bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does repetition of post‐tetanic count every 3 min during profound relaxation affect accelerographic recovery of atracurium blockade?
Authors: Motamed C. , Kirov K. , Combes X. , Duvaldestin P. 
Published: June 2005

Background:  Post‐tetanic count is a valuable method to assess profound neuromuscular blockade. However, subsequent responses to repetitive stimulation might be altered due to post tetanic facilitation (PTF). To avoid PTF, it has been advocated to limit the interval of stimulation from 6 to 10 min. The impact of PTF on 90% recovery of the TOF ratio has not been evaluated. Therefore, we assessed the effect of repetitive PTC stimulation on atracurium blockade with the primary outcome being the time to reach 90% TOF recovery in comparison to classical TOF stimulation.Methods:  After informed consent 20 patients ASA I–II, scheduled for peripheral surgery under general anaesthesia and requiring tracheal intubation were enrolled into the study. Anaesthesia was induced with fentanyl, propofol, and atracurium, 0.5 mg kg−1. Neuromuscular characteristics were assessed at the adductor pollicis by a TOF Watch® accelerometer (Organon, Teknika, Holland) on each arm. After onset of maximum neuromuscular blockade, repetitive PTC every 3 min on one arm and repetitive TOF stimulation every 15 s on the opposite arm was performed. The following parameters were recorded: onset of maximum blockade, mean time of PTC stimulation, the maximum number of responses to PTC, time of the first and second TOF responses, and recovery profile until 90% TOF ratio.Results:  Time to reach 90% TOF recovery was similar on both arms (48 ± 9 min), with a difference of 16 ± 38 s between the arms (P = 0.64). The first and second responses of the TOF on the PTC‐stimulated arm appeared at 29 ± 8 min and 33 ± 7 min, respectively. On the other arm the responses appeared at 30 ± 8 min and 35 ± 8 min, respectively (P < 0.05).Conclusion:  Repetitive PTC stimulation every 3 min hastened the first and second responses of the TOF stimulation but we could not detect a significant difference in the 90% recovery of TOF ratio during atracurium blockade.
Randomized, double‐blind study comparing postoperative effects of treatment timing with histamine H2‐receptor antagonist cimetidine
Authors: Chia Y‐Y. , Chiang H‐L. , Liu K. , Ko N‐H. 
Published: June 2005

Background:  The purpose of this study was to evaluate the effect of timing of preoperative, postoperative, and placebo administration of the H2‐antagonist cimetidine on postoperative pain management and the incidence of side‐effects.Methods:  One hundred and twenty ASA I to II patients, undergoing major gynaecological abdominal surgery, were randomly divided into three groups, and received a standardized general anaesthesia. The patients in the preoperative (‘Pre’) group received an intravenous infusion of cimetidine 4 mg kg−1 prior to anaesthesia induction; the postoperative (‘Post’) group received the same volume of normal saline. Postoperatively, the patients in the Post group received an intravenous infusion of cimetidine 4 mg kg−1; the patients in the Pre group received the same volume of normal saline. The Control group received the same volume of normal saline prior to anaesthesia induction and after the end of operation. Postoperatively, all patients were treated with a patient‐controlled intravenous analgesia system, which was programmed to deliver 1 mg of morphine on demand for three consecutive days.Results:  Pain intensity, morphine consumption, sedation score, and side‐effects were recorded and evaluated. We found no difference among the three groups with respect to pain intensities, morphine usage, sedation scores, and the incidence of nausea, vomiting, pruritus, or dizziness.Conclusions:  Our results suggested that neither preoperative nor postoperative administration of cimetidine 4 mg kg−1 provided a pre‐emptive or preventive analgesic advantage for postoperative pain or morphine consumption, and that the use of cimetidine failed to reduce the incidence of nausea or vomiting.
Postischemic exercise attenuates whereas enriched environment has certain enhancing effects on lesion‐induced subventricular zone activation in the adult rat
Authors: Komitova Mila , Zhao Li Ru , Gidö Gunilla , Johansson Barbro B. , Eriksson Peter 
Published: June 2005

AbstractExperimental stroke increases cell proliferation and neurogenesis in the subventricular zone (SVZ) and in the dentate gyrus subgranular zone (SGZ) in the adult mammalian brain. This study examined the effects of postischemic voluntary exercise (running wheel) and environmental enrichment on the SVZ and SGZ 1 week after focal cortical ischemia in adult spontaneously hypertensive rats. Immunohistochemical labeling was performed for incorporation of specific cell markers such as Ki67 and 5‐bromodeoxyuridine (proliferating and newborn cells), terminal deoxynucleotidyl transferase‐mediated dUTP in situ nick‐end labeling (apoptotic cells), Sox‐2 and glial fibrillary acidic protein (neural stem and progenitor cells), polysialylated neural cell adhesion molecule and doublecortin (neuroblasts). Postischemic exercise and environmental enrichment differentially modulated SVZ cell genesis but lacked effects on the SGZ. Lesion‐induced proliferation of neural stem/progenitor cells and neuronal precursors was attenuated in stroke runners without any effects on apoptosis or neuronal migration in the forebrain. Running activity did not affect the SVZ in intact rats. In contrast to postischemic wheel running, postischemic environmental enrichment did not have attenuating effects on the ipsilateral SVZ and increased proliferating putative neural stem cells and neuronal precursors contralaterally. A significant functional improvement, assessed using a rotating pole, was observed only in the postischemically enriched group and was likely due to other types of plasticity than neuronal replacement at this early time point. It may be concluded that in contrast to enriched environment, exercise during the first postischemic week might be detrimental for regenerative processes initiated in the SVZ after stroke.
Estrogen increases sensory nociceptor neuritogenesis in vitro by a direct, nerve growth factor‐independent mechanism
Authors: Blacklock A. D. , Johnson M. S. , Krizsan‐Agbas D. , Smith P. G. 
Published: June 2005

AbstractEstrogen affects many aspects of the nervous system, including pain sensitivity and neural regulation of vascular function. We have shown that estrogen elevation increases sensory nociceptor innervation of arterioles in Sprague–Dawley rat mammary gland, external ear and mesentery, suggesting widespread effects on sensory vasodilatory innervation. However, it is unclear whether estrogen elicits nociceptor hyperinnervation by promoting target release of neurotrophic factors, or by direct effects on sensory neurons. To determine if estrogen may promote axon sprouting by increasing release of target‐derived diffusible factors, dorsal root ganglia explants were co‐cultured with mesenteric arterioles for 36 h in the absence or presence of 17β‐estradiol (E2). Mesenteric arteriolar target substantially increased neurite outgrowth from explanted ganglia, but estrogen had no effect on outgrowth, suggesting that estrogen does not increase the availability of trophic proteins responsible for target‐induced neurite outgrowth. To assess the direct effects of estrogen, dissociated neonatal dorsal root ganglion neurons were cultured for 3 days in the absence or presence of E2 and nerve growth factor (NGF; 1–10 ng/mL), and immunostained for the nociceptor markers peripherin or calcitonin gene‐related peptide. NGF increased neuron size, survival and numbers of neurons with neurites, but did not affect neurite area per neuron. Estrogen did not affect neuron survival, size or numbers of neurons with neurites, but did increase neurite area per neuron. The effects of these agents were not synergistic. We conclude that estrogen exerts direct effects on nociceptor neurons to promote axon outgrowth, and this occurs through an NGF‐independent mechanism.
Mice lacking dopamine D1 receptors express normal lithium chloride‐induced conditioned taste aversion for salt but not sucrose
Authors: Cannon Claire Matson , Scannell Christopher A. , Palmiter Richard D. 
Published: June 2005

AbstractConditioned taste aversion (CTA), is a form of Pavlovian learning wherein a novel flavour is powerfully associated with subsequent feelings of illness, and is afterwards avoided. In rats, pharmacological blockade of dopamine D1 receptors has been reported to prevent the expression of a CTA to the sweet taste of sucrose or saccharine. We used genetically modified mice to determine whether dopamine D1 receptors are necessary for the expression of a CTA. Food‐deprived mice lacking the dopamine D1 receptor (D1r–/–) did not express a LiCl‐induced (125 or 254 mg/kg) CTA to the sweet taste of 0.5 m sucrose, in agreement with previous pharmacological studies. However, water‐deprived D1r–/– mice did express normal LiCl‐induced (40, 150 and 254 mg/kg) CTA to a salty taste (0.2 m NaCl). Our results suggest that activation of D1 receptors might contribute to the strength of an aversive gustatory association, but might not be required for the formation of a CTA in general.
Comparative evaluation of midazolam and ketamine with midazolam alone as oral premedication
Authors: GHAI BABITA , GRANDHE RADHIKA PRASAD , KUMAR ARUN , CHARI PRAMILA 
Published: June 2005

SummaryBackground : Oral premedication with midazolam and ketamine is widely used in pediatric anesthesia to reduce emotional trauma and ensure smooth induction. However, various dosing regimens when used alone or in combination have variable efficacy and side effect profile. The aim of our study was to investigate and compare the efficacy of oral midazolam alone with a low‐dose combination of oral midazolam and ketamine.Methods : We performed a prospective randomized double‐blind study in 100 children who were randomly allocated into two groups. Group M received 0.5 mg·kg−1 oral midazolam and group MK received 0.25 mg·kg−1 oral midazolam with 2.5 mg·kg−1 oral ketamine. The preoperative sedation score, ease of parental separation and ease of mask acceptance were evaluated on a 4‐point scale. The time to recovery from anesthesia and to achieve satisfactory Aldrete score was also noted.Results : Uniform and acceptable sedation scores were seen in both the groups (group M 95.9%; group MK 97.96%), without any serious side effects. However, the combination offered significantly more children in an awake, calm and quiet state, who were easily separated from their parents (73.46% in MK vs 41% in group M). The induction scores were comparable between the groups. The recovery room characteristics and time to achieve satisfactory Aldrete score were also comparable between the two groups.Conclusions : Oral midazolam alone and a combination of midazolam with ketamine provide equally effective anxiolysis and separation characteristics. However, the combination provided more children in an awake, calm and quiet state who could be separated easily from parents.
Perioperative management of a child with severe hypertension from a catecholamine secreting neuroblastoma
Authors: SEEFELDER CHRISTIAN , SPARKS J. WILLIAM , CHIRNOMAS DEBORAH , DILLER LISA , SHAMBERGER ROBERT C. 
Published: June 2005

SummaryIncreased catecholamine secretion from neuroblastomas can occasionally be demonstrated, but severe hypertension is uncommon. We report the perioperative management of a 5 year old child with stage III adrenal neuroblastoma who presented with malignant hypertension and high norepinephrine and dopamine levels. Hypertensive crises occurred during anesthesia for surgical biopsy and during chemotherapy. After blood pressure control using phenoxybenzamine and enalapril, doxazosin was used successfully as the preoperative α‐adrenergic receptor antagonist for surgical tumor resection.
A unified treatment of top‐down and bottom‐up control of reproduction in populations
Authors: Munch Stephan B. , Snover Melissa L. , Watters George M. , Mangel Marc 
Published: June 2005

AbstractGeneralizations describing how top‐down and bottom‐up processes jointly influence the production of offspring (recruitment) and the number of reproducing adults are lacking. This is a deficiency because (1) it is widely recognized that both top‐down and bottom‐up processes are common in ecosystems; and (2) the relationship between the number of individuals recruiting and number of reproductively active individuals present in that population is of fundamental importance in all branches of ecology. Here we derive a model to consider the joint effects of top‐down and bottom‐up forcing in any ecosystem. In general, during the lifetime of a cohort, bottom‐up effects are likely to limit recruitment over longer periods of time than top‐down effects. Top‐down effects are likely to be most important early in the life history when potential recruits are small in size, and such effects will be more recognizable in small cohorts comprised of slowly growing individuals.
The enemy release and EICA hypothesis revisited: incorporating the fundamental difference between specialist and generalist herbivores
Authors: Joshi J. , Vrieling K. 
Published: June 2005

AbstractThe success of invasive plants has been attributed to their escape from natural enemies and subsequent evolutionary change in allocation from defence to growth and reproduction. In common garden experiments with Senecio jacobaea, a noxious invasive weed almost worldwide, the invasive populations from North America, Australia, and New Zealand did indeed allocate more resources to vegetative and reproductive biomass. However, invasive plants did not show a complete change in allocation from defence to growth and reproduction. Protection against generalist herbivores increased in invasive populations and pyrrolizidine alkaloids, their main anti‐herbivore compounds, did not decline in invasive populations but were higher overall compared with native populations. In contrast, invasive plants lost additional protection against specialist herbivores adapted to pyrrolizidine alkaloids. Hence, the absence of specialist herbivores in invasive populations resulted in the evolution of lower protection against specialists and increased growth and reproduction, but also allowed a shift towards higher protection against generalist herbivores.
Studying invasion: have we missed the boat?
Authors: Puth Linda M. , Post David M. 
Published: June 2005

AbstractInvasive species, and the ensuing homogenization of the world's biota, form a global problem with consequences ranging from the decline and extirpation of native species to threats to human health. The magnitude of this issue demands a thorough understanding of the invasion process, which consists of three main stages: initial dispersal, establishment of self‐sustaining populations, and spread. To assess the relative distribution of research effort among these stages, we conducted a literature review using 873 articles published in 23 major journals over the past 10 years. Of the 873 papers, only 96 (11.0%) studied initial dispersal, and only half of these (6.2% of the total) were empirical. As the first stage in a contingent process, we argue that initial dispersal is the best stage during which to direct management efforts. In addition, initial dispersal has direct relevance for fundamental ecological questions regarding community assembly and metacommunity dynamics. In so far that answering these questions and preventing invasion are goals of ecologists, the disparity in research effort noted here suggests that ecologists need to expand their efforts to include more research on initial dispersal.
Ocular complications of neurological therapy
Authors: Hadjikoutis S. , Morgan J. E. , Wild J. M. , Smith P. E. M. 
Published: June 2005

Treatments used for several neurological conditions may adversely affect the eye. Vigabatrin‐related retinal toxicity leads to a visual field defect. Optic neuropathy may result from ethambutol and isoniazid, and from radiation therapy. Posterior subcapsular cataract is associated with systemic corticosteroids. Transient refractive error changes may follow treatment with acetazolamide or topiramate, and corneal deposits and keratitis with amandatine. Intraocular pressure can be elevated in susceptible individuals by anticholinergic drugs, including oxybutynin, tolterodine, benzhexol, propantheline, atropine and amitriptyline, and also by systemic corticosteroids and by topiramate. Nystagmus, diplopia and extraocular muscle palsies can occur with antiepileptic drugs, particularly phenytoin and carbamazepine. Ocular neuromyotonia can follow parasellar radiation. Congenital ocular malformations can result from in utero exposure to maternally prescribed sodium valproate, phenytoin and carbamazepine. Neurologists must be aware of potential ocular toxicity of these drugs, and appropriately monitor for potential adverse events.
The impact of intrapartum analgesia on infant feeding
Authors: Jordan Sue , Emery Simon , Bradshaw Ceri , Watkins Alan , Friswell Wendy 
Published: June 2005

Objective  To investigate the impact of intrapartum analgesia on infant feeding at hospital discharge.Design  Retrospective cohort.Setting  Maternity unit of a UK district general hospital.Population  A random sample of 425 healthy primiparae delivering healthy singleton babies at term in 2000.Methods  A random sample of primiparae delivering term neonates was identified from the birth register. We retrieved and analysed the corresponding joint midwifery/obstetric case notes.Main outcome measure  Infant feeding method at discharge from hospital.Results  Women [190/424 (45%)] were exclusively bottle feeding their babies at discharge from hospital. No one commenced breastfeeding after hospital discharge. Regression analysis revealed that the main determinants of bottle feeding were as follows: maternal age [odds ratio (OR) 0.90, 95% confidence interval [CI] 0.85–0.95 per year]; occupation (OR 0.63, 95% CI 0.40–0.99 for each category, unemployed, manual, non‐manual); antenatal feeding intentions (OR 0.12, 95% CI 0.080–0.19 for each category, bottle feeding, undecided, breastfeeding); caesarean section (OR 0.25, 95% CI 0.13–0.47, caesarean or vaginal delivery); and dose of fentanyl administered intrapartum (OR 1.004, 95% CI 1.000–1.008, 90% CI 1.001–1.007 for each microgram administered, range 8–500 μg).Conclusions  A dose–response relationship between fentanyl and artificial feeding has not been reported elsewhere. When well‐established determinants of infant feeding are accounted for, intrapartum fentanyl may impede establishment of breastfeeding, particularly at higher doses.
Cohort study of maternal and neonatal morbidity in relation to use of episiotomy at instrumental vaginal delivery
Authors: Youssef Refaat , Ramalingam Uma , Macleod Maureen , Murphy Deirdre J. 
Published: June 2005

Objective  The aim of this study was to investigate the maternal and neonatal morbidity related to use of episiotomy for vacuum and forceps deliveries.Design  Retrospective population‐based cohort study.Setting  Dundee, Scotland.Population  Two thousand one hundred and fifty three women who experienced an instrumental vaginal delivery between January 1998 and December 2002.Methods  Univariate and multivariate logistic regression analyses were performed comparing deliveries with and without the use of episiotomy.Main outcome measures  Extensive perineal tears (third and fourth degree) and shoulder dystocia.Results  Two hundred and forty‐one (11%) of the 2153 women who underwent instrumental vaginal deliveries did not receive an episiotomy. Vacuum delivery was associated with less use of episiotomy compared with forceps (odds ratio 0.10, 95% CI 0.07–0.14). Extensive perineal tears were more likely with use of episiotomy (7.5%vs 2.5%, adjusted OR 2.92, 95% CI 1.27–6.72) as was neonatal trauma (6.0%vs 1.7%, adjusted OR 2.62, 95% CI 1.05–6.54). Use of episiotomy did not reduce the risk of shoulder dystocia (6.9%vs 4.6%, adjusted OR 1.43, 95% CI 0.74–2.76). The findings were similar for delivery by vacuum and forceps.Conclusion  The use of episiotomy increased the risk of extensive perineal tears without a reduction in the risk of shoulder dystocia.
Outcomes of severe pre‐eclampsia/eclampsia in Yorkshire 1999/2003
Authors: Tuffnell D.J. , Jankowicz D. , Lindow S.W. , Lyons G. , Mason G.C. , Russell I.F. , Walker J.J. ,   On behalf of the Yorkshire Obstetric Critical Care Group
Published: June 2005

Objective  To establish the risk of serious complications from severe pre‐eclampsia and eclampsia in a region using a common guideline for the management of these conditions.Design  A five‐year prospective study.Setting  Sixteen maternity units in Yorkshire.Population  All women managed with severe pre‐eclampsia and eclampsia.Methods  A common guideline was developed for the management of women with these conditions. A network of midwives prospectively collected outcome data.Main outcome measure  Incidence of the conditions and serious complication rates.Results  A total of 210,631 women delivered in the 16 units between 1 January 1999 and 31 December 2003. One thousand eighty‐seven women were diagnosed with severe pre‐eclampsia or eclampsia (5.2/1000). One hundred and fifty‐one women had serious complications including 82 women (39/10,000) having eclamptic seizures and 49 women (23/10,000) requiring ICU admission. There were no maternal deaths but 54 out of 1145 babies died before discharge, giving a mortality rate of 47.2/1000. Of the 82 cases of eclampsia, 45 occurred antenatally (55%), 18 before admission to the maternity unit. Eleven cases occurred in labour (13%), including 1 during a caesarean section, and 26 cases occurred following delivery (32%). Twenty‐five women developed pulmonary oedema (2.3% of cases) and six women required renal dialysis (0.55% of cases). One hundred and sixty‐five (15%) required no antihypertensive therapy and 489 (53%) of the remainder required only oral therapy. Two hundred and one (18.5%) required more than one drug.Conclusion  A regional guideline for severe pre‐eclampsia and eclampsia can be developed and implemented. Its use may contribute to a low rate of serious complications.
Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses?
Authors: Elder Dawn E. , Zuccollo Jane M. , Stanley Thorsten V. 
Published: June 2005

Background  Case review after fatal perinatal asphyxia may have medicolegal implications. Accurate diagnosis of cause of death is therefore essential.Objective  To determine consent rate and utility of autopsy after fatal grade III hypoxic ischaemic encephalopathy (HIE) presumed to be secondary to birth asphyxia.Design  A retrospective clinical review from January 1995 to December 2002.Setting  Regional tertiary referral neonatal unit, Wellington, New Zealand.Population  Inclusion criteria were gestation ≥37 weeks, resuscitation after delivery and clinical course of grade III HIE. Exclusions were a recognised major lethal malformation.Methods  Review of clinical records including the autopsy report.Main outcome measures  Consent for autopsy, change in diagnosis after autopsy.Results  Twenty‐three infants died during the time period with a major diagnosis of grade III HIE. Three did not meet inclusion criteria. Of the remaining 20, 11 were female. Median gestation at birth was 40 weeks (range 38–42 weeks) and median birth weight was 3568 g (range 2140–4475 g). In 8/17 of the infants for whom length and head measurements were available, the Ponderal Index suggested intrauterine growth retardation. The 16/20 infants had an autopsy. Four of these were Coroner's cases giving an autopsy rate of 80% with a rate by consent of 60%. In 10 (62.5%) infants, significant new information was added to the clinical diagnoses.Conclusions  Neonatal HIE is a symptom rather than a final clinical diagnosis. A full autopsy is required to fully explore the reasons for fatal neonatal HIE and may provide information that is important medicolegally.