bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral clonidine premedication preserves heart rate variability for patients undergoing larparoscopic cholecystectomy
Authors: Yu H.‐P. , Hseu S.‐S. , Yien H.‐W. , Teng Y.‐H. , Chan K.‐H. 
Published: March 2003

Background: Clonidine has been shown to reduce perioperative circulatory instability. This postoperative analgesic effect of clonidine was also known in previous studies. The aim of the study was to investigate the clinical efficiency of oral clonidine premedication in anesthesia and analgesia in patients undergoing laparoscopic cholecystectomy.Methods: Thirty‐two patients scheduled for elective laparoscopic cholecystectomy were recruited for a prospective, randomized, double‐blinded comparative study. They were allotted randomly to two groups: placebo or clonidine. Patients in the placebo group (n = 16) were premedicated with oral antacid (alugel hydroxide 300 mg), while those in the clonidine group (n = 16) were premedicated with oral clonidine 150 µg before anesthesia. Analysis of heart rate variability was used to quantify the control of heart rate at baseline, and during the pneumoperitoneum and recovery periods. Time of the first request for postoperative analgesic and cumulative analgesic requirements in 24 h were recorded. Data are expressed as mean ± SD.Results: Heart rate variability was reduced in the pneumoperitoneum and postoperative period in the placebo group. Clonidine resulted in a greater perioperative (pneumoperitoneum period) power at all frequency ranges compared with placebo (671.5 ± 470.5 vs. 55.1 ± 51.6 ms2/Hz for total power variability, 170.1 ± 94.4 vs. 16.9 ± 21.1 ms2/Hz for low‐frequency variability and 206.1 ± 95.7 vs. 16.4 ± 15.1 ms2/Hz for high‐frequency variability, P < 0.05). The postoperative analgesic requirement was less (2.3 ± 0.8 vs. 3.2 ± 1.2 dose, P < 0.05) in comparison with the placebo group.Conclusion: Clonidine preserves heart rate control in pneumoperitoneum and recovery periods. Oral clonidine premedication also reduces the requirement for postoperative analgesia.
Anesthesiologists in prehospital care make a difference to certain groups of patients
Authors: Christenszen E. F. , Melchiorsen H. , Kilsmark J. , Foldspang A. , Søgaard J. 
Published: March 2003

Background: Knowledge of the population using prehospital emergency services is scarce except for selected subgroups. Interventions are often made without evaluation. The aim of this study was (1) to describe mortality, hospitalization and the diagnostic pattern among emergency ambulance users and (2) to evaluate the impact of one mobile emergency care unit (MECU) staffed by an anesthesiologist.Design and methods: A descriptive and quasi‐experimental study of consecutive emergency ambulance users during two 3‐month periods: before the MECU (Period 1) and after (Period 2). Hospitalization, diagnostic and 0–180‐day mortality data were requested from national registers. Diagnoses were according to the International Classification of Diseases (ICD).Results: Periods 1 and 2 included 2950 and 2869 users, respectively. The MECU attended 27.7% in Period 2. Fewer users were brought to hospital in Period 2 (87.9% vs. 93.8%, P < 0.0001), especially MECU users (76.5% MECU users vs. 92.3% other users; P < 0.001). Diagnoses included all main ICD‐groups. Overall mortality of all users was 10.2%; no difference between the periods. Cardiovascular and respiratory diseases were among the most frequent and were associated with high mortality. In Period 2 mortality was lower in subgroups: acute myocardial infarction (AMI; n = 177, day 0–180, 13.3% vs. 40.5%, P < 0.001); and respiratory diseases, only short‐term mortality (n = 388, day 0–1 mortality, 0.0% vs. 2.4%, P < 0.05).Conclusion: The diagnostic pattern among emergency ambulance users included all main groups of diseases. After the MECU fewer were brought to hospital. The overall mortality for all ambulance users was not influenced by the MECU. For the subgroups, especially AMI, mortality was lower after the introduction of the MECU.
Effects of human cathelicidin antimicrobial peptide LL‐37 on lipopolysaccharide‐induced nitric oxide release from rat aorta in vitro
Authors: Ciornei C. D. , Egesten A. , Bodelsson M. 
Published: March 2003

Background: Lipopolysaccharides (LPS), released by Gram‐negative bacteria, cause vascular expression of inducible nitric oxide synthase (iNOS) leading to nitric oxide (NO) production and septic shock. Human cathelicidin antimicrobial peptide (LL‐37) can bind and neutralize LPS. We wanted to study whether LL‐37 affects LPS or interleukin‐1β (IL‐1β)‐induced production, release and function of NO in intact rat aorta rings and cultured rat aorta smooth muscle cells.Methods: Isolated segments of thoracic aorta and cultured cells were incubated in the presence of LPS, LL‐37, LPS + IL‐37, IL‐1β, IL‐1β + IL‐37 or in medium alone. Smooth muscle contraction in response to phenylephrine and accumulation of the sdegradation products of NO, nitrate and nitrite, were measured on aorta segments. Levels of iNOS were assessed by Western blot and cytotoxic effects were detected by measurement of DNA fragmentation in cultured cells. Number of viable cells were determined after Trypan blue treatment.Results: Both LPS and IL‐1β reduced contractility in response to phenylephrine and increased NO production as well as iNOS expression. LL‐37 inhibited the LPS depression of vascular contractility induced only by LPS. LL‐37 reduced both the LPS‐ and IL‐1β‐induced NO production and iNOS expression. LL‐37 at high concentrations induced DNA fragmentation and decreased the number of living cells.Conclusion: IL‐37 reduces NO production induced by LPS and IL‐1β. The reduction does not seem to result only from neutralization of LPS but also from a cytotoxic effect, possibly via induction of apoptosis.
Effects of high‐dose propofol on succinylcholine‐induced fasciculations and myalgia
Authors: Kararmaz A. , Kaya S. , Turhanoglu S. , Ozyilmaz M. A. 
Published: March 2003

Background: The purpose of this prospective study was to determine the effects of high‐dose propofol on the incidence of fasciculations and myalgia, and to evaluate changes in creatine kinase levels following the administration of succinylcholine in 90 women who underwent laparoscopy.Methods: Patients were randomly assigned to one of three groups. Induction of anesthesia was performed with thiopentone 5 mg kg−1 in Group I (n = 30), propofol 2 mg kg−1 in Group II (n = 30), and propofol 3.5 mg kg−1 in Group III (n = 30). Then succinylcholine 1 mg kg−1 was administered to the patients for intubation.Results: Fasciculation was absent in 20% of Group III patients, and no vigorous fasciculation occurred in this group. Furthermore, the severity of fasciculation in Group III was significantly lower than in the other two groups (P = 0.01). Seventy per cent of patients had no myalgia in Group III, 39.2% in Group II and 37% in Group I (P = 0.007). Severity of myalgia was also significantly lower in Group III compared with the other two groups (P = 0.011). Post‐operative creatine kinase levels were significantly higher than their baseline values in Groups I and II (P < 0.0001).Conclusion: Administration of propofol 3.5 mg kg−1 is effective in reducing fasciculations and myalgia after succinylcholine.
Low‐dose bupivacaine plus fentanyl for spinal anesthesia during ambulatory inguinal herniorrhaphy: a comparison between 6 mg and 7. 5 mg of bupivacaine
Authors: Gupta A. , Axelsson K. , Thörn S. E. , Matthiessen P. , Larsson L. G. , Holmström B. , Wattwil M. 
Published: March 2003

Background: Inguinal herniorrhaphy is commonly performed as an outpatient procedure. Spinal anesthesia offers some advantages over general anesthesia in this setting.Methods: Forty patients were randomly divided into two groups according to a double‐blind protocol: Group L had spinal anesthesia with bupivacaine 6.0 mg and Group H with bupivacaine 7.5 mg; in both groups, fentanyl 25 µg was added to the spinal anesthetic. The sensory block was measured by ‘pin‐prick’ and the motor block was evaluated by a modified Bromage scale.Results: No differences were seen in the spread, duration and regression of sensory block between the groups on the operated side. A greater number of patients required analgesics during the operation in Group L (6) compared with Group H (1) (P<0.05). The return of the modified Bromage scale to grade 0 was earlier in Group L than in Group H (P<0.05) but the time to mobilization and discharge was similar. Seven patients (17%) needed to be catheterized and two had the catheter retained overnight. Times to home discharge (median) were 350 and 445 min, respectively, in Groups L and H. Postoperatively and during the first week, visual analog pain scores, analgesic requirements and side‐effects were similar between the groups. In Group H, 95% of the patients and in Group L 85% would have the same anesthetic again if operated upon for a similar procedure.Conclusions: Spinal anesthesia with bupivacaine 7.5 mg and fentanyl offers an alternative to general or local anesthesia for ambulatory inguinal herniorrhaphy. However, the long discharge times and risk for urinary retention restrict its routine use in all patients.
Remifentanil‐propofol vs. sufentanil‐propofol: optimal combinations in clinical anesthesia
Authors: Lentschener C. , Ghimouz A. , Bonnichon P. , Pépion C. , Gomola A. , Ozier Y. 
Published: March 2003

Background: Two opioid regimens, computer‐simulated to provide optimal general anesthesia in combination with propofol, were compared using clinical criteria.Methods: Fifty patients undergoing thyroid surgery were blindly, prospectively and randomly allocated to receive either (a) i.v. remifentanil (1.5 µg kg−1, followed by 0.2 µg kg−1 min−1) or (b) i.v. sufentanil (0.2 µg kg−1 followed by 0.2 µg kg−1 h−1). Remifentanil infusion was stopped at the last skin suture. Sufentanil infusion was stopped 30 min before the end of surgery. Intravenous propofol was titrated to keep BIS at 50±5. Remifentanil and sufentanil groups were compared with regards to (a) propofol delivery, (b) hemodynamic and recovery variables, and (c) effect‐site propofol levels during a steady‐state period for effect‐site remifentanil and sufentanil levels. P<0.05 was significant.Results: Groups were similar in demographic data; types and durations of surgery; total propofol consumption; and response, extubation and emergence times. During the steady‐state period for the opioid delivery, the remifentanil and sufentanil effect‐site levels were 5.3 ng ml−1 and 0.18 ng ml−1, respectively (potency ratio=30). In both opioid groups, in accordance with previous computer‐simulations, the effect‐site propofol concentrations remained (a) within a narrow range unaffected by surgical stimuli, (b) significantly smaller in the remifentanil group than in the sufentanil group, but (c) smaller than expected from previous computer‐simulations. More patients required ephedrine following induction of anesthesia in the remifentanil compared with the sufentanil group.Conclusions: The present clinical trial conducted in thyroid surgery is consistent with previous computer‐simulated opioid‐propofol combinations with respect to intraoperative and recovery variables. Effect‐site propofol ranges were, however, lower than expected.
Subarachnoid anesthesia in a patient with type I Gaucher disease
Authors: GarcÍa Collada J. C. , Pereda MarÍn R. M. , MartÍnez A. I. Garrote , Miralles Serrano E. M. , Pacheco López J. F. 
Published: March 2003

Gaucher's disease is a rare genetic disorder characterized by lack or functional insufficiency of glucocerebrosidase, an enzyme accountable for intracellular hydrolysis of glucosyl ceramide and other glycosphingolipids, which results in macrophage storage in the mononuclear‐macrophage system. The severity of Gaucher's disease is correlated with the extent to which the central nervous system is involved. It is associated with the so‐called Gaucher's cells in the bone marrow, but is specifically diagnosed by showing enzyme acid beta‐glucosidase activity in a sample of blood leukocyte or cultured macrophages from skin biopsy. In the last 10 years, an enzyme replacement therapy (alglucerase) for the disease has been available, which has significantly changed approaches to its treatment.Here we report the case of a 56‐year‐old female patient with type I Gaucher's disease who underwent surgery for subcapital hip fracture with subarachnoid anesthesia. Type I Gaucher's disease clinical and pathophysiologic aspects relevant to anesthetic management are discussed. As very few similar cases have been reported in the anesthesiology literature, it is our belief that the present case may help to elucidate some controversial issues relating to the perioperative anesthetic management of patients with type I Gaucher's disease.
Quality of life and seeking help in women with urinary incontinence
Authors: Hägglund Doris , Walker‐Engström Marie‐Louise , Larsson Gregor , Leppert Jerzy 
Published: March 2003

Background. The aims of this population‐based study were to compare the quality of life (QoL) in; (a) women with urinary incontinence (UI) and women without urinary incontinence (wUI) in relation to age, (b) women with stress incontinence and women with urge incontinence, and (c) women who had vs. women who had not consulted a health care service because of UI.Methods. Totally, 787 women who reported symptoms of UI and 787 women who did not report symptoms of UI, aged 18–72 years, were mailed the Short Form‐36 QoL questionnaire (SF‐36) and a question concerning professional consultation. They were also mailed the Detrusor Instability Score questionnaire, which was used to clarify the women as being stress vs. urge incontinent.Results. Women with UI had significantly lower scores on all eight dimensions of the SF‐36. There were low correlations between age and the QoL scores in women with or without UI. Both women with stress incontinence and women with urge incontinence had significantly lower scores on all eight QoL dimensions compared with the women without UI. However, the absolute difference was smaller for women with stress incontinence. Women with urge incontinence consult health care service more often than women with stress incontinence. Women with UI who had consulted health care had significantly lower QoL scores than women with UI who had not consulted health care in seven out of eight dimensions.Conclusions. The QoL, in this female general population, is more affected by women with urge incontinence than women with stress incontinence. Help seeking is associated with substantially lower QoL scores and with urge incontinence.
Transplantation of allogenic anterior lens capsule to the subretinal space in pigs
Authors: Folke Kiilgaard Jens , Katrine Wiencke Anne ,   Erik Scherfig, Ulrik Prause Jan , La Cour Morten 
Published: March 2003

ABSTRACT.Purpose:  To investigate the consequences of transplantation of a new basement membrane to the subretinal space (SRS) as a substitution of Bruch's membrane.Methods: Porcine anterior lens capsules (ALC) were transplanted to the subretinal space of 20 eyes from 19 young Danish landrace pigs. All pigs underwent a three port localized pars plana vitrectomy. Seventeen eyes received naked ALC. In three experiments the ALC was embedded in gelatine, in order to prevent curling of the ALC. The observation period varied between zero and 49 days. The pigs were examined by ophthalmoscopy and fundus photography. Histopathological examination of enucleated eyes was performed at the end of the experiment.Results: ALCs transplanted to the subretinal space were well‐tolerated and caused no inflammation when Bruch's membrane was left undamaged. After 11 days host RPE and glial cells started to cover the ALC in a competitive fashion. When Bruch's membrane was damaged, ingrowths of choroidal vessels and fibroblasts was prominent. The use of gelatine to flatten the ALC did not prevent curling, and gelatine caused pronounced inflammation.Conclusions: It is possible to transplant porcine ALC to the SRS of the pig. ALCs are well‐tolerated in the SRS and are covered with well‐differentiated monolayers of host RPE‐cells, if Bruch's membrane is left intact.
A comparison of risk factors for habitual violence in pre‐trial subjects
Authors: Kaliski S. Z. 
Published: March 2003

Objective: Pre‐trial referrals to the Valkenberg Hospital forensic unit over a 6‐month period were studied. Habitually violent offenders were compared with those with no history of violence.Methods:  Risk factors known to be associated with violent behaviour were elicited, i.e. demographics, behaviour during index offence (such as impulsivity, identity of victim, use of weapon, accomplices, intoxication, psychotic symptoms), psychiatric and family histories, history of suicide attempts, past child abuse, head injury, criminal record, psychiatric diagnosis and presence of medical disorders. EEG's, Barratt's Impulsivity, Zuckerman's Sensation Seeking and Mini‐Mental Scales were administered. Behaviour in the ward during the 30 days was also appraised. Logistic regression models were used to determine relative risks.Results:  There were 155 subjects; 89.7% were male, 71.6% were single and 58.7% were unemployed. For 44.5% the index offence was violent, and 9.7% had committed sexual offences; 61.9% had histories of habitual violence. A psychotic disorder was diagnosed in 32.3% and a personality disorder in 48.4%. Habitually violent subjects were distin‐ guished by a history of issuing threats (OR=3.68; CI=3.19–4.16; P= 0.000), delusions of persecution (OR=3.43; CI=2.67–4.17; P=0.001), history of conduct disorder (OR=1.95; CI=1.70–2.19; P=0.006), alcohol/substance abuse (OR=2.08; CI=1.53–2.61; P=0.008) and violent index offence (OR=1.66; CI=1.54–2.61; P=0.035).Conclusion: This seems to confirm the relationship between threats, feeling threatened, psychosis, a history of antisocial behaviour and alcohol abuse.
Criminal behavior of forensic and general psychiatric patients with schizophrenia: are they different?
Authors: Tengström A. , Hodgins S. 
Published: March 2003

Objective: This study was designed to compare the rate of past criminal behavior among male patients being discharged from forensic and general psychiatric hospitals in four countries.Method: Discharged consecutive patients from eight sites, four general and four forensic psychiatric, were included and asked for participation. Transcripts of past criminal behavior were available for this study. Analyses were limited to men with schizophrenia.Results:One in five of the general psychiatric patients had a criminal record. The criminal histories of the offenders in the general and forensic hospitals were similar, except that all patients who had killed were treated in forensic hospitals.Conclusion:The results point to the need to assess the risk of violent behavior among general psychiatric patients in order to provide them with appropriate treatments designed to prevent criminal recidivism.
Relapse in violent crime in relation to cerebrospinal fluid monoamine metabolites (5‐HIAA, HVA and HMPG) in male forensic psychiatric patients convicted of murder: a 16‐year follow‐up
Authors: Dåderman A. M. , Lidberg L. 
Published: March 2003

Objective:  Our purpose was to investigate if low levels of cerebrospinal fluid (CSF) monoamine metabolites of 5‐HIAA, HVA and HMPG predict relapse in violent crimes.Method:  Relapse in crime and level of CSF monoamine metabolites (5‐HIAA, HVA and HMPG) was studied in a group of 29 murderers. The follow‐up was 16 years.Results:  Fourteen of the 29 murderers were convicted of crime; nine of them committed violent crimes; one was convicted of a new murder. The differences in mean CSF monoamine metabolites were lower in subjects who relapsed into any type of crime, but only the difference in mean CSF HVA was statistically significant.Conclusion:  The risk to commit new murder is very small in males who earlier have been convicted of murder. Low levels of CSF HVA is associated with an increased risk for relapse in any type of crime.
A public‐health perspective on violence
Authors: Melinder K. 
Published: March 2003

Objective:  To describe how specific theories and methods used in public health, especially regarding injuries, are related to violence.Method:  Theories and preventive work in injury research (above accidents) are presented and related to violence.Results: Registration of injuries and an interest in the environment are seen as specific for injuries. In prevention there is a focus on community work and the concept of ‘a safe community’ has been developed. Haddon's matrix offers a foundation for theoretical injury research. It is formed by cross‐tabulating the trichotomy of host‐agent‐environment against a time dimension.Conclusion:  One practical and one theoretical model on how violence might be seen as an injury have been demonstrated. No clear evaluation has been made of the practical model up to now. The theoretical model has the advantage that the model makes it easier to get a more comprehensive picture of how different factors influence violence.
Adult psychopathy and violent behavior in males with early neglect and abuse
Authors: Lang S. , Af Klinteberg B. , Alm P.‐O. 
Published: March 2003

Objective:  Within a Swedish longitudinal project, possible implications of childhood neglect and/or abuse on adult psychopathy checklist (PCL) scores and violent offending were studied.Method:  The subjects were males (n=199), recruited from a socially high‐risk neighborhood and grouped on an index variable of victimization, yielding high (n=110) and low victimization (n=89) groups. To highlight a possible comorbidity of all three problems in the same persons, a combined dimensional and categorical (configural frequency analysis, CFA) approach was applied.Results:  The high victimization subjects exerted significantly more violence, as did subjects with high PCL scores. Furthermore, in the CFA two significant ‘types’ were found: one type indicating that ‘high’ victimization in childhood is closely linked to later ‘extensive’ violence and ‘high’ PCL scores at adult age in the same individuals; the other supporting a frequent co‐occurring of ‘low’ victimization in childhood, ‘none or minor’ later indications of violence and ‘low’ adult PCL scores.Conclusion:  The results point to possible underlying mechanisms linked to all three problems characterizing the affected subjects.
Issues in the measurement of violent incidents and the introduction of a new scale: the ‘attacks’ (attempted and actual assault scale)
Authors: Bowers L. , Nijman H. , Palmstierna T. , Crowhurst N. 
Published: March 2003

Objective:  To review the strengths and weaknesses of existing violent incident measures, and introduce a new scale, the ‘attacks’. The new scale provides an objective measure of incident severity and focuses on interpersonal physical violence in isolation from other behaviours.Method:  The new scale was piloted on six psychiatric wards in the East End of London over a period of 16 weeks. Descriptive data were obtained and validated against official violent incident records.Results:  There were 40 incidents by 21 aggressive patients, most of which occurred on the psychiatric intensive care unit. Striking assaults predominated. Continuous holding of the patient by nurses occurred after 17% of incidents. Special observation was also used as a subsequent management method in more than half of the incidents.Conclusion:  The scale is acceptable to nurses and valid. Interesting questions are raised about the content of training for staff in the prevention and management of violent incidents.