Anesthesiologists face several perioperative challenges when patients need cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion. To adequately care for these patients, anesthesiologists must understand the goals and objectives of the operation in addition to having a basic knowledge of the chemotherapeutic drugs that are frequently used. Optimal anesthetic management of patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion requires control of a complex interplay of physiologic mechanisms, including hyperthermia, abdominal hypertension, electrolyte abnormalities, coagulopathies, increased cardiac index, oxygen consumption, and decreased systemic vascular resistance. As this surgery continues to gain popularity among oncologic surgeons, further studies that clearly define the chemistry, pharmacokinetics, pharmacodynamics, and end points of efficacy need to be performed to elucidate optimal perioperative management.

No abstract

No abstract

No abstract

A nursery outbreak of varicella is reported. Serum from 200 parturient women and 131 of their offspring were studied for antibody to varicella-zoster (V-Z) virus to analyze their immunity to varicella. Antibody titers were measured by the sensitive fluorescent antibody to membrane antigen (FAMA) technique. It was found that approximately 5% to 16% of women of child-bearing age in New York City are susceptible to varicella. Women from Puerto Rico or other subtropical and tropical areas are more likely to be susceptible (16%) than others (5%). Infants born to mothers with detectable V-Z FAMA titers almost always had detectable V-Z antibody at birth. In serial serum specimens obtained from 67 initially seropositive babies during the first year of life, it was found that by 6 months of age most infants were no longer passively protected against varicella. These observations may explain why varicella is not uncommonly observed in young babies.