Legionellosis outbreaks can be difficult to identify, especially if people travel to a common location, are exposed to Legionella , and then return home before becoming sick. State and local health departments take the lead in investigating outbreaks and implementing control measures to remove Legionella from the water identified as the source of infection. CDC is only involved in legionellosis outbreak investigations when additional assistance is requested. State and local health departments are the best source of information for a specific outbreak.
ICP increases for all inhaled agents at MAC , and autoregulation is impaired at levels below that. MAC of isoflurane or desflurane decreases CBF during craniotomy for supratentorial tumors [Fraga M et al. Anesthesiology 98: 1085, 2003] but does not affect ICP. In contrast, MAC of iso/des will decrease CBF and raise ICP in pituitary resections, and subjective measures of brain relaxation suggest that 50% NO plus MAC of iso/des provide better relaxation [Miller] All volatile anesthetics reduce evoked potential and can abolish them at MAC (or MAC with 50% nitrous oxide). - MAC can reduce the reliability of evoked potential monitoring [Lotto ML et al. J Neurosurg Anesth 16: 32, 2004] EEG effects of inhaled anesthetics include an initial increase in amplitude and synchrony, followed by periods of electrical silence as doses increase. Between MAC and , an isoelectric pattern emerges. Sevoflurane and enflurane may be associated with epileptic activity on the EEG