Intraoperative surgical stress was higher under LA and was blunted by carotid shunting under both LA and GA. Within 2 hours after surgery the anesthetic modality no longer had any impact on surgical trauma. The stress response to CEA, regardless of the type of anesthesia, was abolished within 24 hours. Intraoperative stress response, namely hypercortisolemia, directly correlated with subclinical and clinical cerebral hypoperfusion/ischemia during CACC. Hence, attenuation of the stress response to CEA might decrease the incidence of cerebral ischemic events.
remifentanil as a supplement to regional anaesthesia for carotid endarterectomy, provides comfort and analgesia without hampering mental status evaluation.
The special purpose of this memorial is to urge upon your Honorable Body tho great importance of providing our public schools with properly constructed desks and chairs and to request that you will take still further action to attain that end. It is our impression that nearly fifty years ago Boston was among the first, possibly the first city in America to provide individual pupils with a separate desk and separate chair. More recently your Honorable Body has manifested renewed interest in the matter of school seating. the supervisors and the directors of physical training to aid and advise teachers in the seating of pupils and to report their observations and suggestions in regard to seating to the School Committee ; and the publication of Dr. Hartwell's studies of the seating question, Reports of the Director of Physical Training,2-all appear to lie traceable to recommendations emanating from the same special committee.The European movement for the reform of school seating, which began some thirty years ago, was considerably more influenced in its earlier stages by the force of American example than has latterly been the case. Particularly on the Continent, physiologists, physicians, orthopedic surgeons and oculists have taken a leading part in the investigation and discussion of the principles of seating, and their results and conclusions have been given practical effect by numerous govorinental commissions composed of medical and mechanical experts. The movement has led not only to a much higher development of the art of constructing adjustable school furniture than can be found among us, but also to other notable reforms, as for instance, in the construction and lighting of school rooms, the better printing of text-books, reformed methods of penmanship, and the medical inspectiou aud supervision of schools.Several ingenious types of adjustable school desks have been put upon the American market by inventive makers within the past few years, and the number of such types is steadily increasing. Opinions in respect to the theoretical merit and the praclical value of these new inventions appear to ho confused and divided, and there is a good deal of hesitancy on the part of conservative school boards in adopting them for general use. To us this hesitancy seems natural and justifiable in view of the complex nature of the seating problem and the impossibility of solving it out of hand through the rough and ready methods of manufacturing enterprise. Unless and until American inventors and makers of would-be hygienic school desks and seats avail themselves of the lessons to be" learned from the failures and successes of their European contemporaries, they are likely to lose time and money in roundabout and crude experiments, tho cost of which will naturally be defrayed to some extent from the public purse.We respectfully submit that the physical welfare of our school children, and the interests of our taxpayers, and the exigences of municipal economy would be best subserved in this matter if the deliberate and dispa...
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