bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative comfort in paediatric outpatient surgery
Authors: Kokinsky E , Thornberg E , Östlund A.l , Larsson L.e 
Published: March 2003

SummaryPostoperative conditions in hospital and at home were evaluated in 200 paediatric daycase patients by using questionnaires and telephone interviews. Pain was assessed by behaviour observation or a faces rating scale depending on age. Anaesthetic methods, nausea/vomiting, analgesics and parents’ aspects were also recorded. Seventy per cent of the patients received regional anaesthesia. Immediate postoperative analgesia was satisfactory in 75% of the children. When the effects of intraoperatively administered analgesics wore off at home almost half the children rated higher than mild pain. The increased degree of pain at home was especially pronounced after regional anaesthesia. The total incidence of nausea/vomiting was 28% and fentanyl caused nausea and vomiting in a significantly higher proportion of cases. The study points out that immediate postoperative comfort obtained by prophylactic analgesia needs to be followed by analgesics given on a continuous basis for the first days after surgery.
Effect of preoperative paracetamol on gastric volumes and pH in children
Authors: Anderson Brian J. , Rees Sheridan G. , Liley Andrew , Stewart Alistair W. , Wardill Mark J. 
Published: March 2003

SummaryThe effect preoperative paracetamol elixir has on gastric contents is unknown. Children presenting for elective adenotonsillectomy were randomized to receive either paracetamol elixir (40 mg·kg−1) 90 min before surgery or paracetamol suppositories (40 mg·kg−1) intraoperatively. Following induction of anaesthesia a 16 Fr multiple‐oriface orogastric tube was passed into the stomach and measure taken of the residual gastric volume and pH. The children had a mean age of 8.5 years (
SD 3.2) with a weight of 35 kg (
SD 16.5). Children given elixir (n=41) had a mean residual gastric volume of 0.083 ml·kg−1 (95% CI; 0.006, 1.24) and a pH of 1.83 (95% CI; 0.75, 4.49), while those given suppositories (n=40) had a mean residual gastric volume of 0.083 ml·kg−1 (95% CI; 0.008, 0.9) and a pH of 2.07 (95% CI; 0.84, 5.12). There was no significant difference between these two groups. Paracetamol elixir is rapidly absorbed in the gastrointestinal system of children and preoperative administration has no effect on gastric contents. Given paracetamol's slow equilibration rate constant from the central to the effect compartment, children may be given this medication preoperatively for routine surgical procedures.
Relative effectiveness of lignocaine–prilocaine emulsion and nitrous oxide inhalation for routine preoperative laboratory testing
Authors: Gall Olivier , Annequin Daniel , Ravault Nathalie , Murat Isabelle 
Published: March 2003

SummaryWe studied the impact of age‐related factors and the benefits of 50% nitrous oxide or EMLA cream in 108 children undergoing preoperative laboratory testing. Procedural pain was assessed by behavioural scores (CHEOPS) and pain intensity ratings. Age, preexisting behavioural distress and difficulty of venous access were significant predictors of outcome in univariate analysis. Nitrous oxide and EMLA cream were both effective in lowering pain related behaviour and pain ratings generated by the different adult observers and the children where applicable. EMLA cream was more effective than 50% nitrous oxide in children 1–4 years old. Although EMLA cream was responsible for a 28±5 min prolongation of waiting time at the clinic, the present results suggest that it should remain the first line intervention to alleviate pain from venepuncture in paediatric outpatients.
Heart block following propofol in a child
Authors: Sochala C. , VAN Deenen D. , DE Ville A. , Govaerts M.J.M. 
Published: March 2003

SummaryWe present the case of a nine‐year‐old boy afflicted with Ondine's curse, who developed complete atrioventricular heart block after a single bolus of propofol for induction of anaesthesia for strabismus surgery. Ondine's curse, the other name for congenital central hypoventilation syndrome, is characterized by a generalized disorder of autonomic function. Propofol has no effect on the normal atrioventricular conduction system in humans but it reduces sympathetic activity and can highly potentiate other vagal stimulation factors. Heart block has been documented after propofol bolus use in adults but, to our knowledge, not in children. It would appear that propofol is not a good choice for anaesthesia in congenital central hypoventilation syndrome.
Incidence of nausea and vomiting in children after strabismus surgery following desflurane anaesthesia
Authors: Kuhn I. , Scheifler G. , Wissing H. 
Published: March 2003

SummaryIn a prospective, randomized parallel study, 60 ASA I–III children aged 1–17 years, scheduled for elective strabismus surgery, were anaesthetized with desflurane without prophylactic antiemetic medication. The objective of the study was to determine the incidence of postoperative nausea and vomiting after general anaesthesia with desflurane. To decide whether nitrous oxide further influences these symptoms, the patients were randomly assigned to two groups of 30 patients each. One group received desflurane in oxygen/air and a second group received desflurane in oxygen/nitrous oxide. In all children, after intravenous induction and tracheal intubation, anaesthesia was administered as minimal flow anaesthesia with oxygen and nitrous oxide or air according to the random plan. The patients were observed for 48 postoperative hours until their discharge from the ward. The overall incidence of nausea was found to be 37%, and vomiting was seen in 32% of all patients. No statistical correlation was found between the incidence of postoperative emesis and the administration of nitrous oxide or the duration of general anaesthesia. Instead, the incidence of vomiting was 2.5‐fold higher when surgery was performed on both eyes compared with one eye. The relatively low incidence of postoperative nausea and vomiting, as well as the quick recovery from anaesthesia, permitting an early discharge from the postoperative care unit to the ward, show desflurane to be a suitable volatile anaesthetic in strabismus surgery in children.
Remifentanil and propofol for sedation in children and young adolescents undergoing diagnostic flexible bronchoscopy
Authors: Reyle‐Hahn Matthias , Niggemann Bodo , Max Martin , Streich Rita , Rossaint Rolf 
Published: March 2003

SummaryFlexible fibreoptic bronchoscopy (FOB) has become a useful diagnostic and therapeutic procedure in children. We investigated 26 patients (3–14 years) for FOB using a new sedation strategy. All patients received oral premedication and inhalation of topical anaesthetic. Sedation for bronchoscopy was achieved with a continuous infusion of remifentanil and intermittent boluses of propofol. Propofol injection was repeated if sedation was inadequate. Sedation could be successfully performed in all children without adverse effects. Endtidal CO2 concentration and arterial oxygen saturation remained stable throughout the study. All children were awake 5±1.3 min after stopping remifentanil infusion. Sedation with remifentanil/propofol is a new sedation strategy for diagnostic flexible paediatric bronchoscopy in children with spontaneous ventilation.
Anaesthetic technique for transoesophageal echocardiography in children
Authors: Heard C.M.B. , Gunnarsson B. , Heard A.M.B. , Watson E. , Orie J.D. , Fletcher J.E. 
Published: March 2003

Objective: To document the safety and efficacy of an anaesthetic technique in paediatric patients undergoing transoesophageal echocardiography (TOE). Methods: Prospective descriptive study performed in a children’s hospital with all patients undergoing TOE. Topical analgesia of the pharynx was achieved with lidocaine. Anaesthesia was induced with midazolam (25 μg·kg−1), fentanyl (1 μg·kg−1), and propofol (0.5–1 mg·kg−1), followed by a continuous infusion of propofol (5–10 mg·kg−1·h−1). Results: Thirty patients are reported. The mean age was 11.4 ± 5.1 years (range 1–22) and weight 40.5 ± 22.1 kg (range 10–110). All the patients tolerated the procedure well. Two patients experienced brief oxygen desaturations during induction, 10 patients coughed during the procedure, and six patients had significant muscle activity requiring supplemental doses of propofol. None of the patients experienced nausea or vomiting. Conclusion: We conclude that our anaesthetic technique in spontaneously breathing paediatric patients during TOE is effective and appears to be safe in children with heart disease.
The effect on intraocular pressure of tracheal intubation or laryngeal mask™ insertion during sevoflurane anaesthesia in children without the use of muscle relaxants
Authors: Duman Ates , Ögün Cemile Öztin , Ökesli Selmin 
Published: March 2003

Background: We studied the effects of sevoflurane on intraocular pressure after induction in children undergoing either tracheal tube (TT) or laryngeal mask airway (LMA™) insertion without a muscle relaxant Methods: The study included 38 children. Anaesthesia was induced (8%) and maintained (3–4%) with sevoflurane in 100% O2. No muscle relaxant was used. A TT was inserted in group I (n=20), and an LMA in group II (n=18). IOPs were measured after induction, insertion of TT or LMA and at 1, 2 and 3 min thereafter. The heart rate, mean arterial pressures were also recorded. Results: Intraocular pressures increased significantly in group I after TT (P < 0.01) and remained high until after 3 min. The pressures were similar in the LMA group at all measurements. Conclusions: Sevoflurane does not prevent the increase in IOP after intubation without muscle relaxants. LMA does not increase IOP in children after sevoflurane induction.
Postoperative behavioural changes in children: comparison between halothane and sevoflurane
Authors: Foesel T. , Reisch H.J. 
Published: March 2003

Background: A questionnaire, modified from the posthospitalization behavioural questionnaire, was sent to all parents of children under 8 years of age who had elective surgery in the hospital of Lahr during the years 1997 and 1998. The parents were asked about long lasting changes (more than 1 week) in their child’s behaviour after surgery. Methods: The anaesthesia records of all these children were evaluated on the inhalational agent used (halothane or sevoflurane), the type of surgery, the sedative premedication used, the method of inducing anaesthesia and the use of opioids or nonopioids for pain therapy. Four hundred and fifty‐eight of 863 parents responded (53.1%) to the questionnaire. Four hundred and twenty‐seven children had minor ENT surgery and 31 minor urological surgery. Two hundred and eleven children received halothane and 214 sevoflurane as inhalational agent. Results: The parents of 34 of the 211 children (16.1%) receiving halothane and 55 of 214 children (25.7%) receiving sevoflurane reported postoperative behavioural changes. This difference was highly significant (P=0.015). Conclusions: We found that the children having sevoflurane anaesthesia were more likely to develop behavioural problems postoperatively than with halothane.The rate of postoperative behavioural changes was not influenced by the type of surgery, the sedative premedication used, the induction technique or the use of opioids or nonopioid pain therapy.
Pulmonary volume recruitment restores pulmonary compliance and resistance in anaesthetized young children
Authors: Marcus R. J. , Van Der Walt J. H. , Pettifer R. J. A. 
Published: March 2003

Summary Background: Oxygenation and gas exchange are impaired after induction of general anaesthesia. A timed re‐expansion inspiratory manoeuvre (TRIM) improves pulmonary compliance and reverses haemoglobin oxygen desaturation rapidly in lambs. Methods: Twenty children of less than 2 years of age were given a standardized ventilated general anaesthetic. After 15 min of anaesthesia they were randomized to receive either a TRIM or 100% oxygen for 3 min. Dynamic pulmonary compliance and airway resistance were measured. Results: Pulmonary compliance fell by 12% and airway resistance rose by 12% during 15 min of ventilated general anaesthesia. 100% oxygen caused a further fall of 9% in compliance (P=0.016), whilst TRIM resulted in a 30% increase in compliance (P < 0.01). The changes in airway resistance with 100% oxygen and TRIM were not statistically significant. Conclusions: This study shows that TRIM increases pulmonary compliance during standardized ventilated general anaesthesia.
The BCH Epidural System, a safe system for epidural infusion analgesia in children
Authors: Llewellyn N. , Liley A. , Dickson U. , Moriarty A. 
Published: March 2003

Epidural infusions in children are usually delivered by syringe drivers because of the lower volumes of local anaesthetic solutions used in children rather than in adult practice. Recently concern has arisen both via the media and anecdotally over a number of adverse events associated with intravenous administration of bupivacaine. We have designed and validated a system that should significantly reduce the possibility and incidence of this adverse effect.

image
[ The system is based on the reversal of the standard luer‐lock system. ]A female 60 cc syringe is connected to a reversed 150 cm infusion line that is connected to a male epidural filter. The filter connects with standard epidural infusion catheters. The reversal of the luer‐lock system requires that devices are also available for the initial doses of local anaesthetic, for the preparation of the epidural infusion syringe and for administration of rescue boluses of local anaesthetic.With this system it is extremely unlikely that the epidural syringe or infusion catheter can be connected to an intravenous line. It is also less likely that intravenous drugs may be connected to the epidural filter.
Partial orbital rim resection, mesh skin expansion, and second intention healing combined with enucleation or exenteration for extensive periocular tumors in horses
Authors: Beard W. L. , Wilkie D. A. 
Published: March 2003

AbstractOcular and periorbital sarcoids and squamous cell carcinoma are common in equine practice. Extensive involvement of periorbital tissues often necessitates removal of the globe if the function of the eyelids can not be maintained with tumor removal alone. This report describes a modification of the standard enucleation or exenteration technique for cases in which there is insufficient skin to achieve primary closure following complete surgical excision. The caudal portion of the dorsal orbital rim is protuberant; partial excision with an osteotome facilitates skin closure by decreasing the size of the wound. Mesh expansion of skin via multiple rows or parallel stab incisions can also be used as an adjunct to facilitate closure. Four horses underwent enucleation or exenteration using the orbital rim resection and mesh skin expansion techniques for extensive periocular tumors that were unresponsive to prior treatments. Follow‐up intervals ranged from 6 to 42 months and no horses had tumor regrowth.
Transient expression of a vacuolar peroxidase increases susceptibility of epidermal barley cells to powdery mildew
Authors: Kristensen Brian Kåre , Ammitzbøll Henriette , Rasmussen Søren Kjærsgård , Nielsen Kirsten Annette 
Published: March 2003

summaryThe expression of genes encoding the peroxidases, Prx7 and Prx8, is induced in barley leaf tissue after inoculation with the barley powdery mildew fungus, Blumeria graminis f.sp. hordei (DC) Speer (Bgh). The role of these peroxidases in general barley defence responses against fungal attack was investigated using a transient expression system. Colonization frequencies of Bgh on cells transfected with Prx7 or Prx8 expression‐, mutant‐ or fusion‐DNA constructs were compared to the frequencies on cells expressing a β‐glucuronidase (GUS) control construct. Twice the number of powdery mildew colonies were observed on cells expressing Prx7 as compared to control cells. Introduction of either mutant or truncated versions of Prx7 showed that decreased resistance against Bgh was dependent on the presence of the C‐terminal signal peptide required for correct subcellular targeting, but not affected significantly by mutations in the catalytic centre. No impact on Bgh performance was observed after the introduction of Prx8 or mutant constructs. An enhanced accumulation of the apoplastic Prx8 was verified by immunocytology. These results indicate a more complex role of peroxidases in defence responses than was previously suspected.
The role of nurses in the human immunodeficiency virus/acquired immune deficiency syndrome policy process in Botswana
Authors: Phaladze N. A. 
Published: March 2003

AbstractIn Botswana, there is dearth of literature on the role of nursing in health‐care policy and resource allocation and yet nurses constitute the majority (85%) of health manpower. The health‐care delivery system depends mostly on nurses for service provision. There were two main purposes of this study: first, to gather descriptive data from major key players (with particular emphasis on nurses) concerning knowledge of the policy process and resource allocation for management and care of clients with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in Botswana; and, second, to identify nurse characteristics (e.g. position, education, experience, job category) associated with motivation to influence health‐care policy in HIV/AIDS management and care in Botswana. A policy process conceptual framework was used to guide data collection and analysis. A case‐study research method was used to conduct in‐depth interviews from a purposive sample of 19 policy makers, and a survey questionnaire was used to collect data from a purposive sample of 95 registered nurses from six study sites in Botswana. The study findings indicate minimal participation of nurses in health‐care policy process and resource allocation. The demographic variable of position was a predictor of the involvement of nurses in policy and in budgetary decisions. Both survey and interview data indicated that this minimal participation of nurses in the policy process resulted in implementation problems, thus compromising service provision. Implications of the findings for the nursing profession, nursing practice and policy, which address the importance of nurses’ involvement, are discussed.
Nursing as a practical science: some insights from classical Aristotelian science *
Authors: Whelton Beverly J. B. 
Published: March 2003

Abstract This paper discusses a classic Aristotelian understanding of science, nature, and methods of inquiry and proof. It then discusses nursing as a practical science and provides some demonstrations through the application of classical methods. In the Aristotelian tradition an individual substance is a unity of form and matter: form being the intelligible universal that becomes the concept, while matter is the principle of individuation. Science is mediate intellectual causal knowledge. Inquiry uses hypothetical argument, and proof that is from valid syllogistic reasoning with true premises provides necessity and certitude. This proof requires knowledge of the natural kind that gives origin to the attributes under investigation. The variability of nature is overcome by reasoning on the supposition of the end.Within the classical understanding of speculative and practical science, nursing is a practical science. As a science, nursing investigates the principles and causes of its subject, be that human beings, health or nursing behaviours as knowable nursing operations. The goal is knowledge of practice for the sake of practice, but nursing as a science is not operable. Nursing practice, that is nursing art or technologies, must complete the science. Reasoning on the supposition of the end, for example of cardiac compensation, allows one to identify necessary activities and physical states. Three causal demonstrations about decubiti show that demonstrations are possible. Classical science would teach us that the practical science of nursing studies human nature in order to identify principles and causes of health and principles and causes of nursing operations themselves. It also requires that the science ends in practical operation. Thus, proper decisions and individual actions in particular patient situations must complete nursing science.
The non‐linear viscoelastic behaviour of human hair at moderate extensions
Authors: Barnes  , Roberts  
Published: March 2003

Synopsis We report the results of experiments carried out on the stress relaxation of slightly stretched human hair. The results show that human hair is viscoelastic, and that when quickly extended to a moderate degree (0.5–6.5%) and held, the force generated will fall to half its original value in about 15 h. However, the relaxation process is also dependent on extension, so that iso‐chronous (constant time) data is non‐Hookean. We show that the iso‐chronous stress/strain behaviour departs from linearity at about 1% extension and the modulus progressively decreases thereafter according to a power‐law relationship with strain. Résumé Nous présentons ici les résultats d’expériences réalisées afin d’étudier la relaxation de la contrainte appliquée sur un cheveu humain légèrement étiré. Les résultats obtenus montrent que le cheveu humain est viscoélastique, et que lorsque’il est étiré rapidement, et de façon modérée (0,5–6,5%), la force nécessaire pour le maintenir étiré diminue de moitié en 15 heures. La relaxation dépend également du degré d’extension, de sorte que les données isochrones (à temps constant) ne suivent pas la loi de Hooke. Nous avons démontré que le comportement isochrone contrainte/cisaillement dévie du comportement linéaire lorsque le cheveu est étiré de 1% environ et que le module décroît ensuite progressivement en suivant une loi de puissance avec le cisaillement.
The modifiable factors affecting bone mineral accumulation in girls: the paradoxical effect of exercise on bone
Authors: Keay Nicola 
Published: March 2003

SummaryAmongst women in exercise training, the female athlete triad is on the increase. This is the combination of disordered eating, amenorrhoea and osteoporosis. However, the effects of exercise training on bone mineral accumulation in youngsters is not fully known. Bone mass increases rapidly during childhood and adolescence until peak bone mass (PBM) is attained. PBM is an important determinant of adult bone mineral density (BMD) and therefore optimisation of PBM is valuable in the prevention of osteoporosis. This paper reviews the effects of exercise training on the accumulation of bone mineral in girls.