bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of background stress and anxiety on postoperative recovery
Authors: LIU R. , BARRY J. E. S. , WEINMAN J. 
Published: July 2010

SummaryThe effects of background stress and anxiety on both short‐ and long‐term recovery were measured in 30 healthy patients undergoing general anaesthesia for day‐case dental extractions. Standardised questionnaires presented pre‐operatively, assessed psychological status in terms of trait and state anxiety and stress levels. State anxiety was again measured postoperatively; recovery was assessed with pre‐ and postoperative batteries of cognitive tasks. Correlation coefficients revealed that the level of background stress in the preceding 6 months correlated with physical parameters of recovery such as time taken for patients to open their eyes, perceived pain and increased postoperative morbidity. The study also demonstrated that high levels of state anxiety after surgery correlated with postoperative pain. Trait and state anxiety before surgery did not correlate with any parameters of recovery or postoperative morbidity.
Conjunctival oxygen tension monitoring during liver transplantation
Authors: ALCOCK R. , PEACHEY T. , MALLETT S. , DAVIDSON B. , ROLLES K. 
Published: July 2010

SummaryConjunctival oxygen tension has been noted in animal studies to correlate with oxygen delivery. In order to assess this relationship in man, we compared the proportional changes in conjunctival oxygen tension with those in oxygen delivery that occur on the placement and release of the inferior vena caval clamps in 10 patients during orthotopic liver transplantation without veno‐venous bypass. We also examined the changes in mixed venous oxygen saturation at these times. We found a statistically significant correlation between both parameters and oxygen delivery (p < 0.001). However, analysing the data on a Bland and Altman plot of difference versus mean, it is our conclusion that the variation in the data is such that neither conjunctival oxygen tension nor mixed venous oxygen saturation can be used clinically to predict the changes in oxygen delivery that occur during liver transplantation.
Hypomagnesaemia, cardiac arrhythmias and orthotopic liver transplantation
Authors: RANASINGHE D. N. , MALLETT S. V. 
Published: July 2010

SummaryTwo patients who underwent orthotopic liver transplantation and developed peroperative cardiac arrhythmias are presented. In one, the arrhythmias were refractory to treatment with anti‐arrhythmic drug therapy until serum magnesium levels were restored to normal. The other patient had a low pre‐operative serum magnesium level and developed atrial fibrillation on induction of, and during, anaesthesia. Patients undergoing orthotopic liver transplantation may be a group especially predisposed to hypomagnesaemia. The importance of monitoring serum magnesium levels in such patients who develop peroperative cardiac arrhythmias is emphasised.
Lingual haematoma following treatment with streptokinase and heparin; anaesthetic management
Authors: WILLIAMS P. J. , JANI P. , McGlashan J. 
Published: July 2010

SummaryA 79‐year‐old man with a diagnosis of myocardial infarction treated with streptokinase and heparin developed a large lingual haematoma, precipitating dysphagia and upper airway obstruction. Spontaneous haemorrhage into the tongue is a previously unreported but serious complication of thrombolytic therapy. Tracheal intubation was performed under local anaesthesia.
The effects of dobutamine therapy in critically ill patients measured by transoesophageal echocardiography and intracardiac monitoring
Authors: Steltzer H. , Simon P. , Owen A. N. , Thalmann M. , Hammerle A. F. 
Published: July 2010

SummaryFourteen patients with severe hypotension and adult respiratory distress syndrome after trauma (n= 7), general surgery (n = 6) or burns (n = 1) were studied. After volume loading with 6 ml.kg‐1 hydroxyethyl starch over 30 min (time I), dobutamine was infused intravenously at 5 μg.kg‐1.min‐1 (time II) and 10 μg.kg‐1 .min‐1 (time III). A 5 MHz transoesophageal echocardiographic probe was used to image a standard transgastric short axis view of the left ventricle. Haemodynamic data were obtained from thermodilution studies using pulmonary flotation catheterisation. Echocardiographic measurements (off‐line from videotape) and qualitative visual assessment of left ventricular function (visual assessment, on‐line) were performed. All measurements were made after fluid replacement, and during infusion of the two dobutamine doses. An improvement in mean systemic arterial blood pressure and mean stroke volume occurred from time I to the end of dobutamine infusion (p < 0.05). All patients, after volume infusion, were normovolaemic according to transoesophageal echocardiography and there was a good correlation between end‐diastolic area and stroke volume (r = 0.73). During dobutamine infusion, echocardiographic measurements showed no significant dose‐related increase in mean (SD) percentage left ventricular short axis area change from baseline after hydroxyethyl starch (time I: 60 (2); time II: 63 (2); time III: 64 (2)). However, a significant increase in short axis area change was seen in nine of the 14 patients (67%). Analysis of the end‐diastolic area/short axis area change relationship revealed a heterogeneous response to dobutamine. Dobutamine infusion resulted in an improvement in haemodynamics in the majority of patients with sepsis‐related adult respiratory distress syndrome, and transoesophageal echocardiography provided important additional information on ventricular performance.
Effects of the cervical collar on cerebrospinal fluid pressure
Authors: Raphael J. H. , Chotai R. 
Published: July 2010

SummaryWe investigated the hypothesis that cervical collars might compress the internal jugular veins and raise intracranial pressure in head‐injured patients. In a randomised, single‐blind, crossover study of nine patients scheduled for elective spinal anaesthesia the cerebrospinal fluid pressure in the lumbar subarachnoid space was measured with and without a ‘Stifneck’cervical collar applied. There was a significant elevation of cerebrospinal fluid pressure in seven of the patients studied when the cervical collar was applied (p < 0.01). This preliminary study raises the possibility that immobilisation of the cervical spine with the 'Stifneck’cervical collar may, by raising the intracranial pressure, contribute to secondary neurological injury in head‐injured patients in whom intracranial compliance is already reduced.
Infra‐orbital nerve block for relief of postoperative pain following cleft lip surgery in infants
Authors: Ahuja S. , Datta A. , Krishna A. , Bhattacharya A. 
Published: July 2010

SummaryThe study was conducted on 20 infants scheduled for cleft lip repair surgery. Ten were randomly allocated to receive bilateral infra‐orbital local anaesthetic nerve blocks at the conclusion of surgery with the other 10 receiving bilateral ‘sham’blocks as controls. Postoperative pain relief was assessed using a pain assessment scoring system and by monitoring arterial blood pressure, heart rate and respiratory rate. The mean pain assessment score was significantly higher (i.e. better) (p < 0.05) in the infants receiving the local anaesthetic block. There were no significant statistical or clinical differences in the physiological measurements between the two groups. The infants receiving the block required less analgesia in the postoperative period. The results suggest that infra‐orbital nerve block is a simple and effective means of achieving postoperative analgesia after cleft lip repair surgery in infants.
Are pulse oximetry and end‐tidal carbon dioxide tension monitoring reliable during laparoscopic surgery?
Authors: NYARWAYA J.‐B. , MAZOIT J.‐X. , SAMII K. 
Published: July 2010

SummaryCardiorespiratory changes induced by pneumoperitoneum and head‐up tilt may generate alveolar ventilation to perfusion ratio changes and increased systemic vascular resistances. The reliability of end‐tidal carbon dioxide tension and pulse oximetry in predicting arterial carbon dioxide partial pressure and arterial oxygen saturation may therefore be affected. The 35 ASA 1‐2 patients in this study comprised 12 men and 23 women aged 48 (SD 17) years and weighing 71 (SD 14) kg. Twenty‐nine were to undergo upper abdominal laparoscopy for cholecystectomy and six hyperselective vagotomy. Intra‐abdominal pressure was 1.7 (SD 0.9) kPa and head‐up tilt was 5.6 (SD 4.2)°. After abdominal insuflation, arterial carbon dioxide partial pressure significantly increased (p < 0.05). However, the arterial carbon dioxide partial pressure‐end‐tidal carbon dioxide partial pressure gradient remained constant throughout surgery. This gradient was highly correlated with arterial carbon dioxide partial pressure (p < 0.0001), but was not correlated with elapsed time, intra‐abdominal pressure or head‐up tilt. Arterial oxygen saturation was always greater than 95% in all patients and the arterial oxygen saturation‐pulse oximetric saturation gradient was always less than or equal to +4%. In conclusion, end‐tidal carbon dioxide partial pressure and pulse oximetric saturation allow reliable monitoring of arterial carbon dioxide partial pressure and arterial oxygen saturation in the absence of pre‐existing cardiopulmonary disease and/or acute peroperative disturbance.
A comparison of Plasmalyte 148 and 0.9% saline for intra‐operative fluid replacement
Authors: McFARLANE C. , LEE A. 
Published: July 2010

SummaryThirty patients undergoing major hepatobiliary or pancreatic surgery were randomly allocated to receive either 0.9% saline or Plasmalyte 148 (a balanced salt solution), at 15 ml.kg‐1.h‐1. Arterial blood gas analysis was performed before and after surgery. Plasma biochemistry (Na+, K+, Cl‐, lactate) measurements were made before and after surgery and at 24 h after surgery. The patients receiving 0.9% saline had significantly increased chloride concentrations (p < 0.01), decreased standard bicarbonate concentrations (p < 0.01) and increased base deficit (p < 0.01) compared to those receiving Plasmalyte 148. There were no significant changes in plasma sodium or potassium or blood lactate concentrations in either group. The exclusive use of 0.9% saline intra‐operatively can produce a temporary hyperchloraemic acidosis which could be given false pathological significance. In addition it may exacerbate an acidosis resulting from an actual pathological stale. The use of a balanced salt solution such as Plasmalyte 148 may avoid these complications.
Tracheal agenesis
Authors: MANSCHOT H. J. , VAN DEN ANKER J. N. , TIBBOEL D. 
Published: July 2010

SummaryAgenesis of the trachea is a rare anomaly. The main signs are respiratory distress and cyanosis, inability to vocalise and impossible tracheal intubation. In most cases concomitant congenital anomalies of the heart, digestive tract or genitourinary tract are present. Endoscopy and X ray studies will confirm the diagnosis. There is no long‐term surgical solution because no suitable material for a tracheal prosthesis is available at present, therefore the condition is ultimately fatal. We report a case of tracheal agenesis. After the diagnosis was established the baby's lungs were ventilated for several hours via an oesophageal tube and two broncho‐oesophageal fistulae, but she finally died from untreatable respiratory acidosis. Autopsy revealed a Floyd's type III tracheal agenesis and a laryngeal cleft.
Antiemetic efficacy of metoclopramide when included in a patient‐controlled analgesia infusion
Authors: Walder A. D. , Aitkenhead A. R. 
Published: July 2010

SummaryA double‐blind, randomised, controlled trial was performed to assess the antiemetic efficacy of metoclopramide when included in a morphine patient‐controlled analgesia regimen. Fifty ASA grade 1 or 2 patients scheduled for elective intermediate or major gynaecological surgery were allocated into one of two groups. All patients received a standardised anaesthetic and metoclopramide 5 mg was given intravenously 10 min before the end of the procedure. Group 1 received a patient‐controlled analgesia regimen using morphine 1 mg.ml‐1 solution. Group 2 received a patient‐controlled analgesia regimen using morphine 1 mg.ml‐1 with metoclopramide 0.5 mg.ml‐1 solution. Postoperative antiemetic treatment was with metoclopramide 10 mg intramuscularly or cyclizine 50 mg intramuscularly if this was ineffective. Pain scores, sedation scores, and morphine requirement were not significantly different between the groups. There was no difference in nausea scores between the groups, but more patients suffered moderate or severe nausea in group 1 (10 patients) than group 2 (three patients, p < 0.026). We conclude that metoclopramide, when included in a patient‐controlled analgesia regimen, reduces the incidence of moderate to severe nausea, but not the overall incidence of nausea.
A survey of the intended management of acute postoperative pain by newly qualified doctors in the South West region of England in August 1992
Authors: Gould T. H. , Upton P. M. , Collins P. 
Published: July 2010

SummaryA questionnaire designed to assess the knowledge of newly qualified house officers about the management of postoperative pain, was sent to 203 preregistration house officers in the South West region of England. The questionnaire sought information on the following: (1) the prescription of postoperative analgesia for four clinical cases, (2) the use of nonsteroidal anti‐inflammatory drugs in patients with six medical conditions, and (3) the management of a patient who had an epidural infusion. The response rate was 26% (54 house officers) and only 13% of those circulated answered all four clinical cases appropriately. The use of nonsteroidal anti‐inflammatory drugs was often inappropriate. The management of the patient with a postoperative epidural infusion was inadequate when compared with a minimum safe response protocol designed by the authors. The poor theoretical and practical knowledge demonstrated in this survey indicates that urgent changes are required in the undergraduate curriculum to take account of the recent revolution in the management of severe postoperative pain.
A comparison of simple identification tests to distinguish cerebrospinal fluid from local anaesthetic solution
Authors: Tessler M. J. , Wiesel S. , Wahba R. M. , Quance D. R. 
Published: July 2010

SummaryLocal anaesthetic solution is sometimes used to enlarge the epidural space in preparation for the insertion of an indwelling epidural catheter and during subsequent checking a small volume of fluid may be aspirated. Twelve anaesthetists were asked to distinguish 0.1 ml plain bupivacaine 0.25% from 0.1 ml simulated cerebrospinal fluid (CSF) solution. The distinction was based on differences in the physicochemical properties of the two test solutions, namely, temperature, presence of glucose, pH, and turbidity when mixed with thiopentone. Temperature difference resulted in correct identification of the two solutions in 75% of cases, the presence of glucose in 92%, pH in 83%, and turbidity in 25% of cases. No single test resulted in correct identification by all the anaesthetists. We suggest that more than one physicochemical test is required to identify correctly the nature of the small volume of liquid which may be aspirated from an epidural catheter.
Extension of epidural blockade for emergency Caesarean section
Authors: Dickson M. A. S. , Jenkins J. 
Published: July 2010

SummaryA safe and predictable method by which an epidural infusion sufficient for pain control in labour can be rapidly converted to a more intense block adequate for emergency Caesarean section continues to present a challenge. A prospective study was undertaken. The routine use of a bolus dose of 10 ml of 0.5% bupivacaine was assessed as a top‐up for emergency Caesarean section following a 0.1% infusion for labour. This produced an adequate block in 11 out of 18 patients. There were no significant differences in duration of infusion, cumulative local anaesthetic dose or pre‐existing block height in these patients when compared with the remaining seven patients who required an additional top‐up.
Evaluation of clinical effectiveness of the Frova single‐use tracheal tube introducer
Authors: Hodzovic I. , Wilkes A. R. , Stacey M. , Latto I. P. 
Published: July 2010

SummaryA prospective observational study design was used to evaluate the clinical effectiveness of the Frova single‐use tracheal tube introducer. Data were collected from 203 patients. Consultants and trainee anaesthetists completed 61 (30%) and 142 (70%) forms respectively, when the Frova introducer was used. It was successfully placed in the trachea in 194/203 (96%) of patients with two attempts at placement by the first clinician. The first clinician failed to either pass the Frova introducer or railroad the tube in six (3%) and 10 (5%) of the 203 patients respectively. The success rate by the first clinician was significantly influenced by the laryngeal view obtained (p < 0.0001). There was only one failure to place the Frova introducer in the trachea by either the first or second clinician. Airway trauma was detected in 11/203 (5%) patients. In six of these 11 patients blood was detected on tracheal suction; ‘distal hold up’ was elicited in five of these six. The Frova introducer has a high success rate for tracheal placement but has noteworthy potential to produce airway trauma.
The use of the BERCI DCI® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation*
Authors: Low D. , Healy D. , Rasburn N. 
Published: July 2010

SummaryTraditional teaching of laryngoscopy is difficult due to the trainer and trainee lacking a shared view. The Karl Storz BERCI DCI® Video Laryngoscope provides a video image for the trainer and a direct view identical to that of a standard laryngoscope for the trainee. Forty‐nine novice subjects were randomly assigned to a control group (n = 24) taught using a standard Macintosh laryngoscope or a study group (n = 25) taught using the Video Laryngoscope. Following training all subjects were assessed using a standard laryngoscope. Under simulated difficult airway conditions the study group performed better in terms of number of attempts (p = 0.02), number of repositioning manoeuvres required (p = 0.046) and teeth trauma (p = 0.034). The study group were more confident of the success of their tube placement (p = 0.035), found it easier than the control group (p = 0.042) and had improved knowledge of airway anatomy (p = 0.011). We conclude that video laryngoscopy confers benefits in the teaching of tracheal intubation.
Indirect determination of ascorbic acid (vitamin C) by spectrophotometric method
Authors: Nejati‐Yazdinejad Massoud 
Published: July 2010

SummaryA novel spectrophotometric method is described. The procedure involves the use of Cu (II) as vitamin C oxidant. After completion of oxidation reaction, excess of Cu (II) is determined by complexation with alizarin red s (ARS). Thiocyanate ion is used as stabilising agent for Cu (I) which is the product of oxidation reaction. This method is used for determination of vitamin C in fruits and pharmaceutical products. Linearity was found to be perfect in the range 3.5 × 10−6–4.8 × 10−5 m (0.6–8.2 ppm). The detection limit and relative standard deviation of method are 2.0 × 10−6 m (0.35 ppm) and 1.03%, respectively. The proposed method is simple, safe, inexpensive and rapid.
Quantitation by magnetic resonance imaging of heating of commercial baby foods in glass jars
Authors: Gao Amin Maryam H. , Nott Kevin P. , Hall Laurance D. 
Published: July 2010

SummaryThis study demonstrates how magnetic resonance imaging can be used to quantitate the heating of commercially available baby foods as sold in glass jars either ‘on‐line’ during immersion in warmed water in the scanner's magnet, or ‘off‐line’ following microwave heating. The internal temperature distribution can be measured in 2‐ or 3‐dimensions with a precision of ±1.5 °C compared with fibre optical thermo‐probe measurements. Illustrative examples include jars of Heinz ‘Banana & Apple’, Sainsbury's ‘Organic Banana Rice Pudding’ and Cow & Gate ‘Organic Roasted Vegetable Lasagne’. Localised thermal lags induced by pieces of vegetable in the lasagne were observed during on‐line immersion heating. Importantly, the spatially heterogeneous heating by microwaves demonstrates the need for strong warnings about using microwave ovens for heating baby foods.
Application of failure mode and effect analysis (FMEA), cause and effect analysis and Pareto diagram in conjunction with HACCP to a potato chips manufacturing plant
Authors: Arvanitoyannis Ioannis S. , Varzakas Theodoros H. 
Published: July 2010

SummaryFailure mode and effect analysis (FMEA) model has been applied for the risk assessment of potato chips manufacturing. A tentative approach of FMEA application to the snacks industry was attempted in order to analyse the critical control points (CCPs) in the processing of potato chips. Preliminary hazard analysis was used to analyse and predict the occurring failure modes in a food chain system (potato processing and potato chips processing plant), based on the functions, characteristics and/or interactions of the ingredients or the processes, upon which the system depends. CCPs have been identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram and fishbone diagram). Finally, Pareto diagrams were employed towards the optimisation potential of FMEA.
Physicochemical properties of lotus (Nelumbo nucifera Gaertn.) and kudzu (Pueraria hirsute Matsum.) starches
Authors: Geng Zhong , Zongdao Chen , Yimin We 
Published: July 2010

SummaryLotus and kudzu starches have been used as functional foods in East Asia for thousands of years. The objective of this work is to investigate the starches’ basic physicochemical properties. The amylose content was the highest (30.61%) in lotus starch. The average particle size (diameters) was 50.27, 24.08 and 38.97 μm for lotus, kudzu and corn starches, respectively. Lotus starch exhibited a B‐type X‐ray diffraction pattern and kudzu starch exhibited a C‐type pattern. Kudzu starch was characterised by a maximum viscosity immediately followed by a sharp decrease in viscosity, while the lotus starch was characterised by a plateau when the maximum viscosity was reached.
Distribution of lipids and trace minerals in different muscle sites of farmed and wild turbot (Psetta maxima)
Authors: Aubourg Santiago P. , Losada Vanesa , Prego Ricardo 
Published: July 2010

SummaryLipid and trace mineral composition were studied in different sites of the edible flesh of farmed and wild turbot (Psetta maxima). Lipid matter (total content, sterols, tocopherols) showed to accumulate in the edge zone (EZ), except for phospholipid (PL), which provided a distribution that was found to be independent from the kind of turbot and the zone considered. Fatty acid composition of total lipids showed a non‐homogeneous distribution, as the EZ exhibited a different fatty acid group composition (higher monounsaturated and lower polyunsaturated and ω3/ω6 ratio values) than the other zones considered; fewer differences were observed by considering the PL fatty acid composition. Most minerals (Ca, Cu, Fe, Mn and Se) studied showed to be homogeneously distributed along the muscle sites of the wild fish, while more differences were obtained when considering the farmed one. For both kinds of turbots, the most important difference was obtained in the case of Zn, as a largely higher content in the EZ than in the other zones was detected. A close relationship between Zn and total lipid contents (r2 = 0.90 and 0.76 for farmed and wild turbots, respectively) was observed.