A protocol guided by transpulmonary thermodilution and lactate levels for resuscitation of patients with severe burns.

Over-resuscitation is deleterious in many critically ill conditions, including major burns. For more than 15 years, several strategies to reduce fluid administration in burns during the initial resuscitation phase have been proposed, but no single or simple parameter has shown superiority. Fluid administration guided by invasive hemodynamic parameters usually resulted in over-resuscitation. As reported in the previous issue of Critical Care, Sánchez-Sánchez and colleagues analyzed the performance of a 'permissive hypovolemia' protocol guided by invasive hemodynamic parameters (PiCCO, Pulsion Medical Systems, Munich, Germany) and vital signs in a prospective cohort over a 3-year period. The authors' results confirm that resuscitation can be achieved with below-normal levels of preload but at the price of a fluid administration greater than predicted by the Parkland formula (2 to 4 mL/kg per% burn). The classic approach based on an adapted Parkland equation may still be the simplest until further studies identify the optimal bundle of resuscitation goals.

Geografia associativa e imperialismo svizzero. Il caso di Ginevra (1858-1914)

ASSOCIATIVE GEOGRAPHY AND SWISS IMPERIALISM. THE EXAMPLE OF GENEVA (1858-1914) − This article is about geographical society of Geneva and its involvement in the 19th century colonial imperialism. Through this society, Swiss bourgeoisie takes part in the exploration and colonization of the world. Is this participation a sign of Swiss imperialism? This issue will be at the heart of this study.

Targeting burn prevention in the paediatric population : a prospective study of children's burns in the Lausanne area.

QUESTION UNDER STUDY: Domestic accidents are an important problem in paediatric medicine. This study was designed to gain a better understanding of burn mechanisms and target prevention. METHODS: Children treated for burn lesions in the Department of Paediatric Surgery between August 2004 and August 2005 were included in this prospective study. The burn mechanisms, the children's ages and the circumstances in which children were burned as well as their home environment variables were analyzed. RESULTS: The current study included eighty-nine patients, aged between 2 months and 15 years. Seventy-eight percent were less than 5 years old. More than half were boys. Hot liquid scalding was the most frequent mechanism. There does not seem to be an increased risk in the immigrant population or in low economic status families. In most cases, an adult person was present at time of injury. CONCLUSIONS: If we were to describe the highest "at risk" candidate for a burn in our region, it would be a boy aged 15 months to 5 years who is burned by a cup of hot liquid on his hand, at home, around mealtime, in the presence of one or both parents. Reduced attention in the safe domestic setting is probably responsible.

Geografisk och historisk karta öfver Finland till skolornes bruk 1858

1 kartta kahdessa osassa :, vär. ;, 53,3 x 44,1 cm, lehti 59 x 48 cm

Mémoire sur le calendrier arabe avant l'islamisme et sur la naissance et l'âge du prophète Mohammad : présenté à la séance de l'Académie, le 3 avril 1858 / par Mahmoud-Effendi,...

Comprend : Rapport sur le mémoire de M. Mahmoud ; Rapport sur le mémoire de M. Mahmoud

Mrs Powers sur un éléphant [de la troupe des Powers elephants] à New-York : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58885

Mrs Carrie Chapman, président[e] de la ligue internationale du suffrage féminin (cliché C.N. New-York) : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59248

Miss Hollman [i. e. Dorothy Holman], 30-5-20 [finale double dames du championnat du monde à Saint-Cloud avec Mrs Satterthwaite] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59468

Miss Hollman [i. e. Dorothy Holman], 30-5-20 [finale double dames du championnat du monde à Saint-Cloud avec Mrs Satterthwaite] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59469

Guide des constructeurs (Paris. 1858)

Périodicité : Trois fois par mois ; mensuel (irrégulier)

Mrs Rider [Minna Louise Rider jouant au golf] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59884

Mrs Plankinton [jouant au golf] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59887