characterized by social disability, such as autism, schizophrenia and social anxiety. The primary goal of this review is to discuss several key points that have emerged in research on interpersonal space regulation in autism spectrum disorders. Particularly, we review recent behavioral evidence revealing that individuals with autism prefer abnormally larger or shorter interpersonal distance than healthy controls, indicating a deficit in regulating the size of interpersonal space (permeability). Then, we focus on how individuals with autism fail to modify their interpersonal space following a brief cooperative interaction with an unfamiliar adult, suggesting a deficit in adapting interpersonal space to the social context (plasticity). Moreover, we discuss evidence indicating that space regulation deficits primarily affect interpersonal (i.e., social), but not peripersonal (i.e., action), space in autism. Finally, we take into consideration the variables influencing interpersonal space plasticity such as person's perspective and severity of social impairment as well as its neural underpinnings. These findings may provide a critical contribution to understanding of the functional mechanisms underlying interpersonal space regulation and its rehabilitation in autism spectrum disorders., (Copyright © 2020. Published by Elsevier Ltd.)

The space around the body has been defined as action space ( peripersonal space ) and a social space ( interpersonal space ). Within the current debate about the characteristics of these spaces, here we investigated the functional properties and plasticity of action and social space in developmental age. To these aims, children with typical development and autism spectrum disorders were submitted to Reaching- and Comfort-distance tasks, to assess peripersonal and interpersonal space, respectively. Participants approached a person (confederate) or an object and stopped when they thought they could reach the stimulus (Reaching-distance task), or they felt comfortable with stimulus' proximity (Comfort-distance task). Both tasks were performed before and after a cooperative tool-use training, in which participant and confederate actively cooperated to reach tokens by using either a long (Experiment 1) or a short (Experiment 2) tool. Results showed that in both groups, peripersonal space extended following long-tool-use but not short-tool-use training. Conversely, in typical development, but not in autism spectrum disorders children, interpersonal space toward confederate reduced following the cooperative tool-use training. These findings reveal that action and social spaces are functionally dissociable both in typical and atypical development, and that action but not social space regulation is intact in children with autism.

Aging adults typically show reduced ability to ignore task-irrelevant information, an essential skill for optimal performance in many cognitive operations, including those requiring working memory (WM) resources. In a first experiment, young and elderly human participants of both genders performed an established WM paradigm probing inhibitory abilities by means of valid, invalid, and neutral retro-cues. Elderly participants showed an overall cost, especially in performing invalid trials, whereas younger participants' general performance was comparatively higher, as expected.Inhibitory abilities have been linked to alpha brain oscillations but it is yet unknown whether in aging these oscillations (also typically impoverished) and inhibitory abilities are causally linked. To probe this possible causal link in aging, we compared in a second experiment parietal alpha-transcranial alternating current stimulation (tACS) with either no stimulation (Sham) or with two control stimulation frequencies (theta- and gamma-tACS) in the elderly group while performing the same WM paradigm. Alpha- (but not theta- or gamma-) tACS selectively and significantly improved performance (now comparable to younger adults' performance in the first experiment), particularly for invalid cues where initially elderly showed the highest costs. Alpha oscillations are therefore causally linked to inhibitory abilities and frequency-tuned alpha-tACS interventions can selectively change these abilities in the elderly. SIGNIFICANCE STATEMENT Ignoring task-irrelevant information, an ability associated to rhythmic brain activity in the alpha frequency band, is fundamental for optimal performance. Indeed, impoverished inhibitory abilities contribute to age-related decline in cognitive functions like working memory (WM), the capacity to briefly hold information in mind. Whether in aging adults alpha oscillations and inhibitory abilities are causally linked is yet unknown. We experimentally manipulated frequency-tuned brain activity using transcranial alternating current stimulation (tACS), combined with a retro-cue paradigm assessing WM and inhibition. We found that alpha-tACS induced a significant improvement in target responses and misbinding errors, two indexes of inhibition. We concluded that in aging alpha oscillations are causally linked to inhibitory abilities, and that despite being impoverished, these abilities are still malleable., (Copyright © 2018 the authors 0270-6474/18/384419-12$15.00/0.)

Studies in children with Typical Development (TD) and with Autism Spectrum Disorder (ASD) revealed that autism affects the personal space regulation, influencing both its size (permeability) and its changes depending on social interaction (flexibility). Here, we investigate how the nature of social interaction (Cooperative vs. Uncooperative) and the person perspective influence permeability and flexibility of interpersonal distance. Moreover, we tested whether the deficit observed in ASD children, reflects the social impairment (SI) in daily interactions. The stop-distance paradigm was used to measure the preferred distance between the participant and an unfamiliar adult (first-person perspective, Experiment 1), and between two other people (third-person perspective, Experiment 2). Interpersonal distance was measured before and after the interaction with a confederate. The Wing Subgroups Questionnaire was used to evaluate SI in everyday activities, and each ASD participant was accordingly assigned either to the lower (children with low social impairment [low-SI ASD]), or to the higher SI group (children with high social impairment [high-SI ASD]). We observed larger interpersonal distance (permeability) in both ASD groups compared to TD children. Moreover, depending on the nature of social interaction, a modulation of interpersonal distance (flexibility) was observed in TD children, both from the first- and third-person perspective. Similar findings were found in low-SI but not in high-SI ASD children, in Experiment 1. Conversely, in Experiment 2, no change was observed in both ASD groups. These findings reveal that SI severity and a person's perspective may account for the deficit observed in autism when flexibility, but not permeability, of personal space is considered. Autism Res 2017, 10: 144-154. © 2016 International Society for Autism Research, Wiley Periodicals, Inc., (© 2016 International Society for Autism Research, Wiley Periodicals, Inc.)

Much research suggested that recognizing our own body-parts and attributing a body-part to our physical self-likely involve distinct processes. Accordingly, facilitation for self-body-parts was found when an implicit, but not an explicit, self-recognition was required. Here, we assess whether implicit and explicit bodily self-recognition is mediated by different cerebral networks and can be selectively impaired after brain lesion. To this aim, right- (RBD) and left- (LBD) brain damaged patients and age-matched controls were presented with rotated pictures of either self- or other-people hands. In the Implicit task participants were submitted to hand laterality judgments. In the Explicit task they had to judge whether the hand belonged, or not, to them. In the Implicit task, controls and LBD patients, but not RBD patients, showed an advantage for self-body stimuli. In the Explicit task a disadvantage emerged for self-compared to others' body stimuli in controls as well as in patients. Moreover, when we directly compared the performance of patients and controls, we found RBD, but not LBD, patients to be impaired in both the implicit and explicit recognition of self-body-part stimuli. Conversely, no differences were found for others' body-part stimuli. Crucially, 40% RBD patients showed a selective deficit for implicit processing of self-body-part stimuli, whereas 27% of them showed a selective deficit in the explicit recognition of their own body. Additionally, we provide anatomical evidence revealing the neural basis of this dissociation. Based on both behavioral and anatomical data, we suggest that different areas of the right hemisphere underpin implicit and explicit self-body knowledge.

In this study, we investigated the effects of tDCS over the posterior parietal cortex (PPC) during a visual working memory (WM) task, which probes different sources of response error underlying the precision of WM recall. In two separate experiments, we demonstrated that tDCS enhanced WM precision when applied bilaterally over the PPC, independent of electrode configuration. In a third experiment, we demonstrated with unilateral electrode configuration over the right PPC, that only cathodal tDCS enhanced WM precision and only when baseline performance was low. Looking at the effects on underlying sources of error, we found that cathodal stimulation enhanced the probability of correct target response across all participants by reducing feature-misbinding. Only for low-baseline performers, cathodal stimulation also reduced variability of recall. We conclude that cathodal- but not anodal tDCS can improve WM precision by preventing feature-misbinding and hereby enhancing attentional selection. For low-baseline performers, cathodal tDCS also protects the memory trace. Furthermore, stimulation over bilateral PPC is more potent than unilateral cathodal tDCS in enhancing general WM precision., (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Multiple, action-based space representations are each based on the extent to which action is possible toward a specific sector of space, such as near/reachable and far/unreachable. Studies on tool-use revealed how the boundaries between these representations are dynamic. Space is not only multidimensional and dynamic, but it is also known for interacting with other dimensions of magnitude, such as time. However, whether time operates on similar action-driven multiple representations and whether it can be modulated by tool-use is yet unknown. To address these issues, healthy participants performed a time bisection task in two spatial positions (near and far space) before and after an active tool-use training, which consisted of performing goal-directed actions holding a tool with their right hand (Experiment 1). Before training, perceived stimuli duration was influenced by their spatial position defined by action. Hence, a dissociation emerged between near/reachable and far/unreachable space. Strikingly, this dissociation disappeared after the active tool-use training since temporal stimuli were now perceived as nearer. The remapping was not found when a passive tool-training was executed (Experiment 2) or when the active tool-training was performed with participants' left hand (Experiment 3). Moreover, no time remapping was observed following an equivalent active hand-training but without a tool (Experiment 4). Taken together, our findings reveal that time processing is based on action-driven multiple representations. The dynamic nature of these representations is demonstrated by the remapping of time, which is action- and effector-dependent.

In the domain of self-recognition, voice is a critical feature for self/other distinction. The aim of this study was to explore if people have an implicit and/or explicit knowledge of their voice. A group of healthy participants were submitted to an implicit and an explicit self-voice recognition task. They listened to pairs of pre-recorded auditory stimuli (words or pseudowords) pronounced by themselves, by a familiar or an unfamiliar person. Afterwards, in the "Implicit task" participants had to judge whether the pair of stimuli were pronounced by same or different speakers; in the "Explicit task" they had to identify if one of the stimuli was or not their own voice. Results showed a difference between Implicit and Explicit tasks since participants were more accurate in implicit than explicit self voice-recognition. Moreover, in the Implicit task, participants had the same level of accuracy when they had to judge stimuli pronounced with self or others' voice, whereas when an explicit voice-recognition was required, they were less accurate with self than with others' voice., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Aim: The aim of the study was the evaluation of postoperative short term analgesia-based sedation provided by a continuous i.v. morphine vs morphine+remifentanil infusion in the ICU., Methods: A prospective, randomized, controlled study was carried out., Inclusion Criteria: patients aged > 18 years undergoing major surgery (abdominal, vascular, thoracic). A total of 100 patients undergoing balanced anaesthesia, were enrolled; at the end of surgery an i.v. loading morphine dose (0.1 mg/kg) was administered and a continuous ground i.v. infusion (0.24 microg/kg/min) was started. When the patient was admitted to the ICU, a second i.v. continuous infusion was started and patients were allocated into 2 groups with regard to the second opioid: MM = morphine + morphine, MR = morphine + remifentanil. The second continuous infusion (boluses allowed) was titrated to obtain a numerical rate score (NRS) < 3 and Ramsay Scale =or>2. If Ramsay =or< 2 rescue sedation was administered (diazepam)., Results: The groups were homogeneous with regard to gender, age, weight, duration of surgery, intraoperative opioids, SAPS II. The second infusion rate in the first 24 postoperative hours was 0.73+/-0.55 microg/kg/min morphine in MM and 0.06+/-0.05 microg/kg/min remifentanil in RM. Hemodynamic parameters and SpO(2) were similar. Hypnotic consumption and NRS were significantly lower in RM, while Ramsay Scale was higher. Postextubation respiratory rate and minute volume were lower in group MM, while PaCO(2), postoperative nausea and vomiting (PONV) incidence and frequency of diazepam administration were higher. In both groups more than 70% of the patients were very satisfied., Conclusion: The combination of morphine + remifentanil provided better analgesia and sedation than morphine alone, with a lower incidence of side effects and a similar hemodynamic profile and patient satisfaction. The adherence to a clear analgesia based sedation protocol probably represents the most important issue carrying out analgosedation; however, the continuous infusion of a short acting drug, although more expensive, allows better titration and adjustment of the desired level of analgesia and sedation, avoiding the risk of undersedation as well as oversedation with a potential reduction of otherwise unnecessary ICU stays and, consequently, a decrease in comprehensive costs.

Aim: The purpose of this prospective, randomized, controlled study was the comparison of maximal sterile barrier (consisting of mask, cap, sterile gloves, gown, large drape) vs control precautions (mask, cap, sterile gloves, small drape) and of transparent polyurethan film vs gauze dressing for use on central venous (CVC) nontunneled catheters, inserted via the jugular vein. Skin colonization at the insertion site (defined by quantitative skin cultures performed at the time of insertion and in days 2 and 5) was used as a primary endpoint. Catheter tip colonization was also assessed through qualitative culture and CVC related sepsis was defined by the isolation of the same organism from the catheter tip and the blood, with clinical sepsis of no other apparent source., Methods: Eighty-two consecutive patients were enrolled, admitted to a mixed medical-surgical ICU, aged 72+/-12 years, 58% male, SAPS II 42+/-13. One-hundred and seven CVCs were studied (presenting 750 catheter in situ days); CVCs were in place for a mean period of 6.9+/-4.7 days and 5 episodes of central catheter-related bloodstream infection were detected (6.6 per 1000 catheter days)., Results: A multiple logistic regression detected an increased risk of skin colonization in male gender (OR=2.5) and control precautions (OR=3.4) and no difference with regard to age, dressing and diagnostic group., Conclusions: Maximal sterile barrier proved to be an effective and recommended practice. However surveillance skin cultures revealed the common and changing nature of colonization of skin at the insertion site.

Arginase activity in kidney, and small intestine in several mammalian species is sensitive to castration, a finding that could suggest their dependence on testosterone. However, as far as we know, information on regulation of pancreatic arginase activity is scarce. In this paper, the effect of orchidectomy on pancreatic arginase activity in pubescent and adult rats was studied. Male pubescent and adult rats, 21 days old and 4 months old, respectively, were orquidectomizades and sacrificed at various times post-surgery. Groups of intact rats served as controls. Arginase activity and proteins were measured in pancreatic tissue. The activity of this enzyme was measured in serum in addition to glucose, triglycerides and total proteins. In pubescent rats pancreatic and serum arginase activities peaked at day 5 post-surgery, increased arginase activity in adult rats was seen at day 20. Changes in serum and pancreatic proteins in pubescent, but not in adult, castrated rats were observed. Taken together, these results suggest that pancreatic arginase activity is androgen-dependent and that there is age-difference, probably due lo distinct patterns of hormone secretion in pubescent and adult rats.