bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of impedance cardiography to monitor haemodynamic changes during laparoscopy in children
Authors: Kardos Attila , Vereczkey Gábor , Pirót László , Nyirády Péter , Mekler Róbert 
Published: March 2003

Methods: Haemodynamic changes were measured noninvasively using impedance cardiography (ICG) in 30 ASA I children during laparoscopic varicocelectomy under general anaesthesia. After induction and intubation, mechanical ventilation was started, then pneumoperitoneum (PP) was created. During the course of anaesthesia, values of endtidal CO2 pressue (PECO2), peak inspiratory airway pressure (PIP), heart rate (HR), mean arterial blood pressure (MABP), stroke volume index (SVI), cardiac index (CI) and systemic vascular resistance index (SVRI) were recorded at 1 min intervals. We analysed four periods: T1, before induction; T2, after induction; T3, during PP; T4, after desufflation of PP until awake. Results: After induction of anaesthesia a significant reduction of HR, MABP and CI was recorded. Creating PP together with the use of a 15° head down tilt resulted in a further drop in CI, mainly caused by the reduction of SVI, and an elevation of MABP and SVRI. We measured a 25% total decrease of CI. Conclusions: Our patients tolerated this significant reduction of cardiac output well. We have demonstrated that ICG can be used to track the haemodynamic changes caused by PP in children, and suggest that this type of monitoring is useful in this group of age during laparoscopy.
Pharmacokinetics of oral diclofenac and acetaminophen in children after surgery
Authors: Rømsing Janne , Østergaard Doris , Senderovitz Thomas , Drozdziewicz Dominika , Sonne Jesper , Ravn Grete 
Published: March 2003

Background: Our aim was to study the pharmacokinetics and pain scores following administration of single oral doses of either diclofenac or high‐dose acetaminophen (paracetamol). Methods: In the morning, the day after tonsillectomy, children 5–15 years of age were randomized in a double‐blind manner to receive either diclofenac 1–2 mg·kg−1 (n=11) or acetaminophen 22.5 mg·kg−1 (n=10). Postoperative pain was assessed by self‐report and blood samples were drawn every 30 min for 4 h after medication. Results: Large interindividual differences in maximum plasma diclofenac concentrations (Cmax) were found. Mean Cmax was 2.4±1.3 μg·ml−1 and mean tmax was 2±0.5 h. No significant reduction in pain score with diclofenac was seen at any of the assessments during the study period. Eight of 10 children achieved Cmax of acetaminophen within the 10–20 μg·ml−1 antipyretic range. Mean tabs was 0.7±0.3 h and mean Cmax and tmax were 12.7±3.8 μg ml−1 and 1.4±0.5 h, respectively. No significant reduction in pain score with acetaminophen was seen at any of the assessments during the study period. Conclusions: The achieved concentrations of diclofenac and acetaminophen were not able to significantly reduce the children’s pain score during the 5 h postingestion study period. Analgesic plasma acetaminophen concentrations may be higher than those required for antipyresis.
Critical incidents in paediatric anaesthesia: an audit of 10 000 anaesthetics in Singapore
Authors: Tay C.L.M. , Tan G.M. , Ng S.B.A. 
Published: March 2003

Background: We undertook an audit of paediatric perioperative incidents in the first 10000 anaesthetics administered in KK Women’s and Children’s Hospital in Singapore between May 1997 and April 1999. The spectrum of surgery performed ranged from simple ambulatory surgery to open heart surgery for complicated congenital heart diseases. Methods: An audit form is completed for every anaesthetic delivered and critical incidents are reported on the reverse blank page of the audit form. An anaesthetic incident was defined as ‘any incident which affected, or could have affected, the safety of the patient under anaesthetic care’. Results: Two hundred and ninety‐seven critical incidents were reported. The majority of them happened in healthy patients (80.1% ASA I and II) scheduled for elective surgery (73.3%). Critical incidents in infants less than 1 year of age were four times as common as in older children (8.6% versus 2.1%). Incidents occurred mainly during maintenance (80.6%). There was no anaesthetic mortality. Respiratory events were the most common (77.4%) with laryngospasm accounting for 35.7%. Cardiovascular incidents (10.8%) included hypotension from haemorrhage and sepsis, and dysrhythmias. The incidence of equipment and pharmacologically related problems was low. Conclusions: Future reviews of a larger patient population may be helpful to determine trends of perioperative events and whether quality assurance programs have made a difference.
Evaluation of a new paediatric scavenging valve
Authors: TANSER S.J. , JOHNSON A. 
Published: March 2003

Background: Prolonged exposure to anaesthetic gases may be associated with adverse effects. Scavenging is in widespread use in adult anaesthesia but it has been more difficult to find a satisfactory solution for use in paediatric anaesthesia. The Exeter Paediatric T‐piece Scavenging (Exeter PTS) valve has been designed for use with a modified Jackson‐Rees system to allow connection to an active or passive Approved Gas Scavenging System. Methods: Use of the Exeter PTS valve was evaluated in 35 spontaneously breathing paediatric patients (mean age 4.7 years, mean weight 16.7 kg) using each patient as their own control. Atmospheric pollution was measured using a Miran 1B infrared spectrophotometer. Results: When using a modified Jackson‐Rees breathing system with an open‐ended bag, pollution levels of isoflurane exceeded the Occupational Exposure Standard of 50 p.p.m. When the Exeter PTS valve and an active scavenging system were used, pollution was significantly reduced to below 5% of the recommended limit. Conclusions: We conclude that there is a need to reduce atmospheric pollution when using a modified Jackson‐Rees system in spontaneously breathing patients and that this can be achieved by use of the Exeter PTS valve.
Correlation of cleft type with incidence of perioperative respiratory complications in infants with cleft lip and palate
Authors: Takemura Hiroshi , Yasumoto Kazumasa , Toi Takashi , Hosoyamada Akiyoshi 
Published: March 2003

Summary Background: A retrospective survey of 339 infants who had undergone primary plastic surgery for cleft lip and palate was performed to evaluate the concomitant preoperative assessment based on severity grading of the common cold and the correlation of cleft type with the incidence of perioperative respiratory complications. Methods: We assessed the severity of common cold symptoms in the preoperative period using the Common Cold Score, which comprises 10 symptoms and findings. We then determined the association of the incidence of perioperative respiratory complications with the increasing severity of common cold symptoms and also compared the complication incidence in the three cleft types in healthy infants without a common cold. Results: The incidence of perioperative respiratory complications was greater in the group with a suspected presence of a common cold. Infants with severer cleft, who had bilateral cleft lip and palate, even without common cold symptoms, had a significantly higher incidence of perioperative respiratory complications (8.9%) than infants with simple cleft lip (1.7%, P < 0.05). Conclusions: Clinicians should consider postponing primary plastic surgery for cleft lip and palate in infants with a suspected presence of a common cold. Our results also suggest that the presence of a wide cleft is a risk factor for causing perioperative respiratory complications in infants with cleft lip and palate. We believe that a careful preoperative assessment of common cold symptoms in these infants can decrease the incidence of perioperative respiratory complications.
Incidence of postoperative nausea and vomitingin paediatric ambulatory surgery
Authors: Villeret I. , Laffon M. , Duchalais A. , Blond M.H. , Lecuyer A.I. , Mercier C. 
Published: March 2003

Summary Background: We performed a prospective descriptive study over a 5‐month period to determine the incidence of postoperative nausea and vomiting (PONV) during the first 24 h following elective ambulatory paediatric surgery, excluding head and neck procedures. Methods: Four hundred and seven patients, aged 15 days to 16 years, were analysed prospectively. Results: The incidence of PONV was 9.4%, occurring most frequently during the first 3 h after anaesthesia and in hospital but rarely during the journey home. It was associated with age, previous history of PONV, tracheal intubation or use of the laryngeal mask airway (LMA™), controlled or manual ventilation, opioids and absence of oral intake of liquids or solids. Conversely, type of surgery, premedication, induction mode, association of regional anaesthesia, inhaled nitrous oxide, duration of anaesthesia, stay in the postanaesthesia care unit and duration of journey after discharge were not significantly associated with PONV. Conclusions: PONV never induced complications or delayed patient discharge and curative treatment was rapidly effective.
Advances in topical glaucoma therapy
Authors: Willis A. Michelle , Diehl Kathryn A. , Robbin Terah E. 
Published: March 2003

AbstractSignificant advances have recently been achieved in the development of topical glaucoma medications. The primary advantage of a topical preparation is the reduced incidence of adverse systemic effects attributable to a given drug compared to its systemically administered counterpart. However, the strong protective barrier of the eye forces topical ophthalmic preparations to be highly concentrated and in some cases, they have the potential to produce unwanted systemic effects, particularly in smaller animals. Oral carbonic anhydrase inhibitors are commonly associated with adverse effects in both humans and animals. Two recently developed topical carbonic anhydrase inhibitors, dorzolamide and brinzolamide, have shown promise in reducing intraocular pressure in animals and systemic side effects are apparently limited with their use. The topical α2‐agonist apraclonidine, on the other hand, effectively reduces intraocular pressure in cats and dogs, but in its currently available form is likely to induce unwanted systemic effects. Latanoprost is a topical prostaglandin F2α analog that has proven effective in reducing intraocular pressure in dogs and horses, but while systemic side effects have not yet been reported, this topical preparation may exacerbate pre‐existing or concurrent ocular inflammatory disease.
Corneoconjunctival transposition for the treatment of feline corneal sequestra: a retrospective study of 17 cases (1990–1998)
Authors: Andrew Stacy E. , Tou Sandra , Brooks Dennis E. 
Published: March 2003

AbstractObjectiveTo describe and evaluate the use of corneoconjunctival transposition as a surgical treatment for corneal sequestra in cats.Animals studiedFifteen cats (17 eyes) of various breeds and ages with corneal sequestra treated surgically with corneoconjunctival transposition.ProcedureRetrospective medical records study.ResultsMedian age was 39 months. Eight patients were castrated males, five were spayed females, and two were intact females. The left eye was affected in eight cats, the right eye was affected in five cats, and both eyes were affected in two cats. Mean (± SD) sequestrum diameter was 4.4 ± 2.4 mm (range 1–10 mm) and the sequestrum was located centrally in all cases. Sequestra occurred in the superficial stroma in 8/17 corneas, in the anterior one third of the stroma in 3/17 corneas, and in the middle one third of the stroma in 6/17 corneas. Median duration of clinical signs prior to presentation was 39 days (range 14–1095 days). Median time to healing, defined as the number of days from surgery to cessation of medical treatment, was 34 days (range 25–86 days). There were no recurrences and minimal scar formation.ConclusionsCorneoconjunctival transposition is a valid procedure for surgical treatment of corneal sequestra in cats. The procedure results in excellent cosmesis and functional vision with no recurrences.
Pectinate ligament dysplasia and narrowing of the iridocorneal angle associated with glaucoma in the English Springer Spaniel
Authors: Bjerkås Ellen , Ekesten Björn , Farstad Wenche 
Published: March 2003

AbstractObjectiveThe aim of the study was to evaluate if tonometry and gonioscopy could serve as predictors of later glaucoma development in the English Springer Spaniel, a breed prone to developing primary glaucoma.Animals studiedGonioscopy was performed on 279 English Springer Spaniel dogs, 119 males and 160 females, with clinically normal eyes. In addition, 14 dogs, five males and nine females were examined for glaucoma.ResultsA positive relation between pectinate ligament dysplasia (PLD) and narrowing of the relative width of the ciliary cleft (RWOCC) and also between PLD, RWOCC and age was demonstrated. The prevalence of PLD was 25.5%, which is higher than in other breeds reported. A positive association was demonstrated between PLD and glaucoma, as well as between narrowing of the RWOCC and glaucoma. Glaucoma was not observed in dogs with normal appearance of the iridocorneal angle. English Springer Spaniels related to dogs with glaucoma show more narrowing of the RWOCC and more PLD than unrelated dogs.ConclusionThis study demonstrates the positive association between PLD and glaucoma, between narrowing of the iridocorneal angle and glaucoma and the effect of age on the iridocorneal angle. Mating of dogs with normal iridocorneal angles appears to reduce the presence and degree of abnormal appearance of the iridocorneal angle in the offspring. However, breeding only dogs with normal iridocorneal angles without consideration of their relationship to dogs with glaucoma is not a guarantee for preventing glaucoma in the offspring.
Canine choroidal melanoma with metastases
Authors: Hyman Jennifer A. , Koch Seth A. , Wilcock Brian P. 
Published: March 2003

AbstractA 3‐year‐old‐female, spayed Golden Retriever was examined for a unilateral retinal detachment with exophthalmos. Ultrasonographically, a mass was detected withintra‐ and extraocular extension. The orbit was exenterated and the dog recovered uneventfully. Histopathologic diagnosis was a primary choroidal melanoma with orbital extension, however, the behavioral and cytologic features were benign. Routine examinations postsurgically were nonremarkable. Twenty‐one months after surgery the dog was euthanized for respiratory collapse with radiographic signs of metastasis. Necropsy revealed black lesions in the lung and liver. Histopathologic diagnosis was metastatic melanoma with morphology and behavior identical to the primary choroidal melanoma. This is the first definitive case of a canine choroidal melanoma with metastasis.
A new taxon,capricornia(Hesionidae,Polychaeta), illustrating the LITU (‘Least‐Inclusive Taxonomic Unit’) concept
Authors: Pleijel Fredrik , Greg W. Rouse 
Published: March 2003

Phylogenetic taxonomy is applied for the systematization of a newHesionidae, rather than the traditional Linnean system, with an apomorphy‐based definition of the name and without reference to rank. It is argued that biological diversity is better represented without species concepts, but that it is useful to specify when a name refers to a smallest known clade which currently cannot be further subdivided; for this we apply the newly introduced concept LITU (Least‐Inclusive Taxonomic Unit) for the new taxon. LITUs are made identifiable by being italicised with lower‐case initial letter; all other taxon names are italicised with capital initial letter. TheHesionidaeis accordingly namedcapricornia, new taxon, and was found in shallow water at One Tree Island, Capricorn Group, southernmost part of the Great Barrier Reef.capricorniais small (length < 2 mm), and exhibits a number of larvalHesionidaecharacters, but is characterized by large paired ventrally situated penes on segment 9 in adult males. A cladistic parsimony analysis based on morphological characters ofcapricorniaand a selection of otherHesionidaeindicates that it belongs withinGyptiniPleijel 1998, and is the sister group ofAmphidurosHartman (1959).
Levels of IL‐6 and soluble IL‐6 receptor are increased in HIV patients with a history of immune restoration disease after HAART
Authors: Stone SF , Price P , Keane NM , Murray RJ , French MA 
Published: March 2003

Objectives We have previously described immune restoration diseases (IRD) associated with asymptomatic opportunistic infections presenting in immunodeficient HIV patients responding to highly active antiretroviral therapy (HAART). Here we address the question of whether patients with a history of IRD exhibit persistent immune activation, shown by elevated levels of interleukin‐(IL)‐6 and soluble IL‐6 receptor (sIL‐6R).Methods Peripheral blood mononuclear cells (PBMCs) and plasma were collected from HIV patients with nadir CD4 T cell counts of < 80/µL and who had achieved immune reconstitution after HAART with (n=14) or without (n=15) experiencing IRD, severely immunodeficient (SID) patients with < 80 CD4 T cells/µL (n=8) and HIV seronegative controls (n=15). PBMC production and plasma levels of IL‐6, sIL‐6R and interferon (IFN)‐γ (PBMC only) were measured by enzyme linked immunosorbent assay (ELISA). Intracellular flow cytometry was used to determine the predominant cellular source of IL‐6 in HIV patients and controls.Results Unstimulated PBMC from IRD patients produced significantly higher amounts of IL‐6 and sIL‐6R than non‐IRD patients and HIV seronegative controls. The sIL‐6R concentration was also significantly higher in supernatants from mitogen‐stimulated PBMC from IRD patients compared to non‐IRD patients. The production of IFN‐γ did not differ between IRD and non‐IRD patients. IRD patients had significantly higher plasma levels of IL‐6 compared to non‐IRD patients, SID patients and controls. Monocytes were the predominant source of IL‐6 in both HIV patients and controls.Conclusions Patients with a history of IRD after HAART have elevated levels of IL‐6 and sIL‐6R.
The myrosinase‐glucosinolate system in the interaction between Leptosphaeria maculans and Brassica napus
Authors: Andreasson Erik , Wretblad Sofia , Granér Georg , Wu Xiaoming , Zhang Jiaming , Dixelius Christina , Rask Lars , Meijer Johan 
Published: March 2003

summary Leptosphaeria maculans causes blackleg disease, and resistance to this fungal pathogen is an important trait in the breeding of oilseed rape. A better comprehension of the role of the myrosinase‐glucosinolate system in this context is of great value. The present study is the first to address effects on multiple components of this complex system, including concentrations of individual glucosinolates, product formation, myrosinase isoform distribution and activity, and levels of myrosinase binding proteins during the infection process. One resistant B. napus cultivar (Maluka) and one susceptible cultivar (Westar) were compared in the investigation. Our results show that the two cultivars had the same histological distribution, isoform expression, and activity of the myrosinase enzymes. The glucosinolate levels were also similar, with the exception of glucobrassicin and neoglucobrassicin, which were significantly lower in the resistant cultivar at 11 days post‐infection. Growth of the fungus on the plant tissues did not alter glucosinolate levels, suggesting that L. maculans does not degrade these compounds. When the plants were starved of sulphur, and thereby depleted of glucosinolates, no increased susceptibility was observed. Hence, we suggest that the myrosinase‐glucosinolate system does not determine the outcome of the interaction between B. napus and L. maculans.
Core promoter for initiation of Cucumber mosaic virus subgenomic RNA4A
Authors: Sivakumaran K. , Chen M.‐H. , Roossinck M. J. , Kao C. C. 
Published: March 2003

summaryThe core subgenomic promoter for the initiation of Cucumber mosaic virus (CMV) RNA4A was characterized in vitro using a template‐dependent RNA synthesis assay and variants of the core promoter RNAs. The minimal sequence required for specific initiation from the cytidylate (T1) used in vivo consists of 31‐nucleotides (nt) 3′ of T1 and a 13 nt template sequence. This 44 nt RNA was found to provide three elements that contribute to efficient initiation of RNA4A synthesis by the CMV replicase: a stem‐loop secondary structure 3′ of T1, a template sequence that is rich in adenylates and uridylates, and T1 in an unbase‐paired sequence.
Developing information literacy: a key to evidence‐based nursing
Authors: Shorten A. , Wallace . C. , Crookes P. A. 
Published: March 2003

AbstractThis report describes the evaluation of a curriculum‐integrated programme designed to help students develop an awareness of the nursing literature, the skills to locate and retrieve it, and skills required in its evaluation; in other words ‘information literacy’. Positive changes in student performance on objective measures of information‐literacy skills were revealed as well as a significant increase in the levels of confidence of the student in performing those skills. Students who had undertaken the information‐literacy programme (‘programme’ students) performed better on a range of objective measures of information literacy, as well as reporting higher levels of confidence in these skills, than students who had not participated in the programme (‘non‐programme’ students). Evaluation of this programme provides evidence of the potential usefulness of a curriculum‐integrated approach for the development of information‐literacy skills within nursing education. With these underlying skills, students will be better equipped to consolidate and extend their key information‐literacy skills to include research appreciation and application. These are vital for effective lifelong learning and a prerequisite to evidence‐based practice.
Culturally competent care: emphasis on understanding the people of Afghanistan, Afghanistan Americans, and Islamic culture and religion
Authors: Giger J. Newman , Davidhizar R. 
Published: March 2003

AbstractSince the attacks in New York and Washington, DC, in September 2001, increased racial and religious animosity has left Arabs, other Middle Easterners, Muslims, and those who bear physical resemblance to members of these groups, fearful. This article provides information about the people of Afghanistan, Afghanistan Americans, and Islamic culture and religion, which can greatly assist the nurse who is confronted with persons from diverse cultures during the provision of care. The Giger & Davidhizar Transcultural Assessment Model was first published in the International Nursing Review in 1990. This model is now used worldwide and provides an assessment model to assist in understanding cultural phenomena and individuals from different cultures.
Stratum Corneum Barrier Integrity Controls Skin Homeostasis
Authors: Smith Walter 
Published: March 2003

The stratum corneum water barrier controls structural and functional properties of both the epidermis and the dermis. Treatments which chronically disrupt the stratum corneum water barrier can induce changes similar to those seen with ’anti‐aging’ treatments such as (‐Hydroxy acids (AHAs) and Retin A™.Barrier disruption via daily tape stripping increases epidermal and dermal thickness, superficial and integral skin firmness, and improves skin surface texture. Modest or transitory disruption did not produce such effects. Similar results were observed with topical application of AHAs, retinoids or mild irritants after about 4‐6 weeks provided such treatments resulted in prolonged elevation in TEWL (trans‐epidermal water loss). Treatments that did not chronically elevate TEWL could also produce positive cosmetic effects, but such effects were in general restricted to the skin surface or epidermis. Irritation, which was observed with some treatments, was not solely responsible for the positive effects observed.