bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of baricity of intrathecal morphine in children receiving tetracaine spinal anaesthesia for cardiac surgery: a preliminary report
Authors: FINKEL JULIA C. , BOLTZ M. GAIL , CONRAN AISLING M. 
Published: March 2003

Background: This prospective, randomized study examined the effect of baricity of intrathecal preservative‐free morphine on the duration of postoperative analgesia and incidence of side‐effects in infants and children receiving high spinal anaesthesia with hyperbaric tetracaine in combination with a light general anaesthetic. Methods: Fourteen infants and children, aged 7–91 months, undergoing repair of either uncomplicated atrial or ventricular septal defects, were randomized to receive either 10 μg·kg–1 of intrathecal morphine in combination with 0.5% tetracaine D10 (hyperbaric morphine group) or intrathecal morphine mixed with saline and injected sequentially after the administration of 0.5% tetracaine D10 (hypobaric morphine group). After spinal injection, patients were positioned in 30° of Trendelenburg for a minimum of 10 min. Postoperatively, patients were monitored for a minimum of 12 h. Pain scores and the incidence and severity of side‐effects were recorded every 1 h. Results: All patients were extubated at the conclusion of surgery without any incidence of respiratory depression. There was a decreased incidence of vomiting in the hypobaric morphine group and no significant difference in the duration of analgesia. Conclusions: When intrathecal morphine is administered in conjunction with a hyperbaric tetracaine spinal to paediatric cardiac patients in the head down position, sequential administration of the hypobaric solution may mitigate side‐effects.
The reliability of endtidal CO2 in spontaneously breathing children during anaesthesia with Laryngeal Mask AirwayTM, low flow, sevoflurane and caudal epidural
Authors: AASHEIM Per , FASTING SIGURD , MOSTAD Ulf , AADAHL PETTER 
Published: March 2003

Background: Noninvasive devices for monitoring endtidal CO2 (PECO2) are in common use in paediatric anaesthesia. Questions have been raised concerning the reliability of these devices in spontaneous breathing children during surgery. Our anaesthetic technique for elective infraumbilical surgery consists of spontaneous breathing through a Laryngeal Mask Airway (LMATM), low fresh gas flow, sevoflurane and a caudal epidural. We wanted to compare PECO2 and arterial CO2 (PaCO2) during surgery. Methods: Twenty children, aged 1–6 years, scheduled for infraumbilical surgery, were studied and one arterial sample was taken 45 min after induction of anaesthesia. PECO2, inspiratory PCO2, oxygen saturation, heart rate, respiratory rate, mean arterial blood pressure and expiratory sevoflurane concentration were measured every 5 min. The respiratory and circulatory parameters were stable during surgery. Results: The mean PaCO2 – PECO2 difference was 0.15 (0.16) kPa [1.1 (1.2 mmHg)]. Conclusions: PECO2 is a good indicator of PaCO2 in our anaesthetic setting.
Premedication with midazolam in young children: a comparison of four routes of administration
Authors: Kogan Alexander , Katz Jacob , Efrat Rachel , Eidelman Leonid A. 
Published: March 2003

Summary Background: We undertook a study to determine the effects of four routes of administation on the efficacy of midazolam for premedication. Methods: In a randomized double‐blind study, 119 unmedicated children, ASA I–II, aged 1.5–5 years, who were scheduled for minor elective surgery and who had been planned to received midazolam as a premedicant drug, were randomly assigned to one of four groups. Group I received intranasal midazolam 0.3 mg·kg−1; group II, oral midazolam 0.5 mg·kg−1; group III, rectal midazolam 0.5 mg·kg−1; and group IV, sublingual midazolam 0.3 mg·kg−1. A blinded observer assessed the children for sedation and anxiolysis every 5 min prior to surgery. Quality of mask acceptance for induction, postanaesthesia care unit behaviour and parents' satisfaction were evaluated. Thirty patients were enrolled in each of groups I, III and IV. Twenty‐nine patients were enrolled in group II. Results: There were no significant differences in sedation and anxiety levels among the four groups. Average sedation and anxiolysis increased with time, achieving a maximum at 20 min in group I and at 30 min in groups II–IV. Patient mask acceptance was good for more than 75% of the children. Although the intranasal route provides a faster effect, it causes significant nasal irritation. Seventy‐seven percent of the children from this group cried after drug administration. Most parents in all groups (67–73%) were satisfied with the premedication. Conclusions: Intranasal, oral, rectal and sublingual midazolam produces good levels of sedation and anxiolysis. Mask acceptance for inhalation induction was easy in the majority of children, irrespective of the route of drug administration.
Is there a role of a small dose of propofol in the treatment of laryngeal spasm?
Authors: Afshan Gauhar , Chohan Ursula , Qamar‐Ul‐Hoda Mohammad , Kamal Rehana S. 
Published: March 2003

Summary Background: Propofol has been found to depress the laryngeal reflexes. We studied whether this property could be utilized to relieve laryngeal spasm. Methods: This study was conducted over a period of 3 years, and included children aged 3–10 years, ASA status I and II. Most of the children were undergoing minor surgical procedures, under general anaesthesia with Laryngeal Mask Airway (LMA™) and caudal epidural analgesia. Results: During this period, 20 patients developed laryngeal spasm on removal of the LMA at the end of surgery. Initially, they all were treated with 100% O2, with gentle positive pressure ventilation. Out of 20 patients, seven responded well with 100% O2 and gentle positive pressure ventilation. The remaining 13 were treated with a small dose of propofol (0.8 mg·kg−1 body weight). Laryngeal spasm was relieved successfully in 10 patients and three patients required intubation to improve their oxygenation. Conclusions: Propofol in a small dose (0.8 mg·kg−1 body weight) was a useful drug to relieve laryngeal spasm in most children (76.9%) following the removal of the LMA. Because it was not found to be effective in all patients, succinylcholine still has a role to play in critical conditions. However, we recommend propofol as a suitable alternative for relieving laryngeal spasm in situations where succinylcholine is contraindicated.
Preemptive diclofenac reduces morphine use after remifentanil‐based anaesthesia for tonsillectomy
Authors: Öztekin Sermin , Hepağuşlar Hasan , Kar Aysun Afi̇fe , Özzeybek Deni̇z , Artikaslan Oya , Elar Zahi̇de 
Published: March 2003

Summary Background: We investigated the effect of preincisional rectal diclofenac on pain scores and postoperative morphine requirements of children undergoing tonsillectomy after remifentanil‐propofol anaesthesia in a randomized clinical trial. Methods: Induction and maintenance of anaesthesia were with remifentanil and propofol. Forty children were randomly assigned into two groups before incision. The diclofenac group (n=20) received diclofenac suppositories (approximately 1 mg·kg−1) and the control group (n=20) received no treatment. Following discontinuation of remifentanil, patient‐controlled analgesia (PCA) with morphine (a loading dose 50 µg·kg−1, a background infusion 4 µg·kg−1·h−1 and a demand dose 20 µg·kg−1 with 5‐min intervals) was started. We assessed pain score [verbal analogue scales (VAS), 0–10] and sedation level at 5‐min intervals and recorded the total morphine consumption of the first hour in the PACU. Patients were discharged to the ward with a new PCA morphine programme (a demand dose 20 µg·kg−1 with a lockout time of 30 min, for 4 h), and total morphine consumption was recorded. Results: The mean VAS score of the diclofenac group was significantly lower than the control group on arrival in the PACU (2.85 ± 0.77, 7.60 ± 0.83, respectively, P < 0.01) and it remained significantly lower in the PACU stay of the children. The mean total morphine consumption of the diclofenac group was less than the control group in the PACU (130.33 ± 11.26 and 169.92 ± 9.22, respectively, P=0.012) and the ward (50.80 ± 11.38 and 87.77 ± 10.55, respectively, P=0.021). Conclusions: Preemptive diclofenac given rectally reduced pain intensity and morphine requirements of children anaesthetized with remifentanil for tonsillectomy.
A 3:1 volume admixture of 1% propofol and 2.5% thiopentone reduces pain on induction in paediatric anaesthesia
Authors: Pollard R.C. , Makky S. , Mcfadzean J. , Ainsworth L. , Goobie S.M. , Montgomery C.J. 
Published: March 2003

Introduction  The incidence of pain on injection with 1% propofol in adult and paediatric patients ranges from 50 to 100% (1). In paediatric practice, the addition of lignocaine 1 mg·kg−1 to propofol reduces the incidence of pain. The incidence of pain with this technique in a pilot study in our institution was 20%. Thiopentone mixed with propofol may also reduce injection pain (2). The purpose of this study was to evaluate the incidence of pain on injection during intravenous induction using a 3:1 volume admixture of 1% propofol and 2.5% thiopentone (P/T) compared to a 10:1 volume admixture of 1% propofol and 2% lignocaine (P/L).Methods  After ethics committee approval and informed written parental consent, 127 children, aged 1–10 years and weighing < 40 kg were randomised into two groups; group P/L received 5 mg·kg−1 of 1% propofol and 1 mg·kg−1 of lignocaine, group P/T received 3 mg·kg−1 of 1% propofol and 3 mg·kg−1 of 2.5% thiopentone in a standardised fashion. Any subject who was not calm and cooperative immediately prior to induction after establishment of intravenous access was excluded from further study. A single, blinded observer scored pain behavior defined as any one of. a motor response of the arm, a verbal complaint of pain, cry and/or one of three standardised facial expressions of pain.Results  The incidence of pain on injection was higher in the P/L group where 34% subjects experienced pain compared with 14% in the P/T group (χ2 = 7.5, P = 0.006). Motor response was the most frequent pain response in the P/L group (68%).Discussion  The hemodynamic effects, immediate in‐hospital or late recovery profile and incidence of postoperative nausea and vomiting of these admixtures were not evaluated in this study. Our clinical impression is that using either the P/L or P/T combination allowed rapid IV induction, and therefore rapid ventilation and LMA insertion without obvious hypotension. The P/T admixture may be less painful to inject simply because propofol is diluted. The optimum ratio of dilution of propofol with thiopentone may not be 3:1 and requires a dose‐finding study evaluating in detail the efficacy and side effects of other ratios of admixtures.Conclusion  The use of a 3:1 volume admixture of 1% propofol and 2.5% thiopentone compared to a 10:1 volume admixture of 1% propofol and 2% lignocaine reduces pain on injection at induction of anaesthesia in paediatric patients from 34% to 14%, and is a practical solution for pain on injection in pediatric patients.
Diode laser transscleral cyclophotocoagulation for the treatment of primary glaucoma in 18 dogs: a retrospective study
Authors: Hardman Chloe , Stanley Robin G. 
Published: March 2003

AbstractObjectiveTo evaluate a higher total energy protocol for diode laser transscleral cyclophotocoagulation (TSCP) for the treatment of primary glaucoma in dogs.ProceduresDiode laser TSCP was performed on 24 eyes of 18 dogs (six dogs were treated bilaterally). A glaucoma probe with a spot size of 600 microns was applied in 25 sites 3–4 mm posterior to the limbus for dogs. A power of 1000 milliwatts (mW) for a duration of 5000 milliseconds (ms) to deliver an average 125 J of energy per eye, which is higher energy delivery than previously reported for the diode laser for the treatment of canine glaucoma. Anterior chamber needle paracentesis was performed using a 30‐gauge needle until intraocular pressure (IOP) was measured to be less than 15 mmHg by applanation tonometry. Subconjunctival corticosteroids were administered in all cases and a temporary tarsorrhaphy was applied in 13 of the 24 treated eyes. Postoperative topical and systemic corticosteroids, and carbonic anhydrase inhibitors were administered as required to maintain an IOP of less than 25 mmHg. Intraocular pressure was measured at approximately 3 h postoperatively then at 1, 2, 3, 7, 14, 28, 60, 120, and 180 days. Adequate control of IOP was considered to be less than 25 mmHg on re‐examination.ResultsIntraocular pressure was successfully maintained within the normal range in 22/24 eyes (92%). Three eyes required a second diode laser treatment within the first week postoperatively. Two eyes developed recurrence of glaucoma at 8 and 32 weeks postoperatively. Follow‐up ranged from 8 to 21 months. Fourteen eyes were assessed by clinical examination and history to be potentially visual. Of these, seven eyes (50%) regained useful visual function. Mean IOP at 6 months was 11.0 ± 7.6 mmHg and at 12 months was 11.0 ± 8 mmHg. Postoperative complications included cataracts (six cases), corneal ulceration (three cases), and keratitis (three cases). Of 13 cases that were treated postoperatively with a temporary tarsorrhaphy, only one case (8%) developed corneal disease. Of the remaining 11 cases that were not treated with a temporary tarsorrhaphy, there were three cases of corneal ulceration and two cases of vascular keratitis (45% incidence of corneal disease). This was found to be statistically significant (P < 0.05). Postoperative complications of hyphema and phthisis bulbi were not seen in this series.ConclusionLow energy, higher power laser cyclophotocoagulation was effective in the treatment of canine primary glaucoma, with 50% of potentially visual eyes regaining vision, but may cause an increased incidence of secondary cataracts.
Schwalbe line’s cell in the normal and glaucomatous dog
Authors: Samuelson Don , Plummer Caryn , Lewis Patricia , Gelatt Kirk 
Published: March 2003

Objective The canine iridocorneal angle contains an operculum, which is similar to that in nonhuman primates and consists of a peripheral extension of the inner cornea that overlies the anterior‐most portion of the corneoscleral trabecular meshwork. This region contains cells, the Schwalbe line’s (SL) cells, that have been found to have secretory and epithelial characteristics. This region of the iridocorneal angle represents the nonfiltering portion and becomes altered early during spontaneous glaucoma in the Beagle. The present study describes the SL cell for the first time in the dog and changes associated with canine primary open angle glaucoma. Procedures The iridocorneal angles from 18 Beagles with inherited glaucoma (3 months–8 years old) and 17 normal, age‐matched Beagles were placed in 10% buffered formalin for light microscopic evaluation, or 2.5% glutaraldehyde for ultrastructural evaluation. Using at least three fields from each region of the iridocorneal angle (opercular, corneoscleral, and uveal) at ×1000 magnification, trabecular cell nuclei were counted. Results The operculum in the canine iridocorneal angle consisted of the peripheral extension of the corneal endothelium and underlying anterior‐most corneoscleral meshwork, having no direct contact with the angular aqueous plexus. The SL cells associated with operculum‐retained epithelial morphology (polyhedral in shape with rER, Golgi apparatus, and secretory vesicles) in both normal, pre‐and early glaucomatous dogs. In animals with moderate and advanced stages the SL cells often became less epithelial and secretory in appearance. The number of SL cells in normal dogs declined by approximately one‐third by the end of their first year with gradual loss thereafter. In the glaucoma group the decline was more substantial and continuous through the first three years. Conclusions The SL cell is morphologically a distinct cell type within the canine iridocorneal angle that is specifically associated with the nonfiltering portion of the corneoscleral trabecular meshwork. Changes in the SL cells of the glaucomatous dog occurred with regard to age and progression of the disease.
Phylogeny and revision of the leech genus Helobdella (Glossiphoniidae) based on mitochondrial gene sequences and morphological data and a special consideration of the triserialis complex
Authors: Siddall Mark E. , Borda Elizabeth 
Published: March 2003

The relationships, as well as identification of species, within Helobdella (Glossiphoniidae) were explored through phylogenetic analysis and through an overview of the historical systematics of the genus. The phylogeny was determined using morphological data and the mitochondrial gene sequences of cytochrome c oxidase subunit I and nicotinamide adenine dinucleotide dehydrogenase subunit I. A broad representation of 15 ingroup species was sampled, including 10 individuals from South America. Outgroup taxa included five species of Haementeria. Cladistic analysis of all available data resulted in one most parsimonious tree. Results shed light on genetic divergence of members classified as the same species, including those that are not monophyletic. Historically, external morphological characters have played a significant role in contributing to the confusion in the classification of H. triserialis, H. papillata, H. lineata and H. fusca in North America. Re‐evaluation of Verril's Clepsine papillifera var. b and var. d in a phylogenetic context provides a solution. Additionally, the genera Adaetobdella, Acritobdella, Dacnobdella and Gloiobdella created by Ringuelet are returned to Helobdella based on overlapping morphological characters.
Middle Miocene elasmotheriine Rhinocerotidae from China and Mongolia: taxonomic revision and phylogenetic relationships
Authors: Antoine Pierre‐Olivier 
Published: March 2003

Eight elasmotheriine rhinocerotid species have been described from the Middle Miocene of China and Mongolia. In this paper a revised taxonomy is presented based on direct observation and comparison of the available material. A phylogenetic analysis based on 282 morphological characters has led to the reappraisal of Procoelodonta Matthew, 1931, Caementodon Heissig, 1972 and Huaqingtherium Huang & Yan, 1983. The genus Procoelodonta is split into three subgenera: P. (Procoelodonta) Matthew, 1931, P. (Begertherium) Beliaeva, 1971, and P. (Pasalarhinus subg. n). The genus Caementodon is split into two subgenera: C. (Caementodon) Heissig, 1972 and C. (Beliajevina) Heissig, 1974. Four species are assumed to have occurred in the Middle Miocene within the area studied: Procoelodonta (Procoelodonta) mongoliense (Osborn, 1924), ‘P.’ (Begertherium) borissiaki (Beliaeva, 1971), ‘Caementodon’ (Beliajevina) fangxianense (Yan, 1979) and Huaqingtherium lintungense (Zhai, 1978) (=‘Caementodon tongxinensis’ Guan, 1988 =‘Huaqingtherium qiui’ Guan, 1993 =‘Hispanotherium tungurense’ Cerdeño, 1996). Shennongtherium hypsodontus Huang & Yan, 1983 is removed from the Elasmotheriina, owing to dental characters which suggest that it is a teleoceratine. The distribution of the main characters later seen in Elasmotherium is briefly discussed. The persistence and diversity of the Elasmotheriina throughout the Middle Miocene help explain how minute brachyodont animals gave rise to the mammoth‐sized hypsodont Elasmotherium.
Pathogenicity genes of phytopathogenic fungi
Authors: Idnurm Alexander , Howlett Barbara J. 
Published: March 2003

SummaryRecently many fungal genes have been identified that, when disrupted, result in strains with a reduction or total loss of disease symptoms. Such pathogenicity genes are the subject of this review. The large number of pathogenicity genes identified is due to the application of tagged mutagenesis techniques (random or targeted). Genes have been identified with roles in the formation of infection structures, cell wall degradation, overcoming or avoiding plant defences, responding to the host environment, production of toxins, and in signal cascades. Additionally, genes with no database matches and with ‘novel’ functions have also been found. Improved technologies for mutation analysis and for sequencing and analysing fungal genomes hold promise for identifying many more pathogenicity genes.
Analysis of the distribution and structure of integrated Banana streak virus DNA in a range of Musa cultivars
Authors: Geering Andrew D. W. , Olszewski Neil E. , Dahal Ganesh , Thomas John E. , Lockhart Benham E. L. 
Published: March 2003

Summary Banana streak virus strain OL (BSV‐OL) commonly infects new Musa hybrids, and this infection is thought to arise de novo from integrated virus sequences present in the nuclear genome of the plant. Integrated DNA (Musa6+8 sequence) containing the whole genome of the virus has previously been cloned from cv. Obino l’Ewai (Musa AAB group), a parent of many of the hybrids. Using a Southern blot hybridization assay, we have examined the distribution and structure of integrated BSV‐OL sequences in a range of Musa cultivars. For cv. Obino l’Ewai, almost every restriction fragment hybridizing to BSV‐OL was predicted from the Musa6+8 sequence, suggesting that this is the predominant type of BSV‐OL integrant in the genome. Furthermore, since only two junction fragments of Musa/BSV sequence were detected, and the Musa6+8 sequence is believed to be integrated as multiple copies in a tandem array, then the internal Musa spacer sequences must be highly conserved. Similarly sized restriction fragments were detected in four BB group cultivars, but not in six AA or AAA group cultivars, suggesting that the BSV‐OL sequences are linked to the B‐genome of Musa. We also provide evidence that cv. Williams (Musa AAA group) contains a distinct badnavirus integrant that is closely related to the ‘dead’ virus integrant previously characterized from Calcutta 4 (Musa acuminata ssp. burmannicoides). Our results suggest that the virus integrant from cv. Williams is linked to the A‐genome, and the complexity of the hybridization patterns suggest multiple sites of integration and/or variation in sequence and structure of the integrants.
Congruence of terms between lists of problems and the ICNP®– Alpha Version
Authors: Cruz D. M. , Gutierrez B. A. O. , López A. L. , De Souza T. T. , Assami S. 
Published: March 2003

Abstract The International Classification for Nursing Practice (ICNP®) – Alpha Version, is the first rendition of the International Council of Nurses (ICN) efforts to develop a standardized international nursing language system. This system has three principal components: nursing phenomena; nursing actions; and nursing outcomes. This article describes a study of agreements between terms used by nurses of the intensive care unit at the Hospital of the University of Sao Paulo, to designate patients’ nursing problems and the terms proposed by the ICNP®– Alpha Version. The records of 59 interned patients, admitted to the intensive therapy unit, were analysed for nursing problems. Of 336 problem categories listed by the nurses, 153 (45.5%) corresponded to the ICNP® terms. The 183 categories of problems that did not correspond to the ICNP® terms were categorized by the authors as the following: medical diagnoses (37.2%); signs (28.4%); interventions (26.2%); and historical data (8.2%). These results show that there may be no agreement between the concept of nursing phenomena for the ICNP® and of nursing problems for the nurses whose records were analysed. Considering that medical diagnoses, intervention and historical data could not be accepted as nursing phenomena for the ICNP®, the agreement is potentially higher than 45.5%.Readers can access the entire text of the ICNP® Beta Version by visiting http://www.icn.ch/icnpupdate.htm. Other information about the ICNP® and its development can be found at
http://www.icn.ch/icnp.htm.