bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drastic Decrease in Isoflurane Minimum Alveolar Concentration and Limb Movement Forces after Thoracic Spinal Cooling and Chronic Spinal Transection in Rats
Authors: Jinks Steven L. , Dominguez Carmen L. , Antognini Joseph F. 
Published: February 2005

Background
Individuals with spinal cord injury may undergo multiple surgical procedures; however, it is not clear how spinal cord injury affects anesthetic requirements and movement force under anesthesia during both acute and chronic stages of the injury.

Methods
The authors determined the isoflurane minimum alveolar concentration (MAC) necessary to block movement in response to supramaximal noxious stimulation, as well as tail-flick and hind paw withdrawal latencies, before and up to 28 days after thoracic spinal transection. Tail-flick and hind paw withdrawal latencies were measured in the awake state to test for the presence of spinal shock or hyperreflexia. The authors measured limb forces elicited by noxious mechanical stimulation of a paw or the tail at 28 days after transection. Limb force experiments were also conducted in other animals that received a reversible spinal conduction block by cooling the spinal cord at the level of the eighth thoracic vertebra.

Results
A large decrease in MAC (to </= 40% of pretransection values) occurred after spinal transection, with partial recovery (to approximately 60% of control) at 14-28 days after transection. Awake tail-flick and hind paw withdrawal latencies were facilitated or unchanged, whereas reflex latencies under isoflurane were depressed or absent. However, at 80-90% of MAC, noxious stimulation of the hind paw elicited ipsilateral limb withdrawals in all animals. Hind limb forces were reduced (by >/= 90%) in both chronic and acute cold-block spinal animals.

Conclusions
The immobilizing potency of isoflurane increases substantially after spinal transection, despite the absence of a baseline motor depression, or "spinal shock." Therefore, isoflurane MAC is determined by a spinal depressant action, possibly counteracted by a supraspinal facilitatory action. The partial recovery in MAC at later time points suggests that neuronal plasticity after spinal cord injury influences anesthetic requirements.
Variability of Target-controlled Infusion Is Less Than the Variability after Bolus Injection
Authors: Hu Chuanpu , Horstman Damian J. , Shafer Steven L. 
Published: February 2005

Background
Target-controlled infusion (TCI) drug delivery systems deliver intravenous drugs based on pharmacokinetic models. TCI devices administer a bolus, followed by exponentially declining infusions, to rapidly achieve and maintain pseudo-steady state drug concentrations in the plasma or at the site of drug effect. Many studies have documented the prediction accuracy of TCI devices. The authors' goal was to apply linear systems theory to characterize the relation between the variability in concentrations achieved with TCI devices and the variability in concentrations after intravenous bolus injection.

Methods
The authors developed a mathematical model of the variability of any arbitrary method of drug delivery, based on the variability with intravenous bolus injection or the variability with an arbitrary infusion regimen. They tested the model in a simulation of 1,000 patients receiving propofol by simple bolus injection, conventional infusion, or a TCI device. The authors then examined an experimental data set for the same behavior.

Results
The variability of any arbitrary infusion regimen, including TCI, is bounded by the variability after bolus injection. This is observed in the simulation and experimental data sets as well.

Conclusion
TCI devices neither create nor eliminate biologic variability. For any drug described by linear pharmacokinetic models, no infusion regimen, including TCI, can have higher variability than that observed after bolus injection. The median performance of TCI devices should be reasonably close to the prediction of the device. However, the overall spread of the observations is an intrinsic property of the drug, not the TCI delivery system.
Minimum Local Analgesic Doses of Ropivacaine, Levobupivacaine, and Bupivacaine for Intrathecal Labor Analgesia
Authors: Camorcia Michela , Capogna Giorgio , Columb Malachy O. 
Published: February 2005

Background
Doses for intrathecal opioid-local anesthetic mixtures have been arbitrarily chosen. The aim of this study was to compare the analgesic efficacies of intrathecal ropivacaine, levobupivacaine, and bupivacaine for labor analgesia and to determine the analgesic potency ratios for these three drugs. For this purpose, the authors used the up-down sequential allocation model, which estimates the minimum local analgesic dose for intrathecal local anesthetic.

Methods
Ninety-seven nulliparous term parturients in spontaneous labor, requesting combined spinal-epidural analgesia, were randomly allocated to one of three groups to receive 0.25% spinal ropivacaine, levobupivacaine, or bupivacaine. The initial dose of the local anesthetic drug was chosen to be 2.5 mg, and the testing interval was set at 0.25 mg. The subsequent doses were determined by the response of the previous parturient. Efficacy was accepted if the visual analog pain score decreased to 10 mm or less on a 100-mm scale within 30 min. The minimum local analgesic dose was calculated using the method of Dixon and Massey.

Results
The intrathecal minimum local analgesic dose was 3.64 mg (95% confidence interval, 3.33-3.96 mg) for ropivacaine, 2.94 (2.73-3.16) mg for levobupivacaine, and 2.37 (2.17-2.58) mg for bupivacaine. The relative analgesic potency ratios were 0.65 (0.56-0.76) for ropivacaine:bupivacaine, 0.80 (0.70-0.92) for ropivacaine:levobupivacaine, and 0.81 (0.69-0.94) for levobupivacaine:bupivacaine. There were significant trends (P </= 0.021) for greater motor block with bupivacaine and levobupivacaine.

Conclusions
This study suggests a potency hierarchy of spinal bupivacaine > levobupivacaine > ropivacaine.
Attitudes and practices of private medical providers towards family planning and abortion services in Nigeria
Authors: Okonofua F. E. , Shittu S. O. , Oronsaye F. , Ogunsakin D. , Ogbomwan S. , Zayyan M. 
Published: February 2005

Context.  The study was designed to investigate the attitudes and practices of private medical practitioners towards abortion, postabortion care and postabortion family planning in Nigeria.Methods.  Three hundred and twenty‐three private practitioners who were proprietors of private clinics in three states of the country were interviewed with a structured questionnaire that elicited information on their knowledge and experiences of abortion and postabortion care in the cities.Results.  Twenty‐four percent of the doctors reported that they routinely terminate unwanted pregnancies when requested to do so by women, while 82% reported that they frequently treat women who experience complications of unsafe abortion. Over 45% reported that they use manual vacuum aspiration (MVA) for the management of abortion in the first trimester, while 25% use dilatation and curettage (D&C). Nearly 28% reported the use of MVA followed by D&C in the first trimester. Fifty‐seven percent reported their lack of expertise in managing second‐trimester abortions, while those admitting that they manage second‐trimester abortions reported nonstandard methods and procedures. In addition, there was evidence of inadequate counseling of women, lack of institutional protocols and poor use of postabortion family planning by the doctors.Conclusions.  These results suggest the need for a program of retraining of private practitioners on the principles and practices of safe abortion, postabortion care and family planning in Nigeria and the integration of these topics into medical training curricula in the country.
Inhibin A and B as markers of menopause: a five‐year prospective longitudinal study of hormonal changes during the menopausal transition
Authors: Øverlie Inger , MØrkrid Lars , Andersson Anna‐Maria , SkakkebÆk Niels E. , Moen Mette H. , Holte Arne 
Published: February 2005

Objectives.  A more direct and precise hormonal marker of the menopause has been required for some time. The aim of this study was to identify the most accurate marker of the menopause, based on analyses of inhibin A and B, FSH, LH and estradiol (E2), among 59 healthy women without hormonal treatment during the perimenopause and early postmenopause.Methods.  Fifty‐nine women, aged 46–56 years (mean age 51.2 years), were examined annually for 5 years during the menopausal transition and had venous blood drawn simultaneously for later analyses of the above‐mentioned hormones.Results.  Inhibin A showed a steady decline from at least 4 years before the final menstrual period (FMP) until 1 year before menopause, whereas inhibin B had a shorter lasting decline from year 3 to year 2 before menopause, concomitant with a rise in FSH and LH.Conclusion.  The present study confirmed previous observations that inhibin A had a continuous decline starting before the decline of inhibin B, suggesting that an increasing part of the cycle was anovulatory. The fall in inhibin B and the increase in FSH constitute markers of ovarian aging. One year prior to menopause neither inhibin A nor inhibin B could be detected. The disappearance of these peptide hormones is an important predictor of the approaching menopause.
Normative values of Doppler velocimetry of five major fetal arteries as determined by color power angiography
Authors: Konje Justin C. , Abrams Keith R. , Taylor David J. 
Published: February 2005

Objective.  To produce normograms of Doppler indices of major fetal arteries and their ratios relative to the ascending aorta in a cohort of appropriately grown for gestational age fetuses.Methods.  Prospective longitudinal study of 70 women with appropriately grown for gestational age fetuses between 24 and 38 weeks' gestation attending the Fetal Growth Clinic of a large UK teaching hospital. Doppler velocimetry of the middle cerebral (MCA), umbilical (UmA) and renal arteries (RA) and the ascending (AAO) and descending (DAO) aortas were studied using color power angiography. Ratios of the Doppler indices [pulsatility index (PI), resistance index (RI), systolic/diastolic (S/D) ratio] were then calculated using the ascending aorta as the reference numerator for the other four vessels to produce normograms. Regression analysis was performed to determined the significance, if any, of the changes in these ratios with gestation.Results.  The normograms of the various Doppler indices were similar for the middle cerebral artery, ascending and descending aortas. There was an initial rise to a peak between 30 and 32 weeks and then a gradual return to values at 38 weeks similar to those at 24 weeks' gestation. In the renal artery, the indices showed very little variation with gestation. However, there was a gradual fall in the indices with gestation in the umbilical artery. The ratios of the various indices relative to that of the ascending aorta demonstrated an increase with gestation. The changes with gestation were statistically significant for the ratios of the indices from the ascending aorta to those of the middle cerebral, renal and umbilical arteries but not for those of the descending aorta.Conclusions.  The vascular resistance in the five fetal arteries decreased towards the end of pregnancy and the ratios of their indices relative to those of the ascending aorta decreased from 24 to 38 weeks' gestation. Early subtle changes in circulation in compromised fetuses may be identified early from deviations in these normograms.
The effect of placental removal method and site of uterine repair on postcesarean endometritis and operative blood loss
Authors: Baksu Alparslan , Kalan Aysel , Ozkan ArzU , Baksu Başak , Tekelioğlu Meltem , Goker Nimet 
Published: February 2005

Background.  Our purpose was to determine whether blood loss during cesarean section and postoperative endometritis rate were associated with the method of placental removal and site of uterine repair.Methods.  This prospective randomized study involved 840 women who underwent cesarean section. The patients were grouped into four: (1) manual placental delivery + exteriorized uterine repair; (2) spontaneous placental delivery + exteriorized uterine repair; (3) manual placental delivery + in situ uterine repair; (4) spontaneous placental delivery + in situ uterine repair. Patients were excluded if they had received intrapartum antibiotics, had chorioamnionitis, required an emergency cesarean hysterectomy, had rupture of membranes for more than 12 hr, had bleeding diathesis, and had abnormal placentation or prior postpartum hemorrhage. The main outcome measures were postoperative hemoglobin and hematocrit values, and postcesarean endometritis.Results.  There were no statistically significant differences in mean maternal age, parity, gestational age, presence and duration of membrane rupture and number of vaginal examinations between the four groups. The decrease in postoperative hemoglobin (P < 0.05) and hematocrit (P < 0.001) was significantly greater in the manual removal groups (groups 1 and 3) than in the spontaneous expulsion groups (groups 2 and 4) at 48 hr postoperatively. The incidence of postoperative endometritis was significantly higher in manual removal groups (15.2%) (groups 1 and 3) than in spontaneous groups (5.7%) (groups 2 and 4) (P < 0.05).Conclusions.  Manual removal of the placenta at cesarean delivery results in more operative blood loss and a higher incidence of postcesarean endometritis.
Dreaming during anaesthesia in patients at high risk of awareness
Authors: Leslie K. , Myles P. S. , Forbes A. , Chan M. T. V. , Swallow S. K. , Short T. G. 
Published: February 2005

SummaryDreaming during anaesthesia is commonly reported but remains poorly understood. In this study, adult surgical patients at high risk of awareness were randomly assigned to receive bispectral index (BIS)‐guided anaesthesia or routine care, and were interviewed about dreaming three times postoperatively. Dreaming patients (n = 134) were compared with all other patients who were interviewed at least once (n = 2251). Intraoperative dreaming was reported by 4.2%, 3.9% and 3.4% of patients at 2–4 h, 24–36 h and 30 days after surgery, respectively. Fewer BIS‐monitored patients reported intra‐operative dreaming at 2–4 h than control patients (2.7% vs. 5.7%; p = 0.004). Reports of dreaming were similar in the two groups at 24–36 h and 30 days. Dreaming patients were younger (p = 0.001); healthier (p < 0.001) and more likely to be women (p < 0.001), and were less satisfied with anaesthetic care (p = 0.004) than other patients.
Overweight children in Beirut: prevalence estimates and characteristics
Authors: Jabre P. , Sikias P. , Khater‐Menassa B. , Baddoura R. , Awada H. 
Published: February 2005

AbstractObjective  To estimate, for the first time, overweight prevalence and associated characteristics in a representative sample of prepubertal children in Beirut, Lebanon's capital.Design  A cross‐sectional study with a home interview including measurements of weight and height and a structured questionnaire.Subjects  A total of 234 children aged 6–8 years in Beirut: 131 boys, 103 girls.Methods  Prevalence of overweight and obesity was based on the international cut‐off points for body mass index (BMI) by age and gender proposed by the International Obesity Task Force. The characteristics of overweight examined were: age, gender, household and family size, single‐ vs. two‐parent family, parents’ level of education and profession, physical activity and dietary intake of children.Results  Prevalence of overweight and obesity was 26% and 7% respectively in boys, 25% and 6% in girls. Overweight was significantly associated with low physical activity (P < 0.05) and mother's BMI (P < 0.05).Conclusions  This study identified a high proportion of overweight in 6‐ to 8‐year‐old children in Beirut. Reduced physical activity was the most significant factor associated with childhood overweight. Further studies in different regions in Lebanon are necessary to identify national characteristics; prevention efforts will be designed accordingly.
Do ‘clumsy’ children have visual recognition problems?
Authors: Sigmundsson H. , Hopkins B. 
Published: February 2005

AbstractObjectiveVisual recognition by 8‐year‐old children with hand–eye co‐ordination problems (HECP), and by a control group of children without such problems was tested using a task of visual closure.DesignThe task required the children to identify common objects from an incomplete visual presentation.ResultAs predicted, it was found that the HECP children, who were designated as such solely on the basis of their motor difficulties, identified significantly fewer correct objects than their control counterparts.ConclusionsThis finding raises the possibility that the visual processing problems of clumsy children contribute to, or even strongly determine, not only their movement problems but also their learning difficulties.
Mothers’ perceptions of children's quality of life following early diagnosis and treatment for retinoblastoma (Rb)
Authors: Sheppard Linda , Eiser Christine , Kingston Judith 
Published: February 2005

AbstractWe describe the Quality of Life (QoL) and IQ of survivors of retinoblastoma (Rb), both in relation to the normal population and between subgroups of Rb patients differing in relative risk (i.e. unilateral vs. bilateral disease). The sample included 54 children (28 males, age‐range 8–16 years) and their mothers. Mothers completed standardized questionnaires to report their own QoL and that of their child. Children completed a brief IQ test. Compared with population norms, mothers reported lower levels of QoL for their child on total QoL and for sub‐scales measuring Physical and Psychosocial function. Mothers reported their own QoL to be comparable or higher than norms on all but one of eight sub‐scales (energy/vitality). Compared with population norms, children with no visual impairment scored in the normal range for tasks measuring Verbal IQ, but below the mean on tasks measuring Performance IQ. According to their mothers, survivors of Rb have excellent school attendance and take part in most school activities. However, based on standardized questionnaire, they show compromised QoL. We consider that excellent survival rates in Rb are matched with good QoL according to mothers’ report.
Can we detect cervical human papillomavirus (HPV) infection by cytomorphology alone? Diagnostic value of non‐classic cytological signs of HPV effect in minimally abnormal Pap tests
Authors: Bollmann M. , Bánkfalvi A. , Trosic A. , Speich N. , Schmitt C. , Bollmann R. 
Published: February 2005

Objective:  Our aim was to assess the validity of non‐classical cytological signs in minimally abnormal cervical smears for the prediction of HPV infection.Methods:  164 ThinPrep monolayers were re‐screened for mild nuclear changes, disorders of keratinisation, abortive koilocytes and ‘measles cells’, as well as degenerative changes. HPV DNA was detected by GP5+/6+ and MY09/MY11 consensus primer PCR assays.Results:  Seventy six of 164 cases (46.3%) had HPV positivity by PCR. All cytomorphological features studied were significantly associated with the presence of HPV. Mild nuclear changes had 100% sensitivity and 100% negative predictive value for HPV infection.Conclusions:  Our results indicate that non‐classic cytomorphological signs can improve the sensitivity of cytology for detecting HPV. Minimally abnormal Pap smears lacking mild nuclear changes (16%) in the present study – do not require further molecular HPV testing.
HPV triage of women with atypical squamous cells of undetermined significance: a 3‐year experience in an Italian organized programme
Authors: Dalla Palma P. , Pojer A. , Girlando S. 
Published: February 2005

Objective:  The purpose of our study was to determine if Hybrid Capture II assay(HCII) on Liquid Based Cytology (LCB) improves the accuracy (higher sensitivity, similar specificity) than the repeat conventional Pap smear in smears with Atypical Squamous Cell (ASC) of Undetermined Significance diagnosis.Methods:  HPV testing was used to manage women, especially the older ones, with cervical abnormalities detected through our triennial organized screening in order to avoid unnecessary colposcopy and excessive follow‐up if the woman is HPV negative. The HPV DNA Triage was offered without any charge to 909 women with ASC. The Bethesda System was used for the classification of these equivocal cytological findings and more precisely the 1991 version (ASCUS) until the summer 2001 (315 cases) and the new one 2001 classification (ASC‐US and ASC‐H) after this date (594 cases). The presence or absence of a cervical intraepithelial neoplasia of grade I or worse [CIN1+], and of grade II or worse [CIN2+], was confirmed by biopsy.Results:  The HPV DNA Triage showed a good accuracy (specificity over 94%, sensitivity of 37% and PPV for CIN2+ lesions around 30%). The higher values of ASC‐H lesions (.462) for the sensitivity for CIN 2+ probably signify that this lesion is already a SIL.Conclusions:  Our data were comparable with those recently published on the meta‐analysis by Arbyn et al., confirming the promising approach of our guidelines for the treatment of these patients even in terms of Health Technology Assessment (HTA).
Searching for RET/PTC rearrangements and BRAF V599E mutation in thyroid aspirates might contribute to establish a preoperative diagnosis of papillary thyroid carcinoma
Authors: Domingues R. , Mendonça E. , Sobrinho L. , Bugalho M. J. 
Published: February 2005

Objective:  Searching for multiple molecular markers in thyroid aspirates appears to be a promising approach for establishing a preoperative diagnosis of papillary thyroid carcinoma (PTC).Methods:  Based on this hypothesis, a total of 63 samples from 55 patients, were collected at random. RNA was extracted from the residue cells inside the needle used for fine needle aspiration cytology (FNAC) and thereafter molecular analysis was carried out both for RET rearrangements (type 1, 2, 3) and BRAF codon 599 mutation molecule. Results were compared with the cytological and histopathological diagnoses in 24 patients submitted to surgery.Results:  58% PTCs presented a genetic alteration either RET/PTC rearrangement, BRAF V599E mutation or both: three cases of PTCs (25%) presented a RET/PTC rearrangement; three cases of PTCs (25%) presented a BRAF V599E mutation and in one case (8%) both alterations were identified.Conclusions:  The present results suggest that searching for multiple molecular markers in thyroid aspirates may enhance the accuracy of FNAC and refine preoperative diagnosis of PTC.
The role of liquid‐based cytology associated with curettage in the investigation of endometrial lesions from postmenopausal women
Authors: Papaefthimiou M. , Symiakaki H. , Mentzelopoulou P. , Giahnaki A. E. , Voulgaris Z. , Diakomanolis E. , Kyroudes A. , Karakitsos P. 
Published: February 2005

Objective:  This study investigates the role of liquid‐based cytology with ThinPrep® technique, in the detection of endometrial lesions, using direct endometrial sampling from postmenopausal women with the Endogyn endometrial device.Methods:  It was performed on 491 postmenopausal women referred to our clinic for abnormal bleeding or other symptoms and/or a thickness of endometrium >5 mm on ultrasound. Endometrial sampling, dilatation and curettage (D&C) and hysterectomy were performed on all patients. For the diagnosis, the WHO classification scheme was used.Results:  According to our findings a sensitivity of 98.08%, specificity of 100%, positive predictive value of 100%, negative predictive value of 100% and overall accuracy of 98.98% were observed in both endometrial sampling and in D&C.Conclusions:  Endometrial sampling is complementary to D&C for the diagnosis of endometrial lesions and it is necessary for it to be performed before D&C and/or hysterectomy.