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Biomedical subjects

R Sallusti

Publications and source records attributed to R Sallusti.

4 recordsLinked to original sources

Education and training in hyperbaric medicine. The Icelandic experience. An example of international scientific cooperation.

The authors describe their experience in the practice, education and learning in the field of hyperbaric medicine, following a project of international scientific cooperation, first in history, between Italy and Iceland. As a result of this project, the first hyperbaric facility came into use in Iceland in March 1993, initially entirely run and economically supported by the Italian side. Since 1997 the activity has been entirely financed by Icelandic National Health System with a special budget established each year according to an agreement between Icelandic and Italian Health Authorities, leaving the medical and the economical management of the Service to Italian personnel. Hyperbaric medicine is now a reality in the Icelandic medical practice. Moreover, since 1994 young Italian doctors from the University of Trieste, Italy, enrolled in the School of Specialization in Anesthesia, Intensive Care, have received training at the Service of Hyperbaric Medicine of the University of Reykjavik City Hospital, as part of their training. The educational activity, endorsed by the Italian Ministry of University and Research, consists of a theoretical part and of a practical part of operational assistance. At the end of his or her training, the resident has a full knowledge of the indications for hyperbaric oxygen therapy (HBOT) and of the related diagnostic and therapeutic procedures, is autonomous and is able to safely operate an hyperbaric chamber. An analytical report of the activity in year 2000 is also included.

Hyperbaric Oxygenation↗

Altitude decompression sickness. Case presentation.

The in-flight altitude-related decompression sickness (DCS) is not as common as DCS occurring after working or recreational diving, or, at least, it is not commonly described in the medical literature. Though modern aircraft are safer and more reliable, occupants are still subject to the stress of high altitude flight, and altitude DCS still represents a risk to the occupants, mostly if they are exposed to altitudes of 25,000 ft or higher. The authors report their experience about two different accidents involving a US Air Force pilot and a navigator, treated at the Service of Hyperbaric Medicine at Landspitallin Fossvogur, the University of Reykjavik City Hospital, Iceland, because of occurrence of type II altitude-related DCS. A US Navy Oxygen Treatment Table 6 was successfully applied in both cases. Also considered are some aspects related to physiopathology, clinical presentation and therapy of DCS, with particular regard to the occurrence of DCS during flight.

Adult↗

HBO and gas gangrene. A case report.

A 58-year old man, in a mediocre health condition, was admitted into Landspitallin Fossvogur, the University of Reykjavik City Hospital, Iceland, because of fever, chills, local pain and swelling due to the presence of a big old wound in his left heel. The first clinical appearance showed a gas gangrene of the area. The patient immediately underwent a surgical debridement and a fasciotomy, and antibiotic intravenous therapy and hyperbaric oxygen therapy (HBOT) were started. During the treatment the patient suffered for a multi-organ failure syndrome (MOFS), was admitted in ICU and survived. A total of 52 HBO sessions were performed and one month since the admission into the hospital the patient received a skin transplant. He achieved a complete restitutio ad integrum after 78 days of hospitalization. Gas gangrene is a fulminating infection caused by the genus of Clostridia. If not treated, it leads to the death of the host. The actual treatment for gas gangrene includes surgery, antibiotics, general resuscitative measures and HBOT.

Combined Modality Therapy↗

The chain of survival. A review in year 2000.

Worldwide about 1 in 1000 adults every year has a sudden cardiac arrest in out-of-hospital. That means 350,000-400,000 persons in the USA alone, 60,000 persons in Italy. Over 70% of times sudden cardiac arrest occurs at home, the remaining 30% in public settings. The chain of survival concept emphasizes four links associated with survival after sudden cardiac arrest corresponding each with a set of actions that have been done as soon as possible--the early access, the early CPR, the early defibrillation, the early ACLS; in order to develop strength in each link, separate specialized programs are needed, but all of the links must be well connected. The Utstein Style was developed by a task force who suggested a series of recommendations as a starting point for more effective exchange of information about out-of hospital cardiac arrest. The Utstein Style includes a glossary of terms, a template for reporting data from resuscitation studies on cardiac arrest, definitions for time points and time intervals related to an intervention in a resuscitation attempt, definitions of clinical items and outcomes that should be included in reports, and recommendations for the descriptions for how different EMS systems are organized.

Cardiopulmonary Resuscitation↗