bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midazolam co‐induction and laryngeal mask insertion
Authors: Driver I. K. , Wiltshire S. , Mills P. , Lillywhite N. , Howard‐Griffin R. 
Published: February 2007

SummaryWe have studied the effect of alfentanil and midazolam + alfentanil on the conditions for laryngeal mask airway insertion in patients receiving propofol for induction of anaesthesia. Ninety unpremedicated, ASA 1 or 2 adult patients were randomly allocated to one of three groups: group P received propofol only (2.5 mg.kg‐1); group PA received alfentanil (10 μg.kg‐1) followed by propofol (1.25 mg.kg‐1); group PMA received midazolam (0.04 mg.kg‐1) and alfentanil (10 μg.kg‐1) followed by propofol (1.25 mg.kg ‐1). Further boluses of propofol (0.25 mg.kg ‐1 every 15 s) were given if the initial dose was inadequate for induction of anaesthesia. Patients in the midazolam + alfentanil group required less propofol (p < 0.001), had better mouth opening (p < 0.001) and fewer undesired responses to laryngeal mask airway insertion (p < 0.001) than the other two groups.
Retracted: The influence of volume therapy and pentoxifylline infusion on circulating adhesion molecules in trauma patients
Authors: BOLDT J. , HEESEN M. , PADBERG W. , MARTIN K. , HEMPELMANN G. 
Published: February 2007

Summary Adhesion molecules appear to play a pivotal role in tissue damage secondary to the inflammatory process. Besides neutrophiland endothelial‐bound adhesion molecules, soluble forms have been detected in the circulating blood. They seem to be good markers of endothelial damage, but they may also have other biological functions. Plasma concentrations of soluble adhesion molecules (endothelial leucocyte adhesion molecules (sELAM‐1), intercellular adhesion molecule‐1 (sICAM‐1), vascular cell adhesion molecule‐1 (sVCAM‐1), and granule membrane protein 140 (sGMP‐140) were serially measured over 5 days by enzyme‐linked immunosorbent assays (ELISA) in 45 consecutive trauma patients. These received, by random allocation, only either hydroxyethylstarch solution 10% (mean molecular weight 200 000 daltons) (n = 15) or human albumin 20% (n = 15) for volume therapy. Another 15 patients without defined volume therapy received pentoxifylline continuously (1.2mg.kg‐1.h‐1). Measurements were carried out on the day of admission to the intensive care unit (baseline) and during the next 5 days. At baseline, plasma concentrations of all adhesion molecules were similar in all groups. In the hydroxyethyl starch group, sELAM‐1 and sICAM‐1 concentrations decreased significantly (p < 0.05) reaching normal values during the study period whereas the mean (SD) values increased in the pentoxifylline group (sELAM‐1: 71.1 (16.7) to 91.6 (17.8) ng.ml‐1) and the albumin group (sICAM‐1: 400 (81) to 749 (101) ng.ml‐1) (p < 0.05). sVCAM‐1 increased outside the normal range only in the human albumin group (to 760 ± 69 ng.ml‐1) (p < 0.05). sGMP‐140 plasma concentration increased only in those receiving albumin (432 (85) to 550 (93) ng.ml‐1) and this was significantly different to the other groups (p < 0.05). None of the other haemodynamic or laboratory factors could be correlated with plasma concentrations of the adhesion molecules. We conclude that colume therapy with hydroxyethyl starch resulted in a decrease in circulating adhesion molecules in our trauma patients. In contrast, volume therapy with albumin did not exert this effect. Continuous infusion of pentoxifylline did not have a beneficial modulating action on circulating adhesion molecules.
Infusions of subhypnotic doses of propofol for the prevention of postoperative nausea and vomiting
Authors: MONTGOMERY J. E. , SUTHERLAND C. J. , KESTIN I. G. , SNEYD J. R. 
Published: February 2007

Summary We studied the antiemetic effects of a low dose infusion of propofol for 24 h after major gynaecological surgery in a double‐blind, randomised, controlled trial. Fifty women of ASA physical status 1 or 2 undergoing major gynaecological surgery received an infusion of 1% propofol or intralipid at 0.1 ml. kg‐1 h‐1 for 24h after surgery. Pain was managed using morphine. delivered by a patient‐controlled analgesia pump. The degree of postoperative nausea and vomiting was assessed by the nurses using a four‐point ordinal scale, by the patients using a visual analogue scale and by the amount of rescue antiemetic given by the nurses. There were no differences between the two groups in any of the measures of postoperative nausea and vomiting during the first 48 h after surgery. Postoperative nausea and vomiting in the control group was less on the second day compared with the first postoperative day, but not in the propofol group. There were no side effects from the propofol infusion.
Evaluation of the Upsherscope
Authors: PEARCE A. C. , SHAW S. , MACKLIN S. 
Published: February 2007

Summary A new, rigid intubating fibrescope, the Upsherscope, was evaluated in clinical practice. Intubation was attempted in 200 adult patients and was successful in 191, with a median intubation time of 38s, range 14–154s. Intubation was straightforward in just under half of the patients. Difficulties were encountered in picking up the epiglottis, in passing the tracheal tube between the vocal cords and with secretions interfering with the view. In two patients known to be difficult to intubate, the Upsherscope was successful in one patient using an awake technique and failed in the other.
Insertion methods of the laryngeal mask airway
Authors: Dingley J. , Asai T. 
Published: February 2007

Summary The efficacy of the laryngeal mask is widely accepted, but there is a lack of consensus on the best insertion method and on the use of the mask, for certain surgical procedures. We sent a questionnaire to all anaesthetists in Wales to discover the frequency of use of the laryngeal mask and the preferred insertion method. The questionnaire also enquired about the use of the laryngeal mask during anaesthesia for laparoscopic clip sterilisation. Replies were received from 125 consultants (89% of those circulated) and 122 non‐consultants (69%). The insertion method described in the manufacturer's instruction manual was preferred by 30% of consultants and 34% of the others. The next most popular option was insertion of the mask with the cuff partially inflated. Twenty‐three per cent of consultants and 34% of non‐consultants were prepared to use the laryngeal mask during anaesthesia for laparoscopic clip sterilisation. Although the insertion technique described in the instruction manual is the most widely employed, a large number of alternative methods are frequently used.
The paradox of the StatCap carbon dioxide indicator An experimental evaluation of rebreathing
Authors: KAPOOR V. , WATT J. W. H. 
Published: February 2007

Summary The StatCap semiquantitative carbon dioxide detector was evaluated in an experimental setting. The monitor underread at progressively higher concentrations of carbon dioxide. During simulated rebreathing, progressive increases in inspired carbon dioxide resulted in the StatCap readings decreasing. It is recommended that the StatCap be used with caution in circumstances where rebreathing may occur, for example, during manual ventilation with an Ayre's T‐piece.
Injection pain with propofol Reduction with aspiration of blood
Authors: McDonald D. S. , Jameson P. 
Published: February 2007

Summary A randomised, controlled, single‐blind study was performed on 100 patients to investigate a new method of reducing pain on propofol injection. Aspiration of 2 ml of the patient's blood into a syringe of propofol immediately before injection was compared with the addition of lignocaine 20 mg or normal saline 2 ml to the propofol before injection. The addition of blood was significantly more effective in reducing pain on injection than the addition qf' saline (p < 0.001), but was not significantly more effective than the addition of lignocaine.
The effect of pretreatment with ketorolac on pain during intravenous injection of propofol
Authors: Smith A. J. 
Published: February 2007

Summary A randomised, double‐blind, controlled trial was undertaken to compare three different methods of reducing pain during the intravenous injection of propofol. In 101 patients undergoing daycase surgery, verbal rating scores, for pain during injection of propofol were compared immediately after intravenous pretreatment with ketorolac 10 mg, lignocaine 10 mg or saline. Neither pain during injection (p = 0.129), nor venous sequelae at 7 days postoperatively were significantly different between the three treatments. Pain during propofol injection remains a confounding clinical problem.
National provision of acute pain services
Authors: WINDSOR A. M. , GLYNN C. J. , MASON D. G. 
Published: February 2007

SummaryIn order to determine the degree to which the recommendations of the report of the joint working party on ‘Pain after Surgery’ by the Royal College of Surgeons of England and the College of Anaesthetists have been implemented, a postal survey was conducted of all hospitals in the United Kingdom where surgery is performed. The number of hospitals with a multidisciplinary acute pain service had significantly increased from 2.8% before September 1990 to 42.7% at the end of 1994. Over the same period there has been an increase in the number of hospitals with a named clinician responsible for acute pain management, from 20 before 1990 to 230 (65.2%) and the number of hospitals with an acute pain nurse has increased from 8 (2.3%) prior to 1990 to 139 (39.3%). Routine assessment of pain and sedation occurs in 82% of hospitals with established acute pain services and in less than 50% of hospitals without an acute pain service. The use of written protocols, the provision of out‐of‐hours cover and regular training for all staff have increased with time. Research and audit activity related to acute pain management has also improved since 1990.
Epidural infusion of low‐dose bupivacaine and opioid in labour Does reducing motor block increase the spontaneous delivery rate?
Authors: Russell R. , Reynolds F. 
Published: February 2007

SummaryLabouring women were randomly allocated to receive epidural infusions during labour of either 0.125% plain bupivacaine (n = 200) or a combination of 0.0625% bupivacaine with either 2.5μg.ml‐1 fentanyl or 0.25μg.ml‐1 sufentanil (n = 199) each starting at 12 ml.h‐1 and adjusted as necessary to maintain analgesia. The dose of bupivacaine, both hourly (p < 0.001) and total (p < 0.001), was significantly lower in the group receiving the combination. Motor block was significantly less common and less severe in the combination group (p < 0.001). These reductions did not result in a significant increase in spontaneous deliveries. Maternal satisfaction with first (p < 0.001) and second stage analgesia (p < 0.001) was significantly increased in the combination group. The addition of opioid to the epidural infusion did not reduce the incidence of perineal pain. There were no significant differences between the groups in neonatal outcome or the incidence of early postnatal symptoms.
Enalapril/amlodipine combination in cyclosporine‐treated renal transplant recipients: a prospective randomized trial
Authors: Halimi Jean‐Michel , Giraudeau Bruno , Buchler Matthias , Al‐Najjar Azmi , Etienne Isabelle , Laouad Inass , Bruyère Franck , Lebranchu Yvon 
Published: February 2007

Abstract:  Background:  Most hypertensive renal transplant recipients require two or more antihypertensive medications to achieve blood pressure control. However, which medications must be combined is still a matter of debate.Methods:  A prospective randomized open‐label blinded evaluation trial comparing the six‐month effects of the amlodipine–enalapril combination (n = 32) vs. enalapril alone (n = 33) and vs. amlodipine alone (n = 34) on arterial pressure, renal function, albuminuria and tolerability.Results:  At six months, diastolic arterial pressure was more adequately controlled (i.e., <90 mmHg) in the combination group than in the amlodipine and enalapril groups (100% vs. 82.4% and 84.8%, respectively, p = 0.038). The same trend was observed for systolic arterial pressure (65.6% vs. 58.8% and 51.5%, NS). The six‐month change in albuminuria was similar in the combination group and in the enalapril group (−64.7% vs. −59.5%); however, patients in the combination group exhibited a greater reduction in albuminuria than in the amlodipine group (−64.7% vs. −29.0%, p = 0.002). As compared with baseline values, serum creatinine and potassium remained unchanged in the combination group, whereas they increased by 9 ± 12 μmol/L (p = 0.01) and by 0.2 ± 0.4 mmol/L (p < 0.01), respectively, in the enalapril group. The cyclosporine trough levels remained unchanged in the combination group, but increased in the amlodipine group.Conclusion:  Angiotensin‐converting enzyme inhibitor (ACEI)–calcium‐channel blocker (CCB) combination controls arterial pressure more adequately than ACEI alone or CCB alone, reduces albuminuria and may prevent the ACEI‐induced initial rise in serum creatinine.
Ethnic labels in South African English
Authors: MMUSI SHEILA ONKAETSE 
Published: February 2007

ABSTRACT: The urge to label others is a universal phenomenon that is attested in all of the world's languages. South African English, a transplanted language according to Kachru (1990), distinguishes itself from other varieties of English through its unique ethnic labeling terminology. Throughout South African history, the indigenous peoples received a good number of labels, most of which were derogatory in nature ‐ always denoting the superiority of the whites who were doing the labeling. Among others, the terms include Non‐White, Non‐European, Native, Bantu, Hottentot, Bushmen, Coloured, Plural, and so on. It should be noted that the indigenous peoples already had a system of labeling terms that they used to self‐identify as ethnic groups, namely Xhosa, Zulu, Venda, Tswana, Khoikhoi, San and more.British colonial rule as well as the system of Apartheid, which is based on racial segregation, led to the institutionalization of many of these terms, for example, Native, Non‐European, Coloured, Plural, etc. However, political and social developments originating from constant protests by the oppressed, as well as reactions from the government, affected the semantic connotations of some of these terms as well as the creation of new ones. The semantic shifts involved a redefinition of some of the existing terminology ‐ such as Black ‐ from color connotations to political connotations. Other meaning shifts ranged from the melioration (acquiring good value judgements) to the pejoration (acquiring bad value judgements) of some of the terms.This paper focuses on the socio‐political factors that are leading to the shifts in connotation in the post‐Apartheid system by examining the consequences of those shifts for the English lexicon in South Africa.
Presence of the cagA Gene in the Majority of Helicobacter pylori Strains Is Independent of Whether the Individual Has Duodenal Ulcer or Asymptomatic Gastritis
Authors: Go Mae F. , Graham David Y. 
Published: February 2007

ABSTRACT Background
Helicobacter pylori infection presents as many different diseases, including asymptomatic gastritis, peptic ulcer disease, and gastric cancer. Although the virulence factor(s) responsible for different H. pylori‐related diseases have not been identified, several candidate genes are being investigated for such an association. The polymerase chain reaction (PCR) frequently is used to assess the presence of genetic factors associated with pathogenesis of disease; the cagA gene and its product have been postulated to have a disease‐specific relationship to peptic ulcer and gastric cancer because of differential expression in these diseases compared to histological gastritis alone. Materials and Methods.Genomic DNA was amplified by PCR, using synthetic oligonucleotide primers to the cagA gene to determine the prevalence of the cagA gene in 60 H. pylori isolates obtained from well‐documented duodenal ulcer or asymptomatic gastritis patients (30 each). Results were confirmed by hybridization with a 1.4‐Kb cagA probe. Results.The expected PCR product was obtained in 90% of isolates from duodenal ulcer patients, compared to 70% of isolates from individuals with asymptomatic gastritis. The PCR products were polymorphic in size, suggesting cagA gene sequence differences among isolates. Evaluation for the presence of the cagA gene by hybridization with a 1.4‐Kb cagA probe showed a homologous product in 29 of 30 strains [96.7%; 95% confidence interval (CI) = 83–100%] from duodenal ulcer patients versus 25 of 30 strains (83.3%; 95% CI = 65–94%) obtained from individuals with asymptomatic gastritis (p= 0.19). Conclusions.The high prevalence of the cagA gene in asymptomatic gastritis suggests that it will not prove to be a useful marker to distinguish more virulent or disease‐specific H. pylori strains. The genetic heterogeneity among H. pylori strains makes PCR an unwise choice as the single method to determine prevalence of a putative virulence factor. In evaluation of the prevalence of a gene or genetic factor in a population of H. pylori, hybridization with extended probes might be important to ensure that the results are representative of the organism's genotype.
Conservation and Diversity of the Helicobacter pylori Copper‐Transporting ATPase Gene (copA) Sequence Among Helicobacter Species and Campylobacter Species Detected by PCR and RFLP
Authors: Ge Zhongming , Jiang Qin , Taylor Diane E. 
Published: February 2007

ABSTRACT Background
Helicobacter pylori is a causative pathogen of such human stomach diseases as chronic type B gastritis, ulcer, and possibly gastric carcinoma. As a co‐factor in various redox enzymes and an essential trace metal required for the synthesis of metalloproteins, copper might play a role in the pathogenesis of H. pylori. A gene, copA, associated with copper transport, has been isolated from H. pylori UA802. In this study, conservation and diversity of this gene were analyzed among some Helicobacter and Campylobacter species. Materials and Methods.Twenty‐one clinical isolates and strains of helicobacters and campylobacters were used in this study. Methods including polymerase chain reaction (PCR) amplification, restriction fragment‐length polymorphisms (RFLPs), and hybridization were employed to carry out this work. Results.The copA gene was highly conserved in all the H. pylori isolates tested (Helicobacter nemestrinae and Helicobacter felis but not in Helicobacter mustelae and the Campylobacter species), whereas the sequence downstream of the copA appears to diverge among H. pylori isolates. In addition, two restriction patterns of the PCR‐amplified copA fragments from seven H. pylori isolates and H. nemestrinae were identified, and the RFLP of H. nemestrinae was identical to that of one of the H. pylori isolate group. Conclusions.The adenosine triposphatase‐derived copper‐transporting mechanism is employed by various H. pylori strains, H. nemestrinae, H. felis, and perhaps by other Helicobacter species. The nucleotide mutations have risen in the copA gene. It appears that there is a genetic relatedness of the copA gene to H. pylori and H. nemestrinae.
Helicobacter pylori and the Surface Mucous Gel Layer of the Human Stomach
Authors: Shimizu Toshiki , Akamatsu Taiji , Sugiyama Atsushi , Ota Hiroyoshi , Katsuyama Tsutomu 
Published: February 2007

ABSTRACT BackgroundThe colonization of Helicobacter pylori in the surface mucous gel layer (SMGL) was investigated. Materials and Methods.Surgically removed stomachs were obtained from patients and included gastric ulcer (4 cases), duodenal ulcer (2), and gastric cancer (24). Five of these cases were examined at 8, 19, 28, 143, and 171 days after the end of eradication therapy. For the preservation of the SMGL, these specimens were fixed in cold Carnoy's solution, cleared in xylene, and embedded in paraffin. Serial sections were obtained and were stained by dual staining with the galactose oxidasecold thionin Schiff reaction followed by paradoxical Concanavalin A staining and immunostaining for H. pylori. Results.
H. pylori characterstically attached to surface mucous cells and colonized in the SMGL. H. pylori in the SMGL was more abundant than that attached to the surface mucous cells. The degree of H. pylori infection both on the surface of surface mucous cells and in the SMGL correlated well with the severity of gastritis. In the SMGL, this organism obviously preferred to colonize in the layer of surface mucous cell‐type mucins, and the multilaminated structure of the SMGL deteriorated markedly. Eradication of H. pylori restored the structure of the SMGL, and the inflammatory reaction decreased gradually. Conclusion.The SMGL is an indispensable site of H. pylori colonization, and this organism damaged the gastric mucosa partially by causing deterioration of the SMGL. Removal of the organism from the SMGL should be considered for eradication of this organism.
Corrected Identity of Isolates of Helicobacter Pylori Reference Strain NCTC11637
Authors: Akopyants Natalia S. , Jiang Qin , Taylor Diane E. , Berg Douglas E. 
Published: February 2007

Background.The reference strains NCTC11637 and NCTC11638 were among the very first Helicobacters ever cultured and have been distributed through national reference culture collections to researchers throughout the world. Because H. pylori is an extremely diverse species, such reference strains are invaluable as universal standards, provided that they are identified correctly.Materials and Methods. H. pylori strains (previously called “NCTC11637”) from three different sources and NCTC11638 were fingerprinted by the arbitrarily primed polymerase chain reaction (PCR) (also known as random amplified polymorphic DNA, or RAPD) method and further were characterized by NotI digestion and pulsed field gel electrophoresis of total genomic DNA (NotI‐PFGE) and by restriction of PCR‐amplified ureCD and flaA gene segments.Results.RAPD tests of two “NCTC11637” strains from different sources (CCUG17874, UA1178) indicated that they were closely related or identical to NCTC11638. Given the diversity of H. pylori strains and the high sensitivity of the RAPD method, close matches in RAPD patterns from independent clinical isolates are not expected. In contrast, the version of “NCTC11637” from the American Type Culture Collection (ATCC 43504) did not match NCTC11638 in RAPD fingerprint. Concordant results were obtained by NotI‐PFGE and by restriction of PCR amplified gene segments.Conclusions.Two unrelated versions of the reference (type) H. pylori strain NCTC11637 are in general circulation and are distinguished easily by DNA fingerprinting. One matches another reference strain, NCTC11638, whereas the other is distinct from it, as expected of independent clinical isolates. Knowing which “NCTC11637” reference strain one has could be important, especially because H. pylori strains probably are diverse in phenotypic traits that are important for colonization or disease.