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Due to the awareness of the exhaustion of energy resources, some studies on construction techniques, linked to local traditions, to readily available materials, to low load energy and to self- building are been carried out. The high recyclability of natural materials that can be used in low-cost buildings (such as clay, straw, bamboo, wood) associated with construction techniques capable of exploiting the principles of bioclimatic architecture for energy needs, allow us to create building environmentally conscious and responsible. This study was developed according to the following steps: at first, we proceeded to collect information on the state of art. In particular, we analyzed different types of construction based on clay solutions (rammed earth - pisè, hand-formed bricks - adobe, lightened earth, weight-reduced blocks -massoni, cob, extruded blocks, compressed blocks) and different types of materials and/or compositions of clay/sand/straw mixture (clay and straw, clay and wood, clay and minerals aggregates). A series of earthen construction projects has been investigated, in order to identify their technology choices and design, in relation to operational, manufacturing, and constructive aspects. These data were then compared in terms of energy performance, maintainability, flexibility, comfort. The next step involved the design of a habitation module of transitory residencies with wooden framework and outside walls in lighter earth hand-formed blocks. At the same time the project of a special block (made of clay and fibers derived from foliage of common reed -Arundo Donax) was developed, to meet the needs of sustainability and ease of construction. An experimental test on this block was carried out, aimed at the identification of mechanical performance in relation to the different compositions of the mixtures. [ABSTRACT FROM AUTHOR]

Dystrophies are generally classified into progressive, such as Duchenne, Becker, the Emery-Dreifuss, the Central Core, the Nemaline, the King Denborough and congenital and mitochondrial myopathies, which can be present at birth. General anesthesia in myopathic poses several problems. The patient may be a child with initial symptoms, which must be subjected to muscle biopsy or a patient with overt myopathy, with all the events muscular, respiratory and cardiac related to it, to be submitted to any operation under general anesthesia even if regional blocks are also possible. For this reason, it becomes crucial an initial framework preoperative of the myopathic patient. [ABSTRACT FROM AUTHOR]

Considering the high frequency of bleeding complications following fibrinolytic treatment, caudal blockade could be used in association with lower doses of tissue plasminogen activator as a possible new therapeutic approach in management of arterial thrombosis in neonates. [ABSTRACT FROM AUTHOR]

The arrival of the Longobards in Northern Italy in 568 CE marked a period of renewed political stability in the Peninsula after the collapse of the Western Roman Empire. The trajectory of the spread of Longobards in Italy across the Alps and into the South is known from many literary sources. However, their mobility and residence patterns at a population level remain to be fully understood. Here we present a multi-isotopic analysis ( 87 Sr/ 86 Sr and 18 O/ 16 O) of 39 humans and 14 animals buried at the Longobard necropolis of Povegliano Veronese (VR, Italy; 6th-8th century CE), to address mode and tempo of the spread of this population in the Peninsula. The geographical location of Povegliano Veronese plays a key role: the site lies along the Via Postumia, which was one of the main ancient Roman roads of Northern Italy, representing an important route in post-classical Italy. The integration of isotopic data with the archaeological evidence allowed us to determine the presence of individuals from at least three different regions of origin, building a diachronic map of the dynamics of mobility of this group in northern Italy.

The administration of cryopreserved platelets (PLTs) may overcome the limits of platelet shortage and availability, especially during some seasons or in specific contexts like rural areas. After in vitro validation studies, ad hoc prepared buffy coat-derived pooled platelet concentrates (BC-PLTs), treated with dimethyl sulphoxide (DMSO) and cryopreserved (CRY BC-PLTs) at -80 °C with a modified Valeri method, were transfused in patients with severe thrombocytopenia secondary to chemotherapy for acute leukaemia (AL). Five inpatients were enrolled in the pivotal clinical trial NCT02032134: 4 males and 1 female with a mean age of 71 years (range: 65-80). Four patients were diagnosed with acute myeloid leukaemia and 1 had acute lymphoblastic leukaemia.Transfusion of one Unit of CRY BC-PLTs resulted effective in active bleeding control in two patients without any adverse reaction or concomitant antihaemorrhagic therapies. CRY BC-PLTs met the currently accepted criteria for cryopreserved PLTs, their transfusion in patients with AL was safe. (Clinical trial: NCT02032134)., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Cryopreservation for the long-term storage of platelets (PLTs) is a useful method to overcome the limits of platelet shortage. This is an in vitro prospective study to evaluate the count, viability, and function of buffy coat-derived pooled platelet concentrates (BC-PLTs), treated with dimethyl sulphoxide (DMSO) and cryopreserved (CRY BC-PLTs) at -80 °C with a modified Valeri method. PLTs were stored in 6% DMSO with a patented kit. Overall, 49 BC-PLTs from 245 healthy volunteer donors were prepared, cryopreserved, and analysed before and after 3, 6, and 9 months of storage. In flow cytometry, a statistically significant reduction in CD 42b (92.7 ± 4.29% at T0 vs. 23.6 ± 27.5% at T3, 16.38 ± 12.54% at T6, and 17.3 ± 9.6% at T9) and PAC-1 (1.9 ± 1.34% at T0 vs. 0.62 ± 0.4% at T3, 0.63 ± 0.83% at T6, and 0.49 ± 0.48% at T9) was observed after storage. CRY BC-PLTs showed a good and stable endogenous thrombin generation potential (nM min): 529.25 ± 98.64 at T0 vs. 533.04 ± 103.15 at T9 months. CRY BC-PLTs showed a good viability in vitro, according to currently accepted criteria for cryopreserved PLTs., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: The bispectral index (BIS) is a parameter derived by electroencephalography (EEG) which provides a direct measurement of the effects of sedatives and anesthetics on the brain and offers guidance on the adequacy of anesthesia. The literature lacks studies on BIS monitoring in pediatric patients with congenital brain disease undergoing general anesthesia., Clinical Features: A 13-year-old child weighing 32kg, suffering from lobar holoprosencephaly, underwent surgery in which the bispectral index (BIS) monitoring the depth of anesthesia showed an abnormal response. Detailed analysis of the trends of BIS values in the different observation times demonstrated sudden falls and repetitive values of BIS likely related to repetitive epileptiform electrical activity caused by sevoflurane., Conclusion: The BIS is a very useful monitoring tool for assessing the degree of depth of anesthesia and to analyze the electroencephalographic variations of anesthetics. Particular attention should be given to patients with congenital disorders of the central nervous system in which the BIS may give abnormal responses that do not reflect an accurate assessment of the depth of anesthesia., (Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.)

Many authors have reported that tracheal stenosis is a complication that can follow tracheal intubation in both adults and children. The symptoms, when they do appear, can be confused with asthma, with subsequent treatment providing only mild and inconsistent relief. We report here the case of an 8 year old girl admitted to our hospital for whooping cough that was not responding to therapy.

Complications in pediatric anesthesia can happen, even in our modern hospitals with the most advanced equipment and skilled anesthesiologists. It is important, albeit in a tranquil and reassuring way, to inform parents of the possibility of complications and, in general, of the anesthetic risks. This is especially imperative when speaking to the parents of children who will be operated on for minor procedures: in our experience, they tend to think that the anesthesia will be a light anesthesia without risks. Often the surgeons tell them that the operation is very simple without stressing the fact that it will be done under general anesthesia which is identical to the one we give for major operations. Different is the scenario for the parents of children who are affected by malignant neoplasms: in these cases they already know that the illness is serious. They have this tremendous burden and we choose not to add another one by discussing anesthetic risks, so we usually go along with the examination of the child without bringing up the possibility of complications, unless there is some specific problem such as a mediastinal mass.

Background: Research in the field of patient satisfaction first took place in the 1980s in the USA, and later in Europe, aimed at meeting competitive requirements in the field of health care. Very few studies of this type exist in regard to pediatric anesthesia. Our aim was to develop a rapidly interpretable questionnaire to measure the level of parental satisfaction when their children undergo surgery and provide information on those factors triggering anxiety in these children., Methods: Over a period of 18 months 179 parents of children in pediatric surgery responded to 214 questionnaires designed to investigate principally the emotional/behavioral spheres as well as the comfort provided., Results and Conclusions: We found that parents generally expressed a high degree of satisfaction which was good and correlated significantly with environmental comfort and postoperative observations performed by anesthetists and nursing staff. In the children, lack of fear at the moment of being anesthetized, and lack of anxiety on the day preceding surgery, were attributed to the serenity transmitted by the anesthetist and nurses. Significant anxiety resulted from the fear of an unpleasant impact with the operating room.

Background: Ketorolac is a powerful nonsteroidal anti-inflammatory drug widely used for pain control in children and adults. The aim of this study was to evaluate its safety and analgesic efficacy in the neonate., Methods: Ketorolac was used in a group of 18 spontaneously breathing neonates presenting with chronic lung disease, for the control of postsurgical pain and pain from invasive procedures. Pain scores (Neonatal Infant Pain Scale) were assessed before and after i.v. administration of 1 mg.kg(-1) of ketorolac., Results: Total pain control was achieved in 94.4% of the neonates. None of the neonates had haematological, renal or hepatic changes prior to treatment, and these complications did not occur after treatment. No neonate had systemic haemorrhage or bleeding from injection and blood withdrawal sites., Conclusions: Ketorolac could represent an efficacious analgesic alternative to opioids, particularly in neonates. It would avoid the side-effects associated with opioid analgesics, especially respiratory depression.

Advantages of primary fascial closure of abdominal wall defects are mainly in reducing the number of staged procedures with related complications and the need of multiple operation. Nevertheless correction of large defects still remains a challenge to pediatric surgeon. Postoperative paralysis and mechanical ventilation after intraoperative milking of intestinal content and abdominal muscles stretching have been reported to reduce the risks of "forced" primary closure. A series of 64 Omphalocele and Gastroschisis has been reviewed. Associated anomalies are still the main cause of mortality among Omphalocele. Prematurity plays a secondary role on survival of Gastroschisis cases; deaths were mainly due to sepsis. Primary respiratory insufficiency affected a large number of Giant Omphalocele cases (larger than 5 cm with herniated liver) and was associated to a restricted chest structure. All these cases died in the first weeks of life. Primary closure with or without postoperative paralysis and mechanical ventilation showed to reduce in a significant way the postoperative complication rate compared to staged procedures. Mortality and hospital stay were not significantly influenced by different kinds of surgical treatment among Omphalocele. Associated anomalies are an unavoidable limiting factor to survival. Among Giant Omphalocele the use of aggressive primary fascial closure with ventilatory support showed in our hands to be a safe procedure provided that a preoperative selection of cases on the basis of chest X-ray and blood gases has been made.

A Study was carried out on ten patients undergoing operations for brain tumors, who were treated with mannitol solutions. This caused a significant depletion of serum sodium ion and in an increase of discriminate osmolality (to 60 mosM/kg H2O). A hypothesis about the particular biochemical mechanism, involving the electrolyte and water distribution, is presented.