bluuebunny/crossref_metadata_2025_split huggingface dataset:
The heart of the art: emotional intelligence in nurse education
Authors: Freshwater Dawn , Stickley Theodore 
Published: May 2004

The concept of emotional intelligence has grown in popularity over the last two decades, generating interest both at a social and a professional level. Concurrent developments in nursing relate to the recognition of the impact of self‐awareness and reflexive practice on the quality of the patient experience and the drive toward evidence‐based patient centred models of care. The move of nurse training into higher education heralded many changes and indeed challenges for the profession as a whole. Traditionally, nurse education has been viewed as an essentialist education, the main emphasis being on fitness for practice and the statutory competencies. However, the transfer into the academy confronts the very notion of what constitutes this fitness for practice.Many curricula now make reference in some way to the notion of an emotionally intelligent practitioner, one for whom theory, practice and research are inextricably bound up with tacit and experiential knowledge. In this paper we argue that much of what is described within curriculum documentation is little more than rhetoric when the surface is scratched. Further, we propose that some educationalists and practitioners have embraced the concept of emotional intelligence uncritically, and without fully grasping the entirety of its meaning and application. We attempt to make explicit the manner in which emotional intelligence can be more realistically and appropriately integrated into the profession and conclude by suggesting a model of transformatory learning for nurse education.
Reproductive toxicity of 2,5‐hexanedione in male rats
Authors: AOKI KAZUO , KIHAILE PAUL E. , MISUMI JUNICHI , PEI WEI , KUDO MASANOBU 
Published: May 2004

Background, Aims and Method:  2,5‐Hexanedione is an industrial solvent which causes peripheral neuropathy. In the current study, the effect of 2,5‐hexanedione on testicular histology of adult rats as well as sperm concentration, motility, and morphology were studied by administering 100 mg, 200 mg, 400 mg/kg per day for 12 weeks.Results:  No sperm motility was observed in the 200 mg and 400 mg/kg per day treatment groups and significantly reduced motility was observed in the 100 mg/kg per day group. The morphology were also significantly reduced in the 200 mg and 400 mg/kg per day groups compared to the control group, but the sperm concentration was significantly reduced only in the 400 mg/kg per day group. Histological examination of the testes in the 400 mg/kg per day group revealed that two‐thirds of the testes had Sertoli cell only syndrome, whereas in the 200 mg/kg per day group half of the testes showed maturation arrest and sperm as well as spermatids were observed in 83% of the testes.Conclusions:  In conclusion, we have shown that 2,5‐hexanedione severely affected sperm motility even at low doses, whereas high doses adversely affected all the sperm parameters as well as causing testicular injury. (Reprod Med Biol 2004; 3: 59–62)
Successful pregnancy outcome using sperm from severely diseased men with testicular cancer and collagen disease: Three case reports
Authors: SASAKI SACHIKO , SASAKI KEIKO , TAKAHASHI SAYAKA , SASAKI TOSHIE , KYONO KOICHI , ARAKI YASUHISA 
Published: May 2004

Objective:  To confirm the feasibility of using fresh or frozen/thawed spermatozoa from cancer and collagen diseased patients for intracytoplasmic sperm injection (ICSI).Patients:  Two participants were diagnosed with testicular carcinoma and one patient was diagnosed with collagen disease.Methods:  Of the two carcinoma patients, one patient provided a fresh testicular biopsy sample and one patient ejaculated fresh sperm after surgical operation. One collagen diseased patient's sperm was frozen, and three samples were used in subsequent ICSI treatment cycles. Their female partners underwent controlled ovarian hyperstimulation for the retrieval of oocytes.Results:  Two patients with testicular cancer and their respective partners achieved successful pregnancies from ICSI using fresh sperm after surgery. The patient suffering from collagen disease had a successful pregnancy from ICSI using sperm frozen prior to chemotherapy treatment.Conclusions:  Patients with testicular carcinoma or collagen disease who might desire to father children in the future should be offered sperm preservation prior to the initiation of chemotherapy treatment. Under currently available treatment, patients with cases of severe disease can still become biological fathers. (Reprod Med Biol 2004; 3: 69–75)
Molecular screening of unculturable bacteria present in men with reproductive failure
Authors: ANURADHA POTHARAJU , ROZATI ROYA , THANGRAJ K. , KHATRI G. , HANUMANTHARAO P. 
Published: May 2004

Objective:  To determine the presence of unculturable bacteria using polymerase chain reaction (PCR) in infertile men with pyosperrmia.Design:  Perspective clinical study.Setting:  The study took place at the Department of Reproductive Medicine, Owaisi Hospital and Research Center; In vitro Fertilization Unit, Mahavir Hospital and Research Center; Center for Cellular and Molecular Biology; and Bharat Biotech Foundation, Hyderabad, India.Patients:  A total of 68 infertile men and 15 donors, all with no symptoms of genito‐urinary tract infections and sterile semen cultures were included in the study.Interventions:  None.Main outcome measures:  Screening bacteria using routine bacterial cultures and PCR based screening with universal eubacterial primers.Results:  The statistical analysis of all the semen parameters in asthenazoospermic, azoospermic, ceyptazoospermic, severe oligospermic and mild oligospermic patients were found to be significant compared with the controls. All the groups were found to be significant compared with the controls (P < 0.05) except for volume and pus cells in the cryptozoospermia group. The Student's t‐test also was significant for the seminal parameters before and after treatment of 68 selected individuals with pyospermia and sterile cultures. A total of 44.11% (30/68) samples were collected from the negative culture of pyospermic infertile men have shown the presence of bacteria on amplification using PCR with universal eubacterial primers. The DNA was purified and sequenced. The sequences were checked for homology using DNASTAR and Ribosomal DataBase Project II. A total of 90% of the samples have shown the nearest evolutionary relation to Pantoea P102 (AF394539) and 10% of samples have shown close relation with Burkholderia cepacia (AF042161).Conclusion:  The routine bacteriological cultures were unable to detect certain bacterial species particularly with members of enterobacteriaceae family (Pantoea species). Polymerase chain reaction, when used for screening bacteria, can detect the unculturable form of bacteria in infertile men. No amplification for bacterial DNA was obtained in control samples (fertile men with sterile semen cultures.) (Reprod Med Biol 2004; 3: 77– 84)
Effects of dibromoacetic acid on murine spermatozoa and testis
Authors: FUJINOKI MASAKATSU , IMAIZUMI YOSHIE , OHTAKE HIDEKI , YAMAOKA SADAO 
Published: May 2004

Background and Aims:   Bromoacetic acids are a by‐product of water ozonation and dibromoacetic acid (DBAA) in particular, which is a by‐product of disinfection, inhibits male reproductive functions. In order to understand its effects, the spermatozoa and testes of mice were exposed to DBAA.Methods:   Twelve‐week‐old ICR mice were exposed to 10 p.p.m. DBAA. They were examined in regards to effects on the weights of body, testis and epididymis, the histological changes of tesits and the protein expression in testis.Results:   Neither the bodyweight nor the weights of the testis and epididymis of the exposed mice was affected, but approximately 13% of spermatozoa obtained from the cauda epididymis were motile with a drop‐shaped head, and structures resembling residual bodies were found in the testis. Moreover, the expression of two testis proteins was changed by exposure to DBAA.Conclusions:   It was likely that DBAA inhibited male reproductive functions by disturbance of spermatogenesis via change of protein expression. (Reprod Med Biol 2004; 3: 85–93)
Assessment of tracheal intubating conditions in children using remifentanil and propofol without muscle relaxant
Authors: Batra Y.K. , Al Qattan A.R. , Ali S.S. , Qureshi M.I. , Kuriakose D. , Migahed A. 
Published: May 2004

SummaryBackground : Tracheal intubation in children can be achieved by deep inhalational anaesthesia or an intravenous anaesthetic and a muscle relaxant, suxamethonium being widely used despite several side‐effects. Studies have shown that oral intubation can be facilitated safely and effectively in children after induction of anaesthesia with propofol and alfentanil without a muscle relaxant. Remifentanil is a new, ultra‐short acting, selective mu‐receptor agonist that is 20–30 times more potent than alfentanil. This clinical study was designed to assess whether combination of propofol and remifentanil could be used without a muscle relaxant to facilitate tracheal intubation in children.Methods : Forty children (5–10 years) admitted for adenotonsillectomy were randomly allocated to one of two groups to receive remifentanil 2 μg·kg−1 (Gp I) or remifentanil 3 μg·kg−1 (Gp II) before the induction of anaesthesia with i.v. propofol 3 mg·kg−1. No neuromuscular blocking agent was administered. Intubating conditions were assessed using a four‐point scoring system based on ease of laryngoscopy, jaw relaxation, position of vocal cords, degree of coughing and limb movement. Mean arterial pressure (MAP) and heart rate (HR) measured noninvasively before induction of anaesthesia to 5 min after intubation (seven time points).Results : Tracheal intubation was successful in all patients without requiring neuromuscular blocking agent. Intubating conditions were clinically acceptable in 10 of 20 patients (50%) in Gp I compared with 18 of 20 patients (90%) in Gp II (P < 0.05). MAP and HR decreased in both groups after induction of anaesthesia (P < 0.01). Both HR and MAP were significantly lower in Gp II compared with Gp I after tracheal intubation (P < 0.01). No patient in the present study developed bradycardia or hypotension.Conclusions : We conclude that remifentanil (3 μg·kg−1), administered before propofol (3 mg·kg−1) provides acceptable tracheal intubating conditions in children, and completely inhibited the increase in HR and MAP associated with intubation.
Rhabdomyolysis after intraoperative myelography
Authors: Canbay Özgür , Bal Nilüfer , Akinci Seda , Kanbak Meral , Aypar Ülkü 
Published: May 2004

SummaryThis case report suggests that the nonionic contrast agents may cause myoclonic spasms and seizures like the ionic ones.A 14‐year‐old female with congenital scoliosis was scheduled for T2‐L3 scoliosis surgery. She had no medical history of a seizure disorder. After a negative wake‐up test, myelography was performed with iohexol. Myoclonic spasms, disseminated intravascular coagulopathy (DIC) and rhabdomyolysis were diagnosed postoperatively.Anaesthesiologists should be aware of the complications which may occur after the use of nonionic and water‐soluble contrast agents.
Anaesthesia considerations for cardiac MRI in infants and small children
Authors: Odegard Kirsten C. , DiNardo James A. , Tsai‐Goodman Beverly , Powell Andrew J. , Geva Tal , Laussen Peter C. 
Published: May 2004

SummaryBackground : General anaesthesia is frequently necessary in infants and small children undergoing cardiac magnetic resonance imaging (MRI), because of the imaging techniques, MRI environment and potential need for breath‐holding to facilitate imaging. Anaesthetizing paediatric patients with congenital heart disease (CHD) for cardiac MRI poses many challenges for the anaesthetist and this report reviews our experience.Methods : We retrospectively reviewed the anaesthesia and MRI records of all patients who had undergone cardiac MRI between January 2000 and October 2002.Results : A total of 250 children with cardiac disease underwent general anaesthesia for cardiac MRI. ASA classification included class I, 2%; class II; 26%; class III, 60% and class IV, 12%. A total of 168 patients (67%) had undergone previous cardiac surgery, 182 patients (94%) were discharged the same day and 48 patients (19.2%) had cyanotic cardiac defects (SpO2 between 55 and 85%). No scans were interrupted because of low oxygen saturation during breath‐hold or haemodynamic instability. No patient was admitted to the hospital from complications related to general anaesthesia, but one inhouse patient from the cardiology ward was admitted to the cardiac intensive care unit (CICU) after the MRI because of cyanosis and low cardiac output. Seven patients from the CICU were on inotropic infusions when they underwent the MRI procedure and two others needed inotropic support after induction of anaesthesia. Five patients had a brief episode of hypotension during the MRI and responded quickly to interventions.Conclusion : Our experience demonstrates that general anaesthesia for cardiac MRI can be provided safely in infants and small children with CHD, despite the complexity and pathophysiology of many defects, the frequent breath‐holding for image acquisitions and the MRI environment.
Analgesic effect of clonidine added to bupivacaine 0.125% in paediatric caudal blockade
Authors: Joshi Wanda , Connelly Neil Roy , Freeman Katharine , Reuben Scott S. 
Published: May 2004

SummaryBackground : Caudals are a common method of providing pain relief in children undergoing surgery. Clonidine, an α2 agonist, exhibits significant analgesic properties. The current investigation sought to determine whether caudal clonidine added to caudal bupivacaine would decrease pain in paediatric patients undergoing surgery.Methods : Thirty‐six children undergoing elective surgery were studied. Following anaesthetic induction, a caudal was placed (1 mg·kg−1 bupivacaine 0.125%) with an equal volume of either clonidine (2 μg·kg−1) or saline. Perioperative analgesic requirements in the postanaesthesia care unit (PACU) and at home following hospital discharge, and parental pain scores were evaluated.Results : There were no significant demographic, haemodynamic, or pain score differences between the groups. There was no difference in analgesic duration between groups. There were significantly more children who vomited during the first 24 postoperative hours in the clonidine group than in the saline group (eight in clonidine, two in saline; P < 0.05).Conclusion : We do not recommend adding clonidine (2 μg·kg−1) to a bupivacaine (0.125%) caudal block in children undergoing surgery.
Delayed rises in serum S100B levels and adverse neurological outcome in infants and children undergoing cardiopulmonary bypass
Authors: Lardner David , Davidson Andrew , McKenzie Ian , Cochrane Andrew 
Published: May 2004

SummaryBackground : The protein S100B is a marker of brain injury. Early after cardiopulmonary bypass (CPB), serum S100B levels are artefactually high. We investigated whether delayed (48 h) rise in S100B levels may have a role in detecting brain injury after CPB.Methods : Data from 43 children were analysed in this study. Samples were collected at preincision and 30 min, 24 and 48 h postbypass and then analysed by using a commercially available radioimmunoassay (Sangtec100). Charts were reviewed at 3–5 months for evidence of neurological injury.Results : S100B levels were high preoperatively in neonates and universally high immediately postbypass. In 36 children, samples were available for all time points. Compared with preoperative levels, rises occurred at both 24 and 48 h in three patients, only at 24 h in four patients and only at 48 h in three patients. Two patients had evidence of neurological injury. A rise at 48 h was associated with neurological injury (odds ratio 33.9, P < 0.03, 95% CI 1.39–827). There was no association between neurological injury and S100B levels at 24 h. Both the patients with neurological injury had rises at 48 h that were significantly higher than patients with rises at 48 h without injury.Conclusions : The results of this study suggest that monitoring S100B levels in the late postoperative period may still have a role in detecting neurological injury after cardiac surgery in children. Consistent with previous observations, S100B is high preoperatively in neonates and early postbypass in all patients.
Diclofenac and metabolite pharmacokinetics in children
Authors: van der Marel Caroline D. , Anderson Brian J. , Rømsing Janne , Jacqz‐Aigrain Evelyne , Tibboel Dick 
Published: May 2004

SummaryBackground : Data concerning metabolism of diclofenac in children are limited to intravenous and enteric coated oral formulations. There are no data examining diclofenac or its hydroxyl metabolite pharmacokinetics after rectal administration in children.Methods : Infants (n = 26) undergoing tonsillectomy were given diclofenac 2 mg·kg−1 followed by 1 mg·kg−1 8 h as suppository formulation for postoperative analgesia. Serum was assayed for diclofenac, 4′‐hydroxydiclofenac and 5′‐hydroxydiclofenac concentrations during the procedure and 1, 2 and 4 h postoperatively. The formation clearances of diclofenac to hydroxyl metabolites were estimated using nonlinear mixed effects models. A single compartment, first order absorption and first order elimination model was used to describe diclofenac pharmacokinetics. Published data from 11 children given enteric‐coated diclofenac tablets were used to assess relative bioavailability.Results : Mean (sd) age and weight of the patients were 4.5 (1.5) years and 20.5 (4.1) kg. The formation clearance to 4′‐hydroxydiclofenac (% CV) and to 5′‐hydroxydiclofenac were 8.41 (8.1) and 3.41 (113) l·h−1 respectively, standardized to a 70 kg person using allometric ‘1/4 power’ models. Clearance by other routes contributed 33.0 (64) l·h−1 70 kg−1. Elimination clearance of hydroxyl metabolites was fixed at 27.5 l·h−1 70 kg−1. The volumes of distribution of parent diclofenac and its hydroxyl metabolite were 22.8 (19.0) and 45.3 (l.70) kg−1. The suppository formulation had an absorption half‐life of 0.613 (33.2) h with a lag time of 0.188 (24.9) h. Interoccasion variability of formation clearance to 4′‐hydroxydiclofenac, diclofenac volume of distribution, absorption half‐time and lag time for the suppository was 36%, 55%, 14% and 119%, respectively. The relative bioavailability of the suppository compared with an enteric‐coated tablet was 1.26.Conclusion : The formation clearance of the active metabolite 4′‐hydroxydiclofenac contributed 19% of total clearance (44.82 l·h−1 70 kg−1). The rectum is a suitable route for administration of diclofenac in children 2–8 year of age and was associated with a higher relative bioavailabilty than enteric‐coated tablets and an earlier maximum concentration (50 vs. 108 min). This pharmacokinetic profile renders diclofenac suppository a suitable formulation for short duration surgery.
Comparison of ropivacaine with bupivacaine and lidocaine for ilioinguinal block after ambulatory inguinal hernia repair in children
Authors: Tsuchiya Naohisa , Ichizawa Manami , Yoshikawa Yukiko , Shinomura Tetsutaro 
Published: May 2004

SummaryBackground : We have compared ropivacaine with bupivacaine and lidocaine for ilioinguinal block in thirty children undergoing ambulatory inguinal hernia repair.Methods : Patients were assigned randomly to receive 0.5 ml·kg−1 of 0.2% ropivacaine (Group R, n = 10), 0.25% bupivacaine (Group B, n = 10) or 1% lidocaine (Group L, n = 10). The patients’ parents, who were not informed of the type of local anaesthetic employed, evaluated the postoperative pain at 2 h and 6 h after operation using the Wong–Baker FACES Pain Rating Scale.Results : There was a significant difference in the face scale score between Group R and Group L, and Group B and Group L. There was no difference in the face scale score between Group R and Group B. There were no complications or clinical evidence of local anaesthetic toxicity.Conclusions : We have confirmed that bupivacaine and ropivacaine are more effective than lidocaine in the prevention of postoperative pain after children's inguinal hernia repair. We suggest that ropivacaine 0.2% is an alternative to bupivacaine 0.25% for ilioinguinal block in ambulatory paediatric surgery.
Dosage scheme for propofol in children under 3 years of age
Authors: Steur R.J. , Perez R.S.G.M. , De Lange J.J. 
Published: May 2004

SummaryBackground : Propofol is a well‐known drug for adults for total intravenous anaesthesia. Since 1999, the use of propofol has been approved for children less than 3 years of age. However, a suitable dosage scheme for these age groups was not available. The purpose of this study was to describe our clinical experience with the use of a new dosage scheme for propofol in patients under 3 years of age, based on experimental data and known pharmacological principles in children.Methods : A pilot study of 50 patients undergoing TIVA was performed to adapt the existing adult dosage scheme to the requirements of the younger population. Total number and time of administration of boluses and time to awakening were registered and used as criteria to adjust the dosage scheme. The subsequent dosage scheme was then evaluated in 2271 children undergoing anaesthesia for various procedures. Usual anaesthetic parameters were measured to monitor the safety of the patient: ECG, O2 saturation, respiratory frequency and blood pressure. Most of the patients were mechanically ventilated; only 15% were breathing spontaneously.Results : Overall, few side effects were recorded [bradycardia (12%), blood pressure fall (8%), desaturation (1%)], which were easily countered by routine measures.Conclusions : This dosage scheme provides safe and smooth anaesthesia in children less than 3 years of age and is therefore a useful tool for a TIVA technique in small children.
Anaesthetic management of infants with glycogen storage disease type II: a physiological approach
Authors: Ing Richard J. , Ryan Cook D. , Bengur Resai A. , Williams Eric A. , Eck John , Dear Guy de L. , Ross Allison K. , Kern Frank H. , Kishnani Priya S. 
Published: May 2004

SummaryPompe or Glycogen Storage Disease type II (GSD‐II) is a genetic disorder affecting both cardiac and skeletal muscle. Historically, patients with the infantile form usually die within the first year of life due to cardiac and respiratory failure. Recently a promising enzyme replacement therapy has resulted in improved clinical outcomes and a resurgence of elective anaesthesia for these patients. Understanding the unique cardiac physiology in patients with GSD‐II is essential to providing safe general anaesthesia.
Use of intravenous ketorolac in the neonate and premature babies
Authors: Papacci Patrizia , de Francisci Giovanni , Iacobucci Tiziana , Giannantonio Carmen , De Carolis Maria Pia , Zecca Enrico , Romagnoli Costantino 
Published: May 2004

SummaryBackground : Ketorolac is a powerful nonsteroidal anti‐inflammatory drug widely used for pain control in children and adults. The aim of this study was to evaluate its safety and analgesic efficacy in the neonate.Methods : Ketorolac was used in a group of 18 spontaneously breathing neonates presenting with chronic lung disease, for the control of postsurgical pain and pain from invasive procedures. Pain scores (Neonatal Infant Pain Scale) were assessed before and after i.v. administration of 1 mg·kg−1 of ketorolac.Results : Total pain control was achieved in 94.4% of the neonates. None of the neonates had haematological, renal or hepatic changes prior to treatment, and these complications did not occur after treatment. No neonate had systemic haemorrhage or bleeding from injection and blood withdrawal sites.Conclusions : Ketorolac could represent an efficacious analgesic alternative to opioids, particularly in neonates. It would avoid the side‐effects associated with opioid analgesics, especially respiratory depression.