bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of halothane and isoflurane on forearm blood flow in children as determined by venous occlusion plethysmography
Authors: LAIRD C.R.D. , MULHOLLAND D. , CREAN P.M. , BLACK G.W. 
Published: February 2007

SummaryComparative studies have not been made of the peripheral vascular effects of halothane and isoflurane in children. Using a water‐filled venous occlusion plethysmograph, measurements of forearm blood flow were made in 2 groups of 19 children exposed to increasing concentrations of these 2 agents. Halothane and isoflurane caused comparable and dose dependent increases in forearm blood flow and reductions in peripheral vascular resistance and arterial pressure. These findings suggest that, in younger children, reductions in peripheral vascular resistance are partly responsible for decreases in arterial pressure when lower concentrations of these agents are used.
Effect of minimizing preoperative fasting on perioperative blood glucose homeostasis in children
Authors: WELBORN L.G. , NORDEN J.M. , SEIDEN N. , HANNALLAH R.S. , PATEL R.I. , BROADMAN L. , RUTTIMANN U.E. 
Published: February 2007

SummaryTwo hundred healthy, unpremedicated children, ages 1–10 years, scheduled for elective outpatient surgery were studied in order to examine the effect of minimizing preoperative fasting on perioperative blood glucose concentrations in paediatric patients. None of the patients ingested solids after midnight. On the day of surgery, the children were assigned to one of two groups. Group A children (n= 113) were not allowed any liquids for at least 6 h prior to surgery (NPO). Children in Group B (n= 87) ingested 10 ml·kg−1 of apple juice 2–4 h prior to the induction of anaesthesia. All patients received lactated Ringer's solution intraoperatively, unless BG at induction was < 50 mg·dl−1 (2.8 m·mol·l−1) in which case dextrose 2.5% in lactated Ringer's solution was administered. None of the patients who received apple juice was hypoglycaemic during induction of anaesthesia. However, two children in the NPO group had blood glucose values ± 50 mg·dl−1 (2.8 m·mol·l−1) at the time of induction of anaesthesia. Thirteen (11%) patients in Group A and 6 (7%) patients in Group B showed either no change or a further decrease in their postoperative BG concentration as compared with their induction values. Two of 43 patients in Group A and 2 of 41 patients in Group B had gastric fluid volumes > 0.4 ml/kg. All patients in both groups had gastric pH < 2.5. This study shows that gastric fluid volume and pH following a 2–4 h fast are not different from the values measured in children who were subjected to a traditional fasting period of 6 h or longer. Moreover, apple juice consumed 2–4 h prior to surgery neither buffers gastric pH nor does it modify intraoperative glucose homeostasis in children.
Intrathecal morphine for pain control in term infants for oesophageal atresia/tracheooesophageal fistula repair
Authors: KRECHEL S.W. , HELIKSON M.A. 
Published: February 2007

SummaryThree term infants requiring oesophageal atresia with tracheo‐oesophageal fistula repair were managed with intrathecal morphine for postoperative pain control. Excellent pain control was achieved in these infants lasting 22 to 36 h. No complications were noted. As a result of pain control without respiratory depression these infants were extubated immediately postoperatively. The patients were remarkably free of retained secretions, eliminating the need for reintubation and/or repeated suctioning with the associated risk of producing a recurrent tracheo‐oesophageal fistula.
Excessively high plasma bupivacaine concentrations after tonsillar bed and adenoidal injection of 0.25% bupivacaine
Authors: BROWN R.E. , WILHOIT RANDALL D. , SAMUEL MICHAEL P. 
Published: February 2007

SummaryThe injection of local anaesthetics into the tonsillar bed has gained acceptance in the United States as a method for providing postoperative pain relief. A clinical trial was devised in which the tonsillar bed was injected at the upper and lower poles subsequent to the removal of each tonsil. In addition, a small amount of local anaesthetic was sprayed topically by the nares onto the adenoidal beds subsequent to adenoidectomy to alleviate pain from this area. Bupivacaine was used as the local anaesthetic because of its long duration of action. Despite extreme care in the performance of this study, one patient developed ventricular tachycardia subsequent to the injection of bupivacaine. Plasma bupivacaine levels were obtained after tonsillar bed infiltration and nasal instillation post tonsillectomy and adenoidectomy in each of the patients, and though most levels were below toxic ranges, one patient had high serum levels. This high serum level coincided with the development of ventricular tachycardia. On the basis of this finding, we have abandoned this technique for postoperative pain management after tonsillectomy.
The baroreceptor reflex and bradycardia in paediatric craniofacial surgery
Authors: WHITE A. P. , GOAT V. A. 
Published: February 2007

SummaryBradycardia associated with craniofacial surgery has been a recognized phenomenon for many years. The mechanism by which this reflex occurs is almost invariably attributed to the ‘trigemino‐cardiac’ reflex. This paper offers evidence that some bradycardias may result from the ‘baroreceptor reflex'.
Chickenpox: an operating room problem?
Authors: MORRISON JOHN E. 
Published: February 2007

SummaryVaricella (chicken pox), a most common disease, is rarely considered a serious entity by adult oriented anaesthetists and surgeons yet can have an extremely high morbidity and mortality in certain populations. Hospital protocols concerning postponement or cancellation of elective surgery in children suspected of harbouring the disease following exposure in daycare facilities or schools often tend to be ignored. The following is a series of three case reports illustrating different aspects of the problems confronting the anaesthetist and other operating room personnel when a child with varicella enters the surgery suite.
The effects of halothane and isoflurane on hand blood flow in children. (As determined by venous occlusion plethysmography)
Authors: MULHOLLAND D. , LAIRD C.R.D. , CREAN P.M. , BLACK G.W. 
Published: February 2007

SummaryThe effects of increasing concentrations of halothane and isoflurane were studied in two groups of twenty children aged from 2.9 to 9.8 years using the technique of water filled venous occlusion plethysmography. Halothane significantly increased hand blood flow and reduced vascular resistance only at a concentration of 0.5 MAC. However, isoflurane caused significant dose related increases in hand blood flow and reductions in hand vascular resistance at 0.5, 1.0 and 1.5 MAC. These findings suggest that in children isoflurane has a more potent vasodilator effect on the skin circulation than halothane.
Intraoperative somatosensory evoked potential monitoring in achondroplasia
Authors: CUNNINGHAM MICHAEL J. , FERRARI LYNNE R. , KEARSE LEE A. , McPECK KATHLEEN 
Published: February 2007

SummarySurgical airway intervention in children with achondroplastic dwarfism poses potential neurological risk secondary to the neck manipulation required for tracheal intubation and operative head positioning. This is particularly true of achondroplastic dwarfs with radiographically documented foramen magnum and spinal canal stenosis. In these children, upper extremity somatosensory evoked potential monitoring establishes the integrity of sensory conduction from peripheral nerve to cortex, providing intraoperative notification of neurologically significant cervicomedullary compression during laryngoscopy and surgical positioning.
Vecuronium titration for muscle relaxation in myotonic dystrophy
Authors: DIEFENBACH CHRISTOPH , ABEL MANFRED , BUZELLO WALTER 
Published: February 2007

SummaryA 14‐year‐old boy with pronounced myotonic dystrophy and cardiac malformation had a normal ED95 (53 μg·kg−1) of vecuronium, whereas the recovery index (25‐75% twitch recovery) was three times as long as in the absence of neuromuscular disease. We conclude that in young patients with dystrophic muscle disease individual titration of the muscle relaxant with the aid of a nerve stimulator does not preclude a considerable delay in the recovery of neuromuscular transmission.
Pectus excavatum repair in a patient with prune belly syndrome
Authors: HEISLER DAVID B. , LEBOWITZ PHILIP , BARST SAMUEL M. 
Published: February 2007

SummaryWe describe the anaesthetic management of a child with ‘Prune Belly’ syndrome who was presented for repair of pectus excavatum. In addition to having severe restrictive lung disease, the patient was also asthmatic. Prior surgical procedures had resulted in long term debilitation because of pulmonary complications. Principles of anaesthetic management first described more than twenty years ago were utilized and combined with an effective perioperative pain management plan to provide for a smooth and satisfactory postoperative outcome. Repair of the patient's pectus excavatum deformity improved his respiratory mechanics, while the use of thoracic epidural anaesthesia in the immediate perioperative period allowed rapid improvement in pulmonary function.
Anticholinergic prophylaxis does not prevent emesis following strabismus surgery in children
Authors: CHISAKUTA A. M. , MIRAKHUR R. K. 
Published: February 2007

SummaryOne hundred and twenty‐one children were studied in this prospective, randomized double‐blind, placebo‐controlled comparison of the effectiveness of anticholinergic prophylaxis for the prevention of emetic symptoms following strabismus surgery. The children were allocated to three groups, to receive placebo (n= 40), glycopyrrolate (n= 40) or atropine (n= 41). The incidence of intraoperative oculocardiac reflex (OCR) and of postoperative emetic symptoms for 24 h was recorded. The incidence of OCR was 55% in the placebo group compared with 5% and 2% in the glycopyrrolate and atropine groups respectively (P < 0.05). Thirty percent (12/40) of patients in the placebo group, 25% (10/40) in the glycopyrrolate group, and 22% (9/41) in the atropine group experienced nausea and/or vomiting (difference not significant). It is concluded that prophylactic administration of anticholinergic agents during strabismus surgery in children despite being effective against the occurrence of the oculocardiac reflex, does not reduce the incidence of emetic symptoms.
Propofol reduces the incidence of vomiting after tonsillectomy in children
Authors: M. BARST SAMUEL , MARKOWITZ AVRAM , YOSSEFY YORAM , ABRAMSON ALLAN , LEBOWITZ PHILIP , S. BIENKOWSKI ROBERT 
Published: February 2007

SUMMARYWe compared the effect of a propofol‐based anaesthetic to an isoflurane‐based anaesthetic on the incidence of postoperative vomiting in children following tonsillectomy. Thirty‐nine children were enrolled in the study and randomized to receive one of the proposed anaesthetics. All patients underwent a mask induction with halothane, nitrous oxide, and oxygen. Intravenous access was established and all children received fentanyl (2–4 μg·kg‐1) i.v., mivacurium (0.3 mg·kg‐1) i.v. and acetaminophen (10–15 mg·kg‐1) p.r. Following tracheal intubation, patients received either isoflurane (0.8–1.6%) or propofol (120–180 μg·kg‐1 min‐1) i.v. with nitrous oxide 70%/oxygen 30% for maintenance of anaesthesia. Vital signs were maintained within 20% of baseline. All patients were extubated in the operating room. PACU nursing staff recorded episodes of vomiting for 4–6 h prior to discharge. A telephone interview the following day was also used for data recovery. Age, sex, and duration of the procedure were not significantly different between the two study groups. Of 19 patients who received propofol, four vomited (21%); in contrast, of the 20 patients who received isoflurane, 11 vomited (55%). This difference is significant (P= 0.048 two‐tailed Fisher's Exact Test). These data suggest that using propofol for anaesthesia can diminish the incidence of vomiting following tonsillectomy.
Paediatric ventilatory effects of morphine and buprenorphine revisited
Authors: OLKKOLA KLAUS , LEIJALA MAURI , MAUNUKSELA EEVA‐LIISA 
Published: February 2007

SUMMARYThe study describes long term ventilatory effects of 50 or 100 μg·kg‐1 of morphine or 1.5 or 3.0 μg·kg‐1 of buprenorphine when given in repeated intravenous (i.v.) doses, in a double blind fashion, to achieve equal levels of analgesia after thoracotomy. The patients were 56 children, six months to six years of age. Ventilatory rate (VR) was measured over the 24 h study period, and arterial carbon dioxide tension (Paco2) was measured on arrival in the Paediatric Intensive Care Unit (PICU) and at 1, 6, 12 and 18 h. In the buprenorphine groups VRs progressively decreased during the first 2 h and remained significantly lower (P < 0.05) than in the morphine groups for 7 h. For the rest of the study period there were no differences. The Paco2 values did not differ significantly at any point. For safety, prolonged observation of children is needed after intravenous administration of buprenorphine to ensure the ventilatory rate has stabilized.
The Cost of High Unemployment
Authors: Fraser Neil , Sinfield Adrian 
Published: February 2007

In response to R. A. B. Leaper's challenge in the last issue of this journal we present a report which we have just prepared for the BBC North‐East. We believe that a better understanding of the costs of high unemployment to the country is needed to inform decisions on how much we can afford to pay to tackle the problem. In the final section of the paper we show how this evidence can be of value in costing policy options.The last detailed costings of unemployment were published in 1982 for the financial year 1981/82. In February 1982 it appears that a political decision was taken not to publish the latest Treasury estimate updating their 1981 calculations. Since then numerous parliamentary questions on the subject have received very limited answers disputing the validity of the whole exercise.
Care for Elderly People in the European Community
Authors: Henrard Jean‐Claude 
Published: February 2007

AbstractAll EEC countries are faced with an ageing population, which means an increase of people in some way handicapped in everyday activities. A comparison of the solutions adopted by several EEC countries in the sectors of housing, home care services, residential and nursing homes shows that a real medico‐social policy has been worked out only in Denmark and the Netherlands. In France and the United Kingdom, public authorities have certainly defined policies which lay claim to providing overall coverage but they have not provided corresponding resources. In Germany and in Italy there is no clearly defined policy. Here we discuss the various factors which may account for these differences.
Tenure Differences in Income and Housing Benefit in Later Life
Authors: Gibbs Ian , Kemp Peter 
Published: February 2007

AbstractThe first half of this article examines the distribution of income among older people in different housing tenures using secondary analysis of the 1988 Family Expenditure Survey (FES). The use of the term “older household” refers to those where the head of household is aged 55 and over. Income has been adjusted in order to take account of the size and composition of elderly households. The second half of the article examines the effects on the distribution of income when the definition of income is widened to include housing benefit.In 1988 the average weekly income of older households who were owner occupiers was twice that of older households who were renters. While the addition of housing benefit to the definition of income has only a marginal effect in reducing income inequality among all older households it had a more significant impact in reducing income inequalities among older renters more of whom, in comparison to older owner occupiers, were located in the lower income groups.
Family Leave Policy in the United States
Authors: Wisensale Steven K. 
Published: February 2007

AbstractBetween 1987 and 1993 twenty states and the federal government adopted family leave policies. None included any wage replacement. The similarities and differences among these policies are discussed within the context of six major categories: employees covered, company size, length of leave, eligibility, coverage of benefits, and job guarantee. Also discussed is the feasibility of adopting some type of wage replacement as well as the future of family leave in light of the changing demographics of America's families.
Professional Power and Managerial Control: The Case of GP Assessments of the Over‐75S
Authors: Glendinning Caroline , Chew Carolyn , Wilkin David 
Published: February 2007

ABSTRACTThe creation of Family Health Services Authorities from the old Family Practitioner Committees in 1990 marked a turning point in the introduction of managerialism into primary health care services. One of the FHSAs' first responsibilities was the administration of a new Contract for General Practitioners, which had generated considerable opposition from within the profession. This Contract included a new requirement for GPs to make, each year, a written offer of a health check, at home, to all patients aged 75 and over.Particular scepticism was expressed by GPs about the value and effectiveness of routine annual assessments's of this kind. Drawing on interviews with FHSA managers and their professional medical and nursing advisors, this paper examines the strategies adopted by FHSAs in tackling the administration of this particularly controversial requirement. Although apparently effective in the short‐term, the paper concludes that these strategies may have considerable longer‐term short‐comings. The constraints and pressures experienced by FHSAs and the strategies employed to deal with them provide a useful insight into the tensions generated in the course of developing a managerial relationship with professional practitioners who have traditionally enjoyed very high levels of autonomy and independence.
Probation Partnerships, Voluntary Action and Community Justice
Authors: Nellis Mike 
Published: February 2007

ABSTRACTHaving been offered — and prepared to accept — a “centre‐stage”role in the operation of the criminal justice system as recently as 1991, the Probation Service in England and Wales seems increasingly to be marginalized by politicians who, in a more punitive climate, have changed their minds about what is expected of it. As a probation spokesperson has recently said: “the big vision has gone”. One strand of policy which the Probation Service was expected to develop in 1991 was increased partnership with voluntary organizations, but, although progress has been made, it is a policy about which the Service has been very ambivalent, fearing that it may lead in the longer term to privatization of their work. This paper will outline the origins and implications of the policy, note how some local Services have so far responded to it, and suggest that, if pursued in certain fields of activity, partnership could contain an alternative vision to the one that has been lost.
A Different Sort of Doctor: The Police Surgeon in England and Wales
Authors: Bradshaw Yvonne , Savage Stephen P. , Moon Graham , Kelly Kathleen 
Published: February 2007

ABSTRACTPolice surgeons occupy a neglected and potentially influential role in the criminal justice system, falling between medical and legal functions. This article considers the implications of this role which operates at the interface of two major areas of social policy concern. Drawing evidence from a unique survey of police surgeons in England and Wales, it considers specifically, the professional background of police surgeons, the administration and management of the police surgeon service, surgeons' attitudes to aspects of their professional practice and the impact of this role on civil liberties. The paper concludes with a brief discussion of the possibilities for the reform of the police surgeon service.
Oral ulceration: an unusual manifestation of Churg–Strauss syndrome
Authors: Delplace D , Da Costa LM , Goffin L , ME Wechsler , Sass U , André J , Dangoisse C , Song M 
Published: February 2007

AbstractChurg–Strauss Syndrome (CSS) is a relatively rare entity characterized by asthma, transient pulmonary infiltrates, eosinophilia and systemic vasculitis. Oral ulceration is a possible clinical manifestation of some systemic vasculitides, such as Wegener's granulomatosis (WG) or giant cell arteritis, but has never been reported with Churg–Strauss syndrome. We report the first observation of a palatine ulceration in a 15‐year‐old girl with Churg–Strauss syndrome.
Including everyone in research: The Burton Street Research Group
Authors: Abell Simon , Ashmore Jackie , Beart Suzie , Brownley Peter , Butcher Adam , Clarke Zara , Combes Helen , Francis Errol , Hayes Stefan , Hemmingham Ian , Hicks Kerry , Ibraham Amina , Kenyon Elinor , Lee Darren , McClimens Alex , Collins Michelle , Newton John , Wilson Dorothy 
Published: February 2007

Accessible summary

We are people with and without learning disabilities doing research together.
In this paper we talk about the good bits and the bad bits of doing research together.

SummaryIn our paper we talk about what it is like to be a group of people with and without learning disabilities researching together. We describe the process of starting and maintaining the research group and reflect on the obstacles that we have come across, and the rewards such research has brought us. Lastly we put forward some ideas about the role of professionals in such a group that we hope people might find useful.
A COMPARISON OF SKIN POTENTIAL AND SKIN RESISTANCE RESPONSES AS MEASURES OF EMOTIONAL RESPONSIVITY
Authors: Burstein Kenneth R. , Fenz Walter D. , Bergeron James , Epstein Seymour 
Published: February 2007

ABSTRACTThe purpose of this study was to compare gradients of skin resistance (SR) and skin potential (SP) responses generated by differing degrees of psychologically disturbing stimuli, and to determine the significance of the different wave forms of skin potential.SR and SP were simultaneously recorded during a word‐association test that included three levels of psychologically disturbing verbal stimuli.In addition to the a and b waves of the SP response, a second negative wave form, a2, was recorded.SR and all SP wave forms yielded positive gradients as a function of increasing stimulus intensity. Gradients based upon SR and total SP were close to identical. Magnitude measures, which include zero responses, of the SP wave forms yielded steeper gradients than measures of amplitude or frequency. The relative contribution of different SP wave forms to total SP varied with stimulus level.
THE EFFECTS OF EPINEPHRINE AND NOREPINEPHRINE ON AN ASPECT OF COLOR VISION
Authors: Keeler Martin H. , Doehne Edward F. 
Published: February 2007

ABSTRACTWith a test involving image and after‐image relation, it is demonstrated that epinephrine differentially affects reactivity to green (530 mμ) and red (625mμ) stimuli and that most of the response is accounted for by altered response to the green stimulus. Norepinephrine effect was in the same direction but not statistically significant and might be accounted for by endogenous epinephrine secretion.