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Macular hole surgery is one of the most rapidly changing fields in vitreoretinal surgery, the authors discuss the recent acknowledgments and surgical options. Macular holes are classified, and surgical techniques are described in order to have the most successful procedure. Diagnostic tools and surgical instruments improvement allow surgeons to face difficult cases with a variety of surgical options unknown until a few years ago and is mandatory nowadays to approach the different patients with a broad mind.

Duchenne’s muscular dystrophy (DMD) is the most common and severe form of myopathy. Patients with DMD are more sensitive to sedative, anesthetic, and neuromuscular blocking agents which may result in intraoperative and early postoperative cardiovascular and respiratory complications, as well as prolonged recovery from anesthesia. In this case report, we describe a 25-year-old male patient admitted for cholecystectomy under general anesthesia. We induced our anesthesia by oxygen, propofol, fentanyl, and rocuronium bromide. Maintenance was done by fentanyl, rocuronium bromide, sevoflurane, and O2. We report in this case the safety use of sugammadex to antagonize the neuromuscular block and rapid recovery in such category of patients.

Background. The obese patients have differences in body composition, drug distribution, and metabolism. Sugammadex at recovery in a dose of 2 mg kg−1 of real body weight (RBW) can completely reverse the NMB block; in our study we investigated the safety and efficacy of Sugammadex dose based on their ideal body weight (IBW). Methods. 40 patients of both sexes undergoing laparoscopic bariatric surgery were enrolled divided into 2 groups according to the dose of Sugammadex: the first received a dose of 2 mg kg−1 of IBW and the second received a dose of 2 mg kg−1 of RBW. Both were anesthetized with doses calculated according to the IBW: fentanyl 2 μg kg−1, propofol 3 mg kg−1, rocuronium 0,6 mg kg−1, oxygen, air, and desflurane (6–8%). Maintenance doses of rocuronium were 1/4 of the intubation dose. Sugammadex was administrated at recovery. Results. The durations of intubation and maintenance doses of rocuronium were similar in both groups. In IBW group, the / value of 0.9 was reached in 151 ± 44 seconds and in 121 ± 55 seconds in RBW group ( ). Discussion. Recovery times to / of 0.9 are surprisingly similar in both groups without observing any postoperative residual curarization. Conclusion. Sugammadex doses calculated according to the IBW are certainly safe for a rapid recovery and absence of PORC.

Introduction. It is a consensus that the postoperative cognitive function is impaired in elderly patients after general anaesthesia, and such category patient takes more time to recover. Xenon is a noble gas with anesthetic properties mediated by antagonism of N-methyl-D-aspartate receptors. With a minimum alveolar concentration of 0.63, xenon is intended for maintaining hypnosis with 30% oxygen. The fast recovery after xenon anaesthesia was hypothesized to be advantageous in this scenario. Case Presentation. We report the case of 99-year-old woman who underwent sigmoid colon carcinoma resection with colorectal anastomosis. We carried out the induction phase by propofol, oxygen, fentanil, and rocuronium bromide, and then we proceeded to a rapid sequence endotracheal intubation consequently. The patient was monitored by IBP, NIBP, ECG, cardiac frequency, respiratory rate, capnometry, TOF Guard, blood gas analysis, and BIS. For maintenance we administrated oxygen, remifentanil, rocuronium bromide, and xenon gas 60–65%. Shortly after the end of surgery the patients started an autonomous respiratory activity, and a high BIS level was also recorded. Decision was made by our team to proceed into the emergence phase. The residual neuromuscular block was antagonized by sugammadex, modified Aldrete score was implicated, and we got our patient fully awake without any cognitive dysfunction or delirium. Conclusion. The rapid emergence to full orientation in very elderly patient who had been anesthetized by xenon shows concordance to the high BIS values and the clinical signs of the depth of anesthesia.

Il lavoro di ricerca sul tema Giuseppe Bonaviri e le «Novelle saracene» mette a fuoco l itinerario artistico ed esistenziale dello scrittore siciliano. Dall analisi della ricca e multiforme produzione letteraria (narrativa, poetica, teatrale e saggistica) di Bonaviri, alla luce anche di una bibliografia corposa e aggiornata, scaturisce un panorama critico-letterario che procede secondo la scansione temporale delle date di pubblicazione delle singole opere, arricchito di indagini intra e inter-testuali. Particolare attenzione è riservata a Novelle saracene , opera che s inserisce nel solco del genere fiabesco, sino ad oggi poco indagata. I risultati più significativi nascono dalle disamine condotte sulle dinamiche narrative messe in atto dallo scrittore, che modula una singolare poetica dei sensi . L elaborato isola i dati cromatici, olfattivi e sonori presenti nella raccolta per interpretare codici e messaggi sottesi, illustrando le copiose strategie narrative adottate dallo scrittore. La ricerca, che si muove in ambiti in gran parte o del tutto ignorati dalla critica, suggerisce talvolta nuove piste d indagine. Nel quadro dell opera omnia del mineolo l analisi musico-letteraria e teatrale contribuisce alla disamina delle movenze formali e contenutistiche della scrittura bonaviriana. Lo dimostrano le affinità con il filone della musica popolare e con il mondo della rappresentazione teatrale. In primo piano il rapporto autore-lettore, esaminato nelle diverse modalità di trasmissione orale e scritta. Allo stesso tempo si annovera uno studio sulla dimensione fantastica dei racconti, per enuclearne non soltanto le peculiarità e le tematiche, ma per tracciare anche un quadro di consonanze e differenze con altri autori e studiosi di fiabe. Lo studio si sofferma inoltre sull universo della lingua. L esame della corrispondenza, alla luce delle interviste dell autore rilasciate alla stessa dottoranda e delle recensioni prodotte dai critici con i quali l autore soleva intrattenere rapporti, concorre alla delineazione dell itinerario artistico ed esistenziale dello scrittore, oltre che alla genesi di alcune delle sue opere.