bluuebunny/crossref_metadata_2025_split huggingface dataset:
The value of a general therapeutic approach in subjects with irritable bowel syndrome
Authors: Monsbakken K. W. , Vandvik P. O. , Farup P. G. 
Published: January 2005

SummaryBackground : The general therapeutic approach is the cornerstone in the management of irritable bowel syndrome, but the effect is poorly documented.Aim : To evaluate the effect of the general therapeutic approach for irritable bowel syndrome.Methods : Subjects with irritable bowel syndrome identified in a public screening were included. Scores for abdominal symptom (range 0–12), musculoskeletal pain and mood disorders were calculated. After exclusion of other disorders, a doctor presented irritable bowel syndrome as a positive diagnosis, gave information, reassurance and lifestyle advice, but no pharmacotherapy. A dietician gave dietary advice. There was a follow‐up after 6 months.Results : Sixty‐five persons (females/males: 44/21) with mean age 49 years (range 31–76) were included, 31 (48%) were recommended dietary changes. Twenty subjects (31%) had satisfactory relief of symptoms after 6 months. The scores for abdominal symptom was reduced from 3.1 to 2.2 (P = 0.007), the reduction was 2.2 in the diarrhoea‐predominant group given advice compared with 0.4 in the other subjects (P = 0.035). Previous consultations for the complaints, visits for psychiatric disorders, and presence of mood disorders were predictors of persistent complaints.Conclusions : There was a significant relief of symptoms after 6 months, those with psychological co‐morbidity responded less well. The effect of dietary advice was only seen in those with diarrhoea‐predominant irritable bowel syndrome.
Impact on postoperative pain of long‐lasting pre‐emptive epidural analgesia before total hip replacement: a prospective, randomised, double‐blind study
Authors: Klasen J. , Haas M. , Graf S. , Harbach H. , Quinzio L. , Jürgensen I. , Hempelmann G. 
Published: January 2005

SummaryClinical studies on pre‐emptive analgesia have produced inconsistent results. We conducted a clinical study investigating the effect of long‐lasting pre‐emptive epidural analgesia on consumption of analgesics and acute pain. Forty‐two patients scheduled for elective hip replacement for osteo‐arthritis were randomly assigned to receive, on the day before operation, either 5 ml.h−1 ropivacaine 0.2% (study group, n = 21) or 5 ml.h−1 saline (control group, n = 21). Postoperative analgesia was achieved in both groups by patient‐controlled epidural analgesia (PCEA) with ropivacaine 0.2%. The main outcome measure was consumption of local anaesthetics. Additional parameters included visual analogue pain scale (VAS) scores, consumption of rescue analgesics, requests for PCEA boluses, and side‐effects. The pre‐operative parameters and pain scores were similar in the two groups. Epidural blocks provided sufficient operative analgesia in all patients. Pre‐emptive analgesia was continued for 11–20 h and led to significantly decreased pain scores before surgery. The consumption of local anaesthetics was decreased postoperatively in the study group (194 mg vs. 284 mg in the postoperative period). Furthermore, bolus requests occurred more frequently in the control group. VAS scores did not differ significantly between groups. Long‐lasting ‘pre‐emptive’ epidural analgesia decreases postoperative pain with improved pain control.
Coronary artery angioplasty for treatment of peri‐operative myocardial ischaemia
Authors: Obal D. , Kindgen‐Milles D. , Schoebel F. , Schlack W. 
Published: January 2005

SummaryIncreasing numbers of elderly patients with severe co‐existing medical diseases undergo major surgery. With these patients there is also an accompanying risk of age‐related cardiovascular complications such as life‐threatening myocardial ischaemia. We present a patient who suffered a myocardial infarction after a hemicolectomy and suffered a cardiac arrest in the recovery room. The therapeutic options available (e.g. coronary artery bypass grafting, acute percutaneous coronary angioplasty and peri‐operative thrombolysis) are discussed and the successful management of the case by coronary angioplasty and stent implantation is described.
Nefopam or clonidine in the pharmacologic prevention of shivering in patients undergoing conscious sedation for interventional neuroradiology
Authors: Bilotta F. , Ferri F. , Giovannini F. , Pinto G. , Rosa G. 
Published: January 2005

SummaryThe aim of this randomised, double‐blind study was to investigate the usefulness of intravenous nefopam, clonidine or placebo in preventing shivering in patients undergoing conscious sedation for interventional neuroradiological procedures. A total of 101 patients were prospectively enrolled and assigned to one of three groups to receive nefopam, clonidine or placebo. The overall incidence of intra‐operative shivering was significantly lower in patients treated with nefopam than in those treated with clonidine or placebo (2/32 (6%) vs. 11/38 (29%), p < 0.02; 2/32 (6%) vs. 24/31 (77%), p < 0.0001, respectively). The number of patients who required ephedrine infusions to maintain a mean arterial pressure of 100 mm Hg was higher in the clonidine group than in the nefopam and placebo groups (18/38 (47%) vs. 5/32 (17%), p < 0.05; 18/38 (47%) vs. 6/31 (19%), p < 0.05, respectively). We found that both nefopam and clonidine significantly lowered the rate and severity of shivering during interventional neuroradiological procedures. Fewer patients in the nefopam group than in the other two groups required vasoactive drugs.
Doppler estimation of zero flow pressure during changes in downstream pressure in a bench model of a circulation using pulsatile flow*
Authors: Athanassiou L. , Hancock S. M. , Mahajan R. P. 
Published: January 2005

SummaryZero flow pressure is the arterial pressure at which blood flow ceases in the cerebral circulation and may represent the effective downstream pressure of this system. We used a bench model of pulsatile fluid flow to determine whether simulated changes in downstream pressure may be detected by estimation of zero flow pressure. A Doppler probe was used to record flow velocity and a pressure transducer was used to measure driving pressure. Eight different configurations of the circuit were produced, and at each configuration the external pressure around a collapsible segment of the circuit was changed in order to simulate intracranial pressure. Perfusion pressure and zero flow pressure were estimated for each configuration and each level of external pressure. The sensitivity of the model in predicting the change in external pressure from the change in zero flow pressure was 94%. This indicates that estimation of zero flow pressure by this method is a sensitive way of monitoring trends in changes in downstream pressure.
Interaction of arousal states and low dose halothane on the acute hypercapnic ventilatory response in humans
Authors: Pandit J. J. , Moreau B. 
Published: January 2005

SummaryThe purpose of this study was to examine the effect of low dose halothane on the acute ventilatory response to hypercapnia, and to assess whether arousal (due to audiovisual (AV) stimulation or pain) modulates the response to halothane. Single step increases in end‐tidal Pco2 using dynamic end‐tidal forcing were performed from eucapnia (end‐tidal Pco2 held 1 mmHg (0.13 kPa) above ambient) to hypercapnia (end‐tidal Pco2 6 mmHg (0.79 kPa) above ambient) in eight healthy volunteers, with end‐tidal PO2 held at 100 mmHg (13.2 kPa), in six protocols: 1) control conditions (darkened, quiet room, eyes closed) without halothane; 2) control conditions with 0.1 MAC halothane; 3) AV stimulation (bright room, loud television) without halothane; 4) AV stimulation with 0.1 MAC halothane; 5) pain (electrical stimulation of skin over tibia to produce visual analogue pain score 5–6/10) without halothane; 6) pain with 0.1 MAC halothane. Both AV stimulation (p = 0.014) and pain (p = 0.0003) significantly increased the baseline eucapnic minute ventilation modestly (by ∼ 1.5–4 l.min−1). Halothane did not influence the baseline minute ventilation in any arousal state (p = 0.572), nor did it affect the hypercapnic ventilatory response in any arousal state (p = 0.208). Arousal (either AV stimulation or pain) did not affect the ventilatory response to CO2, regardless of the presence or absence of halothane (p = 0.585). We conclude that halothane affects neither baseline minute ventilation nor the response to CO2. Arousal can increase baseline ventilation but has no influence on the ventilatory response to CO2.
Evaluation of ease of intubation with the GlideScope® or Macintosh laryngoscope by anaesthetists in simulated easy and difficult laryngoscopy*
Authors: Lim T. J. , Lim Y. , Liu E. H. C. 
Published: January 2005

SummaryThe GlideScope® is a new video laryngoscope developed for management of the difficult airway. We compared the GlideScope with the Macintosh laryngoscope in simulated easy and difficult laryngoscopy. Twenty anaesthetists were allowed three attempts to intubate in each of four laryngoscopy scenarios in a high fidelity simulator. In the simulated easy laryngoscopy scenarios, the anaesthetists took longer to intubate using the GlideScope than the Macintosh laryngoscope (mean (SD) 19.0 (9.7) s vs. 12.7 (5.9) s, respectively; p = 0.006). There was no difference in the number of successful intubations, ease of intubation or choice of intubating device. In the simulated difficult laryngoscopy scenarios, the anaesthetists took less time to intubate using the GlideScope (23.5 (12.7) s vs. 70.5 (101.2) s, respectively; p = 0.001). The slightly higher success rate with the GlideScope was not statistically significant (20/20 vs. 18/20, respectively; p = 0.5). However, the anaesthetists found it easier to intubate using the GlideScope (median (interquartile range [range]) 1 (1–2 [1–2]) vs. 2 (2–3 [1–3]), respectively; p < 0.0001).
Neuroanaesthetists' experience of workload‐related issues and long‐duration cases
Authors: Willoughby L. , Morgan R. 
Published: January 2005

SummaryA survey of the members of the Neuroanaesthesia Society of Great Britain and Ireland was conducted to examine issues arising from the management of long cases. Replies were received from 47% of neuroanaesthetists. The survey highlights that consultants are working for prolonged periods without adequate rest. This may compromise patient safety, job satisfaction and recruitment to the specialty. These pressures are likely to increase as the European Working Time Directive reduces the availability of trainees, and because of expansion in neurosurgery and neuroradiology. Similar concerns are likely to extend into other anaesthetic specialties with long‐duration cases and may apply to our surgical colleagues.
Clinical comparison of three different anaesthetic depth monitors during cardiopulmonary bypass
Authors: Tirén C. , Anderson R. E. , Barr G. , Öwall A. , Jakobsson J. G. 
Published: January 2005

SummaryThe lack of a gold standard complicates the evaluation and comparison of anaesthetic depth monitors. This randomised study compares three different depth‐of‐anaesthesia monitors during cardiopulmonary bypass (CPB) at 34 °C with fentanyl/propofol anaesthesia adjusted clinically and blinded to the monitors. Coronary artery bypass grafting patients (n = 21) were randomly assigned to all three possible paired combinations of three monitors: Bispectral Index (Aspect Medical), AAITM auditory evoked potential (Danmeter), EntropyTM (Datex‐Ohmeda). Indices were manually recorded every 5 min during CPB. Agreement between paired indices was classified as good, non‐, or disagreement. Anaesthesia was classed as adequate, inadequate, or excessive according to recommended index values. Of the 255 paired indices recorded, 62% showed good agreement, 33% showed non‐agreement, and 5% showed disagreement. Using good agreement between two monitors as a gold standard, a quarter of the measurements indicate inappropriate anaesthetic depth monitoring during CPB with clinically titrated anaesthetic depth.
Cerebrospinal fluid and serum concentrations of beta‐trace protein during pregnancy
Authors: McArthur J. , Hill J. , Paech M. J. , Dodd P. H. , Bennett E.‐J. , Holden J. 
Published: January 2005

SummaryWe conducted a prospective observational study among a cohort of 40 term parturients undergoing spinal anaesthesia for elective Caesarean section, to determine the concentration of β‐trace protein in cerebrospinal fluid (CSF) and serum. Serum and CSF samples, taken at the time of dural puncture, were assayed by nephelometry. The mean serum β‐trace protein concentration was 0.39 mg.l−1 and the mean CSF concentration was 27.9 mg.l−1, giving a mean ratio of CSF to serum concentration of 76. This ratio is higher than that published for non‐pregnant females and for males because of both a higher mean CSF and a lower mean serum β‐trace protein concentration. The concentration correlated positively with both serum creatinine and gestational age. If these concentrations are used to estimate the normal range, we propose that the nephelometric measurement of β‐trace protein might prove a useful diagnostic test for cerebrospinal fluid‐cutaneous fistula in parturients.
Cost effectiveness of drotrecogin alfa (activated) for the treatment of severe sepsis in the United Kingdom*
Authors: Davies A. , Ridley S. , Hutton J. , Chinn C. , Barber B. , Angus D. C. 
Published: January 2005

SummaryDrotrecogin alfa (activated) is licensed in Europe for the treatment of severe sepsis in patients with multiple organ failure. We constructed a model to assess the cost effectiveness of drotrecogin alfa (activated) from the perspective of the UK National Health Service when used in adult intensive care units. Patient outcomes from a 28‐day international clinical trial (PROWESS) and a subsequent follow‐up study (EVBI) were supplemented with UK data. Cost effectiveness was assessed as incremental cost per life year and per quality adjusted life year saved compared to placebo alongside best usual care. Applying the 28‐day mortality outcomes of the PROWESS study, the model produced a cost per life year saved of £4608 and cost per quality adjusted life year saved of £6679. Equivalent results using actual hospital outcomes were £7625 per life year and £11 051 per quality adjusted life year. Drotrecogin alfa (activated) appears cost effective in treating severe sepsis in UK intensive care units.
A point mutation of the ED1 gene in a Japanese family with X‐linked hypohidrotic ectodermal dysplasia
Authors: SEKIGUCHI H. , WANG X. J. , MINAGUCHI K. , YAKUSHIJI M. 
Published: January 2005

Summary.X‐linked hypohidrotic ectodermal dysplasia (EDA) is characterized by the hypoplasia or absence of hair, teeth and sweat glands. In this study, the authors investigated the ED1 gene in a Japanese family with X‐linked hypohidrotic ectodermal dysplasia. The only affected male fulfils the diagnostic criteria for this disorder. His parents were not consanguineous and both of them were healthy. After informed consent, genomic DNA was isolated from the peripheral blood lymphocytes or oral buccal epithelial cells of all members of the family. A polymerase chain reaction fragment containing exon 9 of the ED1 gene was amplified using primers. The patient's amplified fragment, as well as those from his father, mother and sister, were directly sequenced. The sequence from the patient revealed a point mutation (G1149A) in exon 8 of the ED1 gene, which changes codon 291 from glycine to arginine. Heterozygosity was demonstrated in his mother and sister. This mutation has not been reported previously. The amino acid substitution is predicted to disrupt the transmembrane domain, which strongly implies that this is the disease‐causing mutation in the family.
A study into dentists’ knowledge of the treatment of traumatic injuries to young permanent incisors
Authors: KOSTOPOULOU M. N. , DUGGAL M. S. 
Published: January 2005

Summary.Objective.  The aims of this study were to evaluate dentists’ knowledge of the emergency treatment of traumatic injuries to young permanent incisors, and to investigate barriers to treatment.Design.  A closed‐ended questionnaire was sent to 1023 general dental practitioners (GDPs) and community dental officers (CDOs) in West/North Yorkshire and Humberside, UK.Methods.  The questionnaire comprised 17 questions. Six questions asked for general information about the participants (i.e. profession, age, gender, year of graduation, training or education on dental trauma, and willingness to provide emergency care), 10 were relevant to the emergency treatment of crown fractures, root fractures, luxation and avulsion injuries, and the last question queried any perceived barriers to treatment.Results.  Seven hundred and twenty‐four questionnaires were returned, a response rate of 71%, and these indicated that dentists’ knowledge of the emergency treatment of dentoalveolar trauma in children was inadequate. The CDOs were significantly more knowledgeable than the GDPs, as were younger and more recently graduated dentists compared with older ones. The GDPs regarded the difficulty of treating children and the inadequate fees of the UK National Health Service as important barriers to treatment. Dentists who attended continuing dental education courses on dental traumatology had a more thorough knowledge than those who did not.Conclusion.  Overall, the dentists’ knowledge of the emergency treatment of dentoalveolar trauma in children was inadequate. Greater emphasis on undergraduate and postgraduate education in this area is indicated.
An unusual intranasal foreign body in an unsuspecting 9‐year old
Authors: LOVEL S. F. , LOVELOCK D. J. , SHAW A. J. 
Published: January 2005

Summary.This report describes the incidental finding and removal of an unusual intranasal foreign body in a 9‐year‐old boy. The spectrum of items lost and found in the nasal cavity are reviewed before discussing the management of this case. Dental Practitioners should remain vigilant as radiopaque foreign bodies can be identified on commonly taken dental radiographic views. Patients should be referred promptly for foreign body removal in order to minimize potential complications.
Hypomineralized molars and incisors of unknown origin: treatment outcome at age 18 years
Authors: MEJÀRE I. , BERGMAN E. , GRINDEFJORD M. 
Published: January 2005

Summary.Objective.  To assess the outcome of treatment of hypomineralized molars and incisors of unknown aetiology (MIH) in 18‐year‐olds.Design.  A follow‐up study including clinical examination, panoramic radiography and intraoral photos.Sample and method.  Seventy‐six individuals treated at the Eastman Dental Institute in Stockholm during 1978–2001 with the diagnosis MIH. Severity of enamel defects in molars and incisors, prevalence and distribution of extracted molars, type, quality and median duration of restorations, periradicular condition of affected molars, dental occlusion and space closure in cases of extraction, as well as the individual's satisfaction with the treatment, were assessed.Results.  Severe defects with enamel surface breakdown in all four molars occurred in 42% of the individuals and 29% had at least one incisor with yellow/brown opacity in the enamel. At follow up, 42% of the individuals had at least one molar extracted; 18% had all four molars extracted. The median duration of the molar restorations (n = 153) was 5 years. Of the individuals with restored molars, 48% had at least one unacceptable restoration. Periradicular pathology was observed in three molars. The sagittal relations did not differ between individuals with and without extraction of molars. Space closure was acceptable in 87% of the individuals with extracted molars. Eighty percent were satisfied with the treatment.Conclusions.  Extraction of molars with severe enamel defects gave good or acceptable results in a majority of the patients while conservative restorative treatment resulted in a need for additional treatment in approximately half of the patients.
Clinical observations of odontomas in Japanese children: 39 cases including one recurrent case
Authors: TOMIZAWA M. , OTSUKA Y. , NODA T. 
Published: January 2005

Summary.Retrospective investigations of odontomas in Japanese children and one recurrent case were carried out. Thirty‐nine cases of odontoma in 38 children were treated in the Paediatric Dentistry Clinic of Niigata University Dental Hospital between September 1979 and December 2002. The patients consisted of 23 males and 15 females and their ages ranged from 1 year 2 months to 14 years old. The chief complaints were delayed tooth eruption in 19 cases (five: primary teeth, 14: permanent teeth), retention of primary teeth in 11, incidentally found on the radiographic examination in eight cases, and swelling of the jaw in one case. Thirty‐four cases (87%) were associated with tooth eruption disturbances. The most frequently affected region was the maxillary anterior region. Treatment consisted of surgical removal of odontomas in all cases, after which if the impacted teeth did not erupt, exposure of the crown and/or orthodontic traction was performed. Pathological diagnoses were compound odontoma in 30 cases, complex odontoma (n = 7), and compound and complex odontoma (n = 2). A retrospective study of the radiographs revealed the developing process of odontomas in four cases and odontoma disturbed tooth eruption since the early uncalcified developing stage. A recurrent case was a boy aged 6 years 5 months in whom the first surgical removal of odontoma was performed at the age of 1 year 8 months. Recurrence of an odontoma is very rare, but in very young children odontomas are in the early developing stages, containing uncalcified portions, so it is important to perform periodical observations until the succedaneous teeth erupt.
In‐vitro microleakage of repaired fissure sealants: a randomized, controlled trial
Authors: SRINIVASAN V. , DEERY C. , NUGENT Z. 
Published: January 2005

Summary.The aim of this study was to investigate whether differences in surface treatment prior to repair influenced the seal of a resin fissure sealant placed on the occlusal surfaces of permanent molar teeth.Setting.  In‐vitro study.Sample and methods.  One hundred and twenty‐eight extracted human first and second molars were randomly allocated to one of four groups of 32 teeth each. A light cured, unfilled, opaque resin fissure sealant (Delton) was placed on their occlusal surface following cleaning by prophylaxis and acid etching. Following storage in artificial saliva (Saliva Orthana) for a week, duplication of sealant failure was carried out. The teeth were then subjected to one of four different surface treatments: Group 1: with a slow‐speed prophylaxis brush followed by acid etching (control method); Group 2: a slow‐speed bur and acid etching; Group 3: air abrasion and acid etching; and Group 4: acid etching and application of a bonding agent. Following a further week of storage in artificial saliva two layers of impermeable varnish were applied to the nonocclusal surfaces of the teeth; their apices were then sealed with wax and the teeth were immersed in 1% methylene blue for 48 h. The teeth were then sectioned (ISOMET 1000) to achieve three cuts resulting in a maximum of four blocks, i.e. six surfaces per tooth. A total of 715 sections from 126 teeth were scored for microleakage on the intact and repaired side of the fissure sealant.Results.  Statistical analysis did not demonstrate any one single method of repair to be superior to the control method for reapplication of the sealant.Conclusion.  All four techniques compared in this study seem to be acceptable for replacing or repairing lost or fractured fissure sealants. As prophylaxis with a brush rotating at slow speed followed by acid etching, which probably represents current practice, is also the simplest technique that can be practised on children, it is therefore recommended.