bluuebunny/crossref_metadata_2025_split huggingface dataset:
Propofol as sole agent for paediatric day‐case dental surgery
Authors: Moore W. J. , Underwood S. 
Published: July 2010

SummaryAfter intravenous induction of anaesthesia with propofol (4 mg.kg‐1) 80 unpremedicated children admitted for day‐case dental extractions were randomly allocated to receive either an intravenous propofol infusion whilst breathing 100% oxygen, or inhalational nitrous oxide, oxygen and halothane for maintenance of anaesthesia. In both groups, the quality of anaesthesia was acceptable to both anaesthetist and surgeon. Recovery times and postoperative analgesia requirements did not differ significantly between the two groups. No child vomited. Propofol appears to be suitable for use as a sole agent in paediatric day case dental surgery.
The addition of triamcinolone acetonide to bupivacaine has no effect on the quality of analgesia produced by ilioinguinal nerve block
Authors: McCleane G. , Mackle E. , Stirling I. 
Published: July 2010

SummaryIn a study of 30 men undergoing elective inguinal hernia repair under general anaesthesia no difference in postoperative pain, patient rating score or morphine consumption was found between patients who had pre‐operative ilioinguinal nerve block with bupivacaine 0.5% plain and those who received a similar block with bupivacaine 0.5% plain and triamcinolone acetonide 40 mg. Mean (SD) morphine requirements using a patient‐controlled analgesia system were 37 (22.2) mg and 32 (20.3) mg in the bupivacaine and bupivacaine/triamcinolone groups respectively (p > 0.05). The addition of triamcinolone 40 mg to bupivacaine 0.5% offers no advantages over unsupplemented bupivacaine when used for ilioinguinal block.
Sevoflurane anaesthesia for major intra‐abdominal surgery
Authors: QUINN A. C. , NEWMAN P. J. , HALL G. M. , GROUNDS R. M. 
Published: July 2010

SummaryThe cardiovascular effects and recovery characteristics of sevoflurane and isoflurane anaesthesia were compared in 30 gynaecological and 20 general surgical patients undergoing elective intra‐abdominal surgery. Patients were randomly allocated to receive either sevofurane or isofurane as the volatile agent, in a balanced anaesthetic technique including morphine and atropine prernedication and thiopentone, fentanyl. vecuronium and nitrous oxide. The concentration of volatile agent was titrated according to clinical variables. Mean heart rate, systolic and diastolic arterial pressure and duration of surgery did not differ between the two groups. Time to emergence from anaesthesia in the gynaecological patients was significantly faster after sevoflurane compared with isoflurane (p < 0.005). Sevoflurane provided stable anaesthesia during major intra‐abdominal surgery.
Improtance of components of the curriculum vitae in determining appointment to senior registrar posts
Authors: Conn D. A. , Asbury A. J. 
Published: July 2010

SummaryTo evaluate the opinions of regional education advisers, academics and other consultants about features of the curriculum vitae, we undertook a small attitude survey. The response rate was 73%, which provided data from a total of 78 influential anaesthetists. The respondents’ attitude to each feature of the curriculum vitae was reported using a linear visual analogue scale. The three groups had similar attitude scores to most features, but not to research time, training time, higher degrees and abstracts of papers presented to the Anaesthetic Research Society. Publications in the main anaesthesia journals, time in other major medical specialties, research and the possession of a higher degree were scored highly by all respondents. Papers in non‐peer‐reviewed journals, letters, unsubmitted papers, and time in training for general practice attracted lower scores. The free text comments of the many respondents indicated a considerable disillusionment about the whole appointments process.
Analgesic effect of intra‐articular morphine after arthroscopic meniscectomy
Authors: Dierking G. W. , Øtergaard H. T. , Dissing C. K. , Kristensen J. E. , Dalhl J. B. 
Published: July 2010

SummaryA study was performed to assess the analgesic effect of intra‐articular morphine 2 mg in 33 patients undergoing elective arthroscopic meniscectomy. Patients were randomly allocated to receive either 2 mg of morphine hydrochloride in 40 ml of normal saline intra‐articularly and I ml of normal saline intraniuscularly (n = 18), or 40 ml of normal saline intra‐articularly and 2 mg of morphine hydrochloride intramuscularly (n = 15). The latter group was to act as a control for any potential systemic effects of the morphine. All patients received an identical general anaesthesia consisting of propofol, alfentanil, enflurane and nitrous oxide/oxygen. No significant differences between the groups were found in pain scores at rest or during active flexion of the knee at 1‐6 h postoperatively, or during walking at 6 h postoperatively (p > 0.05). Six and two patients in the intra‐articular and intramuscular morphine group, respectively, requested supplemental morphine given intravenously (p > 0.05). In conclusion, no significant differences in pain scores or in requirements for supplemental morphine were observed between patients receiving intra‐articular versus intramuscular morphine 2 mg after elective arthroscopic meniscectomy and consequently no specific local analgesic effect of intra‐articular morphine could be demonstrated.
Pre‐oxygenation: a comparison of two techniques using a Bain system
Authors: Ronney M. J. 
Published: July 2010

SummaryPre‐oxygenation using a standard technique of tidal breathing for 3 min through a Bain system with a fresh gas flow of 8 1.min−1 was compared with up to six vital capacity breaths from the same system. The technique of vital capacity breaths involved initial expiration to residual volume and use of the oxygen flush throughout controlled full inspirations, ensuring that the reservoir bag remained full. No significant problems were encountered using this method. Although three vital capacity breaths produced significantly inferior pre‐oxygenation compared to 3 min of normal breathing, four and five vital capacity breaths were equally effective. With six vital capacity breaths, superior pre‐oxygenation was produced. The use of four or more vital capacity breaths with this technique is a reliable and rapid alternative to 3 min of tidal breathing.
Lignocaine 0.5% for spinal anaesthesia in gynaecological day surgery
Authors: Liew Q. Y. , Tay D. H. B. , Thomas E. 
Published: July 2010

SummarySpinal anaesthesia with 5 ml of lignocaine 0.5% was administered to 30 women presenting for day case minor gynaecological surgery. They were allocated at random to receive the anaesthetic via either a 26‐gauge Atraucan (pencil point) or a 29‐gauge Spinocan (cutting bevel) spinal needle. Onset, duration, spread and regression of sensory and motor blockade, haemodynamic parameters and postoperative complicatons were studies. An upper sensory level of T10 (93.3%) was obtained in all except two patients. No patient complained of discomfort during surgery. The mean onset time was less than 8 min and the mean duration of sensory block was 32.5 min. All patients had complete return of motor power within 1 h and were discharged the same day. Only one patient had a transient episode of hypotension which was easily treated with intravenous fluids. Three were no serious side effects seen postoperatively. We conclude that spinal anaeshtesia with 5 ml of lignocaine 0.5% provides a useful alternative to general anaesthesia for day case minor gynaecological surgery.
Mortality associated with anaesthesia: a qualitative analysis to identify risk factors
Authors: Arbous M. S. , Grobbee D. E. , Van Kleef J. W. , De Lange J. J. , Spoormans H. H. A. J. M. , Touw P. , Werner F. M. , Meursing A. E. E. 
Published: July 2010

From a prospectively defined cohort of patients who underwent either general, regional or combined anaesthesia from 1 January 1995 to 1 January 1997 (n = 869 483), all consecutive patients (n = 811) who died within 24 h or remained unintentionally comatose 24 h after anaesthesia were classified to determine a relationship with anaesthesia. These deaths (n = 119; 15%) were further analysed to identify contributing aspects of the anaesthetic management, other factors and the appropriateness of care. The incidence of 24‐h peri‐operative death per 10 000 anaesthetics was 8.8 (95% CI 8.2–9.5), of peri‐operative coma was 0.5 (0.3–0.6) and of anaesthesia‐related death 1.4 (1.1–1.6). Of the 119 anaesthesia‐related deaths, 62 (52%) were associated with cardiovascular management, 57 (48%) with other anaesthetic management, 12 (10%) with ventilatory management and 12 (10%) with patient monitoring. Inadequate preparation of the patient contributed to 30 (25%) of the anaesthesia‐related deaths. During induction of anaesthesia, choice of anaesthetic technique (n = 18 (15%)) and performance of the anaesthesiologist (n = 8 (7%)) were most commonly associated with death. During maintenance, the most common factors were cardiovascular management (n = 43 (36%)), ventilatory management (n = 12 (10%)) and patient monitoring (n = 12 (10%)). In both the recovery and the postoperative phases, patient monitoring was the most common factor (n = 12 (10%) for both). For cardiovascular, ventilatory and other anaesthetic management, human failure contributed to 89 (75%) deaths and organisational factors to 12 (10%). For inadequate patient monitoring, human factors contributed to 71 (60%) deaths and organisational factors to 48 (40%). Other contributing factors were inadequate communication (30 deaths (25%) for all four aspects of the anaesthetic management) and lack of supervision (particularly for ventilatory management). Inadequate care was delivered in 19 (16%) of the anaesthesia‐related deaths with respect to cardiovascular management, in 20 (17%) with respect to ventilatory management, in 18 (15%) with respect to patient monitoring and in 23 (19%) with respect to other anaesthetic management.
A national census of central neuraxial block in the UK: results of the snapshot phase of the Third National Audit Project of the Royal College of Anaesthetists*
Authors: Cook T. M. , Mihai R. , Wildsmith J. A. W. ,   the Royal College of Anaesthetists Third National Audit Project Working Group
Published: July 2010

SummaryThe first stage of the Royal College of Anaesthetists Third National Audit Project to assess the incidence of major complications of central neuraxial block in the UK was a 2‐week national census of block use. A reporting system was established in the 309 National Health Service hospitals believed to undertake surgical work and data were received from 304, a response rate of 98.7%. Over 90% of these were judged by the reporters to be ‘accurate’. The total number of procedures reported as being performed in the 2‐week period was 27 533: extrapolation using a multiplier of 25 suggests that nearly 700 000 major blocks are performed annually (315 000 spinals, 287 000 cervical, thoracic or lumbar epidurals, 42 000 combined spinal‐epidurals and 56 000 caudal epidurals). After the second stage of the project, which will record complications from the same hospitals over a 12‐month period, these data will be used as denominators to calculate the incidences of complications.
The inhibitory effects of local anaesthetics on the vascular flare responses to bradykinin and substance P in human skin*
Authors: Dias M. P. , Newton D. J. , McLeod G. A. , Khan F. , Belch J. J. F. 
Published: July 2010

SummaryBradykinin and substance P are involved in inflammation and act through Gq‐protein‐coupled receptors. Local anaesthetics inhibit the signalling of these receptors and have potent anti‐inflammatory actions. The aim of this study was to investigate the effects of local anaesthetics on the cutaneous flare responses to bradykinin and substance P. Skin blood flow responses to intradermal injections of bradykinin and substance P were assessed in the absence and presence of anaesthetic and analgesic concentrations of lidocaine, levobupivacaine and ropivacaine. All local anaesthetics significantly attenuated the vascular responses to bradykinin (p = 0.001) and substance P (p < 0.001). There were no differences in this effect between the different agents, but anaesthetic concentrations had a greater attenuating effect than analgesic concentrations on the substance P response (p < 0.001). Local anaesthetics may therefore be useful in the suppression of inflammation and the prevention of postoperative hyperalgesia.
Analgesic efficacy of local anaesthetic wound administration in knee arthroplasty: volume vs concentration
Authors: Andersen L. Ø. , Gaarn‐Larsen L. , Kristensen B. B. , Husted H. , Otte K. S. , Kehlet H. 
Published: July 2010

SummaryWound administration of local anaesthetic may be effective for postoperative pain management in knee arthroplasty, but the analgesic efficacy of local anaesthetic in relation to volume vs concentration has not been determined. In a double‐blinded trial, 48 patients scheduled for total knee arthroplasty were randomly assigned to receive either a high volume/low concentration solution of ropivacaine (20 ml, 0.5%) or a low volume/high concentration solution of ropivacaine (10 ml, 1%), 6 and 24 h postoperatively through an intracapsular catheter. Pain was assessed for 2 h after administration. Pain was reduced in both groups with ropivacaine administration 24 h postoperatively (p < 0.02), but with no difference in analgesia between groups at all time intervals. No reduction in pain scores was observed with ropivacaine injection 6 h postoperatively. The median (IQR [range]) dose of oxycodone administered was 12.5 (10–19 [0–35]) mg in the high volume/low concentration group, and 20 mg (16–40 [0–65]) mg in the low volume/high concentration group (p = 0.005). In conclusion, intracapsular administration of local anaesthetic may have limited analgesic efficacy with no volume vs concentration relationship after total knee arthroplasty.
Disease ecology meets ecological immunology: understanding the links between organismal immunity and infection dynamics in natural populations
Authors: Hawley Dana M. , Altizer Sonia M. 
Published: July 2010

Summary1. Ecological immunology and disease ecology are two relatively young disciplines that apply ecological approaches and principles to traditionally non‐ecological fields. In both cases, an ecological perspective has allowed new insights to emerge by focusing attention on variation over space and time, and by emphasizing the role of the environment in shaping individual responses and the outcome of host‐pathogen interactions. Here we review the growing conceptual interface between these two rapidly evolving fields.2. Areas of synergy between ecological immunology and disease ecology aim to translate variation in within‐host processes (e.g. immunity) into between‐host dynamics (e.g. parasite transmission). Emerging areas of synergy include potential immune mechanisms that underlie host heterogeneity in disease susceptibility, teasing apart the effects of environmental factors such as seasonality and climate on host susceptibility and pathogen dynamics, and predicting the outcome of co‐infection by functionally distinct groups of parasites that elicit different immune responses.3. In some cases, practical limitations have constrained the merging of ideas in ecological immunology and disease ecology. We discuss several logistical challenges, including dissecting the relative roles of host exposure and susceptibility, establishing links between measures of immunity and pathogen resistance in wild populations, and incorporating relevant immune variation into prevailing disease ecology modeling frameworks.4. Future work at the interface of these two fields should advance understanding of life‐history theory, host‐pathogen dynamics, and physiological ecology, and will also contribute to targeted approaches for wildlife health and zoonotic disease prevention.
Telephone follow‐up after treatment for breast cancer: views and experiences of patients and specialist breast care nurses
Authors: Beaver Kinta , Williamson Susan , Chalmers Karen 
Published: July 2010

Aims and objectives.  To explore the views of patients and specialist breast care nurses on telephone follow‐up after treatment for breast cancer.Background.  A recent randomised controlled trial demonstrated that nurse‐led telephone follow‐up led to high levels of patient satisfaction with no physical or psychological detriment. This study aimed to explore in more detail the views of patients randomised to telephone follow‐up and the nurses who conducted telephone appointments.Design.  Qualitative.Method.  Individual interviews with 28 patients and four specialist breast care nurses. Content analysis was used to analyse the interview data.Results.  Telephone follow‐up was convenient for patients and provided continuity of care. Speaking on the telephone was perceived as a more ‘normal’ activity than attending hospital outpatient clinics. A structured approach was appreciated, instilling feelings of confidence that all questions had been asked and no errors had been made. Specialist nurses emphasised the high level of skill required to deliver the intervention and perceived that the telephone approach was well able to meet the individual needs of patients.Conclusions.  Positive views on telephone follow‐up were reported. An experienced and skilled practitioner, with effective communication skills, is required to deliver the intervention and a period of training is recommended. Nurse‐led telephone interventions have a broader applicability to other disease conditions, although more work is needed to develop appropriate interventions and evaluate their effectiveness.Relevance to clinical practice.  Nurses at advanced levels of practice are uniquely placed to deliver such complex interventions. However, a period of initial training with effective peer support and channels for ongoing feedback are essential for administering an intervention that relies on audio rather than visual cues.
A quality framework for personalised residential supports for adults with developmental disabilities
Authors: Cocks E. , Boaden R. 
Published: July 2010

AbstractBackground  The Personalised Residential Supports (PRS) Project provided detailed information about the nature, purposes and outcomes of PRS from the perspectives of key stakeholder groups including people with developmental disabilities, family members and service providers. Although these forms of support have developed over the past two decades, there is a dearth of empirical work that has explored the characteristics of PRS. In contrast, there is a multitude of empirical studies on congregate forms of residential support with a clear trend towards study of the characteristics of relatively small, congregate residential settings.Methods  Personalised Residential Supports was conceived initially in the study as having four key criteria in the support arrangements – a high degree of: individualisation; individual/family influence; informal relationships; and, person‐centredness. Four methods of data collection were used to develop a descriptive framework for PRS: a review of empirical and descriptive literature that met inclusion criteria; case studies carried out over 2 years of six adults whose living arrangements met the initial PRS criteria; a focus group of adults with developmental disabilities; and, a series of written surveys of 18 people who were ‘experts’ in their experience and knowledge of PRS‐type support arrangements. The latter group included family members, service providers and policymakers. Each dataset was analysed separately and independently by the authors and a third researcher, followed by a process of conciliation and consensus in which the quality framework was developed. Two iterations of the expert group surveys were used to fine tune the framework.Results  Qualitative analysis resulted in a PRS quality framework made up of nine themes containing 28 attributes. Descriptions of each theme and attribute are provided. The nine themes were named as: Assumptions, Leadership, My Home, One Person at a Time, Planning, Control, Support, Thriving and Social Inclusion.Conclusion  This study identified the characteristics of PRS as reported by key stakeholder groups. On face value, the themes expressed in the PRS framework have relevance to all forms of supported accommodation, for many different groups of people. The research is continuing by further development of the framework that will enable its use in the evaluation of existing or planned residential support arrangements.
Morphological Study by Scanning Electron Microscopy of the Lingual Papillae in the Middle East Blind Mole Rat (Spalax ehrenbergi, Nehring, 1898)
Authors: Kilinc M. , Erdogan S. , Ketani S. , Ketani M. A. 
Published: July 2010

With 10 figuresSummaryThere is no definite information about the tongue morphology of blind mole rats owing to spreading of these animals to only a certain habitat. For this reason, we aimed to examine the morphological structure of the tongue by scanning electron microscopy (SEM) in this species. In this study, the tongues of four blind mole rats were used and the morphology of its lingual surface, different types of papillae, their characteristics and topographical distribution was described. Three types of papillae (filiform, fungiform and vallate) and lingual prominence were observed. The dorsal surface of the tongue was covered by filiform papilla; and filiform papillae demonstrated the most numerous type of lingual papilla. Fungiform papillae were rounded in shape and randomly distributed particularly on the anterior and medial region. In addition, each fairly convex fungiform papilla was surrounded by a continuous circular pad like a crown. The two oval vallate papillae were situated symmetrically on the posterior region and obliquely to the median line of the tongue. The body of vallate papillae was surrounded by a continuous trench and mucosal folds. The lingual prominence between medial and posterior region and a transversal groove just in front of it were observed. Furthermore, a limited tuber and root based diet and gnawing have together resulted in similarity of the tongue of the rodent, giving it some characteristics typical of a herbivore and an insectivore.
Satisfaction from the ‘Help at Home’ programme in a prefecture of central Greece
Authors: Skaperdas Ioannis , Lavdaniti Maria , Dimitriadou Alexandra , Psychogiou Maria , Sgantzos Markos , Krepia Vassiliki , Sapountzi‐Krepia Despina 
Published: July 2010

Skaperdas I, Lavdaniti M, Dimitriadou A, Psychogiou M, Sgantzos M, Krepia V, Sapountzi‐Krepia D. International Journal of Nursing Practice 2010; 16: 342–351 Satisfaction from the ‘Help at Home’ programme in a prefecture of central GreeceGreece is facing the issue of increasing elderly population and therefore local municipalities started the ‘Help at Home’ programme. The aim of this study is to investigate the elderly's satisfaction from the ‘Help at Home’ programme in a prefecture of central Greece. The sample consisted of 300 elderly people who receive services from the ‘Help at Home’ programme. Data were collected using a questionnaire. The majority of the participants were satisfied with the programme's services and reported high satisfaction from the interpersonal relations with the personnel, from the personnel's professional abilities and from the system's sufficiency in covering the elderly's perceived needs for care, but the satisfaction from the range of services is relatively low. The participants were overall satisfied; however, further research is needed at a national level in order to draw safer conclusion regarding the application of the programme in Greece.