bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case of acute poisoning due to organophosphate insecticide
Authors: KECIK Y. , YORUKOGLU D. , SAYGIN B. , SEKERCI S. 
Published: July 2010

SummaryA case of acute severe organophosphate poisoning by deliberate self administration is reported. The patient required intensive therapy for 30 days. Unusual features of the case were the avoidance of atropine, because of the high risk of ventricular fibrillation, and the ineffectiveness of pralidoxime.
Neuromuscular effects and intubating conditions following mivacurium: a comparison with suxamethonium
Authors: MADDINENI V.R. , MIRAKHUR R.K. , McCOY E.P. , FEE J.P.H. , Clarke R.S.J. 
Published: July 2010

SummaryMivacurium chloride has been assessed in respect of intubating conditions and neuromuscular effects. The influence of suxamethonium on the onset and duration of subsequently administered mivacurium was also studied. A dose of 0.15 mg.kg−1 of mivacurium was found to provide unacceptable intubating conditions at 2 min in 9/9 patients and further studies were conducted using 0.2 mg.kg−1. Intubating conditions with this dose were acceptable in 65% and 80% of patients at 2 min and 2.5 min respectively. In comparison, intubating conditions were acceptable in 100% of patients at 1 min following 1 mg.kg−1 of suxamethonium. The onset of block occurred in 96 s and 97 s after 0.15 mg.kg−1 and 0.2 mg.kg−1 respectively, and the durations of block in terms of recovery of the first twitch (T1) to 25% and 90% of control, and to recovery of train‐of‐four ratio to 0.7, were 16.1 and 17.9; 24.1 and 25.8; and 24.2 and 27.0 min respectively with the two doses. The time for the onset of complete block with suxamethonium 1.0 mg.kg−1 was 50 s and the times to 25% and 90% recovery were 9.8 min and 13.3 min. The differences between suxamethonium and both doses of mivacurium were significant (p < 0.05) but there were no significant differences between the two doses of mivacurium in any of the neuromuscular measurements. Prior administration of suxamethonium had no influence on the effects of mivacurium. Cutaneous flushing was observed in 30 out of 75 patients but this was associated with transient hypotension in only two patients. Our results show mivacurium to have a duration of action approximately half that of comparable doses of the intermediate acting relaxants atracurium and vecuronium.
Dexamethasone reduces pain and swelling following extraction of third molar teeth
Authors: BAXENDALE B. R. , VATER M. , LAVERY K.M. 
Published: July 2010

SummaryExtraction of multiple third molar teeth can cause significant postoperative pain, swelling and trismus, which may result in delayed hospital discharge. We have examined the effect of a single prophylactic dose of oral dexamethasone 8 mg on these complications, in a randomised double‐blind study of 50 adult patients. The number of extractions performed and the operative approach were standardised. Dexamethasone resulted in a significant reduction in pain 4 h postoperatively, and eliminated the need for opioid analgesia in the postoperative period. The incidence of severe swelling was also reduced significantly, but there was no effect an trismus. Postoperative nausea and vomiting were significantly lower in the dexamethasone group. We conclude that the use of prophylactic oral dexamethasone is useful in reducing postoperative analgesia requirements in this group of patients, and may facilitate surgery performed on a day case basis.
Anaesthesia for cardiomyoplasty
Authors: GREENHALGH D. L. , BARMAN D. , HOOPER T. L. 
Published: July 2010

SummaryCardiomyoplasty is a new surgical procedure for the treatment of severe heart failure, but early mortality has been high in the preliminary experience of many centres. This report describes the anaesthetic techniques used for the first two successful cases to be performed in the UK.
Blood ordering practices in obstetric units in the United Kingdom
Authors: Clark V.A. , Wardall G.J. , McGrady E.M. 
Published: July 2010

SummaryA postal questionnaire on blood ordering practices and blood availability was sent to 89 randomly selected maternity units within the United Kingdom. The replies demonstrated a wide variation in crossmatching practices. Of those units that replied, 56% crossmatch for elective and 64% for emergency Caesarean section, 54% for manual removal of placenta, and 29% for fetal distress in labour. The remainder ‘group and screen’ for these indications. Lack of 24 h cover by a resident haematology technician, and location of blood banks distant to the obstetric unit were associated with significant delays in blood availability. More extensive use of the ‘group and screen’ technique may reduce unnecessary crossmatching without jeopardising patient safety, and is advocated for maternity units.
Patient evaluation of four different combinations of intravenous anaesthetics for short outpatient procedures
Authors: Jakobsson J. , Oddby E. , Rane K. 
Published: July 2010

SummaryWe studied 200 female patients (ASA group 1) scheduled for termination of pregnancy under general anaesthesia. The patients were randomly allocated to receive one of four anaesthetic combinations; (1) propofol in combination with ketamine 20 mg, (2) propofol in combination with fentanyl 0.1 mg, (3) thiopentone in combination with fentanyl 0.1 mg, (4) methohexitone in combination with fentanyl 0.1 mg. All patients were breathing oxygen in nitrous oxide 1:2. Patients' self assessments of per‐ and postoperative course and time to discharge were compared. No patient's response suggested light anaesthesia, but dreams were frequently experienced during anaesthesia especially among the propofol‐ketamine combination (29 out of 50). Time to discharge was shortest for the groups of patients given propofol; the mean time was 93 and 96 minfor the ketamine and fentanyl groups respectively. During the recovery period significantly more patients experienced pain in the ketamine‐propofol group. Complaints of nausea were seen in only 15 patients, and seven patients noted psychomimetic side effects during recovery, without any differences between the groups. All four combinations tested offered good conditions for short outpatient procedures. However, the propofol‐fentanyl combination was found to offer the best quality of anaesthesia as assessed by the patients themselves.
An evaluation of a new self‐adhesive patch preparation of amethocaine for topical anaesthesia prior to venous cannulation in children
Authors: DOYLE E. , FREEMAN J. , IM N. T. , MORTON N. S. 
Published: July 2010

SummaryA new preparation of amethocaine in the form of a self‐adhesive patch, designed to provide topical cutaneous anaesthesia prior to venous cannulation, was evaluated in an open study of 189 children. The new preparation of amethocaine was in place for a mean time of 48 min (SD 3.9). Eighty percent of patients had a satisfactory degree of analgesia for venous cannulation. Nine percent of patients experienced moderate pain and 11% experienced severe pain during venous cannulation. In 26% of patients there was slight (24%) or moderate (2%) erythema at the site of application, and in 5% slight oedema was noted at the site of application. Eight percent of patients had slight itching and 1% had moderate itching at the site of application. There was a clinical impression that venous dilatation made cannulation easier than with EM LA cream. These results suggest that this convenient preparation of amethocaine is highly effective at providing adequate topical cutaneous anaesthesia with a short onset time and a low incidence of minor side effects with no evidence of systemic toxicity.
Intercostal neuralgia associated with internal mammary artery grafting
Authors: CONACHER I. D. , DOIG J. C. , RIVAS L. , PRIDIE A. K. 
Published: July 2010

SummaryTwo patients who underwent coronary artery bypass grafting in which the internal mammary arteries were used, developed chronic, atypical chest pain. After further investigation a diagnosis of intercostal neuralgia was made. It is thought that this condition is due to damage to the intercostal nerves when the internal mammary arteries are dissected. Intercostal neuralgia should be included in the differential diagnosis of chest pain after coronary artery surgery, as its recognition may save the patient unnecessary investigation and suffering.
Quality of life after multiple trauma requiring intensive care
Authors: THIAGARAJAN J. , TAYLOR P. , HOGBIN E. , RIDLEY S. 
Published: July 2010

SummaryA prospective observational study using structured interviews was used to assess changes in quality of life experienced by surviving trauma victims after management on a general intensive therapy unit in a district general hospital. Each patient's age, distribution of injuries, severity of illness on admission and duration of management were recorded. Deaths in the study group were excluded by examining the Hospital's‘Patient Administrative System’. Three attempts were then made to contact all known survivors and to assess their quality of life using three previously recognised and validated methods. Eighty‐three survivors of multiple trauma were discharged but 19 were not studied. Of the remaining 64, 42 patients completed the questionnaire. After multiple trauma, patients reported significant decreases in their quality of life in relation to their overall health, happiness, ability to think and to pursue leisure activities, their income and their employment. Their mean Perceived Quality of Life Score decreased by 13% (95% confidence intervals 7.5–19.5%). Sixty‐two percent of survivors experienced severe social disability and a modest or severe impairment at work. The Nottingham Health Profile identified major changes in‘psychological’aspects of quality of life, namely energy and emotional reactions.
Basic simulations for anaesthetists A pilot study of the ACCESS system
Authors: BYRNE A. J. , HILTON P. J. , LUNN J. N. 
Published: July 2010

SummaryThis paper describes the design and initial testing of the ACCESS (Anaesthetic Computer Controlled Emergency Situation Simulator) system, which has been designed to simulate anaesthetic emergencies with the aim of providing training for junior doctors. The simulations require little or no capital expenditure with minimal use of time by staff or trainees. They are based on standard anaesthetic equipment, with a microcomputer providing an image of commonly used instruments. Problems are presented as scenarios administered by the teacher, and test the skills of the pupil. During 64 scenarios, five trainees caused two‘deaths’and solved the problems in a median time of2.5min, while an experienced group of anaesthetists caused one‘death’and took 1.8 min. The simulation was rated by the pupils as easy to use, realistic and a valuable educational tool.
Effect of weaning on oxygen consumption and cardiovascular function A comparison of continuous flow and demand valve systems
Authors: YAM P. C. IP , APPADURAI I. R. , KOX W. J. 
Published: July 2010

SummaryThis study compared the continuous positive airways pressure mode of the demand valve system of the Engstrom Erica ventilator with a custom‐made continuous flow continuous positive airways pressure system in terms of the oxygen cost of breathing during weaning from mechanical ventilation. Ten consecutive patients in our intensive care unit, with thermodilution pulmonary artery flotation catheters in situ, were studied. Measurements were carried out under steady‐state conditions, initially when breathing spontaneously with continuous positive airways pressure via the Erica and then when transition to the continuous flow system was achieved. There were no significant differences between the two methods of providing continuous positive airways pressure in terms of the measured and derived physiological variables studied, with the exception of oxygen consumption. Oxygen consumption with the continuous flow system was significantly less than with the Erica (142.8 (SEM 31.4) ml.min‐1.m‐2 compared with 165.8 (SEM 30.5) ml.min‐1.m‐2, p < 0.05). This difference reflects the reduced oxygen cost of breathing when the custom‐made continuous flow system was used during weaning.
Incidence of Gram‐negative bacteraemia in sepsis syndrome Implications for immunotherapy
Authors: WILLATTS S. M. , SPELLER D. C. E. , WINTER R. J. 
Published: July 2010

SummaryThe incidence of Gram‐negative bacteraemia in 100 patients with sepsis syndrome receiving antibiotics, and admitted to the Intensive Therapy Unit, was only 12%. If endotoxin antibody is only effective in bacteraemic patients and these results are confirmed, there would be little indication for its use in our Intensive Therapy Unit.
Cerebral hypoxia detected by near infrared spectroscopy
Authors: WILLIAMS I.M. , PICTON A.J. , HARDY S. C. , MORTIMER A.J. , McCOLLUM C.N. 
Published: July 2010

SummaryNear infrared spectroscopy is a relatively new technique for monitoring intracerebral oxygen saturation. Using the technique, three episodes of cerebral hypoxia were detected during elective carotid endarterectomy which were not reliably recorded by more standard monitoring of cerebral perfusion. In one case, cerebral hypoxia was related to slippage of the tracheal tube into the right main bronchus and in the other two to episodes of hypotension. Near infrared spectroscopy is a reliable indicator of peripheral cortical perfusion and provides continuous and noninvasive monitoring of intracerebral oxygen saturation.
Cervical spine movement during orotracheal intubation: comparison of the Belscope and Macintosh blades
Authors: GAJRAJ N. M. , CHASON D. P. , SHEARER V. E. 
Published: July 2010

SummaryThis study was designed to compare the degree of cervical spine movement during laryngoscopy and tracheal intubation using the Belscope and Macintosh laryngoscope blades. Twenty ASA 1 and 2 patients scheduled for elective surgery requiring tracheal intubation were studied. Following induction of anaesthesia and muscle relaxation, a neutral cross‐table lateral cervical spine X ray was taken. Laryngoscopy was then performed in each patient using both the Belscope and Macintosh blades. After visualisation of the vocal cords and tracheal intubation the cervical spine X ray was repeated. Movement of the cervical spine was evaluated by tracing bony landmarks on each film and then superimposing the neutral and intubating films. We were unable to demonstrate a difference in the amount of cervical spine movement comparing the two blades. Using the Belscope blade, intubation took longer (median 18 s) than the Macintosh blade (median 12 s, p < 0.01) and was unsuccessful in two patients despite adequate visualisation of the vocal cords.
Performance of the Baxter disposable patient‐controlled analgesia infusor under hyperbaric conditions
Authors: RADCLIFFE J. J. , SPENCER I. 
Published: July 2010

SummaryHyperbaric oxygen treatment may require the concurrent administration of drugs. A study was performed to assess the suitability of the infusor device from the Baxter Patient‐Controlled Analgesia system, for drug delivery during hyperbaric therapy. Thirty infusor devices were used to deliver 5% dextrose, 50% dextrose or propofol solutions under conditions of 1 and 2.3 atmospheres of pressure. The increased pressure caused an increase inflow of 4.27%, 1.79% and 9.84% for 5% dextrose, propofol and 50% dextrose respectively.
Pain during injection of propofol
Authors: Lee T. W. , Loewenthal A. E. , Strachan J. A. , Todd B. D. 
Published: July 2010

SummaryA controlled, double‐blind study was performed to compare the prior administration of intravenous saline 4 ml (n = 36), lignocaine 20 mg (n = 36) or thiopentone 100 mg (n = 43) on the pain produced by intravenous injection of propofol. One hundred and fifteen ASA 1 or 2 patients scheduled for minor surgery were studied using a randomised, double‐blind design. Thiopentone was more effective than lignocaine in reducing the incidence of propofol injection pain (p < 0.03).
Alterations in forearm vascular reactivity in patients with septic shock
Authors: Kienbaum P. , Prante C. , Lehmann N. , Sander A. , Jalowy A. , Peters J. 
Published: July 2010

SummaryPatients with septic shock are haemodynamically unstable and suffer from vasodilation. Studying the human forearm vascular bed in patients with septic shock, we tested the hypothesis that the responses to regionally infused endothelium‐(in)dependent vasodilators and vasoconstrictors are uniformly impaired. Forearm blood flow (FBF, venous occlusion plethysmography) and brachial arterial pressure were determined to calculate forearm vascular resistance (FVR) in eight consecutive sedated, mechanically ventilated patients with septic shock (APACHE II Score range 21–34, SOFA Score 11–16) and 11 healthy volunteers. Despite increased baseline FBF in patients with septic shock (6.1 (SD 1.5) ml.min−1.(100 ml of tissue)−1 compared to 4.7 (1.4) in volunteers) the significant decreases in FVR seen in response to exogenous nitric oxide (nitroprusside) and acetylcholine did not differ between groups. However, compared to volunteers, mitigation of endogenous nitric oxide production by a low dose of NG‐methyl‐l‐arginine acetate (l‐NMMA) caused a significant increase (+ 6.7 mmHg.min.ml−1) in septic patients. Regional vasoconstriction in response to phenylephrine (FVR: + 9.9 vs + 30.7 mmHg.min.ml−1 in controls) and angiotensin II (FVR: + 9.0 vs + 67.4 mmHg.min.ml−1) was markedly impaired. In contrast, vasopressin, in dosages evoking no vasoconstriction in volunteers, induced a significant increase in FVR in septic patients (+ 10.0 mmHg.min.ml−1). In the forearm of patients with septic shock, vasoconstriction by α1‐ and angiotensin II receptor agonists is selectively impaired, whereas the vasoconstrictor response to vasopressin is exaggerated. These findings exclude a generalised impairment of vasomotor activity in patients with septic shock and provide a rationale for vasopressin administration.
Evaluation of the Airtraq® and Macintosh laryngoscopes in patients at increased risk for difficult tracheal intubation*
Authors: Maharaj C. H. , Costello J. F. , Harte B. H. , Laffey J. G. 
Published: July 2010

SummaryThe Airtraq®, a novel single use indirect laryngoscope, has demonstrated promise in the normal and simulated difficult airway. We compared the ease of intubation using the Airtraq with the Macintosh laryngoscope, in patients at increased risk for difficult tracheal intubation, in a randomised, controlled clinical trial. Forty consenting patients presenting for surgery requiring tracheal intubation, who were deemed to possess at least three characteristics indicating an increased risk for difficulty in tracheal intubation, were randomly assigned to undergo tracheal intubation using a Macintosh (n = 20) or Airtraq (n = 20) laryngoscope. All patients were intubated by one of three anaesthetists experienced in the use of both laryngoscopes. Four patients were not successfully intubated with the Macintosh laryngoscope, but were intubated successfully with the Airtraq. The Airtraq reduced the duration of intubation attempts (mean (SD); 13.4 (6.3) vs 47.7 (8.5) s), the need for additional manoeuvres, and the intubation difficulty score (0.4 (0.8) vs 7.7 (3.0)). Tracheal intubation with the Airtraq also reduced the degree of haemodynamic stimulation and minor trauma compared to the Macintosh laryngoscope.
ORIGINAL ARTICLE: A randomised single blinded study of the administration of pre‐warmed fluid vs active fluid warming on the incidence of peri‐operative hypothermia in short surgical procedures*
Authors: Andrzejowski J. C. , Turnbull D. , Nandakumar A. , Gowthaman S. , Eapen G. 
Published: July 2010

SummaryWe compared the effect of delivering fluid warmed using two methods in 76 adult patients having short duration surgery. All patients received a litre of crystalloid delivered either at room temperature, warmed using an in‐line warming device or pre‐warmed in a warming cabinet for at least 8 h. The tympanic temperature of those receiving fluid at room temperature was 0.4 °C lower on arrival in recovery when compared with those receiving fluid from a warming cabinet (p = 0.008). Core temperature was below the hypothermic threshold of 36.0 °C in seven (14%) patients receiving either type of warm fluid, compared to eight (32%) patients receiving fluid at room temperature (p = 0.03). The administration of 1 l warmed fluid to patients having short duration general anaesthesia results in higher postoperative temperatures. Pre‐warmed fluid, administered within 30 min of its removal from a warming cabinet, is as efficient at preventing peri‐operative hypothermia as that delivered through an in‐line warming system.
Serological and genetic study of the ELA W21 specificity
Authors: HIRNI H. , LAZARY S. , GERBER H. 
Published: July 2010

Summary. Investigations on the W21 specificity showed that this antigen is expressed on lymphocytes and platelets but not on erythrocytes. The molecule carrying the antigen W21 moves in the cell membrane independently from ELA locus A and B encoded antigens, as observed in ‘lysostripping’. The W21 specificity occurs with very different gene frequencies in various breeds. In informative families it segregates together with defined gene products of the MHC region.The data suggest strongly that the W21 specificity belongs to the ELA system as a class I gene product, but is governed by a separate locus than the known locus A and locus B allelic series.
Joint Report of the Fifth International Workshop on Lymphocyte Alloantigens of the Horse, Baton Rouge, Louisiana, 31 October‐1 November 1987
Authors: LAZARY S. , ANTCZAK D. F. , BAILEY E. , BELL T. K. , BERNOCO D. , BYRNS G. , McCLURE J. J. 
Published: July 2010

Summary.Six laboratories participated in the Fifth International Workshop on Lymphocyte Alloantigens of the Horse, testing 132 alloantisera against lymphocytes of 880 horses chosen to represent different families and breeds. Most of the alloantisera were produced by lymphocyte immunization between horses matched at the ELA‐A locus. All horses were also tested with antisera contributed to the workshop by participating laboratories which identified ELA specificities A1‐A10 and W12‐W21. Previously identified workshop specificities ELA‐W14, W15 and W19 were accepted as products of the ELA‐A locus based on family and population studies by the workshop. Their designations were changed to ELA‐A14, ELA‐A15 and ELA‐A19, respectively.Two new specificities were identified, namely ELA‐W22 (W22) and ELA‐W23 (W23). Population and family studies indicated that W22 and W23 as well as W13 are products of an ELA locus other than ELA‐A. The presence of these specificities was correlated with the presence of certain ELA‐A locus specificities, e. g. W13 with A3, W22 with A2 and W23 with A5. However, the association was not complete and W13, W22 and W23 also segregated with other ELA‐A specificities in some families.Evidence for recombination was found between the ELA‐A locus and the locus or loci encoding these specificities resulting in seven recombinant haplotypes found among the data presented in this workshop. Further studies are required for definitive assignment of the specificities to a class I or class II locus.
A fast and highly sensitive method for detecting freemartinism in bovine twins using immunomagnetic beads and Y‐specific PCR primers
Authors: Olsaker I. , Hellemann A. L. , Lie Ø , Jørgensen C. B. , Thomsen P. D. 
Published: July 2010

SummaryA method for detecting male cells in the blood of the female calf in bovine heterosexual twin pregnancies has been established. Nucleated cells were isolated from full blood by immunomagnetic separation, lysed by boiling and then subjected to polymerase chain reaction (PCR) amplification with Y chromosome specific primers. Diagnosis was achieved within one day. The method was successfully used on blood samples that had been stored at +4°C for more than one month. Dilution of male blood in female blood showed that XY cells were detectable down to a concentration of 0.1%. This method should be amenable to automatization and can be adapted to any PCR‐based genetic test.