bluuebunny/crossref_metadata_2025_split huggingface dataset:
The response of photosynthesis and stomatal conductance to rising [CO2]: mechanisms and environmental interactions
Authors: AINSWORTH ELIZABETH A. , ROGERS ALISTAIR 
Published: February 2007

ABSTRACTThis review summarizes current understanding of the mechanisms that underlie the response of photosynthesis and stomatal conductance to elevated carbon dioxide concentration ([CO2]), and examines how downstream processes and environmental constraints modulate these two fundamental responses. The results from free‐air CO2 enrichment (FACE) experiments were summarized via meta‐analysis to quantify the mean responses of stomatal and photosynthetic parameters to elevated [CO2]. Elevation of [CO2] in FACE experiments reduced stomatal conductance by 22%, yet, this reduction was not associated with a similar change in stomatal density. Elevated [CO2] stimulated light‐saturated photosynthesis (Asat) in C3 plants grown in FACE by an average of 31%. However, the magnitude of the increase in Asat varied with functional group and environment. Functional groups with ribulose‐1,5‐bisphosphate carboxylase/oxygenase (Rubisco)‐limited photosynthesis at elevated [CO2] had greater potential for increases in Asat than those where photosynthesis became ribulose‐1,5‐bisphosphate (RubP)‐limited at elevated [CO2]. Both nitrogen supply and sink capacity modulated the response of photosynthesis to elevated [CO2] through their impact on the acclimation of carboxylation capacity. Increased understanding of the molecular and biochemical mechanisms by which plants respond to elevated [CO2], and the feedback of environmental factors upon them, will improve our ability to predict ecosystem responses to rising [CO2] and increase our potential to adapt crops and managed ecosystems to future atmospheric [CO2].
Topical anaesthesia in haemodialysis: Evaluation of topical anaesthesia with lidocaine during vascular access in children undergoing long‐term haemodialysis for chronic renal failure
Authors: Türkmen Mehmet , Kavukçu Salih , Soylu Alper , Ay Naim , Sevinç Nilgün , Sersan Ruhsan 
Published: February 2007

Türkmen M, Kavukçu S, Soylu A, Ay N, Sevinç N, Sersan R. International Journal of Nursing Practice 1997; 3: 79–83 Topical anaesthesia in haemodialysis: Evaluation of topical anaesthesia with lidocaine during vascular access in children undergoing long‐term haemodialysis for chronic renal failure Children with chronic renal failure are frequently exposed to painful invasive procedures. Ointments containing lignocaine‐prilocaine, when used before intravenous punctures, have been reported to lessen the pain sensation. The aim of this study was to interpret the effectiveness of lidocaine 2.5% ointment in preventing pain when used before venous and arterial punctures in children undergoing a haemodialysis programme for chronic renal failure. Eight children were included in this study. The pain level was identified by the patients using a linear analogue scale. When topical anaesthetic and placebo were compared, there was no statistical difference in interpretation of pain during arterial (P>0.4), venous (P>0.375) or both (P>0.4) procedures. We conclude that lidocaine 2.5% ointment is not effective in preventing pain in children undergoing long‐term haemodialysis. In these patients some other factors, like psychological factors, puncture technique and needle size must be taken into consideration for the prevention of pain.
Age‐related hearing loss in the dependent elderly population: A model for nursing care
Authors: Tolson Debbie , Stephens Dafydd 
Published: February 2007

Tolson D & Stephens D. International Journal of Nursing Practice 1997; 3: 224–230 Age‐related hearing loss in the dependent elderly population: A model for nursing care Advancing nursing care through the implementation of evidence‐based practice is a legitimate professional ideal. In reality there are many complex issues that need be addressed before such a goal can be achieved. This paper takes an intermediate step towards the realization of this aim in one aspect of continuing care nursing through the presentation of a procedural model. The presented model is designed to stimulate debate as to what could be, and arguably should be the role of the nurse in relation to meeting the auditory rehabilitative needs of dependent elderly patients. The model is based upon a published management model which outlines the auditory rehabilitative process within a psychosocial framework. The original model has been modified as a result of knowledge synthesis from a range of specialist disciplines including nursing. The Audiological Care Model for Nursing is intended to offer an accessible guide to this often neglected aspect of care.
Development of a constipation risk assessment scale
Authors: Duffy Jackie , Zernike Wendy 
Published: February 2007

Duffy J, Zernike W. International Journal of Nursing Practice 1997; 3: 260–263 Development of a constipation risk assessment scale This clinical report details a project conducted to facilitate nurses in their assessment of patients who were ‘at risk’ of becoming constipated and to inform and guide nurses of appropriate strategies of intervention based on their assessment.
Topical anaesthesia of the skin: a review
Authors: FREEMAN J.A. , DOYLE E. , TEE IM NG , MORTON N.S. 
Published: February 2007

SummaryThe ability to provide painless venepuncture and venous cannulation is a major advance in paediatric practice. Topical local anaesthesia of the skin can allow such procedures to be carried out with little or no discomfort in children of all ages. This has obvious psychological benefits for children, particularly those subjected to repeated procedures. The techniques for anaesthetizing the skin to be effective and safe must be based upon an understanding of the anatomy and physiology of the skin, the pharmacology of local anaesthetic agents and their behaviour when applied to the skin. Although eutectic mixture of local anaesthetics (EMLA cream) (Astra Pharmaceuticals) is the market leader, promising new preparations are being evaluated with the aim of decreasing the onset time of effective analgesia. New clinical applications for topical anaesthesia of the skin are appearing and it is likely that these will be increasingly used in the future.
The influence of cold on pain during intravenous induction of anaesthesia with propofol in children
Authors: BORGEAT A. , FUCHS T. , WILDER‐SMITH O.H.G. , ROUGE J.C. , GEMPERLE G. , TASSONYI E. 
Published: February 2007

SummaryPain on injection and quality of induction were compared in 74 children (5–12 years) randomly assigned to receive either 5 mg·kg−1 of cold propofol (group A), 5 mg·kg−1 of cold propofol mixed with lignocaine 1% (group B) or 5 mg·kg−1 of propofol at room temperature (22–23°C) mixed with lignocaine 1% (group C). The group receiving cold propofol had to be stopped due to a very high incidence of pain (70%). The incidence of pain on injection was 3% in group B and 17% in group C (not significant). Quality of induction and side‐effects were similar in the two groups.
Anaesthesia and the Kearns‐Sayre syndrome
Authors: ESTES R. , GINSBERG B. , BLOCH E.C. 
Published: February 2007

SummaryA six‐month‐old infant presented for anaesthesia with, unbeknown to us, some of the manifestations of the Kearns‐Sayre Syndrome. This syndrome is one of the clinical presentations in patients with mitochondral myopathy. The anaesthetic related events and aspects of mitochondral myopathy are described and caveats are suggested for the management of anaesthesia for patients with this type of myopathy.
Ketamine boluses with continuous low‐dose fentanyl for paediatric sedation during diagnostic cardiac catheterization
Authors: RAUTIAINEN PAULA , MERETOJA OLLI A. 
Published: February 2007

SummaryDuring cardiac catheterization, 202 children aged 1 month to 16 yrs were sedated intravenously half an hour after oral premedication with flunitrazepam 0.1 mg·kg−1 (maximum dose 2 mg) to maintain spontaneous breathing and stable and calm conditions for the investigation. Standard fentanyl doses for induction and maintenance were 1 μg·kg−1 and 1 μg·kg−1·h−1, respectively, for all patients. Requirements for supplementary ketamine for induction and maintenance of stable sedation were studied in five age groups (≤0.5 yr, >0.5–2 yr, >2.0–5.0 yr, >5.0–10.0 yr and >10.0 yr). Ketamine doses for induction were 1.5 ± 0.1, 1.5 ± 0.1, 1.2 ± 0.1, 0.9 ± 0.1 and 0.2 ± 0.1 (mean ± SEM) mg·kg−1 in these age groups, respectively. Ketamine requirements for maintenance of sedation were 1.9 ± 0.1, 1.7 ± 0.1, 1.4 ± 0.1, 1.1 ± 0.1 and 0.2 ± 0.1 mg·kg−1·h−1 in the same age groups, respectively. Age dependency of ketamine requirement was shown; the older the patient the less was the need for supplementation. Intravenous sedation with low‐dose fentanyl and ketamine after flunitrazepam premedication provided favourable anaesthesia for cardiac catheterization.
Complications of short term multilumen central venous cannulation in children—a prospective study
Authors: DUMONT S.W. , RALSTON C. 
Published: February 2007

SummaryA prospective study of the incidence of complications, when using multiple lumen central venous catheters in a paediatric intensive care unit, undertook to survey the normal practice of central venous cannulation at the Birmingham Children's Hospital, using a variety of devices and approaches over a period of a year from May 1991. Ninety five percent of the total of 252 devices used were triple lumen, the rest being double lumen catheters. There were 19 failures to secure access at the initial site chosen, but central venous access was secured in all cases. The complication rate during insertion was 18.5%. There were three major and 20 minor non‐infective complications with a total incidence of 7.9%. Twenty seven cases (10.8%) suffered infective complications. The incidence of all complications were comparable to those obtained in studies involving the use of single lumen devices. This fact, coupled with the high success rate in catheter placement by operators of varying experience, suggests that multiple lumen central venous devices can be considered as a safe alternative to single lumen catheters for short term use in children.
Atracurium in the neonate. Dose‐response with halothane
Authors: FFARCS A.J. CHARLTON , FFARCS N.J.N. HARPER , WILSON A.C. , HUNT L.P. 
Published: February 2007

SummaryAtracurium in doses of 40, 65, 85 or 100 μg·kg−1 was given to four groups of five neonates anaesthetized with nitrous oxide and halothane. The dose‐response relationship was determined by measurement of the EMG response to train‐of‐four stimulation. The doses calculated to produce 50 and 95% depression of the first twitch response were 56.3 and 101.3 μg·kg−1 respectively. These values are lower than those reported during nitrous oxide/oxygen/narcotic anaesthesia in neonates and older children breathing halothane. The change in train‐of‐four ratio during onset appeared similar to that observed in adults.
Removal of laryngeal mask airway: airway complications in children, anaesthetized versus awake*
Authors: LAFFON M. , PLAUD B. , DUBOUSSET A. M. , BEN HAJ'HMIDA R. , ECOFFEY C. 
Published: February 2007

SummaryThe laryngeal mask airway (LMA) must be inserted during deep anaesthesia. There are no guidelines concerning the removal of LMA, i.e., in awake or anaesthetized patients. The aim of this randomized prospective study was to compare the incidence of respiratory complications after LMA removal in anaesthetized or awake paediatric patients. Sixty children (ASA PS I or II), ranging from 4 months to 12 years of age, were studied. In patients breathing spontaneously, anaesthesia was induced and maintained with nitrous oxide, oxygen and halothane. Patients were randomly divided into two groups: group 1 removal of LMA in awake patients, or group 2 removal of LMA in anaesthetized patients, i.e., in patients receiving halothane at an alveolar concentration of 2 MAC adjusted for age and oxygen for 5 min. In both groups, patients received 100% oxygen after removal of LMA. After removal the incidence of respiratory complications was highest (P < 0.05) in group 1. Therefore, in healthy children undergoing elective surgery, the authors conclude that it is safer to perform the LMA removal in anaesthetized patients.
Clinical management of infants and newborn babies undergoing major surgery utilizing a rapid infusion device
Authors: BEEBE DAVID S. , BECK DANIEL , BELANI KUMAR G. 
Published: February 2007

SummaryIn this paper we describe the perioperative management of a premature infant who underwent excision of a giant sacrococcygeal teratoma, a newborn infant who had a partial hepatectomy for a haemangioendothelioma of the liver and an 18‐month‐old infant who had repair of abdominal aortic, renal and iliac arterial aneurysms. In each case a rapid infusion device was used to deliver warm, washed and ventilated blood to replace massive intraoperative blood loss. Although the blood loss in each operation was in excess of twice the total blood volume of the patient, losses were replaced effectively with the rapid infusion device without any significant hypovolaemic episodes. Successful management of newborn babies and infants undergoing surgery with large and potentially hazardous blood loss can be provided using the rapid infusion device. Paediatric anaesthesiologists should strongly consider using this technology when caring for a baby or infant during surgery where massive haemorrhage may occur.
Barotrauma due to obstruction of the breathing system during a CT‐scan examination in a child
Authors: GRIFFITH N. , MILLAR C.L. 
Published: February 2007

SummaryA case of pulmonary barotrauma is described in a child undergoing a CT scan in the prone position. Anaesthesia was uneventful until the final exiting movement from the scanner when inadvertent total occlusion of the expiratory limb of a Jackson‐Rees modification of the Ayre's T‐piece occurred. The rapid rise in intrapulmonary pressure caused bilateral pneumothoraces despite the use of an uncuffed tracheal tube. The unusual demands of anaesthesia in the X‐ray department may have contributed to this uncommon complication of the use of an Ayre's T‐piece.
Continuous caudal anaesthesia during inguinal hernia repair in an awake, 1440 g infant
Authors: TOBIAS JOSEPH D. , HERSEY SHANNON 
Published: February 2007

SummaryThe physiological immaturity of respiratory musculature and central respiratory control centres leads to an increased risk of apnoea and respiratory complications following general anaesthesia in the neonate. Regional anaesthetic techniques such as caudal epidural anaesthesia may obviate the need for general anaesthesia and lessen the risks of perioperative morbidity. Although these techniques have been used frequently in neonates, we are unaware of previous reports of continuous caudal anaesthesia in infants less than 2000 g. We present our experience with continuous caudal anaesthesia using 3% chloroprocaine in a 1440 g infant during repair of bilateral inguinal hernias.
Dose of propofol required to insert the laryngeal mask airway in children
Authors: ALLSOP E. , INNES P. , JACKSON M. , CUNLIFFE M. 
Published: February 2007

SummaryWe have assessed the ease of insertion of the Brain Laryngeal Mask Airway (LMA) after induction of anaesthesia with propofol in 60 healthy unpremedicated children aged between four and nine years. Patients were randomly allocated into three groups: group A = propofol 2.5 mg·kg−1; group B = propofol 3 mg·kg−1 and group C = propofol 3.5 mg·kg−1. Propofol was mixed with lignocaine 0.5 mg·kg−1. Insertion conditions were assessed subjectively as good, acceptable, unacceptable or impossible. Insertion of the LMA was possible in all patients. Good and acceptable conditions were obtained in 35%, 70% and 95% in groups A, B, and C respectively (P < 0.0001). There was no statistically significant inter group variation in systolic and diastolic arterial pressure or in heart rate for five min after induction. All measured cardiovascular changes were considered to be clinically insignificant in healthy children. We conclude it is safe and effective to insert a LMA immediately after induction of anaesthesia with propofol 3.5 mg·kg−1.
Prevalence of unsuspected myopathy in infants presenting for clubfoot surgery
Authors: ZANETTE GASTONE , MANANI GIOVANNI , PITTONI GIOVANNI , ANGELINI CORRADO , TREVISAN CARLO P. , TURRA SISTO 
Published: February 2007

SummaryThe objective of this study was an evaluation of the prevalence of myopathies in paediatric patients scheduled for orthopaedic surgery (clubfoot) performed under regional anaesthesia. Seventeen infants scheduled for lower limb orthopaedic surgery were studied to verify coexisting neuromuscular disorders with electromyography and muscle biopsy during surgery. All surgical procedures were performed under caudal block or spinal anaesthesia, associated with light general anaesthesia. No major cardiorespiratory, neurological or malignant hyperthermic complications (muscle rigidity, arrhythmias, hyperpyrexia) were observed. Combined neurological, electromyographic and biopsy studies showed a high rate of myopathic changes (70%). Performance of clubfoot surgery under light general anaesthesia with regional techniques was free from any problems. The high rate of myopathic changes (70%) observed in the muscle biopsies suggests that precautions should be taken with paediatric patients for clubfoot surgery and a regional anaesthesia technique with adequate monitoring may be helpful to prevent possible malignant hyperthermia related problems.
Can persistent cerebral damage be caused by hyperglycaemia?
Authors: BUSH G.H. , STEWARD D.J. 
Published: February 2007

SummaryAn eight‐year‐old girl demonstrated severe and persistent neurological damage following an uneventful anaesthetic for a planned appendicectomy. The perioperative period was remarkable only in that the patient experienced very severe hyperglycaemia and an epileptiform convulsion. A possible mechanism for neurological damage as a result of severe hyperglycaemia is described.
Moebius syndrome: a review of the anaesthetic implications
Authors: FERGUSON SCOTT 
Published: February 2007

SummaryMoebius syndrome is a rare congenital anomaly characterized by multiple cranial nerve palsies, orofacial malformations and limb anomalies. This study retrospectively reviewed the anaesthetic records of 19 children with Moebius syndrome who had anaesthesia at the Royal Alexandra Hospital for Children over a 15 year period and analysed the complications which occurred. Affected children most commonly present for anaesthesia for correction of strabismus, or for orthopaedic procedures to improve limb function. Despite the abnormal facies and drooling of saliva, these children are almost always of normal intelligence. Problems can arise during anaesthesia, with a high incidence of difficult or failed intubation. The use of a facemask and spontaneous breathing technique, where appropriate, seems to present no problems and maintaining an airway in this way appears to be safe. However, the potential for problems with aspiration of oral secretions should be remembered and the use of antisialogogue premedication is recommended. Affected children have a high incidence of other anomalies, including congenital cardiac disease, spinal anomalies, corneal abrasions and peripheral neuropathies and a careful preoperative assessment is essential.
Comparison of 25 G and 29 G Quincke spinal needles in paediatric day case surgery. A prospective randomized study of the puncture characteristics, success rate and postoperative complaints
Authors: KOKKI H. , HENDOLIN H. 
Published: February 2007

SummaryA comparison of a 25 G with a 29 G Quincke needle was performed in paediatric day case surgery. Sixty healthy children aged 1 year to 13 years were randomly allocated to have spinal anaesthesia with either 25 G or 29 G Quincke needle without an introducer needle. There was a failure rate of 10% with the 29 G spinal needle compared with 0% with the 25 G needle. The time needed to perform dural puncture was shorter using 25 G than 29 G needle, 22 (±31)(SD) vs 59 (±63) s. The time taken for cerebrospinal fluid to appear at the needle hub was also longer, 4 (±3) vs 8 (±5) s. The number of puncture attempts was similar, 1.2 (±0.6) vs 1.4 (±0.8), with 25 G and 29 G needle. Low back pain, 5 vs1, and nonpositional headache, 2 vs 4, after 25 G and 29 G needles, respectively, were the most frequent postoperative complaints. Mild postdural puncture headache occurred in one eight year old male patient in the 25 G group. In conclusion, lumbar puncture without introducer needle was possible with both needles. The puncture characteristics favoured the 25 G needle. A shorter needle could partly alleviate the difficulties with the 29 G needle.
Anaesthesia and recently vaccinated children
Authors: VAN DER WALT J.H. , ROBERTON D.M. 
Published: February 2007

SummaryMost countries have active vaccination programmes for children aged two months and older. It is likely that many children presenting for medical procedures which require general anaesthesia have been vaccinated recently. Although there is no evidence suggesting increased risks associated with anaesthetizing recently vaccinated children there are many theoretical reasons why this situation needs critical assessment and review. After vaccination there is local swelling and pain at the site of the injection and the most common side effects seen are fever, malaise, headache, rash and myalgia which may last from one day to three weeks. Anaesthesia, stress and trauma are known to suppress the immune system. It is suggested that if possible, children should not be subjected to anaesthesia for elective procedures within two to three weeks after vaccination. Urgent procedures should be managed according to anaesthetic principles which will minimize the effect of anaesthesia on the physiological system affected by the immunization process at the time. Paediatric anaesthesia risk management programmes should include vaccination data to enable the risks of anaesthesia in recently vaccinated children to be analysed.
Spontaneous neonatal gastric perforation
Authors: YOUNG AMBER E.R. , SURY MICHAEL R.J. 
Published: February 2007

SummarySpontaneous neonatal gastric perforation is a rare neonatal event. We report three cases which demonstrate that significant cardiovascular instability can occur in these patients. We suggest that if the diagnosis is known preoperatively, invasive monitoring should be instituted, and that it is likely that these children will require large volumes of colloid and inotropic support.
Mitochondrial myopathies: an unusual cause of hypotonia in infants and children
Authors: KEYES MARY A. , VAN DE WIELE BARBARA , STEAD STANLEY W. 
Published: February 2007

SUMMARYChildren frequently undergo muscle biopsy for the workup of hypotonia under general anaesthesia which poses unique risks in patients with undiagnosed muscle disease. Mitochondrial myopathies are a relatively newly recognized cause of myopathy and multisystem disease in both adults and children. The diagnosis is complex. In addition to causing myopathy, there are metabolic derangements present in some cases that may be life‐threatening. We present three cases of children with hypotonia where the diagnosis was suspected in two patients, and confirmed in the third. The question of whether patients with mitochondrial myopathies are at increased risk for developing malignant hyperthermia is discussed.