bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in carabid beetle diversity within a fragmented agricultural landscape
Authors: Magagula C. N.
Published: December 2004

The distribution of carabid and cicindelid (Coleoptera: Carabidae) beetles in five distinct habitats (riparian, mature orchard, pine windbreak, young orchard, natural veld), within Tambuti Citrus Estate (Swaziland) was examined by pitfall trapping over 18 months. Habitats with high vegetation and litter cover had the highest species diversity and larger specimens, e.g. riparian border and pine windbreak, while the lowest diversity was observed in intensively managed mature citrus orchards. While species such as Tefflus delagorguei Guérin occurred in all the habitats sampled, certain species illustrated habitat specificity; e.g. Dromica ambitiosa Péringuey was observed only in the pine windbreaks while Haplotrachelus sp. Chaudoir occurred mainly in the vegetated riparian and natural veld habitats. Four unidentified carabid beetles were exclusive to the riparian border habitat. This habitat was the only one with a distinct assemblage of species in the agricultural mosaic studied. Multivariate analyses were used to assess the role of soil and environmental variables in relation to the ground beetle diversity within the agricultural mosaic studied.
Aspects of reproductive biology of Labeo horie Heckel (Pisces: Cyprinidae) in Lake Chamo, Ethiopia
Authors: Dadebo Elias , Ahlgren Gunnel , Ahlgren Ingemar
Published: December 2004

Labeo horie
Heckel is increasingly becoming commercially important in Lake Chamo but its reproductive biology in the lake is not well enough to guide its management. Sex ratio, breeding season, length at first maturity and fecundity of
L. horie
were studied from 1197 fish samples collected between August 1998 and October 1999 in Lake Chamo, Ethiopia. The sex ratio was significantly different (χ
2
 = 12.12,
P
 < 0.001). The peak‐breeding period was during the rainy months of March to May, during which time more than 90% of both sexes had ripe gonads. The size at maturity (
L
m50
) of males was 52 cm while the
L
m50
of females was 62 cm. The smallest ripe male in the catch was 46.7 cm and weighed 890 g while the smallest ripe female caught was 49.5 cm and weighed 1145 g. The weight of ripe ovaries ranged from 54.3 g to 991.8 g and contained between 68,400 and 1,320,400 eggs. Relative fecundity ranged between 60 and 290 eggs per g of body weight. The relationships between fecundity and total length and between fecundity and total weight were curvilinear, while the relationship between fecundity and ovary weight was linear.
L. horie conformed to the general pattern of reproduction in a tropical environment where peak‐breeding activity occurred during the rainy season. In order to protect the spawning population, fishing pressure should be minimized during breeding time at the shallower littoral regions.
Black‐backed jackal diet at Mokolodi Nature Reserve, Botswana
Authors: Kaunda S. K. K. , Skinner J. D.
Published: December 2004

We examined the feeding habits of black‐backed jackals at Mokolodi Nature Reserve, Botswana, by analysing 237 scats collected between November 1995 and February 1997. Jackal dietary habits reflected the availability of a wide variety of food items and the differential vulnerability of prey. Potential animal and plant food available to jackals varies throughout the year because of its seasonal character. Seasonality of prey occurrence in scats was pronounced for small mammals, miscellaneous fruits and invertebrates. Across all seasons, mammals were the most common food resource (32.4%, n = 168), followed by anthropogenic items (14.8%), fruits (12.9%), invertebrates (10.8%), birds (8.5%), unidentified items (3.5%) and reptiles (1.4%). The presence of domestic mammals and poultry remains in scats reveals their importance in the diet of jackals and the tendency of jackals to frequent human settlements in search of food. Some ecological implications of jackal dietary habits are also explored.
Status and ecology of the golden monkey (Cercopithecus mitis kandti) in Mgahinga Gorilla National Park, Uganda
Authors: Twinomugisha D. , Basuta G. I. , Chapman C. A.
Published: December 2004

Given the degree to which tropical ecosystems are currently being disturbed by human activities, it is essential to set priorities for conservation and thus it becomes important to consider how best to set these priorities. From this perspective, this study provides the first detailed investigations of Cercopithecus mitis kandti, the golden monkey, focusing on the population in Mgahinga Gorilla National Park (MGNP), Uganda. Specifically, we (1) establish the current status of the golden monkey in terms of population size and distribution within the park in relation to vegetation types and altitude, and (2) investigate the golden monkey's feeding ecology. A total of 67 censuses of 4+ km transects were conducted along a cumulative distance of 299 km and 132 social groups were encountered. Densities were estimated to have increased by 1.6 times since a census 8 years ago, and the total population in the park is estimated to be between 3164 and 5059 individuals. The average size of golden monkey groups in MGNP is 30 individuals (range 3–62). This is similar to that of other subspecies in neighbouring forests. In contrast, the census conducted 8 years before estimated average group size to be eight individuals. Golden monkeys were observed to eat 21 plant species and they were inferred to eat an additional eleven from signs left behind and reports. Both study groups relied upon leaves (primarily young leaves), fruits and invertebrates for food, but the amount of time they fed on these different types of foods varied between the groups. Given the apparent increase in density since the census 8 years ago, the golden monkeys of MGNP appear to be doing well. However, given the number of snares and the extent of illegal extraction of bamboo found during the census, conservation efforts should be increased.
Fire induced changes in the foraging behaviour of impala Aepyceros melampus in Lake Mburo National Park, Uganda
Authors: Wronski Torsten
Published: December 2004

The impact of fire on the foraging behaviour of impala (Aepyceros melampus), was studied in the Lake Mburo National Park, Uganda. Two indices of foraging efficiency were used to establish differences in feeding behaviour in burnt and unburnt control areas. These are acceptable grass/browse abundance (AGA/ABA), expressed in terms of feeding time achieved per 50 steps and food ingestion rate (FIR), expressed as the cumulative percentage. Accumulation of above ground grass biomass was also measured in burnt and control areas. After burning, the grazing efficiency remains constant throughout the dry season, while the browsing time achieved per 50 steps decreases drastically. In the control areas AGA decreased with increasing length of the dry season while ABA increased. When expressed in terms of cumulative percentage (FIR), the results show a significant increase of 31% in foraging time spent grazing and a 24% decrease in foraging time spent browsing, in burnt areas. The results confirm the classification of impalas as intermediate or mixed feeders with a distinct preference for grass. Impala foraging patterns after burning are discussed and compared with investigations on the effect of burning on the behaviour of impalas and Buffon's kob (Kobus kob kob) in other areas of Africa.
Snail diversity, abundance and distribution in Arabuko Sokoke forest, Kenya
Authors: Lange Charles N. , Mwinzi M.
Published: December 2004

This study sought to investigate land‐snail diversity, abundance and distribution in Arabuko Sokoke forest. Sampling was done using standard timed direct search and litter sample methods. In total, 25 species and 1263 specimens were recorded. The 25 species rank Arabuko Sokoke forest as the second richest coastal forest in land snails in East Africa. The 25 species, however, are not uniformly distributed across the forest. The majority of the snails were localized with low levels of abundance. Eight species were restricted to one forest type, whereas those shared among forest types tended to concentrate in one forest type. Only five species,Gulella radius, Gulella foveolata, Gonaxis kibweziensis, Pseudoglessula biovini and Opeas gracilis,were widespread. The highest snail diversity was recorded in the mixed forest, implying that special conservation of this habitat is necessary for retention of the broadest molluscan diversity. The observation that some species rare in the mixed forest were recorded in excess fromBrachystegiaandCynometraforest, further suggests that conservation of the entire A. Sokoke forest is critical for efficient molluscan conservation. Species recorded in low levels of abundance are probably declining and investigation on the snails' ecology to understand factors that influence the snails' diversity is recommended.
Linking two elephant refuges with a corridor in the communal lands of Zimbabwe
Authors: Osborn F. V. , Parker G. E.
Published: December 2004

Wildlife corridors, protected bands of suitable habitat linking core populations of plants and animals, are seen as the best solution to the problem of habitat fragmentation. A corridor between two wildlife refuges was identified in the communal lands of Zimbabwe. Results of tracking the current preferred migration of bull elephants between the two refuges using radio collars were combined with a GIS analysis to examine the zone where conservation of habitat would have least impact on current activities within the communal lands. A suitable corridor was identified using least‐cost analysis allowing for the improved conservation of the elephants and therefore potentially increasing the benefits to local residents by both reducing human/elephant conflict and increasing income from sport hunting and tourism in the region. Recent political violence in the corridor region, the illegal killing of elephants and the loss of suitable habitat makes the implementation of this corridor unlikely.
Dietary composition of wildebeest (Connochaetes taurinus) kongoni (Alcephalus buselaphus) and cattle (Bos indicus), grazing on a common ranch in south‐central Kenya
Authors: Ego W. K. , Mbuvi D. M. , Kibet P. F. K.
Published: December 2004

This paper gives the results of a study conducted at Game Ranching Ltd, situated at the Athi Kapiti Plains, Kenya, to determine the dietary composition of cattle (Bos indicus L), kongoni (Alcephalus buselaphus Pallas) and wildebeest (Connochaetes taurinus Burchell), through two forage growing seasons (wet and dry). The dietary preferences and overlaps between the species were also determined.

The diet preference of the three herbivores was determined using a microhistological analysis technique. The three dominant grasses in the ranch: Themeda triandra Fork, Digitaria macroblephara (Hack.) Stapf and Penisetum mezianum Leeke, formed the major diets of the animals. The browse component of the diets increased during the dry season by about 100% for all the animal species, with cattle always having twice as much browse as the wild herbivores. However, the animals selected similar diets in terms of plant species during both seasons but were more selective during the wet season. Dietary overlaps were always above 75%, but more than this during the dry season. The dietary overlaps were lower between cattle and wild herbivores than between the wild herbivores. The diet preference index for the animals differed from season to season, and from plant to plant.
Natural regeneration and ecological recovery in Bwindi Impenetrable National Park, Uganda
Authors: Mwima Polycarp Musimami , McNeilage Alastair
Published: December 2004

This study tests the justification for displacement and compensation of persons in a previously settled land for natural ecological recovery, and helps in the understanding of patch dynamics in a semi‐mountain tropical rain forest environment. The study area comprised parts of the Mbwa River Tract in Bwindi Impenetrable National Park in Uganda that had been settled and cultivated for at least 20 years prior to park reclassification. The extent, state and speed of regeneration of the cleared forest (CF) after resettlement were not known. There was therefore need for a baseline study as prerequisite for future ecological monitoring of forest recovery. Strip‐plots at 200 m intervals running across the tract were therefore established for this study.

1.17 km2 of forest had been cleared for cultivation in the tract and regeneration in adjacent forest (MF) was better than in the CF, based on the abundance of seedlings. The CF was more diverse in species composition than the MF, and with predominantly pioneer tree species growing. The CF was ecologically important as a water catchment area and a habitat for several animal species, and there were indications that it was heading for ecological recovery.
Elephant calling patterns as indicators of group size and composition: the basis for an acoustic monitoring system
Authors: Payne Katharine B. , Thompson Mya , Kramer Laura
Published: December 2004

The paper gives evidence that the vocal activity of elephants varies with group size, composition and reproductive status, and that elephants' calling patterns could therefore provide the basis for a remote monitoring system. We examined a 3‐week set of array‐based audio recordings of savanna elephants (Loxodonta africana), searching for diagnostic acoustic parameters. An acoustic array made it possible to locate recorded sounds and attribute the calls to particular elephants or elephant groups. Simultaneous video recordings made it possible to document visible behaviour and roughly correlate it with vocalizations. We compared several measures of call density in elephant groups containing up to 59 individuals, and found that rates of calling increased with increasing numbers of elephants. We divided all call events into three structural types (single‐voice low‐frequency calls, multiple‐voice clustered low‐frequency calls, and single‐voice high frequency calls), and found that the incidence of these varies predictably with group composition. These results suggest the value of a network of listening systems in remote areas for the collection of information on elephant abundance and population structure.
Prediction by computerised tomography of distance from skin to epidural space during thoracic epidural insertion
Authors: Carnie J. , Boden J. , Gao Smith F.
Published: December 2004

Summary In this single group observational study on 29 patients, we describe a technique that predicts the depth of the epidural space, calculated from the routine pre‐operative chest computerised tomography (CT) scan using Pythagorean triangle trigonometry. We also compared the CT‐derived depth of the epidural space with the actual depth of needle insertion. The CT‐derived and the actual depths of the epidural space were highly correlated (r = 0.88, R2 = 0.78, p < 0.0001). The mean (95% CI) difference between CT‐derived and actual depths was 0.26 (0.03–0.49) cm. Thus, the CT‐derived depth tends to be greater than the actual depth by between 0.03 and 0.49 cm. There were no associations between either the CT‐derived or the actual depth of the epidural space and age, weight, height or body mass index.
Mathematical modelling and simulation for planning critical care capacity*
Authors: Costa A. X. , Ridley S. A. , Shahani A. K. , Harper P. R. , De Senna V. , Nielsen M. S.
Published: December 2004

Summary Using average number of patients expected in a year, average length of stay and a target occupancy level to calculate the number of critical care beds needed is mathematically incorrect because of nonlinearity and variability in the factors that control length of stay. For a target occupancy in excess of 80%, this simple calculation will typically underestimate the number of beds required. More seriously, it provides no quantitative guidance information about other aspects of critical care demand such as the numbers of emergency patients transferred, deferral rates for elective patients and overall utilisation. The combination of appropriately analysing raw data and detailed mathematical modelling provides a much better method for estimating numbers of beds required. We describe this modelling approach together with evidence of its performance.
The effects of sevoflurane and desflurane in vitro on platelet–leukocyte adhesion in whole blood
Authors: Horn N. A. , De Rossi L. , Robitzsch T. , Hecker K. E. , Hutschenreuter G. , Rossaint R.
Published: December 2004

Summary The interaction between platelets and leukocytes plays an important role in inflammatory and thrombotic processes. We investigated whether the volatile anaesthetics sevoflurane and desflurane alter the formation of platelet–leukocyte aggregates and the expression of P‐selectin on platelets. Whole blood was incubated with 1 and 2 minimum alveolar concentration (MAC) sevoflurane or desflurane. Unstimulated and adenosine diphosphate, or thrombin receptor agonist peptide‐6‐stimulated samples were stained with flourochrome‐conjugated antibodies. The formation of platelet–leukocyte conjugates and the expression of P‐selectin on platelets were measured using flow cytometry. Sevoflurane was found to enhance the binding of platelets to lymphocytes, neutrophils and monocytes, it also increased the expression of P‐selectin on platelets especially in the stimulated samples. Desflurane decreased the percentage of lymphocyte–platelet, neutrophil–platelet and monocyte–platelet conjugates principally in unstimulated samples. The results show that these two volatile anaesthetics have differing effects on the formation of platelet–leukocyte conjugates in vitro. Sevoflurane also enhanced the expression of P‐selectin on platelets.
Impact of an Outreach team on re‐admissions to a critical care unit
Authors: Leary T. , Ridley S.
Published: December 2004

Summary Re‐admissions have been cited as a measure of critical care quality and outreach teams have recently been introduced to improve critical care delivery. The aim of this study was to examine whether the number, causes and sequence of re‐admissions to critical care altered as a result of the introduction of an outreach team. Re‐admissions between April 2000 and November 2001 were examined. The reasons for re‐admission were classified as (i) same pathology or disease process; (ii) new, but related, pathology; (iii) new and unrelated pathology; (iv) exacerbation of other comorbidities. During the two‐year period, a total of 2546 patients were admitted to critical care of which 100 were re‐admitted (49 before outreach and 51 after outreach). The reasons for re‐admission did not vary before or after the introduction of the outreach team (same pathology 15 vs. 15; new, but related, pathology 17 vs. 23; new, but unrelated, 14 vs. 9; exacerbation of comorbidity 3 vs. 4, respectively, Chi‐squared = 2.07, df = 3, p = 0.56). There was also no difference between the duration of stay on the general ward in between the critical care unit admissions before (median 2.93 [interquartile range 1.32–6.05] days) or after (median 2.25 [interquartile range 1.06–6.32] days) the introduction of an outreach team. As we could not detect any change in patterns of re‐admissions as a result of the introduction of an outreach team, we would suggest that although outreach is an important development for critical care, its performance should be measured by other parameters.
Survey of change in practice following simulation‐based training in crisis management
Authors: Weller J. , Wilson L. , Robinson B.
Published: December 2004

Summary We investigated the long‐term effects on clinical practice of a simulation‐based course in anaesthesia crisis management. A questionnaire was posted to all anaesthetists who had attended a course in the preceding year. The response rate was 69% (66/96). The crisis management course was valued highly by respondents, who perceive a change in practice as a result of the training. This change in practice was not limited to the specific clinical events simulated in the course, but applied to a wide range of events and to routine practice. The high rate of subsequent critical events reported in the survey supports the need for training in this area. This survey suggests that simulation‐based training in crisis management is an effective form of continuing medical education for anaesthetists.
Analgesia during radial artery cannulation: Comparison of the effects of lidocaine applied by local injection or iontophoresis
Authors: Sherwin J. , Awad I. T. , Sadler P. J. , Liddle A. M. , Rowbotham D. J.
Published: December 2004

Summary We compared the effect of lidocaine injection with lidocaine iontophoresis for pain relief during radial artery cannulation prior to induction of anaesthesia. Patients were allocated randomly to one of two groups. Group 1 (n = 15) received iontophoresis for 10 min prior to cannulation, using 4% lidocaine 4 ml. Group 2 (n = 15) received local infiltration of 1% lidocaine 1 ml using a 25G needle. Pain scores were recorded immediately after cannulation using a 10‐cm visual analogue scale (VAS). There was no difference in mean (SD) pain scores [group 1: 2.2 (1.5) cm; group 2: 2.3 (2.7) cm; 95% CI of difference −1.8 to 1.5 cm]. Lidocaine delivered by iontophoresis is an effective and painless method of providing analgesia for radial artery cannulation.
Mobile phones in the hospital – past, present and future
Authors: Klein A. A. , Djaiani G. N.
Published: December 2004

Summary The phenomenon of electromagnetic interference by mobile phones is real and potentially clinically significant. This has been recognised by the Department of Health and the Medical Devices Agency, leading to bans on phone use in hospitals. Current evidence suggests that mobile phones can cause malfunction of medical equipment, but only when used in close proximity. Allowing phone use in non‐patient care areas and improving staff education may improve compliance with hospital policies.
The use of remifentanil in the anaesthetic management of patients undergoing adrenalectomy: A report of three cases
Authors: Breslin D. S. , Farling P. A. , Mirakhur R. K.
Published: December 2004

Summary The use of remifentanil has been recommended because of its ability to minimise the hypertensive response to tracheal intubation and surgical stimulation in various types of surgery. We describe the use of remifentanil in the anaesthetic management of three cases of open adrenalectomy, two for removal of a phaeochromocytoma and one for removal of an adrenal cortical tumour. Although the use of remifentanil was associated with no adverse events in the patient undergoing resection of the adrenal cortical tumour, its administration was associated with significant hypotension and bradycardia in the two phaeochromocytoma patients, who had both been given α‐ and β‐adrenergic receptor blocking drugs before surgery. It did not prevent the increases in blood pressure or plasma catecholamine levels associated with tumour manipulation in these patients. Remifentanil should therefore be used with caution in patients receiving α‐ and β‐adrenergic receptor blocking drugs. The use of potent vasodilators may still be necessary during tumour manipulation even if remifentanil is being infused.
A randomised crossover comparison of patient‐controlled sedation and patient‐maintained sedation using propofol
Authors: Rodrigo M. R. C. , Irwin M. G. , Tong C. K. A. , Yan S. Y.
Published: December 2004

Summary This randomised, crossover study compared patient‐controlled sedation using boluses of propofol and patient‐maintained sedation using a target‐controlled infusion of propofol. Twenty‐three patients aged 18–35 years having surgical removal of bilateral third molar teeth under local anaesthesia during two separate visits were studied. In the majority of patients, both techniques provided moderate sedation, good operating conditions, stable physiological parameters and a high degree of patient satisfaction. Two patients became over‐sedated during patient‐controlled sedation. The time taken for titration to adequate sedation was longer with patient‐maintained sedation than with patient‐controlled sedation [mean (SD) = 8.6 (3.7) min vs. 5.7 (3.1) min, p < 0.005]. The mean overall propofol consumption was similar with both techniques. The majority of patients preferred patient‐maintained sedation to patient‐controlled sedation, p < 0.05.
A survey of peri‐operative use of magnesium sulphate in adult cardiac surgery in the UK
Authors: Roscoe A. , Ahmed A. B.
Published: December 2004

Summary We conducted a postal survey of cardiac anaesthetists in the UK, to determine the extent of magnesium sulphate (MgSO4) use and the main indications for its administration. Questionnaires were sent to anaesthetists at 35 UK hospitals undertaking adult cardiac surgery. Responses were received from 24 hospitals (69%) totalling 124 individual responses. Twenty‐five (20%) of the anaesthetists responding to the questionnaire routinely gave magnesium other than in cardioplegia. The most common indications for administration were arrhythmia prophylaxis and treatment, myocardial protection and the treatment of hypomagnesaemia.
Bilateral paravertebral blockade for conventional cardiac surgery
Authors: Cantó M. , Sánchez M. J. , Casas M. A. , Bataller M. L.
Published: December 2004

Summary This prospective observational study aimed to assess the feasibility and efficacy of bilateral continuous paravertebral blockade combined with general anaesthesia in ‘on‐pump’ cardiac surgery. One hundred and eleven elective patients had two paravertebral catheters inserted: one either side of the midline within 2.5 cm of the spinous process of the third or fourth thoracic vertebrae, through which a mixture of ropivacaine and fentanyl was infused during and after surgery. In the first 47 patients, haemodynamic and analgesia data were recorded. In all patients, time to tracheal extubation, length of stay in the intensive care unit and the hospital, morbidity and mortality, and any complication attributable to the regional blockade were recorded. The technique was associated with good haemodynamic stability, good postoperative analgesia and short times to tracheal extubation, with few significant complications.
The use of hypothermia as a method of neuroprotection during neurosurgical procedures and after traumatic brain injury: A survey of clinical practice in Great Britain and Ireland
Authors: Pemberton P. L. , Dinsmore J.
Published: December 2004

Summary Hypothermia has been employed as a method of neuroprotection for many decades. The evidence base for its use is limited, and the balance between benefit and risk is unclear. We felt that in light of this confusion it would be interesting to canvas the opinion of the members of The Neuroanaesthesia Society of Great Britain and Ireland. A questionnaire was sent to all 274 members enquiring into their use of hypothermia during a variety of different neurosurgical procedures and in the management of the head‐injured patient. A 75% response rate was achieved. The results showed that over half (58%) of those who replied attempted to cool the patient during cerebral aneurysm surgery. Forty‐one per cent of respondents attempt to induce hypothermia in the head‐injured patient. However, for other neurosurgical procedures most felt that the disadvantages of cooling the patient outweigh the advantages. The use of hypothermia remains a contentious issue, and as yet there is no clear answer as to whether it should be employed as a method of neuroprotection.
Reduction of motion sickness in prehospital trauma care*
Authors: Fleischhackl R. , Dörner C. , Scheck T. , Fleischhackl S. , Hafez J. , Kober A. , Bertalanffy P. , Hoerauf K.
Published: December 2004

Summary Motion sickness adds to the discomfort of many patients being transported by ambulance. Recent research has demonstrated the effectiveness of oxygen therapy in reducing motion sickness during transport to hospital. However, patients reported negative reactions to wearing a facemask, which produced feelings of claustrophobia and anxiety. We therefore tested the hypothesis that supplemental oxygen inhaled from a new oxygen delivery device OxyArm™, which avoids direct contact with the patients skin, may reduce the incidence of motion sickness and increase patient satisfaction. Forty patients suffering from minor trauma were included in a prospective, randomised trial. Twenty patients received oxygen administered using a conventional Venturi mask (group 1), and 20 patients received oxygen using the new OxyArm™ device (group 2). Measurements made included oxygen saturation (SaO2), heart rate, systolic and diastolic blood pressures, and patients' subjective score of satisfaction with smell of the device, claustrophobia, inconvenience produced by the oxygen inhalation device and nausea were scored using a visual analogue scale. All patients were haemodynamically stable and comparable between the two groups. Peripheral SaO2 increased in both groups. The scores of nausea and claustrophobia were significantly lower in the OxyArm group, in addition, satisfaction with the OxyArm device was significantly higher. In conclusion, the use of OxyArm™ device produced a lower incidence of motion sickness combined with the additional benefit of greater patient satisfaction, when compared with a conventional facemask, during prehospital transfer of trauma patients.
Comparison of closed circuit and Fick‐derived oxygen consumption in patients undergoing simultaneous aortocaval occlusion
Authors: Hofland J. , Tenbrinck R. , Van Eijck C. H. J. , Eggermont A. M. M. , Gommers D. , Erdmann W.
Published: December 2004

Summary Agreement between continuously measured oxygen consumption during quantitative closed system anaesthesia and intermittently Fick‐derived calculated oxygen consumption was assessed in 11 patients undergoing simultaneous occlusion of the aorta and inferior vena cava for hypoxic treatment of pancreatic cancer. All patients were mechanically ventilated using a quantitative closed system anaesthesia machine (PhysioFlex®) and had pulmonary and radial artery catheters inserted. During the varying haemodynamic conditions that accompany this procedure, 73 paired measurements were obtained. A significant correlation between Fick‐derived and closed system‐derived oxygen consumption was found (r = 0.78, p = 0.006). Linear regression showed that Fick‐derived measure = [(1.19 × closed system derived measure) – 72], with the overall closed circuit‐derived values being higher. However, the level of agreement between the two techniques was poor. Bland–Altman analysis found that the bias was 36 ml.min−1, precision 39 ml.min−1, difference between 95% limits of agreement 153 ml.min−1. Therefore, we conclude that the two measurement techniques are not interchangeable in a clinical setting.
Eliminating protein from reusable laryngeal mask airways
Authors: Coetzee G. J.
Published: December 2004

Summary Laryngeal mask airways (LMAs) have the potential to act as a vector for the transmission of prion diseases. This study was undertaken to define the problem of protein contamination and to investigate three alternative cleaning methods. Forty‐eight LMAs were allocated to one of four groups, stained with erythrosin and given a total stain score and a grid stain score in order to determine the degree of protein contamination. Eighteen randomly selected LMAs that had been routinely cleaned and sterilised (group 1) were compared with 12 LMAs that had been washed and scrubbed with the benefit of prior staining (group 2), 13 that had been washed and scrubbed without any visual guide (group 3) and 13 that had been cleaned using a Biosonic© ultrasonic cleaning system (group 4). The results show that none of the cleaning methods achieved optimal results, as all methods left proteinaceous material on some masks. The study showed that: (i) staining as a guide to cleaning does not lead to more effective removal of proteinaceous material; (ii) systematic cleaning and scrubbing does lead to more effective removal of proteinaceous material from surfaces other than the grid area; and (iii) ultrasonic cleaning was more effective than other methods of cleaning for the removal of proteinaceous material from those areas of the mask most inaccessible, such as the grid.
Job satisfaction, stress and burnout in Australian specialist anaesthetists
Authors: Kluger M. T. , Townend K. , Laidlaw T.
Published: December 2004

Summary A postal survey was sent to specialist anaesthetists in Australia looking at aspects of job satisfaction, dissatisfaction and stress. Burnout was measured using the Maslach Burnout Inventory. The response rate was 60% (422/700) with the majority of respondents being male (83%). Stressful aspects of anaesthesia included time constraints and interference with home life. Experienced assistants and improved work organisation helped to reduce stress. The high standard of practice and practical aspects of the job were deemed satisfying, whereas poor recognition and long hours were the major dissatisfying aspects of the job. With respect to burnout, high emotional exhaustion, high levels of depersonalisation and low levels of personal achievement were seen in 20, 20 and 36% of respondents, respectively. Female anaesthetists reported higher stress levels than males (p = 0.006), but tended to prioritise home/work commitments better than males (p = 0.05). Private practitioners rated time issues of high importance compared with public hospital doctors, whereas public hospital doctors rated communication problems as being more significant than with private specialists. Although burnout levels are high in anaesthetists, they compare favourably with other medical groups. There are, however, aspects of the anaesthetist's job that warrant further attention to improve job satisfaction and stress.
Temperature course and distribution during plasma heating with a microwave device
Authors: Hirsch J. , Bach R. , Menzebach A. , Welters I. D. , Dietrich G. V. , Hempelmann G.
Published: December 2004

Summary In spite of the much shorter thawing times, the use of microwave devices for heating units of fresh frozen plasma is still being discussed. Concerns about general and localised overheating are the main arguments against the use of microwave devices. We evaluated the warming of fresh frozen plasma using the recently introduced Transfusio‐therm 2000® microwave blood warmer. Units of fresh frozen plasma were weighed and the heating times were recorded. The surface temperature of the fresh frozen plasma bags during heating was recorded every 10 s. Temperature variation on the surface was examined by measuring the difference between peripheral and centrally placed temperature sensors. After heating, plasma temperature was determined using a calibrated thermometer. There were no signs of overheating during the heating process. The surface temperature of three units of fresh frozen plasma heated simultaneously (n = 45) was 34.0°C (SD, 1.5°C) after a mean heating time of 23.2 min (SD, 1.1 min). The mean (SD) temperature difference was −0.6 (0.5)°C and the mean (SD) plasma temperature was 33.6 (0.8)°C. Heating one fresh frozen plasma unit at a time (n = 20), the mean (SD) heating time was 6.3 (0.4) min. The surface temperature after heating was 34.3 (0.2)°C, the mean (SD) temperature difference was −0.6 (0.4)°C and the mean (SD) plasma temperature after heating 33.1 (0.6)°C. We conclude that no general or localised overheating of fresh frozen plasma occurs during or after heating with the microwave blood warmer.
Hypotension following combined spinal‐epidural anaesthesia for Caesarean section
Authors: Mendonca C. , Griffiths J. , Ateleanu B. , Collis R. E.
Published: December 2004

Summary Eighty‐seven pregnant mothers undergoing elective Caesarean section were randomly allocated either to the full left lateral position (n = 45) or to the supine position with 12° left lateral tilt (n = 42) after a combined spinal–epidural (CSE) in the sitting position and an initial 2 min in the full right lateral position. Fewer mothers were hypotensive while in the study position [29 (64%) in lateral group vs. 38 (90%) in the tilted supine group; p = 0.03]. Mothers in the lateral group tended to become hypotensive after turning them back to the tilted supine position immediately before surgery; hence the number of mothers who were hypotensive from the insertion of the CSE until delivery were similar [36 (80%) vs. 38 (90%)]. Mothers in the lateral group needed a lower dose of ephedrine to treat their hypotension while in their study position {median (interquartile range [range]) 6 (0–12 [0–36]) mg vs. 12 (6–18 [0–36]) mg, respectively; p = 0.04} but ephedrine requirements were similar overall {12 (6–12 [0–36]) mg vs. 12 (6–18 [0–36]) mg}, respectively. The full left lateral position reduces the incidence of early hypotension compared with the tilted supine position with tilt, and makes it easier to treat.
Evaluation of oesophageal pulse oximetry in patients undergoing cardiothoracic surgery*
Authors: Kyriacou P. A. , Powell S. L. , Jones D. P. , Langford R. M.
Published: December 2004

Summary Pulse oximetry probes placed peripherally may fail to give accurate values of blood oxygen saturation when the peripheral circulation is poor. Because central blood flow may be preferentially preserved, we investigated the oesophagus as an alternative monitoring site. A reflectance blood oxygen saturation probe was developed and evaluated in 49 patients undergoing cardiothoracic surgery. The oesophageal pulse oximeter results were in good agreement with oxygen saturation measurements obtained by a blood gas analyser, a CO‐oximeter and a commercial finger pulse oximeter. The median (IQR [range]) difference between the oesophageal oxygen saturation results and those from blood gas analysis were 0.00 (−0.30 to 0.30 [−4.47 to 2.60]), and between the oesophageal oxygen saturation results and those from CO‐oximetry were 0.75 (0.30 to 1.20 [−1.80 to 1.80]). Bland–Altman analysis showed that the bias and the limits of agreement between the oesophageal and finger pulse oximeters were −0.3% and −3.3 to 2.7%, respectively. In five (10.2%) patients, the finger pulse oximeter failed for at least 10 min, whereas the oesophageal readings remained reliable. The results suggest that the oesophagus may be used as an alternative monitoring site for pulse oximetry even in patients with compromised peripheral perfusion.
Validation of a tonometric noninvasive arterial blood pressure monitor in the intensive care setting
Authors: Steiner L. A. , Johnston A. J. , Salvador R. , Czosnyka M. , Menon D. K.
Published: December 2004

Summary Intra‐arterial measurement is considered the gold standard for continuous, beat‐to‐beat arterial blood pressure monitoring. However, arterial cannulation can be difficult and may cause complications such as thrombosis and ischaemia. Recently, a tonometric system, the Colin CBM‐7000 has been developed for noninvasive beat‐to‐beat measurement of arterial blood pressure from the radial artery. We assessed the level of agreement between the CBM‐7000 and invasive radial artery measurements in 15 patients on a neuro‐intensive care unit. Agreement of systolic, diastolic and mean arterial pressure values was limited, with ≈ 34% of mean arterial pressures differing by over 10 mmHg. In many cases, this was due to a downward drift of the noninvasive measurements over time. Furthermore, there was a tendency to underestimate low pressures and overestimate high pressures. In our opinion, the Colin CBM‐7000 cannot be recommended for continuous blood pressure monitoring in the intensive care setting.
Clinical evaluation of a continuous oxygen consumption monitor in mechanically ventilated patients
Authors: Donaldson L. , Dodds S. , Walsh T. S.
Published: December 2004

Summary We measured oxygen consumption using a new noninvasive modular metabolic monitor, M‐COVX™, in ventilated critically ill patients. Oxygen consumption was measured continuously as part of routine monitoring for up to 24 h following mechanical ventilation in 27 patients admitted to a general intensive care unit. We explored several possible sources of error. Most errors related to inaccurate tidal volume measurement, which resulted in rejection of a median 14% (interquartile range 8–34%) of data. Water accumulation in the pneumotachograph was responsible and occurred more frequently with water bath humidifiers. After manual removal of erroneous data mean oxygen consumption values were virtually identical to calculated values in 24 of 27 patients. We conclude that in most ventilated patients averaging of continuous oxygen consumption data with the M‐COVX module results in small errors.
The effect of mechanical cleaning and thermal disinfection on light intensity provided by fibrelight Macintosh laryngoscopes
Authors: Bucx M. J. L. , De Gast H. M. , Veldhuis J. , Hassing L. H. , Meulemans A. , Kammeyer A.
Published: December 2004

Summary The increased use of thermal decontamination procedures for fibrelight laryngoscope blades, to comply with international guidelines, will have considerable economical effects. We evaluated the effect of mechanical cleaning plus thermal disinfection at 90°C, with or without subsequent steam sterilisation at 134°C, on light intensity provided by fibrelight laryngoscopes. After mounting the blades in a special frame with a built‐in light source, light intensity was measured using radiometer/photometer. In total, 14 blades provided by 11 companies were tested. The majority of fibrelight laryngoscope blades were fairly resistant to the damaging effects of machine washing plus disinfection at 90°C (mean [range] reduction in light intensity 34.6%[2.1–78.3%]). However, when exposed to an additional sterilisation procedure at 134°C, the majority of blades were unable to withstand the combined treatment for 300 cycles (mean [range] reduction in light intensity 86.5%[32.0–98.7%]). This study stresses the need for fibrelight laryngoscope blades which are more resistant to thermal decontamination procedures than those available at present.
Clinical and economic choices in anaesthesia for day surgery: A prospective randomised controlled trial
Authors: Elliott R. A. , Payne K. , Moore J. K. , Harper N. J. N. , St Leger A. S. , Moore E. W. , Thoms G. M. M. , Pollard B. J. , McHugh G. A. , Bennett J. , Lawrence G. , Kerr J. , Davies L. M.
Published: December 2004

Summary We compared the cost‐effectiveness of general anaesthetic agents in adult and paediatric day surgery populations. We randomly assigned 1063 adult and 322 paediatric elective patients to one of four (adult) or two (paediatric) anaesthesia groups. Total costs were calculated from individual patient resource use to 7 days post discharge. Incremental cost‐effectiveness ratios were expressed as cost per episode of postoperative nausea and vomiting (PONV) avoided. In adults, variable secondary care costs were higher for propofol induction and propofol maintenance (propofol/propofol; p < 0.01) than other groups and lower in propofol induction and isoflurane maintenance (propofol/isoflurane; p < 0.01). In both studies, predischarge PONV was higher if sevoflurane/sevoflurane (p < 0.01) was used compared with use of propofol for induction. In both studies, there was no difference in postdischarge outcomes at Day 7. Sevoflurane/sevoflurane was more costly with higher PONV rates in both studies. In adults, the cost per extra episode of PONV avoided was £296 (propofol/propofol vs. propofol/ sevoflurane) and £333 (propofol/sevoflurane vs. propofol/isoflurane).
Anaesthetic implications of anorexia nervosa
Authors: Seller C. A. , Ravalia A.
Published: December 2004

Summary The provision of anaesthesia for patients suffering from anorexia nervosa or bulimia nervosa is not without its risks. The anaesthetist needs to appreciate that these eating disorders can predispose the patient to significant risk of multi‐organ dysfunction related to starvation and purging. Any such organ dysfunction can have serious implications on morbidity and mortality. Therefore, careful peri‐operative management is essential to avoid anaesthetic complications. Both disorders are common, with incidences in the general population of up to 30% in girls and young women. A review of the literature on the provision of anaesthesia for anorexic patients was carried out to evaluate the potential impact of these disorders on the patient's physiology and the subsequent implications for anaesthesia.
The anaesthetic management of a patient with a reninoma
Authors: Nicholson J. P. , Rayman G. , Donaldson P. , Driver I. K.
Published: December 2004

SummaryWe report on the anaesthetic management of a 28‐year‐old woman presenting for excision of a reninoma. This is a very rare tumour of the juxtaglomerular cells of the kidney, which can be cured immediately by surgery. Previous reports have failed to record the presence or absence of peri‐operative cardiovascular lability. We have shown that blood pressure, cardiac index (CI) and systemic vascular resistance (SVRI) were remarkably stable in our patient throughout surgery, even during manipulation of the tumour. Isolation of the tumour was associated with a 23% reduction in SVRI, and a similar decrease in blood pressure. The cardiovascular lability associated with the removal of catecholamine‐secreting tumours was not seen in this case.
Comparison of heart rate variability in supine, and left and right lateral positions
Authors: Ryan A. D. , Larsen P. D. , Galletly D. C.
Published: December 2004

Summary In order to determine whether differences exist in cardiac autonomic tone between different body positions that may be used in unconscious subjects, we examined beat‐to‐beat heart rate variability (HRV) in volunteers lying supine, and in left lateral and right lateral positions. We studied 24 subjects, aged 20–35 years in each of the three positions on one study day, and 6 subjects in each of the three positions on each of six different study days. In both groups of subjects we observed no difference in heart rate, respiratory frequency, total power (0.02–0.45 Hz) of HRV or the proportion of power in the high (0.15–0.45 Hz), low (0.08–0.15 Hz) or very low (0.02–0.08Hz) frequency bands among the three positions. These results suggest that there are no cardiac autonomic tone advantages to be gained by placing a person in the recovery position on one side compared with the other.
Equine dinucleotide repeat loci COR081–COR100
Authors: Tallmadge R L , Evans K G , Hopman T J , Schug M D , Aquadro C F , Bowling A T , Murray J D , Caetano A R , Antczak D F
Published: December 2004

This paper describes a fifth set of 20 characterized horse dinucleotide repeat markers developed at Cornell University.