bluuebunny/crossref_metadata_2025_split huggingface dataset:
Syuptomatology, quality of life and economic features of irritable bowel syndrome—the effect of hypnotherapy
Authors: HOUGHTON L. A. , HEYMAN D. J. , WHORWELL P. J. 
Published: July 2010

SUMMARY Aims: The purposes of this study were to quantify the effects of severe irritable bowel syndrome on quality of life and economic functioning, and to assess the impact of hypnotherapy on these features. Methods: A validated quality of life questionnaire including questions on symptoms, employment and health seeking behaviour was administered to 25 patients treated with hypnotherapy (aged 25–55 years; four male) and to 25 control irritable bowel syndrome patients of comparable severity (aged 21–58 years; two male). Visual analogue scales were used and scores derived to assess the patients' symptoms and satisfaction with each aspect of life. Results: Patients treated with hypnotherapy reported less severe abdominal pain (P < 0.0001), bloating (P < 0.02). bowel habit (P < 0.0001), nausea (P < 0.05). flatulence (P < 0.05). urinary symptoms (P < 0.01), lethargy (P < 0.01), backache (P= 0.05) and dyspareunia (P= 0.05) compared with control patients. Quality of life, such as psychic well being (P < 0.0001), mood (P < 0.001), locus of control (P < 0.05), physical well being (P < 0.001) and work attitude (P < 0.001) were also favourably influenced by hypnotherapy. For those patients in employment, more of the controls were likely to take time off work (79% vs. 32%; p = 0.02) and visit their general practitioner (58% vs. 21%: P = 0.056) than those treated with hypnotherapy. Three of four hypnotherapy patients out of work prior to treatment resumed employment compared with none of the six in the control group. Conclusion: This study has shown that in addition to relieving the symptoms of irritable bowel syndrome, hypnotherapy profoundly improves the patients’quality of life and reduces absenteeism from work. It therefore appears that, despite being relatively expensive to provide, it could well be a good long‐term investment.
High prevalence of Helicobacter pylori infection in Japanese patients with membranous nephropathy
Authors: MORIYAMA T. , KANEKO T. , FUJII M. , TSUBAKIHARA Y. , KAWANO S. , IMAI E. 
Published: July 2010

SummaryBackgroundMembranous nephropathy is the most common cause of nephrotic syndrome in Japanese adults, and is often precipitated by systemic diseases such as infection, neoplasm, and autoimmune conditions. Recently, the Helicobacter pylori antigen was detected histochemically in the glomeruli of membranous nephropathy patients, raising the possibility that H. pylori may be the pathogen that causes.AimTo reveal the p1revalence of H. pylori infection in the Japanese membranous nephropathy population and to test the therapeutic efficacy of H. pylori eradication on the course of disease in membranous nephropathy patients.MethodsThe prevalence of H. pylori infection was investigated by the HM‐CAP method in 32 membranous nephropathy patients and an age‐matched control group (C: n = 243).ResultsA significantly higher H. pylori infection rate was found in membranous nephropathy patients than in the control group (positive/total: membranous nephropathy 21/32 vs. C 108/243, P < 0.05 by chi‐squared test). Eradication of H. pylori was achieved in four membranous nephropathy patients with proteinuria who were receiving glucocorticoid therapy, three of whom experienced a reduction of proteinuria after eradication.ConclusionsWe found a higher prevalence of H. pylori infection in Japanese membranous nephropathy patients than in age‐matched control subjects, which suggests the possible involvement of H. pylori infection in the pathogenesis of membranous nephropathy.
Coinfection of Helicobacter pylori and Neisseria subflava is closely associated with lymph follicle formation in human stomach
Authors: NAKAMURA M. , MATSUI H. , SERIZAWA H. , MURAYAMA S. Y. , YAMAGUCHI T. , TAKAHASHI T. , MATSUMOTO T. , YAMADA H. , HIBI T. , TSUCHIMOTO K. 
Published: July 2010

SummaryBackgroundMany reports have described coinfection of Helicobacter pylori and other bacteria in the gastric mucosa in humans. However, relatively few have reported the relation of coinfection with pathological characteristics.AimTo culture and identify bacteria other than H. pylori from the gastric mucosa of 64 patients undergoing scheduled gastric biopsy for various gastric conditions. The relation of coinfection with the pathological changes was also investigated.MethodsFrom colonies showing characteristics different to those of H. pylori, bacteria were identified by the 16S rRNA gene sequence using FASTA. Cluster analysis was performed using GENETYX‐MAC and a phylogenetic tree was constructed using the UPGMA method. The correlation of pathological observation and the existence of identified bacteria and H. pylori were also analysed.ResultsForty‐eight per cent of patients were positive to H. pylori, and 27% were positive to Neisseria species. Coinfection of the two bacterial existences was significantly linked. DNA sequencing studies revealed these Neisseria strains to coincide mostly with Neisseria subflava. With regard to the interaction of pathological characteristics, Neisseria and H. pylori coinfection was closely related to lymph follicle formation.ConclusionsCoinfection of H. pylori and N. subflava was found to be closely related to lymph follicle formation.
Chronic biochemical cholestasis in patients receiving home parenteral nutrition: prevalence and predisposing factors
Authors: LLOYD D. A. J. , ZABRON A. A. , GABE S. M. 
Published: July 2010

SummaryBackground  Chronic biochemical cholestasis has been shown to be associated with a fivefold increase in histologically advanced liver disease in patients receiving home parenteral nutrition.Aims  To investigate prevalence of chronic biochemical cholestasis in home parenteral nutrition patients and examine factors influencing its occurrence.Methods  Records of all patients receiving home parenteral nutrition for >6 months treated at a single centre were reviewed and plasma biochemistry recorded. Logistic regression analysis was employed to identify factors associated with prevalence of chronic biochemical cholestasis.Results  Records of 113 patients were reviewed. The point prevalence of chronic biochemical cholestasis was 24%, increasing to 28% if patients receiving parenteral fluid and electrolytes only were excluded. In multivariate analysis, presence of colon in continuity was associated with a significantly lower prevalence of chronic biochemical cholestasis, while total parenteral calorie intake was associated with a higher prevalence of chronic biochemical cholestasis. No association was seen between small intestinal lengths or between parenteral lipid intake and chronic biochemical cholestasis in multivariate analysis.Conclusions  Chronic biochemical cholestasis is common in patients receiving home parenteral nutrition. High parenteral calorie intake and lack of a colon in continuity with small intestine are independently associated with an increased risk of chronic biochemical cholestasis.
The neuromuscular transmission monitor
Authors: WINDSOR J. P. W. , SEBEL P. S. , FLYNN P. J. 
Published: July 2010

SummaryThe neuromuscular transmission monitor (NTM) is a new device for measuring neurornuscular transmission during anaesthesia, We have assessed its use in comparison with a force transducer and found for single twitch and train‐of‐four modes that there was a strong positive correlation between the two methods. This device appears reliable in use and provides a satisfactory alternative to conventional neuromuscular monitoring.
Influence of meptazinol on metabolic and hormonal responses following major surgery
Authors: KAY N. H. , ALLEN M. C. , BULLINGHAM R. E. S. , BALDWIN D. , McQUAY R. J. , MOORE H. A. , PRICE R. K. , SEAR J. W. 
Published: July 2010

SummaryOpioid drugs in high doses can obtund the stress response to major surgery but only at the expense of marked cardiorespiratory depression. The postoperative hormonal response to surgical stress was measured in 20 patients undergoing hysterectomy who were given either meptazinol 100 mg or morphine 15 mg intramuscularly at the end of the surgery. Both drugs at the doses used failed to diminish the stress response. Those patients who received meptazinol showed elevated prolactin levels: this may be an indicator of agonist activity at the μ1, opioid receptor.
Organophosphate insecticide poisoning
Authors: KIPLING R. M. , CRUICKSHANK A. N. 
Published: July 2010

SummaryOrganophosphate insecticides are widely used agents which are quickly absorbed through the skin and mucous membranes. The effects of acute exposure to these agents can be severe and intensive therapy may be required. Specific drugs are available to reverse the muscarinic, nicotinic and central effects of these poisons. When given early they are very effective and early diagnosis and treatment may therefore be life‐saving. A case of acute poisoning with an organophosphate anticholinesterase insecticide is reported. The signs and symptoms of acute poisoning are described and a rational approach to specific treatment is discussed.
Fulminating epiglottitis in adults
Authors: WARNER JENNIFER A. , FINLAY W. E. I. 
Published: July 2010

SummaryThree cases of epiglottitis in previously healthy young adults are reported. Two of these were fatal and occurred within nine months of each other. Both patients died within 24 hours of the development of definitive symptoms. The seriousness of this condition is stressed: a management protocol is suggested, based on our experience and the literature is reviewed.
Self‐administered isoflurane in labour
Authors: McLEOD D. D. , RAMAYYA G. P. , TUNSTALL M. E. 
Published: July 2010

SummaryEntonox (50% nitrous oxide in oxygen) and isoflurane (0.75% in oxygen) were compared as analgesics in the first stage of labour in 32 consenting women. The drugs were self‐administered and given in random sequence, each during five consecutive uterine contractions. Each patient acted as her own control. Linear analogue pain scores were signijicantly lower (p < 0.001) with isoflurane than with Entonox, but scores for drowsiness were higher for isoflurane. Further study is needed to assess the effects of more prolonged use of isoflurane in labour.
Alfentanil and memory function
Authors: KENNEDY D. J. , OGG T. W. 
Published: July 2010

SummaryTwo groups of 20 patients undergoing day case vaginal termination of pregnancy received either methohexitone and alfentanil 7.5 μg/kg or methohexitone and fentanyl 1.5 μg/kg. Their recovery times and memory function at 1 and 2 hours after surgery were compared. No difference in the recovery of the 2 groups was noted bur at 2 hours after operation the alfentanil group showed impairment of memory for new facts compared with pre‐operative memory function testing. This was not evident in the fentanyl group. Apart from this finding alfentanil was adjudged to be a suitable agent for day case anaesthesia.
Recovery from day‐case anaesthesia
Authors: CARTER J. A. , DYE A. M. , COOPER G. M. 
Published: July 2010

SummarySixty unpremedicated patients undergoing dilatation and curettage were allocated randomly to receive one of three inhalational agents (halothane, enflurane or isoflurane) to supplement 67% nitrous oxide in oxygen after induction of anaesthesia with methohexitone. Recovery was assessed by the time patients took to open their eyes, to give their correct date of birth, to regain their pre‐operative level of manipulative skill with a children's postbox toy, and by comparing pre‐operative and postoperative performance of a paper and pencil test (the p‐deletion test). There was no difserence in the time to open eyes or to regain their pre‐operative score with the postbox whether the patients received halothane, enflurune or isoflurane. Patients in the isoflurane group took longer than patients in the enflurane group to give their correct date of birth, but they performed better in the p‐deletion test postoperatively, completing more lines with the same number of errors. Patients receiving enflurane committed more errors postoperatively in the p‐deletion test. The incidence of complications was low and was not influenced by the choice of inhalational agent.
Peri‐operative dreaming in paediatric patients who receive suxamethonium
Authors: O'SULLIVAN E. P. , CHILDS D. , BUSH G. H. 
Published: July 2010

SummaryA prospective study is described of peri‐operative dreaming in 144 paediatric patients aged 5–14 years who received suxamethonium for day case surgery. No case of awareness was elicited. One group received pretreatment with 80 mg/kg tubocurarine. The incidence of dreaming in the 72 patients who were not pretreated was 16.7% compared with 2.8% in the patients pretreated with tubocurarine. This difference is statistically significant. The use of an intermittent suxamethonium technique gives a high incidence of dreaming which may be caused by muscle spindle discharge that produces cerebral arousal. Pretreatment with a non‐depolarising agent decreases this risk of dreaming.
Paediatric postoperative analgesia
Authors: FELL D. , DERRINGTON M. C. , TAYLOR E. , WANDLESS J. G. 
Published: July 2010

SummaryFifty children who underwent day case herniotomy received either a caudal injection of 1 ml/kg bupivacaine 0.25% or infiltration of the wound edges at the end of surgery with 0.5 mllkg bupivacaine 0.25%, allocated at random. Postoperative pain and demeanour were assessed initially by an observer and later by use of a parental questionnaire. Wound infiltration of local anaesthetic solution provided analgesia which was comparable to that associated with caudal block, and the incidence of side effects was similar in the two groups. Wound infiltration of local anaesthetic offers a simple, safe alternative to caudal block for provision of postoperative analgesia in this group of patients.
A comparison of oxygen therapy devices used in the postoperative recovery period
Authors: WILLIAMS A. B. , JONES P. L. , MAPLESON W. W. 
Published: July 2010

SummarySeventy‐one patients scheduled to undergo upper or lower abdominal surgical procedures were allocated at random to one of seven treatment groups: in the recovery room they were to receive oxygen via a 40% Ventimask with 10 litres/minute oxygen flow, or via either a Hudson mask or a nasal cannula with 3,6 or 9 litres/minute oxygen flow. The 40% Ventimask gave the most consistent, satisfactory postoperative values of PaO2 but the much cheaper nasal cannula at 6 or 9 litres/minute was generally adequate in conscious patients. The performance of the intermediately priced Hudson mask was similar to that of the nasal cannula at these flows. The unconscious state was associated with a 45% lower PaO2 than the rousable or awake states. Differences between the treatments with regard to postoperative PaCO2 were small and non‐significant. The nasal cannula with 6 litres, minute humidified oxygen flow is recommended for routine treatment, and the Ventimask for unconscious patients.
Cannulation of the epidural space
Authors: McNeill M. J. , Thorburn J. 
Published: July 2010

SummaryA group of 685 obstetric patients were randomly allocated to have their epidural block performed using either a 16‐gauge or an 18‐gauge Tuohy needle. Bleeding was noted from needle or catheter trauma in 18% of patients and it proved impossible to insert the catheter in 3%. The majority of mothers experienced little discomfort during the procedure but 2% found insertion to be very uncomfortable. There was no significant difference in the complication rate, ease of use, or patient discomfort between the 18‐ or 16‐gauge needles. Epidural analgesia, although safe, is not without hazard. It may be difficult to perform and may, rarely, cause considerable discomfort.
Prolonged anaesthesia with isoflurane and halothane
Authors: JANTZEN J.‐P. A. H. , KLEEMANN P. P. , WITTON P. K. , MERTZLUFFT F. , KLEIN A. M. , DICK W. F. 
Published: July 2010

SummaryHepatic function was assessed pre‐operatively and on the first and sixth postoperative days in 40 healthy patients who underwent prolonged maxillofacial surgery with isoflurane or halothane anaesthesia. No major changes were observed in hepatic enzymes or bilirubin. One‐stage prothrombin time and Factor VII concentrations decreased on the first postoperative day and this change‐was more pronounced in the halothane group. The results support the use of isoflurane rather than halothane for prolonged anaesthesia in respect of the synthesising function of the liver.
A comparison of nalbuphine with fentanyl for postoperative pain relief following termination of pregnancy under day care anaesthesia
Authors: BONE M. E. , DOWSON S. , SMITH G. 
Published: July 2010

SummaryA double‐blind investigation was undertaken to compare the efficacy of nalbuphine and fentanyl in the prevention of pain after day case termination of pregnancy. Forty patients were allocated randomly to receive nalbuphine 0.25 mg/kg or fentanyl 1.5 μg/kg immediately before induction of anaesthesia. The patients completed scores for pain and nausea, and performed a reaction time test to assess recovery. An observer assessed patient appearance at 1, 2 and 4 hours postoperatively. Patients who received nalbuphine had significantly lower pain scores at 1 hour (p < 0.01) and 2 hours (p < 0.05) and required significantly (p < 0.05) less postoperative analgesia. No significant differences were found between the groups for incidence of nausea or for observer assessment of appearance. There was some evidence of psychomotor impairment at 2 hours in the nalbuphine group. Freedom from Controlled Drug Act regulations and improved analgesia with nalbuphine, render it more satisfactory for day case surgery than the more commonly used fentanyl.
The antiemetic action of propofol
Authors: McCollum J. S. C. , Milligan K. R. , Dundee J. W. 
Published: July 2010

SummaryEighty patients who underwent minor gynaecological surgery were anaesthetised with either incremental propofol or incremental methohexitone after an opioid premedication. The group anaesthetised with propofol had significantly fewer emetic sequelae and the results suggest that propofol has a definite antiemetic action.
An additional tactile test
Authors: Horton W. A. , Perera S. , Charters P. 
Published: July 2010

SummaryAn additional clinical test to confirm laryngeal placement of tracheal tubes is described. Using the new test, placement was confirmed in all of 50 patients studied in whom difficulty would have been anticipated using previously described tactile tests (male patients with lower molar teeth). Two anaesthetists with small hands averaged 98% confirmations in two series each of 100 consecutive unselected intubations. A simple modification of the tests enables their application after nasotracheal intubation; even with small hands, a confirmation rate of 96% in 50 consecutive cases was found. The three tactile tests are reviewed and analysed. In the authors' combined experience of 14 cases of difficult laryngoscopy the tests gave reliable confirmation in 12 patients. Familiarity with these tests is stressed to be important for their reliable implementation.
Factors that influence cutaneous reactions following administration of thiopentone and atracurium
Authors: LYNAS A. G. A. , CLARKE R. S. J. , FEE J. P. H. , REID J. E. 
Published: July 2010

SummaryAtracurium was administered by a variety of techniques to determine whether these influence the onset or duration of muscular relaxation, and the frequency of cutaneous reactions, after a standard induction dose of thiopentone. One‐hundred‐and‐fifty patients were allocated randomly to receive the drug by one of five methods: into a fast‐flowing crystalloid infusion in the antecubital fossa; into a winged needle in the antecubital fossa with flushing after the thiopentone; into a winged needle in the antecubital fossa without flushing; into a winged needle in the dorsum of the hand without flushing. The above groups received atracurium freshly removed from the refrigerator whereas the fifth group were given atracurium which had been maintained at room temperature for at least 2 weeks. The frequency of cutaneous reactions was between 60 and 70% overall and there were no significant differences either in this or in the onset or duration of action between the groups. A further 25 patients with a history of drug allergy were also investigated by the first method and showed no significant differences in response, but 25 patients aged over 70 years had a significantly lower frequency of cutaneous reactions with a higher frequency of hypotension than the other groups.
Postoperative recovery rooms
Authors: GOODCHILD C. S. 
Published: July 2010

SummaryPostoperative recovery rooms have been used in the United Kingdom for just over 30 years. Anaesthetic and surgical practices have improved during this time but the clinical problems encountered are unchanged essentially. Several surveys have reviewed complications that occur; the most common causes of postoperative morbidity and mortality are still cardiovascular and respiratory problems, the latter particularly of the upper airway. In contrast there are no data available on the standard of staff and equipment in recovery rooms. The results of a survey of this aspect of postoperative recovery rooms in hospitals in Wessex, North West Thames and Yorkshire Regional Health Authorities are reported. Particular effort was made to define the facilities available. The results indicate that 70% of hospitals do not provide staffing levels and facilities which meet recommendations of the Association of Anaesthetists of Great Britain and Ireland. The implications of these findings with regard to anaesthetic morbidity and mortality are discussed.
Coronary vasospasm during percutaneous trigeminal rhizotomy
Authors: SWERDLOW B. , SHUER L. , ZELCER J. 
Published: July 2010

SummaryA case of myocardial infarction as a result of coronary vasospasm during percutaneous trigeminal rhizotomy is presented. Potential consequences of the profound sympathetic response during this procedure are discussed. Invasive haemodynamic monitoring as well as prophylaxis with nitrates and calcium antagonists may be useful in patients prone to coronary vasospasm who undergo this procedure.
Continuous blockade of the lumbar plexus after knee surgery—postoperative analgesia and bupivacaine plasma concentrations
Authors: DAHL J. B. , CHRISTIANSEN C. L. , DAUGAARD J. J. , SCHULTZ P. , CARLSSON P. 
Published: July 2010

SummaryIn a double blind, randomised, controlled investigation the analgesic effect of a continuous block of the lumbar plexus with bupivacaine compared with sodium chloride was examined in 20 patients with postoperative pain after knee‐joint surgery. The infusion was given through a catheter inserted in the neurovascular fascial sheath of the femoral nerve, according to the three‐in‐one block technique. The patients treated with bupivacaine had significantly lower pain scores and a significantly lower demand for morphine. Side effects related to the catheters or the infusions of bupivacaine were not observed.
Long‐term performance of Tec vaporizers
Authors: CARTER K. B. , GRAY W. M. , RAILTON R. , RICHARDSON W. 
Published: July 2010

SummaryWe reviewed the maintenance records of lee vaporizers which had been in clinical use for up to 4 years. Tec 4s and Enfluratec 3s were found to be extremely reliable, but Fluotec 3s suffered progressively from mechanical and calibration problems. Their most recurrent fault was sticking valves caused probably by thymol crystallising on the valve faces. This fault did not occur with Fluotec 4s, which are designed to prevent liquid agent reaching the valve surfaces. We found, in a study of the effects of thymol accumulation, that only occasional draining of a Fluotec vaporizer is required to keep thymol concentration below the level at which its output is reduced. We conclude that, if regular field calibration checks are carried out as a safety measure, the service interval for Tee vaporizers could be extended beyond Ohmeda's present recommendation of one year.