bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment adherence of youth and young adults with and without a chronic illness
Authors: Rosina Robyn , Crisp Jackie , Steinbeck Kate 
Published: December 2004

AbstractThe present study was undertaken to explore the psychosocial functioning of young people with chronic illness, their beliefs about treatment adherence, difficulties with adherence and concerns about living with their illness. A small correlational study was undertaken to compare the psychosocial functioning of young people, with and without chronic illness, aged between 12 and 24 years. Subjects were recruited from a metropolitan teaching hospital. Group 1 included 44 young people with chronic illness; Group 2 included 41 young people without chronic illness. Both groups were divided on the basis of age: younger (12–18 years, n = 24); older (19–24 years, n = 61) and sex (female = 43; male = 42). Subjects completed the Achenbach self‐report questionnaire as a measure of psychosocial functioning, and a second questionnaire constructed for this study to explore treatment adherence. Psychosocial functioning scores were found to be similar on the majority of subscales. Young women with chronic illness were, however, found to have significantly higher internalizing scores than young women without chronic illness. A significant negative relationship was found for the chronic illness group between internalizing scores and treatment adherence. The findings highlight potential areas of difficulty in psychosocial functioning of some young people with chronic illness. They also suggest the existence of a subgroup of young people with chronic illness who experience more problems than their peers. More research is needed to generate evidence about this possible subgroup to determine predictors of psychosocial functioning and test the timing and efficacy of psychosocial interventions.
Psychological hardiness, workplace stress and related stress reduction strategies
Authors: Lambert Vickie A. , Lambert Clinton E. , Yamase Hiroaki 
Published: December 2004

AbstractContending with stressful situations in the workplace is a common occurrence for all health care providers. Stress has numerous devastating effects on the workplace environment, as well as upon individuals who become victims of stress. However, enhancing psychological hardiness may facilitate an individual's ability to deal with workplace stress. Psychological hardiness, a personality style consisting of commitment, control and challenge, encourages human survival and the enrichment of life through development. This article provides an overview of psychological hardiness and workplace stress, and proposes strategies that one can use to enhance commitment, control and challenge in an effort to reduce the impact of stress.
Pain, nociception and the developing infant
Authors: WOLF ANDREW R. 
Published: December 2004

SummaryThe study of paediatric pain and the provision of safe but reliable analgesia for all age groups has become a central issue in paediatric anaesthesia. For the practising paediatric anaesthetist, this represents a major challenge: the developing infant is not a single discrete entity but one that changes constantly with increasing maturity of individual organs. Recent developments in both basic and clinical sciences has given valuable insights into this process, giving the clinician a firm basis to provide analgesia at all ages. This review looks at some of the most interesting recent developments in this field.
An epidural catheter introducer in children
Authors: YAMASHITA MASAO 
Published: December 2004

SummaryUsefulness of an epidural catheter introducer was tested in paediatric epidural anaesthesia. We tried to place an epidural catheter in 100 infants and children. When catheter insertion was difficult, an epidural catheter introducer, which was made of a piece of 6‐Fr suction tubing, was utilized. The introducer is threaded over the epidural catheter down to the hub orifice of the epidural needle. The catheter can then be advanced into the epidural space through this introducer. In this way, we were able to place the catheter in 94 percent of patients. Even a simple introducer is effective in passing the epidural catheter into the epidural space in infants and children. Perhaps manufacturers should provide threading devices with catheters or epidural needles.
Evaluation of the efficiency of heat and moisture exchangers during paediatric anaesthesia
Authors: LUCHETTI MARCO , PIGNA ANTONIA , GENTILI ANDREA , MARRARO GIUSEPPE 
Published: December 2004

SummaryThis study evaluates the efficiency of heat and moisture exchangers (HMEs) in allowing adequate humidification and warming during anaesthesia in children. Eighteen paediatric patients undergoing anaesthesia were divided into two groups: group A ten patients: infants up to 10 kg→Hygrobaby HME; group B 8 patients: children above 10 kg→Hygroboy HME. The following parameters were evaluated: body temperature (bT), room temperature (rT), fresh gas temperature, HME warm‐up time, inspired and expired gases temperature and humidity, conserving efficiency, and duration of anaesthesia. Gas temperatures were recorded by means of a recorder fitted with four thermal probes. Humidity values were mathematically derived. The correlation between efficiency and rT, bT, and fresh gas temperature was computed. In both groups the inspired gases temperatures were below 30??C. Inspired absolute humidity was never more than 28 mgH2O??l−1. The conserving efficiency was good (0.93 in both groups). A positive correlation was found between efficiency and fresh gas temperature. HMEs did not meet the minimum standards for humidity and heating during anaesthesia in children, although their conserving efficiency was found to be satisfactory.
A comparison of halothane and isoflurane for gaseous induction of anaesthesia in infants
Authors: BAGSHAW O. N. T. , STACK C. G. 
Published: December 2004

SummarySixty‐four ASA 1 and 2 infants between the ages of 44 weeks postconceptual age and one year presenting for routine, elective surgery were randomly anaesthetized with either 3% halothane in oxygen (Group H) or 5% isoflurane in oxygen (Group I). Patients in Group I took a mean (sd) time of 70.1(13.6) s to loss of eyelash reflex and 80.0 (13.5) s to tolerating the face mask, compared with 80.2 (17.7) s and 93.4 (20.5) s in Group H (P=0.028 and 0.0072, respectively). There were no significant differences between the groups for preinduction or induction state, lowest oxygen saturation, or the incidence of airway related complications or interventions. This study demonstrates that 5% isoflurane in oxygen induces anaesthesia in infants more quickly than 3% halothane in oxygen, without any increase in the incidence or severity of airway‐related complications.
The influence of breathing system filters on paediatric capnography
Authors: HARDMAN J.G. , MAHAJAN R.P. , CURRAN J. 
Published: December 2004

SummaryBreathing system filters are in common use during paediatric anaesthesia. Expired gas sampling from the patient side of these filters may contaminate and saturate the sampling line, while sampling from the machine side may cause underestimation of end‐tidal carbon dioxide (P
ECO
2). The aim of this investigation was to elucidate the degree of underestimation of P
ECO
2 induced by sampling from the machine side of a breathing system filter. Ten spontaneously breathing children and ten children receiving mechanical ventilation under general anaesthesia were studied. P
ECO
2 was higher at the patient side of the filter in both ventilated and spontaneously breathing groups (P<0.002 for each). The bias in measuring at the machine side of the filter was significantly greater in the spontaneously breathing children as compared with the mechanically ventilated children (−1.8 vs −0.7 kPa; P<0.004).
Open heart surgery; pump prime effects and cerebral arteriovenous differences in glucose, lactate and ketones
Authors: SANDSTRÖM KERSTIN , NILSSON KRISTER , ANDRÉASSON SVENERIK , LARSSON LARS E 
Published: December 2004

SummaryThis study included 17 young children, who were operated with cardioplumonary bypass for congenital heart defects and were cooled to 20°C or 25°C. No glucose, except for the pump prime solution, was administered during surgery. Samples of arterial blood, cerebral venous blood from the jugular bulb and mixed venous blood from the bypass circuit were obtained and analysed for concentrations of glucose, lactate and ketones as well as oxygen saturation. The prime content of lactate significantly contributed to the arterial lactate concentrations, which together with the cerebral arteriovenous (A‐V) lactate differences remained elevated throughout the bypass period. The prime content of glucose had less influence on the arterial concentrations and these did not increase until the rewarming period, when indications of gluconeogenesis from lactate were found. Arterial ketone concentrations also increased during rewarming in parallel with significant cerebral uptake of ketones. The lowest cerebral A‐V glucose, lactate and oxygen saturation differences were found at the target minimum temperature and this effect was significantly more pronounced in the patients cooled to 20°C.
Comparison of three techniques for induction of anaesthesia with sevoflurane in children
Authors: DUBOIS MARIE‐CLAUDE , PIAT VÉRONIQUE , CONSTANT ISABELLE , LAMBLIN OLIVIER , MURAT ISABELLE 
Published: December 2004

SummaryThis study was designed to evaluate the clinical characteristics of three induction techniques using sevoflurane in children scheduled for tonsillectomy: incremental induction with sevoflurane(2,4,6,7%) in 100% O2 (group IC‐O2; n=23); induction with high concentration of sevoflurane in 100% O2 (group HC‐O2; n=22); and induction with high concentration of sevoflurane in a mixture of O2:N2O(50:50) (group HC‐N2O; n=20). Induction was well accepted and well tolerated in most children. The addition of nitrous oxide resulted in faster loss of consciousness (P< 0.001) compared to the other induction techniques and in a tendency for reduced excitement compared with the same rapid technique without nitrous oxide
(P=0.053). Time to tracheal intubation was identical in the three groups and intubation conditions were scored as good in most children. During the early induction phase, an increase in SAP and HR was observed in the three groups. Changes were maximal at two min after the beginning of induction in the three groups. SAP and HR values were back to baseline values at the time of tracheal intubation. In conclusion, the addition of nitrous oxide to a high sevoflurane concentration decreases the time to loss of eyelash reflex, tends to reduce the incidence of excitement and is not associated with an increased incidence of respiratory complications even in patients with obstructive airway.
Transcutaneous carbon dioxide monitoring during diabetic ketoacidosis in children and adolescents
Authors: McBride Mary E. , Berkenbosch John W. , Tobias Joseph D. 
Published: December 2004

SummaryObjective : Our aim was to evaluate the utility of transcutaneous CO2 (TC‐CO2) monitoring in following the response to therapy in children and adolescents in diabetic ketoacidosis (DKA) requiring ICU admission.Methods : During therapy for DKA, TC‐CO2 was monitored and compared with the serum bicarbonate values (HCO3−). As clinically indicated, serum electrolytes including serum HCO3− were drawn and at the same time, the TC‐CO2 value was recorded. Using the TC‐CO2 value and the equation (PaCO2 = 1.5 × HCO3− + 8), a calculated HCO3− value was determined. The measured serum HCO3− value was subtracted from the calculated HCO3− value and the absolute difference was recorded. The difference between the measured serum HCO3− and the calculated HCO3− was analysed using analysis of variance after stratification for serum HCO3− values and patient age ranges. Calculated to serum HCO3− values were compared using linear regression analysis. In addition, serum HCO3− values were plotted against TC‐CO2 values to derive an equation from these data which would relate the TC‐CO2 values to the measured serum HCO3−.Results : The cohort included 28 patients ranging in age from 1.6 to 21 years (9.4 ± 4.7 years) and in weight from 13 to 96 kg (35.6 ± 18.2 kg). Two additional patients were not included as the initial TC‐CO2 values were inaccurate because of tissue hypoperfusion. In the remaining 28 patients, the absolute difference between the calculated bicarbonate and serum bicarbonate values was 1.5 ± 1.2 mmol·l−1. The difference was ≤2 mol·l in 74.4% of samples and ≤5 mmol·l−1 in 99.2%. No difference in the value between the calculated and measured serum HCO3− was present according to serum HCO3− value or patient's age. Linear regression analysis of calculated HCO3− against serum HCO3− revealed a slope of 0.95 and an r2 value of 0.88. Linear regression analysis using serum HCO3− against TC‐CO2 resulted in the following equations:
image
Conclusions : TC‐CO2 correlates with serum HCO3− and can be used to follow therapy in children and adolescents in DKA.
Conjoined twins – the anaesthetic management of 15 sets from 1991–2002
Authors: Thomas Jenny M , Lopez J Tessa 
Published: December 2004

SummaryThe Red Cross War Memorial Children's Hospital, Cape Town, South Africa is the only dedicated children's hospital in sub‐Saharan Africa and, as such, is the referral hospital for complex procedures from this region.Fifteen sets of conjoined twins have presented for separation from 1991 to 2002, and a total of 34 sets since 1964.Anaesthesia for procedures on conjoined twins is a demanding, exacting and meticulous exercise, whether prior to or during separation. Anaesthesia forms part of the multidisciplinary management of the babies. Emphasis is laid on preoperative assessment, goal‐directed planning of theatre and the staff involved in the surgery, duplication of all equipment necessary for anaesthetizing and monitoring two infants in one operating room, and having plans in place to avoid overcrowding. Challenges encountered in anaesthesia for these twins include identifying anatomical conjunctions, airway management, acquiring vascular access, the potential for enormous blood loss, and maintaining normothermia. Planning for the postseparation period and the reconstruction and rehabilitation of the babies is essential from the time of their initial admission.Meticulous attention to detail, monitoring and vigilance are mandatory. Successful management of conjoined twins relies on close communication and cooperation of all members of the multidisciplinary team.
Restorative nursing: toward a philosophy of postmodern punishment
Authors: Gadow Sally 
Published: December 2004

AbstractNursing practice in correctional settings is ethically unique. Its premise is the contradiction between causing harm (the purpose of imprisonment) and acting for patients’ good (the purpose of health care). I describe three ethical regions in which correctional nurses can practise, based on different philosophies: punishment as retribution, as rationality, and as paradox. Retribution and rationality resolve the ethical contradiction by relegating offenders to intractable otherness. Restorative nursing based on paradox is an oppositional practice that preserves the contradiction, making engagement possible between prisoner and nurse. Endorsement by nursing of one of the three philosophies of punishment could redefine care for the entire profession.
European withdrawal of appetite suppressants
Authors: Kinnell H. G. 
Published: December 2004

SummaryThe temporary delicensing of the centrally acting appetite suppressants (first in April 2000, then in May 2001) by the European Commission's Committee on Proprietary Medical Products was premature and possibly unjustified. While their ultimate fate is awaited, the European Drugs Evaluation Agency declined to release the information on which its withdrawal advice was based.
Should we recommend low‐fat diets for obesity?
Authors: Pirozzo S. , Summerbell C. , Cameron C. , Glasziou P. 
Published: December 2004

SummaryDietary fat intake has been blamed for the increase in adiposity and has led to a worldwide effort to decrease the amount of fat in the diet. However, the comparative efficacy of this approach is debatable. Whilst short‐term dietary intervention studies show that low‐fat diets lead to weight loss in both healthy and overweight individuals, it is less clear if a reduction in fat intake is more efficacious than other dietary restrictions in the long term. The purpose of this systematic review was to determine the effectiveness of low‐fat diets in achieving sustained weight loss when used for the express purpose of weight loss in obese or overweight people. A comprehensive search identified six studies that fulfilled our criteria for inclusion (randomized controlled trial, participants either overweight or obese, comparison of a low‐fat diet with another type of weight‐reducing diet, follow‐up period that was at least 6 months in duration and inclusion of participants 18 years or older without serious disease). There were a total of 594 participants in the six trials. The duration of the intervention varied from 3 to 18 months with follow‐up from 6 to 18 months. There were no significant differences between low‐fat diets and other weight‐reducing diets in terms of sustained weight loss. Furthermore, the overall weight loss at the 12–18‐month follow‐up in all studies was very small (2–4 kg). In overweight or obese individuals who are dieting for the purpose of weight reduction, low‐fat diets are as efficacious as other weight‐reducing diets for achieving sustained weight loss, but not more so.
Dusting off the epidemiological triad: could it work with obesity?
Authors: Egger G. , Swinburn B. , Rossner S. 
Published: December 2004

SummaryThe search for effective ways of dealing with obesity has centred on biological research and clinical management. However, obesity needs to be conceptualized more broadly if the modern pandemic is to be arrested. The epidemiological triad (hosts, agent/vectors and environments) has served us well in dealing with epidemics in the past, and may be worth re‐evaluating to this end. Education, behaviour change and clinical practices deal predominantly with the host, although multidisciplinary practices such as shared‐care might also be expected to impact on other corners of the triad. Technology deals best with the agent of obesity (energy imbalance) and it's vectors (excessive energy intake and/or inadequate energy expenditure), and policy and social change are needed to cope with the environment. The value of a broad model like this, rather than specific isolated approaches, is that the key players such as legislators, health professionals, governments and industry can see their roles in attenuating and eventually reversing the epidemic. It also highlights the need to intervene at all levels in obesity control and reduces the relevance of arguments about nature vs. nurture.
Hyperpigmentation mimicking Laugier syndrome, levodopa therapy and Addison's disease
Authors: Vega Gutiérrez J , Miranda Romero A , Martínez G , Torrero MV , López de Juan M 
Published: December 2004

ABSTRACTThe Laugier–Hunziker syndrome is an acquired, idiopathic, benign mucocutaneous hypermelanosis that usually occurs on the lips and oral mucosa, although it may appear at other sites. Nails are frequently involved, mainly forming longitudinal hyperpigmented bands. We report the case of a patient that presented a typical picture of this entity, nearly 1 year after the beginning of treatment with levodopa. Two years after the first lesions occurred, she developed Addison's disease. The patient suffered from a diffuse discrete hyperpigmentation (it was more remarkable on exposed areas) and an intensification of the melanotic macules that were previously noticeable before in oral and genital mucosa, fingers, toes and nails. Hormonal replacement treatment enabled the control of laboratory and general manifestations and to decrease the degree of mucocutaneous hyperpigmentation considerably, despite initial hyperpigmented lesions persisting in described areas.
Cytotoxic γ/δ subcutaneous panniculitis‐like T‐cell lymphoma: report of a case with pulmonary involvement unresponsive to therapy
Authors: Guizzardi M , Hendrickx IAG , Mancini LL , Monti M 
Published: December 2004

ABSTRACTPeripheral subcutaneous panniculitis‐like T‐cell lymphoma (PSPTCL) is a rare form of cutaneous lymphoma recently proposed as a distinct clinicopathological entity. It usually presents with multiple indurated subcutaneous plaques or tumours, most commonly located on the extremities and trunk and clinically mimicking lobular panniculitis. Associated constitutional symptoms due to haemophagocytic syndrome may advance or, more often, complicate the clinical course in about 40–70% of cases. Finding of TIA‐1+ and perforin + cytolytic granules in atypical pleomorphic lymphocytes suggests PSPTCL origin from granular cells of T‐cell or natural killer cell phenotype. Cells have a CD3+ CD4+ CD8– or CD3+ CD4– CD8+ T‐cell phenotype. Moreover, these lymphomas can express natural killer cell associated antigens, such as CD56, especially in γ/δ variants. PSPTCL following an indolent clinical course with recurrent self‐healing lesions have been described. The prognosis of most PSPTCL is poor even when treated with aggressive chemotherapy. This paper reports a case of PCTCL in a young woman with T‐cytotoxic differentiation, with rapid progression unresponsive to several treatments.
Indolent systemic mast cell disease: immunophenotypic characterization of bone marrow mast cells by flow cytometry
Authors: Bodni RA , Sapia S , Galeano A , Kaminsky A 
Published: December 2004

ABSTRACTBackground Mast cell disease has a low prevalence and is difficult to diagnose in the absence of the characteristic skin lesions that usually accompany the condition. Extracutaneous involvement is not easy to assess. There are reports in the recent literature on the use of tryptase as a reliable immunohistochemical marker as well as on the study of the immunophenotype of bone marrow mast cells. The latter is of great help for the diagnosis of systemic involvement as, after the skin, the bone marrow is the organ most commonly affected by the disease.Objective We describe two cases of indolent systemic mast cell disease (SMCD) where flow cytometry was used to identify immunophenotypical characteristics of bone marrow mast cells. Recent advances in the application of this technique prove it can be a good diagnostic tool for assessing systemic involvement of the disease.Patients and methods Two adult subjects with indolent SMCD had multiple clinical symptoms. Cutaneous lesions were the clue to the diagnosis but, subsequently, in the presence of disturbing symptoms, involvement of other organ systems was confirmed. In both cases, the authors used flow cytometry techniques, as described by Escribano et al. (1998) to define the immunophenotype of bone marrow mast cells.Results Both patients were diagnosed with indolent SMCD with cutaneous and bone marrow involvement. Also, they presented visible clues to the presumptive bone, cardiovascular and nervous system involvement. Gastrointestinal manifestations were documented in one case.Conclusions The use of flow cytometry on bone marrow samples from patients with mastocytosis reveals immunophenotypic differences that can serve to allow classification of these subjects in the category of indolent SMCD even though involvement of another organ system may not be thoroughly confirmed.
Bullous scleroderma‐like changes in chronic graft‐versus‐host disease
Authors: Moreno JC , Valverde F , Martinez F , Vélez A , Torres A , Fanego J , Ocaña MS 
Published: December 2004

ABSTRACTCutaneous graft‐versus‐host disease (GVHD) is the most common clinical setting for GVHD after bone marrow transplantation. Chronic cutaneous GVHD is categorized according to the type of skin lesions into lichenoid and sclerodermoid variants, but bullous scleroderma‐like changes are exceptional. Recently, we studied a patient with these alterations. This is the second case described in the literature.