bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parental presence during induction enhances the effect of oral midazolam on emergence behavior of children undergoing general anesthesia
Authors: Arai Y.‐C. P. , Ito H. , Kandatsu N. , Kurokawa S. , Kinugasa S. , Komatsu T. 
Published: June 2007

Background:  Pre‐anesthetic anxiety and emergence agitation are major challenges for anesthesiologists in pediatric anesthesia. Thus, sedative premedication and parental presence during induction of anesthesia (PPIA) are used to treat pre‐anesthetic anxiety in children. The aim of the present study was to test if a combination of mother presence and midazolam premedication is effective for improving emergence condition in children undergoing general anesthesia.Methods:  Sixty children were allocated to one of three groups: a sedative group (0.5 mg/kg oral midazolam), a PPIA group or a sedative and PPIA group. When anesthesia was induced with 7% sevoflurane in 100% oxygen, qualities of mask induction were rated. Anesthesia was maintained with sevoflurane (1.5–2.5%) in 60% oxygen and intravenous fentanyl 4 μg/kg. During emergence from anesthesia, the score of the child’s emergence behavior was rated.Results:  The children in the midazolam group showed a better quality of mask induction compared with those in the PPIA group, the addition of parental presence to oral midazolam did not provide additional improvement of mask induction. In contrast, the children in the midazolam + PPIA group were less agitated than those in the other groups at emergence from anesthesia.Conclusion:  Parental presence during induction of anesthesia enhanced the effect of oral midazolam on emergence behavior of children undergoing general anesthesia.
Ultrasound controlled nerve stimulation in the elbow region: high currents and short distances needed to obtain motor responses
Authors: Sauter A. R. , Dodgson M. S. , Stubhaug A. , Cvancarova M. , Klaastad Ø. 
Published: June 2007

Background:  Electrical nerve stimulation is commonly used to perform peripheral nerve blocks. The purpose of this study was to investigate the relation between stimulating currents and the distance between the needle‐tip and stimulated nerves.Methods:  In 18 volunteers the radial and ulnar nerves were stimulated in the elbow region from opposite directions. Needle‐to‐nerve distances were measured by high‐frequency ultrasound when motor responses to electrical stimulation were elicited with currents of 5, 2, 1 and 0.5 mA and impulse widths of 0.1 ms. Additionally, current thresholds for nerve stimulation were identified when the needle‐tip was in contact with the nerve.Results:  The ulnar nerves responded to electrical stimulation from a significantly greater distance than the radial nerves. Threshold levels at needle‐to‐nerve contact ranged from 0.4 to 4.5 mA for the radial nerve and from 0.32 to 2.0 mA for the ulnar nerve. They were significantly lower for the ulnar nerve than for the radial nerve. Currents required to obtain neuromuscular responses often exceeded the recommended current levels for nerve stimulation.Conclusions:  Our results show significant differences in the ease of stimulation between the radial and ulnar nerves. High current thresholds and short nerve‐to‐needle distances were often needed to obtain neuromuscular responses in two nerves in the elbow region.
Physiological restitution after night‐call duty in anaesthesiologists: impact on metabolic factors
Authors: Malmberg B , Persson R , Jönsson B. A. G. , Erfurth E.‐M , Flisberg P , Ranklev E , ØRbaek P 
Published: June 2007

Background: Several studies have shown impaired mental well‐being and performance in physicians work on call, but knowledge of the physiological effects is scarce. The aims of the present study were to investigate if there was a metabolic stress response in the restitutional phase after night‐call duty, indicating potential negative health effects, and determine whether there were differences between physician specialities.Methods: Anaesthesiologists (n= 19) were compared with paediatricians/ear, nose and throat (ENT) surgeons (n= 18). On an ordinary workday, 1 and 3 days after work on night call, blood samples were taken for analysis of glucose, thyroid‐stimulating hormone (TSH), free thyroxine, testosterone, insulin growth factor‐1 (IGF‐1), high‐ and low‐density lipoprotein cholesterol (HDL and LDL), triglycerids (TG) and insulin. Saliva cortisol was sampled on an ordinary working day, a day including 16‐h night call, the third day following, and for anaesthesiologists also on a day off work.Results: TSH differed significantly between days in both groups, with a 26% lower level 1 day after on‐call duty (P< 0.001). A 48% cortisol rise in the morning preceding night duty was found for paediatricians/ENT surgeons (P< 0.01).Conclusion: The significant dip in TSH level 24 h after night‐call duty indicates a metabolic effect of working on night call and should be studied further. However, the levels were within the normal range and the overall results do not imply any serious metabolic changes and only minor differences were seen between specialist groups.
OESTROGEN AND NIGROSTRIATAL DOPAMINERGIC NEURODEGENERATION: ANIMAL MODELS AND CLINICAL REPORTS OF PARKINSON'S DISEASE
Authors: Liu Bin , Dluzen Dean E 
Published: June 2007

SUMMARY

The exact nature of oestrogen (positive, negative or no effect) in the dopaminergic neurodegenerative disorder Parkinson's disease is controversial.
In the present review, we summarize the data on oestrogen and nigrostriatal dopaminergic neurodegeneration in animal models and clinical reports of Parkinson's disease.
Most animal studies support the ability of oestrogen to function as a neuroprotectant against neurotoxins that target the nigrostriatal dopaminergic system.
Retrospective and prospective clinical studies generally support the findings from animal studies that oestrogen exerts a positive, or, at worst, no effect, in Parkinson's disease.
Oestrogen was chosen as one of the 12 neuroprotective compounds to be attractive candidates for further clinical trials (Phase II or III) in 2003.
CAN NITRIC OXIDE‐GENERATING COMPOUNDS IMPROVE THE OXIDATIVE STRESS RESPONSE IN EXPERIMENTALLY DIABETIC RATS?
Authors: Mohamadin Ahmed MA , Hammad Lamiaa NA , El‐Bab Mohamed Fath , Gawad Hala S Abdel 
Published: June 2007

SUMMARY

The present study was designed to evaluate the protective effects of the nitric oxide (NO)‐generating compounds l‐arginine (l‐Arg) and sodium nitroprusside (SNP) on oxidative stress markers in streptozotocin (STZ)‐diabetic rats.
Diabetes was induced after a single intraperitoneal injection of STZ (60 mg/kg). Rats were divided into non‐diabetic (control), diabetic and treated diabetic groups. The treated diabetic groups were supplemented with l‐Arg (300 mg/kg), SNP (3 mg/kg per day) or glibenclamide (0.6 mg/kg per day) orally for 4 weeks.
At the end of the experiment, fasted rats were killed by cervical decapitation. Blood was collected for estimation of glucose, haemoglobin, glycosylated haemoglobin (HbA1c), total cholesterol, high‐density lipoprotein–cholesterol and triglycerides. Thiobarbituric acid‐reactive substances (TBARS; an index of lipid peroxidation), superoxide dismutase, glutathione peroxidase, catalase, nitrate/nitrite (NOx) and reduced glutathione (GSH) were estimated in liver and kidney homogenates.
A significant increase was observed in plasma glucose levels and HbA1c, with a concomitant decrease in haemoglobin levels, in diabetic rats. These alterations reverted back to near normal after treatment with the NO‐generating compounds. A loss of bodyweight, polydipsia, polyphagia and elevated levels of serum cholesterol and triglycerides were observed in diabetic rats. Hyperglycaemia was accompanied by a significant increase in tissue TBARS and a decrease in NOx, GSH and anti‐oxidant enzymes, whereas, supplementation with l‐Arg and SNP significantly reduced TBARS levels and increased GSH and anti‐oxidant enzyme activities. Linear regression analysis indicated that blood glucose and TBARS were had a significant positive correlation with HbA1c, whereas a negative correlation was observed between GSH and NOx.
It is concluded that NO‐generating compounds improve most of the biochemical abnormalities and anti‐oxidant levels in diabetic rats. The beneficial effects of NO‐generating compounds can be attributed to the generation of NO and/or enhanced anti‐oxidant enzyme activities.
CHRONIC SALT LOADING AND CARDIOVASCULAR‐ASSOCIATED CHANGES IN EXPERIMENTAL DIABETES IN RATS
Authors: Maeda CY , Schaan BD , Oliveira EM , Oliveira VL , De Angelis K , Irigoyen MC 
Published: June 2007

SUMMARY

High‐sodium intake may increase blood pressure and diabetes is a salt‐sensitive condition. In the present study, we evaluated cardiovascular changes and their neurohumoral mechanisms in streptozotocin (STZ)‐diabetic rats that underwent chronic salt loading.
We studied male Wistar rats (150–280 g) 14 days after the injection of either STZ (50 mg/kg, i.v.; D; n = 18) or citrate buffer (C; n = 16). After the induction of diabetes, animals were maintained for 14 days with free access to standard rat chow and tap water (C and D groups) or 1% NaCl solution (C‐S and D‐S groups). We conducted two experiments. Experiment 1 consisted of basal arterial pressure (AP) measurement (30 min) followed by the evaluation of AP responsiveness to phenylephrine and sodium nitroprusside. One day later, with the rats anaesthetized, a blood sample was collected to test for glycaemia, plasma angiotensin‐converting enzyme (ACE) activity and renin. Kidneys were removed for the determination of tissue ACE activity. Experiment 2 comprised 24 h urine collection followed by 3 days of cardiovascular records, which consisted of a 30 min basal AP measurement, followed by injection of blockers of the vasopressin system, the renin–angiotensin system (RAS) and the sympathetic system. Basal haemodynamic data, baroreflex evaluation and AP responses to blockade of the vasopressin system with vasopressin V1 receptor antagonist (aAVP; 10 mg/kg, i.v.), the RAS by losartan (10 mg/kg, i.v.) and the sympathetic system by hexamethonium (20 mg/kg, i.v.) were determined.
Glycaemia was similar between C and C‐S (P = 0.612) and between D and D‐S (P = 0.552), but higher in diabetic compared with non‐diabetic rats (P < 0.0001). The D‐S rats had an increment of 24% in mean AP compared with D (120 ± 4 vs 97 ± 2 mmHg, respectively; P = 0.0001), which was not seen in C‐S compared with C rats. A positive association was noted between urinary sodium and mean AP (r = 0.37; P = 0.04). Plasma renin was undetectable in D‐S rats. The response to acute drug blockade of vasopressin and the RAS was similar among groups, but hexamethonium elicited a more pronounced decrease in AP in D‐S compared with D rats (P = 0.001).
The main neurohumoral mechanisms of salt‐induced cardiovascular changes in STZ‐diabetes are increased sodium and vascular sensitivity to adrenergic stimuli, which act in combination to produce a final result of higher AP levels, a finding not observed in control rats. Baroreflex derangements induced by diabetes were not affected by salt overload.
ARTERIAL STIFFNESS AND CARDIOVASCULAR OUTCOME
Authors: Zoungas Sophia , Asmar Roland P 
Published: June 2007

SUMMARY

Studies have reported an association between arterial function indices and cardiovascular risk factors, as well as the risk of incident cardiovascular events, including coronary heart disease and stroke.
The data are overwhelmingly in favour of an independent role for aortic pulse wave velocity in predicting fatal and non‐fatal cardiovascular events in healthy and diseased populations and in the evaluation of cardiovascular risk.
Augmentation index may independently predict all‐cause mortality and cardiovascular events in coronary and end‐stage renal disease patients, but some outcome studies have questioned its usefulness in hypertensive subjects and dialysis patients.
Systemic arterial compliance, to this time, has not been shown to independently predict cardiovascular outcome.
Future cardiovascular risk is greatly modified by prior disease and risk factors; the greatest additional value in measuring arterial stiffness and compliance may be in those with little or no end‐organ disease.
HEREDITARY AND ENVIRONMENTAL INFLUENCES ON ARTERIAL FUNCTION
Authors: Hayward CS , Benetos A 
Published: June 2007

SUMMARY

With the ageing population and increasing heart failure, arterial function has been shown to contribute to cardiovascular risk because of its adverse effects on ventriculovascular coupling. Population studies have confirmed independent prognostic information of arterial stiffening on cardiovascular survival.
The term ‘arterial function’ encompasses a range of phenotypes, including measures of arterial structure/remodelling, measures of arterial wall mechanics, surrogate measures of stiffness and of wave reflection. There exists significant interaction between these measures and none is truly independent of the others. Added to this complexity is the recognition that, although arterial function has a strong genetic component, quantification requires a range of techniques from twin to family and population studies.
The contribution of heritability is often derived from statistical models with input from genomic scanning and candidate gene studies. Studies to date confirm a significant heritable component for the majority of phenotypes examined. However, it has also been recognized that the factors involved in blood pressure maintenance are likely to be separate to those in arterial structural degeneration with ageing. Candidate genes for arterial function go beyond those of the sympathetic and renin–angiotensin systems and include genes involved in signalling pathways and extracellular matrix modulation.
The present review examines the evidence for heritability of the major arterial function phenotypes with environmental and ageing modulation. A brief overview of the impact of atherosclerotic risk factors on arterial function is included.
AGE, HYPERTENSION AND ARTERIAL FUNCTION
Authors: McEniery Carmel M , Wilkinson Ian B , Avolio Albert P 
Published: June 2007

SUMMARY

Ageing exerts a marked effect on the cardiovascular system and, in particular, the large arteries. Using a variety of techniques to assess arterial stiffness, many cross‐sectional studies have demonstrated a significant relationship between age and aortic stiffness, although the age‐related changes observed in peripheral arteries appear to be less marked.
The relationship between arterial stiffness and hypertension is more complex. The distending, or mean arterial, pressure is an important confounder of measurements of arterial stiffness and, therefore, must be taken into consideration when assessing arterial stiffness in hypertensive subjects or investigating the effect of antihypertensive agents. Current methods for correcting for differences in distending pressure involve pharmacological manipulation, statistical correction or mathematical manipulation of stiffness indices.
Many studies have provided evidence that both peripheral (muscular) and central (elastic) arteries are stiffer in subjects with mixed (systolic/diastolic) hypertension compared with normotensive subjects. However, it is unclear to what extent differences in mean arterial pressure explain the observed differences in hypertensive subjects. In contrast, isolated systolic hypertension is associated with increased aortic, but not peripheral artery, stiffness, although the underlying mechanisms are somewhat unclear.
Traditional antihypertensive agents appear to reduce arterial stiffness, but mostly via an indirect effect of lowering mean pressure. Therefore, therapies that target the large arteries to reduce stiffness directly are urgently required. Agents such as nitric oxide donors and phosphodiesterase inhibitors may be useful in reducing stiffness via functional mechanisms. In addition, inhibitors or breakers of advanced glycation end‐product cross‐links between proteins, such as collagen and elastin, hold substantial promise.
SEX HORMONES AND THE CARDIOVASCULAR SYSTEM: EFFECTS ON ARTERIAL FUNCTION IN WOMEN
Authors: Teede HJ 
Published: June 2007

SUMMARY

It has long been hypothesized that oestrogen may be cardioprotective. This hypothesis is supported by diverse and comprehensive mechanistic studies in animals and humans. Consistently, in observational studies, oestrogen use in post‐menopausal women significantly reduced cardiovascular disease. Contrastingly, large interventional trials focusing on chronic disease prevention in older post‐menopausal women have suggested neutral (oestrogen alone) or adverse (combined oestrogen/progestin preparations) cardiovascular effects.
The negative initial interpretation and extrapolation of the early randomized, controlled interventional trials, primarily the Women's Health Initiative, has recently been theoretically reconciled with the positive mechanistic and observational studies. As a new interventional literature emerges, it has been suggested that if oestrogen is used from menopause onwards it is likely to be protective, but if instituted after endothelial damage has occurred in an oestrogen‐deficient post‐menopausal state, the beneficial vessel wall effects are not observed and the procoagulant effects result in overall increased cardiovascular risk.
The present article reviews the literature on arterial function and oestrogen use in the setting of the early endothelial protection theory. This theory is generally supported by the data on oestrogen effects on arterial function. In general, in studies of premenopausal women the effects of oestrogen were positive, with similar benefits noted if oestrogen was used early after menopause. However, where hormone therapy was commenced some years after menopause, the beneficial effects on arterial function were not observed. In clinical practice, hormone therapy is primarily used at menopause for the treatment of menopausal symptoms. The data on arterial function reviewed herein, along with emerging interventional human studies, suggest that the cardiovascular effects of this practice are not adverse.
High intraspecific recombination rate in a native population of Candidatus Pelagibacter ubique (SAR11)
Authors: Vergin Kevin L. , Tripp H. James , Wilhelm Larry J. , Denver Dee R. , Rappé Michael S. , Giovannoni Stephen J. 
Published: June 2007

SummaryRecombination is an important process in microbial evolution. Rates of recombination with extracellular DNA matter because models of microbial population structure are profoundly influenced by the degree to which recombination is occurring within the population. Low rates of recombination may be sufficient to ensure the lateral propagation of genes that have a high selective advantage without disrupting the clonal pattern of inheritance for other genes. High rates of recombination potentially can obscure clonal patterns, leading to linkage equilibrium, and give microbial populations a population genetic structure more akin to sexually interbreeding eukaryotic populations. We examined eight loci from nine strains of candidatus Pelagibacter ubique (SAR11), isolated from a single 2L niskin sample of natural seawater, for evidence of genetic recombination between strains. The Shimodaira–Hasegawa test revealed significant phylogenetic incongruence in seven of the genes, indicating that frequent recombination obscures phylogenetic signals from the linear inheritance of genes in this population. Statistical evidence for intragenic recombination was found for six loci. An informative sites matrix showed extensive evidence for a widespread breakdown of linkage disequilibrium. Although the mechanisms of genetic transfer in native SAR11 populations are unknown, we measured recombination rates, ρ, that are much higher than point mutation rates, θ, as a source of genetic diversity in this clade. The eukaryotic model of species sharing a common pool of alleles is more apt for this SAR11 population than a strictly clonal model of inheritance in which allelic diversity is controlled by periodic selection.
Initial clinical evaluation of a new pneumatic intracorporeal lithotripter
Authors: Rané Abhay , Kommu Sashi S. , Kandaswamy S.V. , Rao Pradeep , Aron Monish , Kumar Rajeev , Gupta Narmada 
Published: June 2007

OBJECTIVETo test the clinical efficacy of the StoneBreakerTM (LMA Urology, Gland, Switzerland), a novel device which is much more compact and ergonomic than other current intracorporeal pneumatic lithotripters, and more powerful, generating contact pressures of up to 2.9 MPa, thereby enabling better pneumatic fragmentation and removal of stones during percutaneous nephrostolithotomy (PCNL), ureteroscopic stone fragmentation (USF) and vesical stone lithotripsy (VL).PATIENTS AND METHODSWe prospectively evaluated 102 patients, comprising 49 PCNLs, 48 USFs and 5 VLs, treated using the StoneBreaker. The stone size, position, number of shocks required to fragment the stone to effect complete clearance, and degree of retropulsion were documented in each case; any evidence of urothelial trauma was noted.RESULTSAll stones were satisfactorily fragmented and all patients rendered stone‐free. Very few shocks were required, and documented retropulsion was minor. There was no evidence of consequential urothelial trauma at the end of any procedure.CONCLUSIONThe StoneBreaker appears to be a safe, effective, robust and compact device for intracorporeal lithotripsy.
Evaluation of dynamic lymphoscintigraphy and sentinel lymph‐node biopsy for detecting occult metastases in patients with penile squamous cell carcinoma
Authors: Hadway Paul , Smith Yuko , Corbishley Cathy , Heenan Susan , Watkin Nicholas A. 
Published: June 2007

OBJECTIVETo evaluate the introduction of dynamic lymphoscintigraphy and sentinel lymph‐node (SLN) biopsy (used to detect occult lymph node metastases in patients with penile cancer and clinically impalpable inguinal lymph nodes at presentation) at a UK tertiary referral centre for penile cancer.PATIENTS AND METHODSIn all, 75 patients with penile squamous cell carcinoma of stage T1, grade ≥ 2, and unilateral or bilateral impalpable groin nodes, were prospectively enrolled over a 2‐year period. Patients underwent lymphoscintigraphy with 99mtechnetium‐labelled nanocolloid which was injected intradermally around the tumour or into the distal penile shaft skin. Four hours later, the SLN(s) were identified during surgery using a hand‐held γ‐probe and intradermal injections with blue dye. Completion lymph node dissection was subsequently used in patients with tumour‐positive SLNs.RESULTSIn all, 255 SLNs were removed from 143 groins; all excised nodes had taken up the radioactive marker, and the blue dye was evident in 87%. Eighteen of 75 (24%) patients and 21 of 143 groins (15%) had a tumour‐positive SLN. All but one patient went on to completion lymph node dissection. Three of these 18 (17%) had further disease in other than SLNs. Six of 143 (4%) groins developed minor complications. One false‐negative result was reported at a median (range) follow‐up of 11 (2–24) months.CONCLUSIONThis technique is feasible for managing penile cancer in a UK tertiary referral centre. The initial results suggest that it can accurately identify the SLN(s), which can then be removed for pathological review with minimal morbidity.