bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategies used for managing symptoms by women with fibromyalgia
Authors: Kengen Traska Theresa , Rutledge Dana N , Mouttapa Michele , Weiss Jie , Aquino Jordan 
Published: February 2011

Aims. The goal of this study was to describe how persons with fibromyalgia manage their lives given the multiple symptoms they experience, in particular how they use non‐pharmacologic strategies, or how they incorporate these strategies along with pharmacologic agents.Background. Persons with fibromyalgia, a widespread chronic pain condition, often suffer from considerable fatigue, sleep disturbances and morning stiffness. Medical management does not lead to a cure, and sufferers must self‐manage to maintain a good quality of life.Design. This qualitative descriptive study used group interview methodology.Methods. Data were obtained from eight women with fibromyalgia. Women’s mean age was 61 (range 54–81). Participants were invited to participate in a 90‐ minute group interview focused on symptom management. In the interview, open‐ended questions allowed them to speak freely about managing multiple fibromyalgia symptoms. Content analysis by the first and second authors led to the identification of themes, which were validated by the co‐authors who attended the interviews.Results. Participants reported many strategies to cope with fibromyalgia symptoms and manage their lives. Main strategies included: ‘pacing/planning’, ‘distraction techniques’, ‘coping with touch sensitivity’, ‘putting on the mask’ and ‘medications’. In addition, ‘social support’ from others with fibromyalgia and from family members was reported to be very important.Conclusions. Study findings demonstrate that women with fibromyalgia can develop strategies that enable them to cope with a life encumbered with chronic pain and fatigue. Moreover, this study confirmed effective fibromyalgia management strategies reported in other studies. Further research is needed on risks/benefits of these and other self‐management strategies used by women with fibromyalgia.Relevance to clinical practice. Our findings suggest that nurses should discuss the self‐management strategies found with persons who have fibromyalgia in the context of individual patient experiences.
Effectiveness of pharmacy interventions in improving availability of essential medicines at the primary healthcare level
Authors: Nunan Michael , Duke Trevor 
Published: February 2011

SummaryObjective  To assess the effectiveness of pharmaceutical systems interventions in improving the availability of essential medicines at the primary care level.Methods  Literature search for examples of pharmaceutical systems interventions in low and middle income countries that evaluated the impact of specific interventions on medicines’ availability. Qualitative and quantitative studies were included.Results  Seventeen studies were included, on privatisation of drug distribution, user‐fees, revolving drug funds (RDFs), supervisory visitation programmes, staff training initiatives, community‐directed interventions (CDIs) and disease‐specific drug programmes. We found no studies on non‐monetary staff incentives or the use of national pharmacy standards. Generally, the quantity and quality of evidence was low; evidence was strongest for supervisory visitation programmes and CDIs.Conclusion  Several interventions have the potential for improving medicines’ availability without requiring large‐scale international cooperation or global policy change. The absence of evidence in this field does not prove lack of effect. There is a need for more systematic studies of multi‐faceted pharmaceutical interventions to improve drug availability in the context of difficult health systems, such as structured supervision of remote health facilities, CDIs, staff training, integration of disease‐specific programmes, implementation of national pharmacy standards, non‐monetary staff incentives and measures to ensure cost is not a barrier to access. A standardised approach to measuring the availability of essential medicines is needed.
Disseminated adiaspiromycosis: case report of a liver transplant patient with human immunodeficiency infection, and literature review
Authors: Pelegrín I. , Ayats J. , Xiol X. , Cuenca‐Estrella M. , Jucglà A. , Boluda S. , Fernàndez‐Sabé N. , Rafecas A. , Gudiol F. , Cabellos C. 
Published: February 2011

I. Pelegrín, J. Ayats, X. Xiol, M. Cuenca‐Estrella, A. Jucglà, S. Boluda, N. Fernàndez‐Sabé, A. Rafecas, F. Gudiol, C. Cabellos. Disseminated adiaspiromycosis: case report of a liver transplant patient with human immunodeficiency infection, and literature review. Transpl Infect Dis 2011: 13: 507–514. All rights reservedAbstract: Disseminated adiaspiromycosis is a rare infection that is sometimes associated with immunocompromised situations. We report the case of a patient, infected with human immunodeficiency virus and receiving highly active antiretroviral therapy, who had a liver transplant for hepatocellular carcinoma. The patient presented skin and pulmonary lesions due to adiaspiromycosis during immunosuppressive therapy. A review of >60 cases in the literature shows that adiaspiromycosis is a rare infection and Emmonsia is a dimorphic fungus that is difficult to grow. It should be considered a possible diagnosis in case of fungal infection and pulmonary granulomatosis. We should be aware of emerging adiaspiromycosis in patients with risk factors of immunosuppression, particularly transplant recipients. In these patients in particular, liposomal amphotericin B therapy should be considered.
Routine preoperative gastric emptying is seldom indicated. A study of 85 594 anaesthetics with special focus on aspiration pneumonia
Authors: Mellin‐Olsen J. , Fasting S. , Gisvold S. E. 
Published: February 2011

Background: The aim of this study was to determine the incidence and severity of pulmonary aspiration of gastric contents during anaesthesia, to determine the short‐ and long‐term morbidity, and to evaluate present routines for preoperative gastric emptying. During the study period, preoperative gastric emptying was done only when intestinal obstruction was suspected.Methods: We routinely record prospectively all problems during and after anaesthesia by means of a database. All data for the 5 years from 1989 to 1993, a total of 85 594 anaesthetic procedures, were analyzed. The hospital charts were also reviewed for those patients where aspiration to the lungs had occurred.Results: Pulmonary aspiration of gastric contents was detected in 25 cases; all occurred in patients receiving general anaesthesia. The incidence was 4.1 times higher in emergency procedures than in electives. There were no aspirations in 30 199 patients receiving regional anaesthesia. The complication occurred in all phases of anaesthesia, but clinical morbidity was low in most cases. Three cases showed serious morbidity immediately after the event, but recovered. Two cases showed serious long‐term morbidity, but also recovered completely. No patients died. No cases, except possibly one, might have been prevented by stricter routines for preoperative gastric emptying.Conclusion: We found a low incidence of pulmonary aspiration. When it occurs, it carries a low risk for serious morbidity. Emergency cases for general anaesthesia are most at risk. Regional anaesthesia is considered safe. There is no evidence that preoperative gastric emptying should be routinely done in emergency cases, except in patients with suspected ileus/subileus.
Effect of pre‐ vs postoperative tonsillar infiltration with local anesthetics on postoperative pain after tonsillectomy
Authors: Molliex S. , Haond P. , Baylot D. , Prades J. M. , Navez M. , Elkhoury Z. , Auboyer C. 
Published: February 2011

Background: Since pre‐incisional peritonsillar infiltrations of local anesthetic solutions have been suggested to reduce postoperative pain after tonsillectomy, we compared the efficacy of either pre‐ or postoperative local anesthetic infiltration upon post‐tonsillectomy pain.Methods: After the induction of general anesthesia, 68 consecutive healthy patients, ranging in age from 8 to 65 years, were randomly allocated to either receive peritonsillar infiltration with 0.25% bupivacaine (group 1) or normal saline (group 2) before incision. A third group (group 3) had their peritonsillar region infiltrated with 0.25% bupivacaine after the completion of surgery but before the patients were awakened from anesthesia. All the patients were treated in the same way in the postoperative period: NSAIDs were given intravenously to adults and rectally to children. Acetaminophen was given intravenously or rectally (children aged < 15 yr) if additional analgesic support was requested by the patient. Additional acetaminophen consumption was recorded daily. Pain scores were assessed on every patient with the use of a visual analogue scale (VAS) at rest, 1, 5, 9, 13, 17, 21 and 36 h after surgery, and also on swallowing during the first postoperative day.Results: Global VAS pain scores were lower in the groups treated with bupivacaine infiltration during the first 24 h after surgery (P < 0.05). Supplementary analgesic consumption was lower in group 3 than in group 2 during the 0–9 h interval immediately following surgery (P < 0.05). There were no statistically significant differences for any other parameters between the 3 groups.Conclusion: These results suggest that the timing of peritonsillar infiltration with bupivacaine is not of clinical importance and does not affect the quality of postoperative analgesia in patients undergoing tonsillectomy.
Effects of halothane, isoflurane and sevoflurane on ischemiareperfusion injury in the perfused liver of fasted rats
Authors: Imai M. , Kon S. , Inaba H. 
Published: February 2011

Background: Although intraoperative ischemia‐reperfusion of the liver generally occurs under general anesthesia, little is known about the direct effect of anesthetic agents on hepatic injury due to this phenomenon. The effect of volatile anesthetics on ischemia‐reperfusion injury was studied using isolated liver perfusion.Methods: The liver was isolated from 24‐h‐fasted male Sprague‐Dawley rats and perfused through the portal vein with a modified Krebs‐Ringer bicarbonate solution in a recirculating perfusion‐aeration system. Ischemia was induced by reducing the baseline perfusion pressure from 1.2 to 0.2 kPa followed by reperfusion to baseline level. The ischemia‐reperfusion injury was assessed by LDH release from the perfused liver. We studied the effect of halothane, isoflurane and sevoflurane on the ischemia‐reperfusion injury during 20 min of control conditions, exposure of the liver to 60 min of ischemia and reperfusion for 90 min.Results: Ischemia was evident by reduced portal vein flow and oxygen consumption, and caused an increase in lactate production. Reperfusion caused a transient reduction in lactate production and a significant increase in LDH release. All anesthetics reduced hepatic oxygen consumption and increased the net lactate production during control conditions. Volatile anesthetics also significantly attenuated LDH release during reperfusion. The suppression of LDH release was observed even when isoflurane was administered during the reperfusion period, but not when it was administered only during ischemia.Conclusion: These results indicate that volatile anesthetics may protect the fasted liver from early, neutrophil‐independent, ischemia‐reperfusion injury by acting during the reperfusion phase.
Epidural and intrathecal opioids for postoperative pain management in Europe — a 17‐nation questionnaire study of selected hospitals
Authors: Rawal N. , Allvin R. ,   Euro Pain Study Group on Acute Pain
Published: February 2011

Background: A questionnaire study conducted with the help of selected contact persons in 17 countries in Europe attempted to create a picture of the practice of acute pain management with the use of spinal opioid analgesia (SOA).Methods: A questionnaire was mailed to anaesthesiologists in 105 European hospitals. Depending on the population, 5–10 hospitals from each country were selected by a country co‐ordinator.Results: A total of 101 (96.2%) completed questionnaires were returned. During 1 year SOA was used in 55117 patients (6.6% of all in‐patient surgical procedures); of these, 89.2% received epidural opioids and 10.8% intrathecal opioids (ratio 8: 1). The most common opioid for SOA was morphine; fentanyl was also used quite frequently; 12 different opioids and 8 non‐opioids had been used. ASA 1–2 patients receiving epidural morphine were nursed on surgical wards in 58.4% of the hospitals; in 25.7% of hospitals even ASA 3–4 were nursed on surgical wards. Respiratory depression (requiring naloxone treatment) was noted in 45 of the 49 183 patients who received epidural opioids (0.09%); 33 of these patients had received morphine. In more than 75% of hospitals the monitoring variables were respiratory rate, sedation level and pulse oximetry. There was a great difference between hospitals and countries regarding duration of monitoring.Conclusions: This questionnaire study showed that SOA was used in about 7% of 836 000 in‐patients undergoing surgery at the 105 selected hospitals. Epidural opioids were used eight times more often than intrathecal opioids. Morphine was the commonest opioid for SOA. The duration of monitoring differed greatly between hospitals and countries; the need for official guidelines is emphasized.
Effects of thoracic vs. lumbar epidural anaesthesia on systemic haemodynamics and coronary circulation in sevoflurane anaesthetized dogs
Authors: Hirabayashi Y. , Shimizu R. , Fukuda H. , Saitoh K. , Igarashi T. 
Published: February 2011

Background: Although many investigators reported changes in coronary circulation during thoracic epidural anaesthesia (TEA), no previous studies have attempted to compare it with lumbar epidural anaesthesia (LEA) concerning coronary circulation. Our aim was to compare effects of TEA on systemic haemodynamics and coronary circulation with those of LEA in anaesthetized dogs.Methods: In dogs receiving 1.5% sevoflurane, 2% lidocaine (0.1 ml kg−1)was injected into the epidural space via an epidural catheter inserted at either the T7‐T8 (TEA group, n=8) or L5‐L6 (LEA group, n=8) interspace, and the same dose was repeated again 30 min later.Results: Heart rate and maximum left ventricular dP/dt decreased in the TEA group but were unchanged in the LEA group. Decreases in mean arterial pressure were found for both groups, and they were more substantial in the TEA than in the LEA group. Decreases in left ventricular minute work index were found for both groups, and they tended to be more substantial in the TEA than in the LEA group. Coronary perfusion pressure and blood flow decreased in both groups. Calculated coronary vascular resistance increased in the TEA group but was unchanged in the LEA group.Conclusion: The most significant difference between TEA and LEA concerning coronary circulation was characterized by an increase in coronary vascular resistance in the TEA group, which was not present in the LEA group. The increase in coronary vascular resistance caused by TEA may be explained by a coronary vasoconstriction caused by a lower myocardial oxygen demand.
Effect of lidocaine on histamine release and Ca2+ mobilization from mast cells and basophils
Authors: Yanagi H. , Sankawa H. , Saito H. , Iikura Y. 
Published: February 2011

Background: Various anesthetic drags have been known to induce allergic reactions, which have been caused by histamine release from mast cells/basophils. Although lidocaine is reported to suppress allergic reactions, there have been no reports about lidocaine's direct effects to inhibit histamine release from mast cells/basophils.Methods: We examined the effect of lidocaine on histamine release in vitro from freshly extracted as well as cultured mast cells and basophils. Additionally, the effects of lidocaine on intracellular calcium concentration were monitored by assessing Fura‐2 signals in cultured cells.Results: Lidocaine (10−3∼10−2 M: approximately 234∼2340 μg/ ml) inhibited both the IgE‐dependent and IgE‐independent histamine release from all mast cells/basophils in a dose‐dependent manner. However, lidocaine inhibited the IgE‐dependent response more than the IgE‐independent response (P<0.01). Lidocaine also inhibited increases in intracellular Ca2+ to a greater extent after IgE‐dependent stimulation as compared with IgE‐independent stimulation. The degree of the inhibition of histamine release by lidocaine appeared to parallel decreases in Ca2+ mobilization.Conclusions: Our results indicate that lidocaine directly inhibits histamine release from both rodent mast cells and human basophils in vitro at concentrations from 10−3 to 10−2 M (234 to 2340 μg/ml). That may be influenced by Ca2+ mobilization. Although these results are not immediately relevant to clinical practice, allergic reaction caused by direct effect of lidocaine seems to be impossible.
Cerebral autoregulation is impaired in patients resuscitated after cardiac arrest
Authors: Nishizawa H. , Kudoh I. 
Published: February 2011

Background: Cerebral autoregulation is important to maintain a constant perfusion in the face of changes in blood pressure. It is reported to be impaired in pathologic states, including hypertension, cerebral infarction, and head injury. However, it is not clear whether cerebral autoregulation is impaired in resuscitated patients after cardiac arrest.Methods: Cerebral autoregulation in comatose patients after cardiac arrest was assessed by using an indirect method of cerebral blood flow (CBF). Eight patients who had cardiac arrest outside of the hospital and were successfully resuscitated in the emergency room were included in this study. A catheter was inserted percutaneously into the right internal jugular vein and positioned so that the tip was in the jugular bulb. Mean arterial pressure (MAP) was changed to a value of 30% lower or higher than baseline MAP by infusing trimethaphan or methoxamine, respectively. At each MAP level, arterial and jugular bulb venous blood gases were measured, and arterial‐jugular bulb venous oxygen content difference (AVDO2) was calculated.Results: The 1/AVDO2 (CBFI) and oxygen saturation of jugular bulb venous blood (SjvO2) significantly decreased at the lower MAP level, and significantly increased at the higher MAP level. The ratio of the CBFI at the lower MAP level to the CBFI at baseline (CBFI‐L/CBFI‐B) inversely correlated with the Sjvo2 at baseline.Conclusions: Assuming that the cerebral metabolic rate of oxygen does not change during the interventions in MAP, the changes of CBFI and SjvO2 seen after the decrease or increase in MAP indicate that cerebral autoregulation was impaired in these resuscitated patients. The degree of the impairment of cerebral autoregulation may be secondary to the degree of brain injury caused by the cerebral ischemia accompanying cardiac arrest.
Investigation of seedling‐stage salinity tolerance QTLs using backcross lines derived from Oryza sativa L. Pokkali
Authors: Alam Rebjana , Sazzadur Rahman M. , Seraj Zeba I. , Thomson Michael J. , Ismail Abdelbagi M. , Tumimbang‐Raiz Ellen , Gregorio Glenn B. 
Published: February 2011

With 2 figures and 5 tables AbstractA population of BC3F4 rice lines derived from a cross of salt‐tolerant Pokkali and sensitive IR29 was developed for validation of the Saltol QTL and comparison of this QTL effect with background QTLs. Specific BC3F4 progenies from the advanced backcross population were found to have similar salinity tolerance at the seedling stage even without the Saltol alleles. Therefore, additional QTLs responsible for seedling‐stage salinity tolerance were investigated by screening and genotyping with markers at multiple loci throughout the 12 rice chromosomes. Single marker regression (SMR) using Q‐Gene detected seven QTLs above the threshold logarithm of the odds of 3.0. Single marker analysis using IciMapping detected the same markers linked to the seven QTLs identified by SMR. Likelihood ratio test‐based on stepwise regression (LRT‐RSTEP) analysis using IciMapping, more suitable for BC3F4 introgression lines located six QTLs, of which two were common with SMR and included two significant segments within Saltol. The new non‐Saltol QTLs represent targets for further study to evaluate their usefulness in breeding for higher levels of seedling‐stage salinity tolerance in rice.
Slab partial melts from the metasomatizing agent to adakite, Tafresh Eocene volcanic rocks, Iran
Authors: GHORBANI MOHAMMAD R. , BEZENJANI RASOUL N. 
Published: February 2011

AbstractGeochemical and mineralogical characteristics of the Eocene volcanic succession in Tafresh area of the Urumieh–Dokhtar Magmatic Assemblage (UDMA) are unique in the 2000‐km‐length assemblage. Demonstrating rather steep rare earth element (REE) patterns and the widespread presence of amphibole (+biotite) phenocrysts are two distinct characters that dominate the Eocene volcanic succession of mainly andesitic composition. Coincidence of the geochemical and mineralogical characteristics of the whole volcanic succession with adakites, rather amphibole‐ (+biotite) rich dacitic (with 61–64 wt% SiO2) stocks and dykes, is considered as the key in unraveling the role of ‘slab‐derived melt contribution’ in petrogenesis of the volcanic succession. Slab‐derived melting has been an ongoing process that metasomatized some parts of the mantle wedge from which hybrid rocks (andesites) are derived. Basalts with distinct signatures of slab melt metasomatism are yet another support for the occurrence of slab melting. Interlayering of normal, island‐arc‐type calc‐alkaline volcanic rocks with the slab‐melt metasomatized basalts and hybrid andesites suggests that the slab melting has been motivated by the subduction. Formation of the Tafresh Caldera, the likely consequence of an explosive eruption, is compatible with the volatile‐bearing nature of the adakitic volcanism in the study area. It is indicated by the ubiquitous presence of the hydrous minerals. Beneath the Tafresh area, in Eocene time, the subducting slab seems to have reached a critical high depth that is enough for the development of amphibolite–eclogite. The slab deformation, motivated by the geometry of subduction and/or the underlying mantle's steeper geotherms, is suggested to have resulted in the slab melting that helped develop a rock assemblage unique to the UDMA.
Relicts of deformed lithospheric mantle within serpentinites and weathered peridotites from the Godzilla Megamullion, Parece Vela Back‐arc Basin, Philippine Sea
Authors: HARIGANE YUMIKO , MICHIBAYASHI KATSUYOSHI , OHARA YASUHIKO 
Published: February 2011

AbstractRelicts of deformed lithospheric mantle have been identified within serpentinites and weathered peridotites recovered from nine dredge sites and one submersible dive site from across the Godzilla Megamullion, which was emplaced at the now‐extinct Parece Vela Rift in the Parece Vela Basin, a back‐arc basin in the Philippine Sea. The serpentinites consist dominantly of lizardite ± chrysotile and magnetite with minor relict primary minerals that include pyroxene, spinel, and rare olivine. The weathered peridotites consist of pyroxene, spinel, lizardite ± chrysotile, and magnetite as well as weathering products of olivine. These rocks were classified in hand specimen into three types with different structures: massive, foliated, and mylonitic. In thin‐section the serpentine minerals show no sign of deformation, whereas relict primary minerals show evidence of plastic deformation such as undulose extinction, kink bands, dynamic recrystallization, and weak to moderate crystallographic preferred orientations. Therefore, the serpentinites and weathered peridotites result from the static replacement and weathering of previously ductile‐deformed peridotite. Given their location close to or on the detachment surface that exposed them, the relicts of peridotite provide evidence of deformation in the lithospheric mantle that could be related to the formation and emplacement of the Godzilla Megamullion in the Parece Vela Rift.