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Rosolen V, Turoldo F, Zamaro G, Del Bianco F, Pezzotti P, Castriotta L, Barbone F. COVID-19 vaccination effectiveness in the population of Friuli Venezia Giulia, North-East Italy. Control of bias associated with divergent compliance to policies in a test-negative case-control study. BMC Public Health 2023; 23:2476. [PMID: 38082276 PMCID: PMC10714502 DOI: 10.1186/s12889-023-17244-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Vaccine effectiveness (VE) studies consolidate knowledge of real-world effectiveness in different contexts. However, methodological issues may undermine their conclusions: to assess the VE against COVID-19 within the Italian population, a specific threat to validity is related to the consequences of divergent compliance to the Green Pass policy. METHODS To address this challenge we conducted a test negative case-control (TNCC) study and multiple sensitivity analysis among residents aged ≥ 12 in Friuli Venezia Giulia Region (FVG), North-east Italy, from February 1, 2021 to March 31, 2022. Information regarding 211,437 cases of COVID-19 infection and 845,748 matched controls was obtained from the regional computerized health database. The investigation considered: COVID-19 infection, hospitalization, and death. Multiple conditional logistic regressions adjusted for covariates were performed and VE was estimated as (1-OR COVID-19vaccinated vs. unvaccinated)x100. Mediation analyses were carried out to offset potential collider variables, particularly, the number of swabs performed after the introduction of pandemic restrictions. RESULTS Full-cycle VE against infection decreased from 96% (95% CI: 96, 97) in the Alpha period to 43% (95% CI: 42, 45) in the Omicron period. Booster dose raised the protection in Omicron period to 67% (95% CI: 66, 67). Against the evasive Omicron variant, the protection of the booster dose was 87% (95% CI: 83, 90) for hospitalization and 90% (95% CI: 82, 95) for death. The number of swabs performed was included as a covariate in the adjustments, and the mediation analysis confirmed that it was a strong mediator between vaccination and COVID-19-related outcomes. CONCLUSIONS The study suggests that, under similar TNCC settings, mediation analysis and adjustment for number of diagnostic tests should be included, as an effective approach to the challenge of differential testing behavior that may determine substantial selection bias. This correction allowed us to align with results from other studies that show how full-cycle VE against infection was initially high but decreased over time by variant circulation, counterbalanced by booster dose that raised protection across variants and outcome severity.
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Affiliation(s)
- Valentina Rosolen
- Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Via Cassa Di Risparmio 10, Trieste, 34121, Italy
| | - Federico Turoldo
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy
| | - Gianna Zamaro
- Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Via Cassa Di Risparmio 10, Trieste, 34121, Italy
| | - Flavio Del Bianco
- Prevention Technical Platform, "AS FO" Western Friuli Health Authority, Via della Vecchia Ceramica 1, Pordenone, 33170, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, National Institute of Health (ISS), Viale Regina Elena 299, Rome, 00161, Italy
| | - Luigi Castriotta
- Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Via Cassa Di Risparmio 10, Trieste, 34121, Italy
- Institute of Hygiene and Evaluative Epidemiology, Friuli Centrale University Health Authority, Via Colugna 50, Udine, 33100, Italy
| | - Fabio Barbone
- Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Via Cassa Di Risparmio 10, Trieste, 34121, Italy.
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy.
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Zucca P, Rossmann MC, Dodic M, Ramma Y, Matsushima T, Seet S, Holtze S, Bremini A, Fischinger I, Morosetti G, Sitzia M, Furlani R, Greco O, Meddi G, Zambotto P, Meo F, Pulcini S, Palei M, Zamaro G. What Do Adolescents Know About One-Health and Zoonotic Risks? A School-Based Survey in Italy, Austria, Germany, Slovenia, Mauritius, and Japan. Front Public Health 2021; 9:658876. [PMID: 33869135 PMCID: PMC8045784 DOI: 10.3389/fpubh.2021.658876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/23/2021] [Indexed: 12/31/2022] Open
Abstract
More than 60% of the 1,700 infectious diseases that affect human come from animals and zoonotic pandemics, after starting from sporadic phenomena limited to rural areas, have become a global emergency. The repeated and frequent zoonotic outbreaks such as the most recent COVID-19 pandemic can be attributed also to human activities. In particular, the creation of enormous intensive domestic animal farms, the indiscriminate use of antibiotics, the destruction of forests, the consumption of the meat of wild animals and the illegal animal trade are all factors causing the insurgence and the transmission of zoonotic diseases from animals to humans. The purpose of this study was to explore the knowledge of the One Health concept including the zoonotic risk potentially derived from illegally traded pet animals and wildlife among adolescents in 6 different countries (Italy, Austria, Slovenia, Germany, Mauritius, and Japan). A representative sample of 656 students was recruited and all participants took an anonymous questionnaire. Data were analyzed by ANOVAs to estimate the prevalence of correct health prevention behaviors and to identify the influential factors for these behaviors. After two theoretical-practical lectures, the same anonymous questionnaire was administered for the second time in order to assess the efficacy of the program. The proportion of students who did not know that many diseases affecting humans come from animals is 28.96% while 32.16% of them did not know what a zoonosis is. The circularity of the One Health concept related to the transmission of diseases from animals to humans and vice-versa is not understood from a large prevalence of the adolescents with 31.40 and 59.91% of wrong responses, respectively. Furthermore, rabies is not considered as a dangerous disease by 23.02% of the adolescents. After two theoretical-practical classroom sessions, the correct answers improved to 21.92% according to the different question. More than a third of the student cohort investigated showed a profound ignorance of the zoonotic risks and a poor understanding of the One Health concept. The authors believe that the teaching of health prevention with a One Health approach and a practical training should be included in every school curriculum.
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Affiliation(s)
- Paolo Zucca
- Central Directorate for Health, Social Policies and Disabilities, Friuli Venezia Giulia Region, Trieste, Italy.,Biocrime Veterinary Medical Intelligence Centre, c/o International Police and Custom Cooperation Centre, Thörl-Maglern, Austria
| | - Marie-Christin Rossmann
- Biocrime Veterinary Medical Intelligence Centre, c/o International Police and Custom Cooperation Centre, Thörl-Maglern, Austria.,Agriculture, Forestry, Rural areas Veterinary Department, Land Carinthia, Klagenfurt, Austria
| | | | | | | | - Steven Seet
- Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Susanne Holtze
- Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Alessandro Bremini
- Central Directorate for Health, Social Policies and Disabilities, Friuli Venezia Giulia Region, Trieste, Italy.,Biocrime Veterinary Medical Intelligence Centre, c/o International Police and Custom Cooperation Centre, Thörl-Maglern, Austria
| | - Ingrid Fischinger
- Biocrime Veterinary Medical Intelligence Centre, c/o International Police and Custom Cooperation Centre, Thörl-Maglern, Austria.,Agriculture, Forestry, Rural areas Veterinary Department, Land Carinthia, Klagenfurt, Austria
| | - Giulia Morosetti
- South Tyrol Health Department, Veterinary Services Bolzano, Bolzano, Italy
| | - Marcello Sitzia
- Italian Financial Police, Regional Command Friuli Venezia Giulia Region, Trieste, Italy
| | - Roberto Furlani
- Italian Financial Police, Regional Command Friuli Venezia Giulia Region, Trieste, Italy
| | - Oronzo Greco
- Italian Financial Police, Regional Command Friuli Venezia Giulia Region, Trieste, Italy
| | - Giulio Meddi
- SCIP International Service of Police Cooperation, International Police and Custom Cooperation Centre, Thörl-Maglern, Austria
| | | | | | | | - Manlio Palei
- Central Directorate for Health, Social Policies and Disabilities, Friuli Venezia Giulia Region, Trieste, Italy
| | - Gianna Zamaro
- Central Directorate for Health, Social Policies and Disabilities, Friuli Venezia Giulia Region, Trieste, Italy
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Castriotta L, Rosolen V, Barbiero F, Tomietto M, de Dottori M, Barbone F, Zamaro G. [Impact of the COVID-19 epidemic in Friuli Venezia Giulia Region (Northern Italy): assessment of factors associated with the risk of death by competing risks analysis]. Epidemiol Prev 2021; 44:128-135. [PMID: 33412803 DOI: 10.19191/ep20.5-6.s2.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES to investigate the role of gender, age, province of residence, and nursing home residency on the risk of death for residents in the Friuli Venezia Giulia (FVG) Region (Northern Italy) tested positive for Covid-19, considering recovery as a competing event. The secondary objective is to describe the impact of the Covid-19 epidemic in FVG and in the Regions of Northern and Central Italy in terms of incidence and mortality compared to the national data. DESIGN retrospective cohort study. SETTING AND PARTICIPANTS resident population in FVG in the period between 29 February and 25 June 2020. MAIN OUTCOME MEASURES in order to describe the impact of the Covid-19 outbreak in FVG, in terms of incidence and mortality compared to the national data, the standardized incidence (SIR) and mortality (SMR) ratios and their respective 95% confidence intervals (95%CI) were calculated compared to the Italian population for the northern and central Regions of Italy and the autonomous Provinces (PA) of Trento and Bolzano. A retrospective cohort study was conducted on subjects residing in FVG to whom at least one naso-oropharyngeal swab (hereafter, named swab) resulted positive for Covid-19. For each subject included in the cohort, the observation period started with the first positive swab and ended with the first of the following events: death, recovery or censored, which means that at the end of the observation period the subject was still alive and positive. The cause of death was assigned to Covid-19 if a subject had not yet recovered at the time when the event occurred. Cohort members were considered recovered after two negative consecutive swabs. The sub-hazard ratio (SHR) was estimated by applying the regression model of competing risks by Fine and Gray, in which the event of interest was the death caused by Covid-19 and the competing event was recovery. The explanatory variables included in the multiple models are: gender, age at the beginning of the observation period, the Province of residence, and nursing home residency. The cause-specific hazard was estimated using Cox proportional hazard regression. RESULTS during the observation period, 3,305 cases and 345 deaths were recorded in FVG; SIR and SMR resulted, respectively, equal to 0.64 (95%CI 0.61-0.68) and 0.43 (95%CI 0.37-0.50). The FVG was the Northern Region one with the lowest incidence and mortality. The cohort consisted of 3,121 residents in FVG with at least one swab with a positive Covid-19 result during the study period. The SHR of dying for Covid-19 is equal to 16.13 (95%CI 9.73-26.74) for people with age 70-79 years and 35.58 (95%CI 21.77-58.15) with age >=80 years respect those with age <70 years. It is higher in males (SHR 1.71; 95%CI 1.34-2.17). There is no evidence that being resident in a nursing home affects the SHR (SHR 0.91 and 95%CI 0.69-1.20). As regards the province as an explanatory variable, the sub-hazard of death in the province of Trieste appears to overlap to the sub-hazard of Pordenone used as a reference; for the provinces of Udine and Gorizia the sub-hazards seem lower than the reference. CONCLUSIONS while other Northern Regions and autonomous Provinces show higher standardized incidence and mortality compared with Italy, FVG and Veneto do not. In FVG, male gender and age are important determinants of death while there is no evidence that the condition of guest in a nursing home increases the sub-hazard of death.
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Affiliation(s)
- Luigi Castriotta
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste.,Istituto di igiene ed epidemiologia clinica, Azienda sanitaria universitaria Friuli centrale, Udine
| | - Valentina Rosolen
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste.,IRCCS materno infantile Burlo Garofolo, Trieste;
| | | | - Marco Tomietto
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste
| | | | - Fabio Barbone
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste.,Dipartimento di area medica, Università degli Studi di Udine
| | - Gianna Zamaro
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste
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Zucca P, Rossmann MC, Osorio JE, Karem K, De Benedictis P, Haißl J, De Franceschi P, Calligaris E, Kohlweiß M, Meddi G, Gabrutsch W, Mairitsch H, Greco O, Furlani R, Maggio M, Tolomei M, Bremini A, Fischinger I, Zambotto P, Wagner P, Millard Y, Palei M, Zamaro G. The "Bio-Crime Model" of Cross-Border Cooperation Among Veterinary Public Health, Justice, Law Enforcements, and Customs to Tackle the Illegal Animal Trade/Bio-Terrorism and to Prevent the Spread of Zoonotic Diseases Among Human Population. Front Vet Sci 2020; 7:593683. [PMID: 33240962 PMCID: PMC7670834 DOI: 10.3389/fvets.2020.593683] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/29/2020] [Indexed: 12/26/2022] Open
Abstract
Illegal animal trade (pet, wildlife, animal products, etc.) is an example of transnational organized crime (T.O.C.) that generates a large business with huge profit margins. This criminal activity causes several negative effects on human health (zoonoses), animal health and welfare, market protection, consumer fraud and may be used as tool of agro/bio-terrorism. Illegal animal trade can facilitate the spread of zoonoses that are defined as diseases and infections that are transmitted by vertebrate animals to man. Humans are affected by more than 1,700 known pathogens: 60% of existing human infectious diseases are zoonotic and at least 75% of emerging infectious diseases of humans have an animal origin and 72% of zoonoses originate from wildlife or exotic animals. The Bio-Crime Project was developed in 2017 by Friuli Venezia Giulia Region (Italy) and Land Carinthia (Austria) together with other public institutions to combat illegal animal trade and to reduce the risk of disease transmission from animals to humans. Project partners agreed that a multi-agency approach was required to tackle the illegal animal trade that was high value, easy to undertake and transnational crime. The Bio-crime model of cross-border cooperation introduces the novel approach of replicating the cooperative framework given by the triad of Veterinary Public Health, Justice and Law Enforcements/Customs across borders using the International Police and Custom Cooperation Centres (IPCCCs) as a connection link among public entities of the neighbor countries. This model has been recognized as a best practice at European level because it can be easily replicated and scaled up without any supplementary cost for Member States.
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Affiliation(s)
- Paolo Zucca
- Central Directorate for Health, Social Policies, and Disabilities, Trieste, Italy.,Bio-crime Veterinary Medical Intelligence Centre - c/o International Police and Custom Cooperation Centre, Thörl-Maglern, Austria
| | - Marie-Christin Rossmann
- Agriculture, Forestry, Rural areas Veterinary Department, Land Carinthia, Klagenfurt, Austria.,Bio-crime Veterinary Medical Intelligence Centre - c/o International Police and Custom Cooperation Centre, Thörl-Maglern, Austria
| | - Jorge E Osorio
- Department of Pathobiological Sciences, School of Veterinary Science, Madison, WI, United States
| | - Kevin Karem
- Centre for Global Health Leadership, Centre for Disease Control and Prevention, Atlanta, GA, United States
| | - Paola De Benedictis
- OIE Collaborating Centre and National Reference Centre for Infectious Diseases at the Animal-Human Interface, FAO and National Reference for Rabies, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Josef Haißl
- Public Prosecutor Office, Klagenfurt, Austria
| | | | | | | | - Giulio Meddi
- SCIP International Service of Police Cooperation, International Police and Custom Cooperation Centre, Thörl-Maglern, Austria
| | | | | | - Oronzo Greco
- Italian Financial Police, Regional Command Friuli Venezia Giulia Region, Trieste, Italy
| | - Roberto Furlani
- Italian Financial Police, Regional Command Friuli Venezia Giulia Region, Trieste, Italy
| | - Marcello Maggio
- Italian Army, Regional Command Friuli Venezia Giulia Region, Trieste, Italy
| | | | - Alessandro Bremini
- Central Directorate for Health, Social Policies, and Disabilities, Trieste, Italy.,Bio-crime Veterinary Medical Intelligence Centre - c/o International Police and Custom Cooperation Centre, Thörl-Maglern, Austria
| | - Ingrid Fischinger
- Bio-crime Veterinary Medical Intelligence Centre - c/o International Police and Custom Cooperation Centre, Thörl-Maglern, Austria.,Agriculture, Forestry, Rural areas Veterinary Department, Land Carinthia, Klagenfurt, Austria
| | - Paolo Zambotto
- Veterinary Services, Autonomous Province of South Tyrol, Bolzano, Italy
| | - Peter Wagner
- Health and Care Management Department, Veterinary Services, Land Styria, Graz, Austria
| | - Yvonne Millard
- Veterinary Services, Land Burgenland, Eisenstadt, Austria
| | - Manlio Palei
- Central Directorate for Health, Social Policies, and Disabilities, Trieste, Italy
| | - Gianna Zamaro
- Central Directorate for Health, Social Policies, and Disabilities, Trieste, Italy
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Abstract
Healthy Ageing is an important focus of the European Healthy Cities Network and has been supported by WHO since 2003 as a key strategic topic, since 2010 in cooperation with the Global Network of Age-friendly Cities and Communities. Based on the methodology of realist evaluation, this article synthesizes qualitative evidence from 33 structured case studies (CS) from 32 WHO European Healthy Cities, 72 annual reports from Network cities and 71 quantitative responses to a General Evaluation Questionnaire. City cases are assigned to three clusters containing the eight domains of an age-friendly city proposed by WHO's Global Age-friendly City Guide published in 2007. The analysis of city's practice and efforts in this article takes stock of how cities have developed the institutional prerequisites and processes necessary for implementing age-friendly strategies, programmes and projects. A content analysis of the CS maps activities across age-friendly domains and illustrates how cities contribute to improving the social and physical environments of older people and enhance the health and social services provided by municipalities and their partners.
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Affiliation(s)
- Josephine Jackisch
- Healthy Ageing, Disability and Long-term Care, Public Health Consultant, Copenhagen, Denmark
| | - Gianna Zamaro
- Healthy City Project, Municipality of Udine, Regional Health Trust for Purchasing and Shared Services, Italy
| | - Geoff Green
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Manfred Huber
- World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK 2100 Copenhagen Ø, Denmark
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Abstract
'Caring and Supportive Environments' are fundamental to a social model of health and were a core theme of Phase V (2009-13) of the WHO European Healthy Cities Network. Deploying the methodology of realist evaluation, this article synthesizes qualitative evidence from 112 highly structured case studies from 68 Network cities and 71 responses to a General Evaluation Questionnaire, which asked cities to analyze city attributes and trends. A schematic model was developed to describe the interaction between action targeted toward children, migrants, older people and action on social and health services, health literacy and active citizenship-the six subtopics clustered within the theme Caring and Supportive Environments. Four hypotheses were tested: (i) there are prerequisites and processes of local governance that increase city capacity for creating supportive environments; (ii) investing in health and social services, active citizenship and health literacy enhance the social inclusion of vulnerable population groups; (iii) there are synergies between social investment and healthy urban planning; and (iv) these investments promote greater equity in health. The evaluation revealed many innovative practices. Providers of health and social services have developed partnerships with agencies influencing wider determinants of health. Health literacy campaigns address the wider context of people's lives. In a period of economic austerity, cities have utilized the social assets of their citizens. Realist evaluation can help illuminate the pathways from case study interventions to health outcomes, and the prerequisites and processes required to initiate and sustain such investments.
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Affiliation(s)
- Geoff Green
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | | | - Gianna Zamaro
- Friuli Venezia Giulia Regional Health Trust for Purchasing and Shared Services, Italy
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de Leeuw E, Green G, Tsouros A, Dyakova M, Farrington J, Faskunger J, Grant M, Ison E, Jackisch J, Lafond LJ, Lease H, Mackiewicz K, Ostergren PO, Palmer N, Ritsatakis A, Simos J, Spanswick L, Webster P, Zamaro G, Crown J, Kickbusch I, Rasmussen N, Scally G, Biddle M, Earl S, Petersen C, Devlin J. Healthy Cities Phase V evaluation: further synthesizing realism. Health Promot Int 2015; 30 Suppl 1:i118-i125. [DOI: 10.1093/heapro/dav047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zamaro G, Romano E, Molassi M, Tonzar M, Bertuzzi CA, Auci E. [Cardiovascular effects of a combination of vecuronium and low-dose fentanyl in atropinized and non-atropinized subjects]. Minerva Anestesiol 1992; 58:1237-42. [PMID: 1363488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
The cardiovascular effects of the pharmacologic association of low-dose fentanyl (2 micrograms/kg) and vecuronium (120 micrograms/kg) have been studied in 38 ASA I and II atropinized and non-atropinized patients scheduled for abdominal surgery during induction of anaesthesia with thiopentone or propofol. Whatever the induction agent used, heart rate was consistently reduced in patients not receiving an anticholinergic drug, while it was unchanged in patients treated with atropine intravenously. In non-atropinized patients impressively lower minimum heart rates were observed during induction of anaesthesia with thiopentone. In this last group one patient suffered from a cardiac arrest resolved without sequelae. In patients treated with the association between vecuronium and low doses of fentanyl a pretreatment with atropine is always indicated. Propofol seems to be a better induction agent than thiopentone.
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Affiliation(s)
- G Zamaro
- Istituto Polidisciplinare, Università degli Studi di Trieste
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Zamaro G, Romano E, Molassi M. [Comparison of 2 exchangers of heat and humidity in anesthesia (Hygrobac vs Ultipor BB50)]. Minerva Anestesiol 1989; 55:363-5. [PMID: 2633085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Comparison between Hygrobac and Ultipor BB50, two commercially available heat and moisture exchangers, shows that the former is more efficient: temperature (T degrees C) and water content (absolute humidity, AH) of the inspired gas is greater with Hygrobac than Ultipor BB50. However, both HMEs work at the low limit of the normally accepted range of T degrees C and AH for intubated patients.
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