bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adwa: from monument to document
Authors: Triulzi Alessandro 
Published: November 2003

SummaryTo the Italian historian the Battle of Adwa in March 1896 has offered a field of interpretation which has been heavily marked by the events that occurred between (and within) the two countries—Ethiopia and Italy—before and after the battle. Adwa has been variously depicted by Italian historiography of the liberal period as a major military defeat, a political mistake by Crispi's expansionist government and the result of deep contrasts within the newly born state over the ‘colonial burden'. Fascist historiography painted Adwa as proof of liberal decay and political inefficiency. Adwa's name could be avenged only in the battlefield, which was done during Mussolini's invasion of Ethiopia in 1935-36. From the Ethiopian point of view, Adwa's image changes no less. Until recently, the Battle of Adwa was painted as the landmark for Ethiopian unification and independence during the colonial era. Menelik's momentous victory at Adwa crowned his bid for power in the national arena, while his successful ability to stave off external colonial pressure appeared to cancel, or rather conceal, the internal policy of expansion and consolidation of his country's rule in the region. Today's insistence on Adwa as an African victory appears to be the dominant historiographical representation. The different interpretations all contain elements of truth, yet all, if frozen into historiographical truths, become embarrassing to the historian who needs documents, rather than monuments, as tools of analysis. To many historians both in Italy and Ethiopia, Adwa's respective symbolism of victory/defeat has been transformed into an icon, an historiographical monument, unassailable and immovable. The centenary of Adwa allows us to reconsider historical events of a shared past as critical documents and biased representations reflecting their own culture and time. This article attempts to deconstruct the historiographical monument of Adwa in Italian society so as to transmit such a heavily coded event to the critical examination of future historians in both Italy and Ethiopia.
The effects of tobacco smoke on the homocysteine level–a risk factor of atherosclerosis
Authors: SOBCZAK ANDRZEJ 
Published: November 2003

AbstractHomocysteine may promote atherogenesis and thrombogenesis. There is evidence from case—control and cross‐sectional cohort studies that there is a positive association between plasma homocysteine levels and coronary artery disease, cerebrovascular disease and peripheral vascular disease. There is also some evidence that certain life‐style factors such as cigarette smoking may affect homocysteine levels. In this work is presented a review of recent opinion about the influence of tobacco smoking on homocysteine levels.
Naltrexone implants can completely prevent early (1‐month) relapse after opiate detoxification: a pilot study of two cohorts totalling 101 patients with a note on naltrexone blood levels
Authors: FOSTER JOHN , BREWER COLIN , STEELE TERRY 
Published: November 2003

AbstractEarly relapse is common after opiate withdrawal and deprives addicts of important opportunities to develop new, opiate‐free cognitive‐behavioural habits. The oral opiate antagonist naltrexone (NTX) significantly reduces relapse only when rigorously supervised and/or probation‐linked. Simple but effective NTX implants, containing 1G NTX and giving an average blockade of 6–7 weeks, have been available since 1997. We present outcome data for two cohorts. Group 1 were the first 55 consecutive implanted British patients (76% male, 51% unemployed, 64% in social classes III–V). Group 2 were a second consecutive group of 46. Implants were inserted subcutaneously mainly during rapid opiate detoxification under general anaesthesia or sedation. The follow‐up rate for group 1 was 100%. At 12 weeks after first implantation, 21% of group 1 patients and 26% of group 2 patients had apparently resumed opiate use. Thirty per cent of patients tested‐out the blockade in the first week. None reported any opiate effects at less than 5 weeks after insertion. In other patients, typical blood NTX levels 4–5 weeks post‐insertion were in the range 3–5 ng/ml, which is evidently enough to block 500 mg of pure diamorphine. NTX implants provide considerable protection against early relapse and may increase the likelihood of therapeutically useful periods of abstinence after opiate withdrawal. Troublesome tissue reactions were infrequent. Improvements in implant technology and duration are already occurring. We stress that implants strengthen rather than replace the therapeutic alliance.
Possible mechanisms of action in quercetin reversal of morphine tolerance and dependence
Authors: NAIDU PATTIPATI , SINGH AMANPREET , JOSHI DIPESH , KULKARNI SHRINIVAS 
Published: November 2003

AbstractIn an earlier study, we reported the ability of quercetin to reverse the development of morphine tolerance and dependence in mice. In the present study we have attempted to explore the possible involvement of nitric oxide (NO) system in quercetin reversal of morphine tolerance and dependence in mice. Co‐administration of L ‐N G ‐nitro arginine methyl ester (L ‐NAME) or quercetin with morphine during the induction phase (days 1–9) delayed the development of tolerance to the antinociceptive action of morphine and also reversed naloxone precipitated withdrawal jumps. L ‐Arginine administration during the induction phase enhanced the development of tolerance to the antinociceptive effect of morphine but had no effect on the naloxone‐precipitated withdrawal jumps. During the expression phase (day 10) acute administration of quercetin or L ‐NAME reversed, whereas L ‐arginine facilitated naloxone‐ precipitated withdrawal jumps in morphine‐tolerant mice, but none of these drugs affected the nociceptive threshold in morphine‐tolerant mice. Further, co‐administration of quercetin or L ‐NAME with L ‐arginine during the induction phase antagonized the latter effects on the development of morphine tolerance. Also, prior administration of quercetin or L ‐NAME reversed the L ‐arginine potentiation of naloxone‐precipitated withdrawal jumps in morphine‐tolerant mice. The results of the present study suggest that quercetin reversal of morphine tolerance and dependence may involve its ability to suppress nitric oxide synthase (NOS) activity.
Predicting treatment time with the Lidcombe Program: replication and meta‐analysis
Authors: Kingston Mary , Huber Anna , Onslow Mark , Jones Mark , Packman Ann 
Published: November 2003

AbstractBackground: The benefits of treating stuttering close to onset have become obvious in recent years, and the Lidcombe Program has emerged as an effective and safe treatment method for children in their preschool years. The benefits of implementing the programme with young children, however, need to be weighed against the knowledge that many children recover from stuttering without treatment. In light of this, speech‐language therapists need to know how long treatment is likely to take and whether treatment time can be predicted. In particular, they need to know if adopting a ‘watchful waiting’ approach—to see if natural recovery occurs—jeopardizes responsiveness to treatment. A recent Australian study of 250 preschool‐age children found that stuttering rate was the only significant predictor of treatment time with the Lidcombe Program. In other words, children whose stuttering was more severe took longer to pass through the programme. There were other trends in the data but they did not reach significance.Aims: The present study, conducted independently in the UK, was designed to replicate the Australian study. Direct replication enabled pooling of the data from the two studies in a meta‐analysis.Methods & Procedures: The study included 66 children who began treatment before 6 years of age. They were treated with the Lidcombe Program at a specialist stuttering clinic in Norwich. Logistic regression analyses were conducted on the data. The data from both the British and Australian cohorts were pooled in a meta‐analysis.Outcomes & Results: Results indicated that Stage 1 of the Lidcombe Program was completed in a median of 11 clinic visits, which is in line with the findings of the Australian study. Stuttering rate at first clinic visit was again found to be a significant predictor of treatment time. The remaining data trends were similar to those in the Australian data. In the meta‐analysis, stuttering rate was once more found to be a predictor of treatment time. Of particular interest, however, was that the increased power provided by the meta‐analysis identified an additional predictor, namely onset‐to‐treatment interval. Contrary to what is known about the responsiveness of children to the Starkweather and Gottwald treatment, and contrary to what might be expected given what we know about natural recovery, children who had been stuttering for more than 12 months took less time to progress through the programme than children who had been stuttering for less than 12 months.Conclusions: These findings indicate that delaying intervention with the Lidcombe Program for 1 year after onset, within the preschool years, is unlikely to jeopardize responsiveness to treatment. The clinical implications of these findings are discussed.
Autism and autism risk in siblings of children with specific language impairment
Authors: Tomblin J. Bruce , Hafeman Laura L. , O'Brien Marlea 
Published: November 2003

AbstractBackground: Several studies have shown that family members of children with autism have elevated rates of spoken and written speech and language problems. Aims: This study asked whether there was also a greater rate of siblings with autism among probands with specific language impairment.Methods & Procedures: The probands in this study were 158 children with specific language impairment and 132 children with normal language status. These probands had 522 siblings who were examined for risk of autism using the Autism Behavior Checklist. Siblings found to be at risk were then examined using the Autism Diagnostic Interview—Revised and the Autism Diagnostic Observation Schedule‐G.Outcomes & Results: A concentration of siblings with risk for a diagnosis of autism was found in association with probands who had poor spoken language skills. Four siblings of the 522 (0.8%) met the diagnostic standards for autism. All the probands of these siblings had spoken language scores below − 1 SD and three had diagnoses of spoken language impairment.Conclusions: These data provide additional support for a familial association between autism and spoken language impairment.
Preanesthetic Medication with Intranasal Midazolam for Brief Pediatric Surgical Procedures
Authors: Davis Peter J. , Tome Julie A. , McGowan Francis X. , Cohen Ira Todd , Latta Karen , Felder Herman 
Published: November 2003

Background
The perfect preanesthesia medication and its ideal route of administration are still debated, but for pediatric surgical patients undergoing brief procedures, preanesthesia medication is frequently omitted because of the concern that it will prolong the child's recovery from anesthesia. The effects of nasally administered midazolam on anesthetic recovery and hospital discharge times were determined in 88 ASA physical status 1 and 2 ambulatory surgical patients undergoing a brief surgical procedure.

Methods
Using a randomized, double-blind, placebo-controlled design, 88 ambulatory surgical patients 10-36 months of age undergoing myringotomy and tube insertion were entered into the study. All patients were randomly assigned to one of three medication groups. One group received 0.2 mg/kg intranasal midazolam; a second group received 0.3 mg/kg intranasal midazolam; and the third group received intranasal saline drops. All patients were anesthetized with nitrous oxide, oxygen, and halothane administered via mask. The duration of anesthesia lasted between 9 and 10 min. After preanesthetic medication, the children were evaluated for ease of separation and induction of anesthesia. In addition, the time from when the anesthetic was discontinued until the child recovered from anesthesia and the time the child was discharged home were recorded by a nurse observer blinded to the patient grouping.

Results
Children receiving midazolam had smoother, calmer parent-child separation and anesthesia induction scores, and their anesthesia recovery times and hospital discharge times were the same as those receiving placebo.

Conclusions
For children undergoing brief surgical procedures, nasal midazolam provides satisfactory anxiolysis without delaying anesthesia recovery and hospital discharge.
Parturients Infected with Human Immunodeficiency Virus and Regional Anesthesia
Authors: Hughes Samuel C. , Dailey Patricia A. , Landers Daniel , Dattel B. J. , Crombleholme William R. , Johnson Judy L. 
Published: November 2003

Background
It is estimated that 1.5 million Americans are infected with the human immunodeficiency virus (HIV-1), and the consequences of HIV infection are a leading cause of death in women aged 15-44 yr. Thus, HIV-1 disease, or acquired immunodeficiency syndrome, occurs with increasing frequency in the parturient, and there is little information concerning the risks of regional anesthesia. Fear of spreading infection to the central nervous system or adverse neurologic sequelae have led some clinicians to advise against regional anesthesia. Thus, this study was undertaken to evaluate the possible problems or risks associated with regional anesthesia in parturients infected with HIV-1 and to determine whether anesthesia affected the clinical course of the disease.

Methods
The clinical course and immunologic function of 30 parturients infected with HIV-1 were evaluated prospectively. Extensive medical and laboratory evaluation before delivery and 4-6 months postpartum was undertaken. Medical problems related to HIV-1 disease and use of antiviral drugs also were monitored. The anesthetic management was dictated by the clinical situation and the patient's wishes were careful postpartum follow-up to evaluate possible neurologic changes or infection.

Results
Regional anesthesia was administered in 18 parturients, and 12 received small doses of opioids or no analgesia. There were no changes in the immunologic parameters studied (CD4+, p24, beta 2 microglobulins), and HIV-1 disease remained stable in the peripartum period. There were no infections, complications, or neurologic changes in the peripartum period. Sixty-eight percent of the infants were HIV-1-negative and, in 21% of infants, the HIV-1 status was indeterminate (probably negative).

Conclusions
This prospective study of parturients infected with HIV-1 demonstrated that regional anesthesia can be performed without adverse sequelae. There were no neurologic or infectious complications related to the obstetric or anesthetic course. The immune function of the parturient was stable in the peripartum period. Although the number of patients studied was small, with careful medical evaluation, regional anesthesia is an acceptable choice in the parturient infected with HIV-1.
Volumetric Capnography in Children
Authors: Ream Robert S. , Schreiner Mark S. , Neff Joseph D. , McRae Karen M. , Jawad Abbas F. , Scherer Peter W. , Neufeld Gordon R. 
Published: November 2003

Background
Lung growth in children is associated with dramatic increases in the number and surface area of alveolated airways. Modelling studies have shown the slope of the alveolar plateau (phase III) is sensitive to the total cross-sectional area of these airways. Therefore, the influence of age and body size on the phase III slope of the volumetric capnogram was investigated.

Methods
Phase III slope (alveolar dcCO2/dv) and airway deadspace (VDaw) were derived from repeated single-breath carbon dioxide expirograms collected on 44 healthy mechanically ventilated children (aged 5 months-18 yr) undergoing minor surgery. Ventilatory support was standardized (VT = 8.5 and 12.5 ml/kg, f = 8-15 breaths/min, inspiratory time = 1 s, end-tidal partial pressure of carbon dioxide = 30-45 mmHg), and measurements were recorded by computerized integration of output from a heated pneumotachometer and mainstream infrared carbon dioxide analyzer inserted between the endotracheal tube and anesthesia circuit. Experimental data were compared to simulated breath data generated from a numeric pediatric lung model.

Results
An increased VDaw, a smaller VDaw/VT, and flatter phase III slope were found at the larger tidal volume (P < 0.01). Strong relationships were seen at VT = 12.5 ml/kg between airway deadspace and age (R2 = 0.77), weight (R2 = 0.93), height (R2 = 0.78), and body surface area (R2 = 0.89). The normalized phase III slopes of infants were markedly steeper than that of adolescents and were reduced at both tidal volumes with increasing age, weight, height, and body surface area. Phase III slopes and VDaw generated from modelled carbon dioxide washout simulations closely matched the experimental data collected in children.

Conclusions
Morphometric increases in the alveolated airway cross-section with lung growth is associated with a decrease of the phase III slope. During adolescence, normalized phase III slopes approximate those of healthy adults. The change in slope with lung growth may reflect a decrease in diffusional resistance for carbon dioxide transport within the alveolated airway resulting in diminished acinar carbon dioxide gradients.
Cerebral Oxygenation during Pediatric Cardiac Surgery Using Deep Hypothermic Circulatory Arrest
Authors: Kurth Dean C. , Steven James M. , Nicolson Susan C. 
Published: November 2003

Background
Deep hypothermic circulatory arrest is a widely used technique in pediatric cardiac surgery that carries a risk of neurologic injury. Previous work in neonates identified distinct changes in cerebral oxygenation during surgery. This study sought to determine whether the intraoperative changes in cerebral oxygenation vary between neonates, infants, and children and whether the oxygenation changes are associated with postoperative cerebral dysfunction.

Methods
The study included eight neonates, ten infants, and eight children without preexisting neurologic disease. Cerebrovascular hemoglobin oxygen saturation (SCO2), an index of brain oxygenation, was monitored intraoperatively by near-infrared spectroscopy. Body temperature was reduced to 15 degrees C during cardiopulmonary bypass (CPB) before commencing circulatory arrest. Postoperative neurologic status was judged as normal or abnormal (seizures, stroke, coma).

Results
Relative to preoperative levels, the age groups experienced similar changes in SCO2 during surgery: SCO2 increased 30 +/- 4% during deep hypothermic CPB, it decreased 62 +/- 5% by the end of arrest, and it increased 20 +/- 5% during CPB recirculation (all P < 0.001); after rewarming and removal of CPB, SCO2 returned to preoperative levels. During arrest, the half-life of SCO2 was 9 +/- 1 min in neonates, 6 +/- 1 min in infants, and 4 +/- 1 min in children (P < 0.001). Postoperative neurologic status was abnormal in three (12%) patients. The SCO2 increase during deep hypothermic CPB was less in these patients than in the remaining study population (3 +/- 2% versus 33 +/- 4%, P < 0.001). There were no other significant SCO2 differences between outcome groups.

Conclusions
Brain oxygenation changed at distinct points during surgery in all ages, reflecting fundamental cerebral responses to hypothermic CPB, ischemia, and reperfusion. However, the changes in SCO2 half-life with age reflect developmental differences in the rate of cerebral oxygen utilization during arrest, consistent with experimental work in animals. Certain intraoperative cerebral oxygenation patterns may be associated with postoperative cerebral dysfunction and require further study.
Thoracic Epidural Anesthesia Attenuates Halothane-induced Myocardial Sensitization to Dysrhythmogenic Effect of Epinephrine in Dogs
Authors: Kamibayashi Takahiko , Hayashi Yukio , Mammoto Tadanori , Yamatodani Atsushi , Taenaka Nobuyuki , Yoshiya Ikuto 
Published: November 2003

Background
The autonomic nervous system plays a critical role in the central modulation of cardiac dysrhythmias. Because sympathetic blockade by thoracic epidural anesthesia has been documented to protect patients from various stress responses, the authors speculate that epidural anesthesia can attenuate the dysrhythmogenic interaction between halothane and epinephrine.

Methods
In adult mongrel dogs anesthetized with halothane, the dysrhythmogenic dose (DD) of epinephrine, defined as the smallest dose producing four or more premature ventricular contractions within a 15-s period, was determined in the presence of thoracic epidural mepivacaine or saline. To address the effect of circulating mepivacaine after epidural administration, the authors examined the DD of epinephrine in the presence of intravenous mepivacaine. They also investigated the effect of thoracic epidural anesthesia in bilaterally vagotomized dogs.

Results
Epidural mepivacaine significantly increased the DD of epinephrine compared with epidural saline. However, intravenous mepivacaine did not affect the DD of epinephrine, even when the plasma concentration of mepivacaine during the dysrhythmias was twice that in the epidural mepivacaine group. The beneficial effect of epidural mepivacaine was not seen in bilaterally vagotomized dogs.

Conclusions
Thoracic epidural anesthesia attenuated the myocardial sensitization by halothane, and vagal activity had an essential role in this action.
Local Anesthetics Inhibit Substance P Binding and Evoked Increases in Intracellular Calcium sup 2+
Authors: Li Yue-Ming , Wingrove Douglas E. , Too Phon H. , Marnerakis Margarita , Stimson Evelyn R. , Strichartz Gary R. , Maggio John E. 
Published: November 2003

Background
During spinal and epidural anesthesia, local anesthetics reach concentrations in cerebrospinal fluid and spinal cord tissues at which their actions may extend beyond the classic blockade of sodium channels. This study examines the effects of several clinical and experimental local anesthetics on the binding and actions of a peptide neurotransmitter, substance P, known to be important in nociceptive transmission in the dorsal horn.

Methods
The binding of radiolabeled (Bolton-Hunter modified) substance P was studied in chick brain membranes in the presence of local anesthetics. The increase in intracellular calcium [Ca2+]in evoked by substance P was measured by the fluorescent indicator fura-2 loaded in a murine cell line expressing substance P (NK1) receptors. Cells were preincubated with bupivacaine before and during the transient addition of substance P.

Results
Both substance P binding and Ca2+ increase were inhibited half-maximally by approximately 1 mM bupivacaine at pH 7.5, whereas tetracaine, lidocaine, and benzocaine were slightly less potent at inhibiting binding. Concentration-dependent substance P-binding studies showed that bupivacaine's inhibition was not competitive. Inhibition of substance P binding by bupivacaine increased with increasing pH, but the protonated species appears to have some inhibitory activity, and quaternary lidocaine also inhibited binding. There was no stereoselectively to the binding inhibition.

Conclusions
Because millimolar concentrations of local anesthetics are within the range measured in spinal cord during intrathecal and epidural procedures, these results are consistent with a direct action of local anesthetics on tachykinin-mediated neurotransmission during regional anesthesia.