bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between plasma cortisol and gastric mucosa prostaglandin levels in rats with stress ulcers
Authors: GITLIN N. , GINN P. , KOBAYASHI K. , ARAKAWA T. 
Published: July 2010

SUMMARYA correlation between the levels of plasma cortisol, gastric mucosal prostaglandins and the degree of gastric ulceration produced by stress in rats was examined. Four groups of rats were evaluated. Group A, the cold stressed group; group B, their controls; group C, those receiving intraperitoneal indomethacin; and group D, those receiving intraperitoneal saline. Group A developed stress ulcers and their gastric mucosal prostaglandin levels (prostaglandin E2 (PGE2) and prostacyclin levels, as measured by its stable metabolite 6—keto‐prostaglandin F1α (6—keto‐PGF‐1α, but not thromboxane) were significantly reduced when compared with their respective non‐stressed controls. The plasma cortisol levels in both group A and B increased slightly in the first hour but there was no statistical difference between the two groups and there was no change at 2, 3 or 4 h of stress. Group C (indomethacin) also developed ulcers and had low gastric mucosal prostaglandin levels when compared with group D (saline). The plasma cortisol levels did not alter in either group C or D. It has been postulated that stress ulcers may involve the depletion of gastric mucosal prostaglandin levels which, in turn, may be a consequence of a higher plasma cortisol level. A decrease in gastric prostaglandins independent of any change of plasma cortisol levels was demonstrated in this study and the mechanism of production of stress gastric ulcers remains obscure.
Enprostil, a prostaglandin E2 analogue, in the treatment of duodenal ulcer; a multicentre' comparison with cimetidine
Authors: JAZRAWI R. P. , NORTHFIELD T. C. , REED P. I. , COCKEL R. , SCHILLER K. F. R. , BARKER E. S. 
Published: July 2010

SUMMARYIn a multicentre trial, 120 patients with endoscopically diagnosed duodenal ulcer were randomly allocated to treatment with either 35 μg enprostil b.d. or 400 mg cimetidine b.d. for up to 6 weeks on a double‐blind basis. After 6 weeks, 82% (42/51) of enprostil‐treated patients and 92% (44/48) of cimetidine‐treated patients were healed. Corresponding healing figures on an intention‐to‐treat basis were 70% and 76%. No significant differences were detected between treatments with respect to healing rates or symptom control at any time. Side‐effects were reported by 14 patients taking enprostil and 17 patients taking cimetidine; none were serious but they resulted in withdrawal of one and two patients respectively. Enprostil was found to be similar in efficacy and tolerance to cimetidine.
The timing of evening meal and ranitidine administration—effects on patterns of 24 hour intragastric acidity
Authors: ORR W. C. , FINN A. L. , ALLEN M. , ROBINSON M. G. , WILSON T. 
Published: July 2010

SUMMARYIntragastric pH‐metry was utilized to assess the effect of the time of meal ingestion and ranitidine administration on 24‐h intragastric acidity. Twelve volunteers with a documented history of duodenal ulcer were studied in a four‐way crossover design. Subjects randomly received ranitidine at 18.00 and 22.00 hours, with and without food. Serial blood samples were collected and analysed for ranitidine by high pressure liquid chromatography. Over the interval of 18.00–0.700 hours, the mean hydrogen‐ion activity was significantly lower with the 18.00 hour dose than with the 22.00 hour dose (P≤ 0.05). There were no differences between the four treatments in median pH or mean hydrogen‐ion activity over the 23‐h study interval. There were no differences between treatments in peak ranitidine concentrations, time to peak concentration, area under the serum‐concentration time curve or elimination half‐life.
Short report: lipid and vitamin B12 malassimilation in pancreatic insufficiency
Authors: JØRGENSEN B. BANG , PEDERSEN N. THORSGAARD , WORNING H. 
Published: July 2010

SUMMARYPatients with exocrine pancreatic insufficiency have steatorrhoea as well as vitamin B12 malassimilation. To investigate whether this is caused by the pancreatic insufficiency per se or whether intestinal bacterial overgrowth contributes to the condition, 10 patients with pancreatic steatorrhoea were studied. Intestinal culture was done. Lipid and vitamin B12 assimilation was estimated from faecal spot tests, using 14C‐triolein and 58Co‐vitamin B12 as tracers and 51CrCl3 as marker. Out of the 10 patients, 9 had either vitamin B12 malassimilation (n= 8), and/or bacterial overgrowth (n= 5). These 9 patients were retested with pancreatic enzyme therapy, with and without addition of the antibiotics metronidazole and cefalexin. The lipid assimilation was significantly increased by enzyme therapy but did not improve further on additional antibiotic treatment. The vitamin B12 assimilation did not improve significantly on enzyme therapy nor with additional antibiotic treatment.
Omeprazole versus famotidine in the short‐term treatment of duodenal ulcer disease
Authors: FAVE G. DELLE , ANNIBALE B. , FRANCESCHI M. , QUATRINI M. , CASSETTA M. R. , TORSOLI A. 
Published: July 2010

SUMMARYThe efficacy and safety of omeprazole, in 241 patients with active recurrent duodenal ulcer from 21 Italian centres, was studied in a multicentre double‐blind randomized trial comparing 20 mg omeprazole o.m. or 40 mg famotidine nocte with endoscopic examination, symptom recording, laboratory screening and gastrin assay. In a per protocol analysis, the duodenal ulcer healing rates for omeprazole and famotidine, documented by endoscopy, were 62% (68/109) and 33% (39/117) after 2 weeks of treatment (P < 0.001), 92% (96/104) and 80% (86/108) cumulative after 4 weeks (P < 0.05), and 99% (102/103) and 92% (96/104) after 6 weeks (P < 0.05), respectively. The results of this trial demonstrate that 20 mg omeprazole o.m. is superior to 40 mg famotidine nocte in duodenal ulcer healing.
Budesonide and prednisolone suppress peripheral blood natural killer cells in Crohn's disease
Authors: van IERSSEL A. J. H. M. , VAN DER SLUYS VEER A. , VERSPAGET H. W. , GRIFFIOEN G. , van HOGEZAND R. A. , LAMERS C. B. H. W. 
Published: July 2010

SUMMARY Aim: To study the effect of oral budesonide and prednisolone on peripheral blood natural killer (NK) cell activity in patients with active ileocaecal Crohn's disease (Crohn's disease activity index, CDAI ≧ 200). Methods: One group of patients was treated for 10 weeks with oral budesonide (n= 9; 9 mg/day), and another group of patients for the same period with prednisolone (n= 9; 40 mg/day). Budesonide was tapered to 6 mg/day after 8 weeks and prednisolone after 2 weeks to 5 mg/day in the last week. Before treatment, and at 2, 4 and 10 weeks of treatment, natural killer cell activity was determined with a 51Cr release assay, and the number of CD16+ NK cells by Fluoresence activated cell sorter (FACS) analysis. Results: Budesonide, as well as prednisolone treatment, significantly decreased natural killer cell activity at weeks 2 and 4. This decrease was found to be accompanied by a similar decrease in the number of CD16+ NK cells. At 10 weeks, natural killer cell activity had almost returned to pre‐treatment levels in the budesonide group and was significantly higher than pre‐treatment levels in the prednisolone group. Disease activity was significantly decreased in all patients at week 2 until the end of the trial period. Conclusion: Both budesonide and prednisolone treatment suppress peripheral blood natural killer cell activity of patients with active ileocaecal Crohn's disease by decreasing the numbers of CD16+ NK cells in the circulation.
Meta‐analysis: the effect of antibiotic resistance status on the efficacy of triple and quadruple first‐line therapies for Helicobacter pylori
Authors: FISCHBACH L. , EVANS E. L. 
Published: July 2010

SummaryBackground  Information regarding the effects of drug resistance on therapies for Helicobacter pylori is limited.Aims  To determine the effect of drug resistance on the efficacy of first‐line treatment regimens for H. pylori and identify the most efficacious treatments in the presence of drug resistance.Methods  We searched for studies using the keywords: ‘Helicobacter pylori’,‘resistance’ and ‘treatment’ or ‘therapy’. Multilevel meta‐regression models were used to determine the effect of drug resistance on treatment efficacy.Results  We analysed data from 93 studies with 10 178 participants. For triple therapies, clarithromycin resistance had a greater effect on treatment efficacy than nitroimidazole resistance. Metronidazole resistance reduced efficacy by 26% in triple therapies containing a nitroimidazole, tetracycline and bismuth, while efficacy was reduced by only 14% when a gastric acid inhibitor was added to the regimen. Quadruple therapies containing both clarithromycin and metronidazole were the most efficacious; >80% of H. pylori infections were consistently eradicated with these regimens.Conclusions  Drug resistance was a strong predictor of efficacy across triple therapies for the eradication of H. pylori in adults. Resistance to either clarithromycin or metronidazole, but not both simultaneously, may be overcome by using quadruple therapies, especially those containing both clarithromycin and metronidazole.
Cardiac transplantation at Harefield
Authors: GREBENIK CATHERINE R. , ROBINSON P. N. 
Published: July 2010

SummaryIn the period January 1980 to February 1984, 91 heart transplant operations were performed at Harefield Hospital. The current statistics of the transplantation programme are presented. The survival rate since the introduction of the immunosuppressive agent Cyclosporin A is 78% at one year. This paper summarises the special care required for these patients with particular reference to the anaesthetic management.
Patient monitoring in the operating theatre
Authors: MACKENZIE N. , FORREST A.L. 
Published: July 2010

SummaryThe vital importance of patient monitoring during anaesthesia is well recognised. There is little information available, however, on the actual practice of instrumental monitoring in the operating theatre. This study examined present‐day practice and compared it with that of 1976. The main findings were an increase in frequency of electrocurdiographic monitoring, especially for non‐major surgery, and a smaller increase in blood pressure recording. Monitoring of other variables remained essentially unchanged. Possible reasons for this are given and suggestions made for improvements.
Thumb paraesthesia after neuromuscular twitch monitoring
Authors: SIA R. L. , STRAATMAN N. J. A. 
Published: July 2010

SummaryNine patients, who had operations for ear and nose pathology and developed left thumb paraesthesia after neuromuscular twitch monitoring with the Gould Statham UC3 force displacement transducer are described. The pathophysiology and prevention of the complication is discussed.
Electrocardiographical changes in the peri‐operative period, A pilot study
Authors: Griffin R.M. , Phipps J.A. , Evans J.M. 
Published: July 2010

SummaryThe value of continuous electrocardiogram recording in the peri‐operative period has been examined. In a group of 15 patients. 14 developed changes two of which persisted into the postoperative period. Dysrhythmias, ST segment and T‐wave changes occurred frequently. Continuous recording is of potential benefit in the study of cardiovascular disease and therapy in the peri‐operative period.
The effect of magnesium trisilicate mixture, metoclopramide and ranitidine on gastric pH, volume and serum gastrin
Authors: O'SULLIVAN G. , SEAR J. W. , BULLINGHAM R. E. S. , CARRIE L. E. S. 
Published: July 2010

SummaryEighty women (40 for elective Caesarean section and 40 for elective gynaecological surgery) were randomly assigned to one of five treatment groups and received pre‐operatively either no medication; magnesium trisilicate mixture (BP) 30 ml; metoclopramide 10 mg intramuscularly; ranitidine 150 mg orally on the night prior to, and the morning of, surgery; or metoclopramide 10 mg intramuscularly in combination with oral ranitidine 150 mg (the latter again given on the night prior, and the morning, of surgery). The effect of these medications on intragastric pH. volume and serum gastrin‐17 was measured. No patient receiving ranitidine had a pH of less than 4. Magnesium trisilicate mixture resulted in the largest intragastric pH change although one woman in this group had a pH of 1.7. The largest intragastric volumes were seen in the patients who had received magnesium trisilicate mixture, whilst the patients who had received metoclopramide in combination with ranitidine had the smallest intragastric volumes. Magnesium trisilicate mixture and metoclopramide resulted in no change in serum gastrin levels. However, in the subjects who had received ranitidine on the night prior to surgery, the fasting serum gastrin was significantly higher (p < 0.01) than the values in the remaining subjects, the mean (SEM values being 60.3(6.3) pg/ml in those not receiving ranitidine and 111.3(19.5) pg/ml in those who had been given ranitidine.
Ludwig's Angina. The anaesthetic management of nine cases
Authors: Loughnan T.E. , Allen D.E. 
Published: July 2010

SummaryWe reviewed nine patients with Ludwig's angina who required surgical drainage over a 24‐month period. This represents the largest series reported in world literature. All of these patients were managed successfully by a combination of tracheal intubation and early surgical intervention. None required tracheostomy, which is the previously recommended procedure of choice for airway management.
The laryngeal mask airway
Authors: BRAIN A. I. J. , McGHEE T. D. , McATEER E. J. , THOMAS A. , ABU‐SAAD M. A. W. , BUSHMAN J. A. 
Published: July 2010

SummaryA new form of airway has recently been described, which is introduced blindly into the hypopharynx to form a seal around the larynx, so permitting spontaneous or positive pressure ventilation without penetration of the larynx or oesophagus. The further development of this new airway is described and the results of 18 months' clinical experience are presented. The airway was used successfully in 118 patients, 17 of whom received controlled ventilation of their lungs. It was used in place of the facemask in routine anaesthesia, and was of particular value in ophthalmic, dental and ear, nose and throat procedures and where difficulties with the airway were expected. The incidence of sore throat and other problems was low. Experience of more than 500 cases suggests that the laryngeal mask airway may have a valuable rôle to play in all types of inhalational anaesthesia, while its proven value in some cases of difficult intubation indicates that it may contribute significantly to the safety of general anaesthesia.
Some predisposing factors to hypersensitivity reactions following first exposure to Althesin
Authors: SIMPSON P. J. , RADFORD S. G. , LOCKYER J. A. , SEAR J. W. 
Published: July 2010

SummaryThree possible factors predisposing to Althesin hypersensitivity, namely total dose, method of administration, either by bolus dose or infusion, and pregnancy have been studied in patients receiving the drug for the first time. Of 137 patients given Althesin, four exhibited clinical signs of mild hypersensitivity, while C3 conversion alone, indicative of a subclinical reaction, was seen in a further six patients. No reactions were observed in two control groups in whom anaesthesia was induced with thiopentone. Neither the total dose nor method of administration appeared consistently to influence the incidence of reactions, but eight of the ten patients producing an altered response to Althesin were pregnant.
Anaesthetic experience with percutaneous lithotripsy
Authors: PETERSON G. N. , KRIEGER J. N. , GLAUBER D. T. 
Published: July 2010

SummaryPercutaneous lithotripsy has evolved over the last several years as a procedure for removing renal calculi via percutaneous puncture of the renal collecting system. This article reviews our initial anaesthetic experience with 48 procedures and identifies both actual and potential complications. The most significant complication identified is instillation of large volumes of irrigation fluid into the retroperitoneal space. Two cases of metabolic acidosis and abdominal distension are presented. One responded to treatment while the other progressed to a fatal disseminated intravascular coagulopathy. Recommendations to prevent this are given.
Prolonged sedation and paralysis in a pregnant patient
Authors: THOMAS D. , WINDSOR J. P. W. 
Published: July 2010

SummaryThe spontaneous delivery of an infant with normal Apgar scores following 16 hours of maternal paralysis and sedation with atracurium and Althesin is described. A coincidental complication of subclavian vein thrombosis possibly due to the infusion of Althesin through the central venous catheter is also discussed.
Mortality following surgery for fractures of the neck of femur
Authors: Goucke C. R. 
Published: July 2010

SummaryThe mortality following surgery for hip fractures during 1982 is reviewed. 91 procedures were performed on 89 patients. The mortality rate at 4 weeks following general anaesthesia was 2.7%. This is much lower than previously reported. Possible reasons for the variation in mortality between this series and others, are discussed.
Subarachnoid anaesthesia for elective Caesarean section
Authors: MICHIE A. R. , FREEMAN R. M. , DUTTON D. A. , HOWIE H. B. 
Published: July 2010

SummaryForty patients who underwent elective lower segment Caesarean section under subarachnoid anaesthesia received either 2.0 ml 0.5% cinchocaine in 6% dextrose or 2.5 ml 0.5% bupivacaine in 8% dextrose via a 26‐gauge needle with the patient in the left lateral position. Onset time was rapid in both groups and the distribution of maximum ascent of sensory analgesia was T1 T6. Efficacy of analgesia was greater in the bupivacaine group, although the duration of both sensory and motor blockade was shorter than following cinchocaine. There were no significant differences between the two groups either in the incidence and severity of complications or in the condition of the neonates. The high incidence (50 65%) and often profound extent of hypotension seen throughout the trial, confirm the ineffectiveness of crystalloid preload of 1500 ml as a single prophylaxis against hypotension.
Penetrating tracheal injury in a child
Authors: HAMILTON‐FARRELL M. R. , EDMONDSON L. , CANTRELL W. D. J. 
Published: July 2010

SummaryA case is reported of a 3.5‐year‐old child with a stab wound in the neck, that penetrated the trachea. A pneumomediastinum was present. The anaesthetic problems are discussed and the child's management outlined.
The Ruben circle anaesthesia System
Authors: SIK M. J. , EVELEIGH D. J. , LEWIS R. B. 
Published: July 2010

SummaryThe Ruben circle anaesthesia System was studied in the spontaneous breathing mode, and under certain conditions there was incompetence of the replaceable mushroom control valve. This causes a reverse flow of gas which results in rebreathing of expired gas when the System is used on spontaneously breathing patients. A patient Simulator was used to investigate the way in which the reverse flow of gas depends on ventilatory parameters and fresh gas flow. The inspired concentration of carbon dioxide increased for increased fresh gas flow and for decreased tidal volume. These results were confirmed by observations on anaesthetised adult and paediatric patients during spontaneous breathing. We conclude that the System in its present form, is not suitable for use on spontaneously breathing paediatric patients.
Anaphylactoid reaction to vecuronium followed by systemic reaction to skin testing
Authors: FARRELL A. M. , GOWLAND G. , McDOWELL J. M. , SIMPSON K.H. , WATKINS J. 
Published: July 2010

SummaryAn unusual case is presented of a systemic anaphylactoid reaction to tubocurarine and subsequently to vecuronium. Intradermal testing with vecuronium following the latter response was negative at recommended test dose levels but at a higher concentration it initiated a hazardous systemic response. The laboratory investigations and possible mechanisms involved in this unusual case are discussed in detail since they may relate to other patients who experience anaphylactoid responses to anaesthetic drugs and who then undergo intradermal testing.
Fatal paradoxical thrombo‐embolism during anaesthesia
Authors: COLEMAN S. A. , WILSON‐MACDONALD J. 
Published: July 2010

SummaryDeep venous thrombosis is a recognised complication of trauma to the leg and may lead to pulmonary thrombo‐embolism, but paradoxical thrombo‐embolism is rare. A case of fatal paradoxical thrombo‐embolism which followed a leg injury in a previously fit 36‐year‐old male is presented and contributory factors are reviewed.
Pneumonectomy in a patient with ventricular septal defect
Authors: MacGILLIVRAY R. G. , ROCKE D. A. , SHAMA D. M. , MITHA A. S. 
Published: July 2010

SummaryA young man with severe unilateral bronchiectasis and a ventricular septal defect presented for pneumonectomy. Intra‐operative monitoring, which included continuous measurement of systemic and pulmonary oxygen saturations by oximetry, revealed transient reversal of the intracardiac shunt across the defect. The implications of this combination of cardiac and pulmonary disease for anaesthetic management are discussed.
Differential flow from multihole epidural catheters
Authors: POWER I. , THORBURN J. 
Published: July 2010

SummaryThis pressures used in vivo to administer epidural doses of local anaesthetic were recorded for 16‐ and 18‐gauge multihole catheters. Observations were made on 10 patients in labour for each catheter gauge. The pressure range for the 16‐gange catheters was 39.9–266 kPa, with a mean of 167.2 kPa, and for 18‐gauge, a range of 53.2–266 kPa, mean. 159 kPa. Similar pressures were then applied in vitro to 10 catheters of each gauge, and the flow of fluid observed from the three holes. For each size of catheter, with increasing pressure, flow appeared at the proximal, then the middle, and finally the distal hole. This emphasises that the effect of epidural doses can vary depending on the pressure of injection, especially if the catheter had been passed partially through the dura.
Intra‐ocular pressure changes during rapid sequence induction of anaesthesia
Authors: EDMONDSON L. , LINDSAY S. L. , LANIGAN L. P. , WOODS M. , CHEW H. E. R. 
Published: July 2010

SummaryThe changes in intra‐ocular pressure associated with two different anaesthetic induction and tracheal intubation techniques were compared (n = 30). After pre‐oxygenation, Group A received thiopentone (5 mg/kg) followed by suxamethonium (1.5 mg/kg), both within 25 seconds, and Group B atracurium (0.5 mg/kg) followed by thiopentone (5 mg/kg) again both within 25 seconds. Tracheal intubation occurred after one minute in Group A and 2 minutes in Group B to allow for full paralysis. In Group A intra‐ocular pressure did not alter significantly from baseline and the maximum increase was only 0.93 mmHg. The statistical type II error risk was consistently below 55% and all 95% confidence limits included negative values. Intra‐ocular pressure in Group B was consistently lower than baseline (p < 0.05) but with a longer induction‐intubation interval. These results therefore provide valuable information about the‘balance of risks' when choosing a muscle relaxant for an inadequately starved patient with a penetrating eye injury.