bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationships between circulating leptin concentrations and other hormonal parameters in obese and non‐obese women with polycystic ovary syndrome
Authors: Kikuchi Nobumasa , Andoh Kazumichi , Mizunuma Hideki , Minegishi Takashi 
Published: March 2003

Aim: To clarify the role of leptin in women with polycystic ovary syndrome (PCOS), we analyzed whether serum leptin levels correlate with other hormonal parameters in obese and non‐obese women with PCOS.Methods: We studied 20 obese (body mass index, BM ≥25 kg/m2) and 20 non‐obese (BMI <25 kg/m2) women with PCOS diagnosed by the existence of menstrual disturbance, elevated serum level of luteinizing hormone (LH) with normal follicle‐stimulating hormone (FSH) and the characteristic polycystic appearance of the ovaries on transvaginal ultrasound images. Blood samples for LH, FSH, estradiol, testosterone (T), androstenedione (Δ4) and leptin were obtained, and the relationships between variables were examined by calculating Spearman correlation coefficients.Results: Mean levels of leptin, T and Δ4 in obese PCOS women were significantly higher than those in non‐obese PCOS women, but this was not the case for BMI, bodyweight and waist to hip ratio. In all the 40 PCOS women considered together, there were significant positive correlations of leptin with BMI, waist to hip ratio, and Δ4 levels. However, in each group separately, serum leptin levels in obese PCOS women correlated only with BMI and bodyweight, whereas serum leptin levels in non‐obese PCOS women correlated with serum A4 levels.Conclusion: Although further study is needed to assess the role of leptin on ovarian function in non‐obese women with PCOS, present findings do not support the fact that leptin is involved in the development of hormonal abnormalities in obese women with PCOS. (Reprod Med Biol 2002; 1: 49–54)
High‐dose therapy and autologous transplantation for lymphoma: The Peter MacCallum Cancer Institute experience
Authors: Dowling A. J. , Prince H. M. , Wirth A. , Wolf M. , Januszewicz E. H. , Juneja S. , Seymour J. F. , Gates P. , Smith J. G. 
Published: March 2003

Abstract Background: High‐dose therapy (HDT) with autologous bone marrow or blood cell transplantation for the treatment of lymphoma commenced at Peter MacCallum Cancer Institute in 1986. Aim: To examine the patient characteristics and outcomes of patients with non‐Hodgkin’s lymphoma (NHL) and Hodgkin’s disease (HD) treated with HDT and autologous transplantation at our Institute in the first 10 years of the service (1986–95). Methods: A retrospective analysis was performed examining patient characteristics, prior chemotherapy regimens, pretransplant disease status, HDT regimen, source of stem cells, time for haematopoietic recovery, complications of transplantation, response rates, overall survival (OS) and progression‐free survival (PFS). Results: Sixty‐seven patients with NHL were treated with an estimated 5‐year OS rate of 44% (95% confidence interval (CI) 32–56%) and PFS rate of 34% (95% CI 21–44%). Factors independently predictive of an unfavourable PFS on multivariate analyses were presence of constitutional symptoms at transplant (P < 0.002) and chemotherapy‐resistant disease at transplant (P = 0.02). Twenty‐three patients with HD were treated with a 5‐year predicted OS rate of 74% (95% CI 56–92%) and PFS rate of 57% (95% CI 36–77%). There was no difference in PFS for HD patients who relapsed either within 12 months of completion of front‐line therapy or after this time (P = 0.5). The transplant‐related mortality for the entire cohort was 17%, with a progressive decrease over time. Conclusion: HDT with autologous transplanta‐ tion achieves durable PFS and OS in patients with lymphoma. Improved patient selection, therapy modifications according to prognostic factors and ongoing improvements in supportive care should improve outcomes further. (Intern Med J 2001; 31: 279–289)
Immediate and long‐term results of radiofrequency ablation of pulmonary vein ectopy for cure of paroxysmal atrial fibrillation using a focal approach
Authors: Sanders P. , Morton J. B. , Deen V. R. , Davidson N. C. , Sparks P. B. , Vohra J. K. , Kalman J. M. 
Published: March 2003

Abstract Background: Atrial fibrillation (AF) is frequently initiated by focal activity originating in the pulmonary veins. We present the early and long‐term results of a focal approach to pulmonary‐vein ablation for cure of paroxysmal AF. Aims: The aim of this study was to establish the effectiveness of focal pulmonary vein radiofrequency ablation (RFA) for cure of paroxysmal AF. Methods: Fifty‐one consecutive patients (35 male; 45 ± 11.4 years) were considered for RFA on the following criteria: (i) symptomatic drug refractory AF, (ii) high‐density atrial ectopy, bursts of atrial tachycardia or AF, (iii) absence of structural heart disease and (iv) provision of informed consent. Pulmonary vein mapping and RFA were by single trans‐septal puncture, which was only performed in patients with adequate focal activity at the time of procedure. Focal activity was present spontaneously or was elicited by isoprenaline, burst pacing or AF induction and cardio­version. Results: One patient was excluded from the analysis due to non‐pulmonary vein triggers. Trans‐septal mapping and RFA were not performed in 22 patients (44%) due to: (i) inadequate ectopy (17), (ii) recur­rent AF (1), (iii) inability to cross septum (2) and (iv) multiple foci (2). Of 28 patients, RFA was attempted with procedural success in 23 patients (82%), with no acute complications. Mean fluoro‐­ scopy time for patients having RFA was 29 ± 11.5 mins. Pulmonary vein stenosis occurred in one case. Ten patients had symptomatic recurrence and, of those, two had further RFA. At a mean follow up of 11 ± 8 months, 15 patients (54% ablated, 30% of the total cohort) remained free of AF without anti‐arrhythmics. Conclusion: This series highlights the low long‐term success rate of RFA to cure AF by targeting pulmon­ary vein initiators using a focal approach. Electrical pulmonary vein isolation may provide better long‐term results. (Intern Med J 2002; 32: 202−207)
Thyrotoxic, hypokalaemic periodic paralysis in Australasian men
Authors: Tran H. A. , Kay S. E. , Kende M. , Doery J. C. G. , Colman P. G. , Read A. 
Published: March 2003

Abstract The present study describes the clinical and laboratory features of 11 patients with thyrotoxic, hypokalaemic periodic paralysis, presenting to five Melbourne teaching hospitals between 1991 and 2000. All 11 patients were Asian or Polynesian men aged 18−41 years, and most had experienced previous episodes of acute, unexplained paralysis. All cases resolved without significant morbidity. Thyrotoxic, hypokalaemic periodic paralysis is a potentially life‐threatening and terrifying condition, which is often under‐recognized and will present with increasing frequency in the community. The diagnosis should be considered in any Asian−Australian male presenting with sudden onset paralysis. (Intern Med J 2003; 33: 91−94)
Sevoflurane for dental extraction in children with Tetralogy of Fallot
Authors: Chiu C.l , Wang C.y 
Published: March 2003

SummaryTwo children with Tetralogy of Fallot presented for dental extraction. Anaesthesia was induced rapidly and smoothly by inhalation of sevoflurane. We discussed the advantages of sevoflurane as an induction agent as compared to halothane in these children.
Anaesthetic implications of rigid spine syndrome
Authors: Jørgensen Bent G. , Laub Michael , Knudsen Rolf H. 
Published: March 2003

SummaryThe perioperative management of a 14‐year‐old girl, suffering from the muscular disorder rigid spine syndrome, is presented. The anaesthetic implications with regard to possible difficult intubation, cardiac involvement, malignant hyperthermia, neuromuscular blocking agents, and postoperative recovery are discussed.
Tropisetron reduces postoperative vomiting in children undergoing tonsillectomy
Authors: Jensen Anette B. , Christiansen Dorte B. , Coulthard Kingsley , Wilkins Andrew , Roberts Greg , Van Der Walt Johan H. , Rasmussen Mette 
Published: March 2003

SummaryIn this patient, parent and investigator blinded, randomized, placebo‐controlled study, children undergoing tonsillectomy (mean age 6.4 years) received either intravenous placebo (n=36) or tropisetron 0.2 mg·kg−1 up to 5 mg (n=35) at induction of anaesthesia with halothane, nitrous oxide and oxygen. Morphine and paracetamol were given in theatre for postoperative pain. Episodes of vomiting were recorded during the first 24 h after surgery. Intravenous tropisetron was significantly (P<0.001, chi‐squared) more effective than placebo in controlling the incidence and frequency of emesis during the first 24 h: vomiting was reduced from 89% to 46% and the mean number of vomits from 4.6 to 2.4. Minor side‐effects occurred equally in both the placebo and active groups. Intravenous tropisetron is an effective and safe antiemetic for reducing postoperative vomiting in children undergoing tonsillectomy or adenotonsillectomy.
Tropisetron plus dexamethasone is more effective than tropisetron alone for the prevention of postoperative nausea and vomiting in children undergoing tonsillectomy
Authors: Holt Rikke , Rask Pernille , Coulthard Kingsley P. , Sinclair Mark , Roberts Greg , Van Der Walt Johan , Mackenzie Valmai , Rasmussen Mette 
Published: March 2003

SummaryThe 5‐HT3 antagonists are effective in reducing postoperative nausea and vomiting (PONV) associated with paediatric tonsillectomy. Although prophylactic tropisetron can reduce the incidence of PONV by half, the resulting level of over 40% is still unacceptably high. The aim of this study was to evaluate the effect of adding dexamethasone to tropisetron. In a blinded study, 59 children (mean age 6.1 years) were administered 0.1 mg·kg−1 up to 2 mg of tropisetron and 66 children (mean age 5.7 years) received the same dose of tropisetron plus 0.5 mg·kg−1 up to 8 mg of dexamethasone. Both drugs were given intravenously during induction of anaesthesia for tonsillectomy. During the inpatient stay of 24 h, the incidence of postoperative vomiting in the tropisetron alone group was 53% compared with 26% in the combination group (P=0.002, chi‐squared). A significant reduction in nausea from 53% to 30% was also observed (P=0.02). Parents completed a daily diary for 5 days following discharge. Delayed vomiting occurred in 27% and 11% of the tropisetron and combination therapy groups, respectively (P=0.025) Sixteen percent and 9%, respectively, required medical attention (P=0.27). Tropisetron plus dexamethasone is more effective than tropisetron alone in reducing the incidence of PONV following paediatric tonsillectomy.
Soluble P‐selectin and the postoperative course following cardiopulmonary bypass in children
Authors: Lotan D , Prince T , Dagan O , Keller N , Ben‐Abraham R , Weinbroum A , Gaby A , Augarten A , Smolinski A , Barzilay Z , Paret G 
Published: March 2003

Background: Cytokine‐inducible leucocyte‐endothelial adhesion molecules were shown to affect the postoperative inflammatory response following cardiopulmonary bypass (CPB). Soluble P‐selectin (sP‐selectin) is one of these molecules. We investigated the correlation between plasma sP‐selectin levels and the intra‐ and postoperative course in children undergoing CPB.Methods: Serial blood samples of 13 patients were collected preoperatively upon initiation of CPB and seven times postoperatively. Plasma was recovered immediately and frozen at – 70°C until use. Circulating soluble selectin molecules were measured with a sandwich enzyme‐linked immunoabsorbent assay technique.Results: The significant post‐CPB changes in sP‐selectins plasma levels were associated with patient characteristics, operative variables and postoperative course. sP‐selectin levels correlated significantly with surgery time, aortic cross‐clamping time and inotropic support, as well as with the postoperative Pediatric Risk of Mortality score, hypotension and tachycardia.Conclusions: A relation between CPB‐induced mediators and both early and late clinical effects is suggested. The up‐regulation and expression of sP‐selectin indicate neutrophil activation as a possible mechanism for the increase, and inhibiting it may reduce the inflammatory response associated with CPB.
Comparison of recovery after intermediate duration of anaesthesia with sevoflurane and isoflurane
Authors: Le Berre Pierre‐Yves , Wodey Eric , Joly Agnès , Carré Philippe , Ecoffey Claude 
Published: March 2003

Background: The purpose of this study was to compare recovery from anaesthesia after sevoflurane and isoflurane were administered to children for more than 90 min. Methods: After parental informed consent and ethical committee approval, children aged between 2 months and 6 years, ASA I or II, were randomly allocated to sevoflurane (n=20) or isoflurane (n=20) groups. Halogenated agents were discontinued following skin closure and patients were ventilated mechanically with 100% oxygen until minimum alveolar concentration (MAC) values awake were obtained (endtidal concentrations 0.6 MAC for sevoflurane and 0.4 MAC for isoflurane). Effective perioperative analgesia was provided by a caudal block. Results: The mean (± SD) duration of anaesthesia was 132 ± 38 min and 139 ± 49 min for sevoflurane and isoflurane, respectively. Early recovery occurred sooner in the isoflurane group (time to extubation was 16 ± 7 min and 11 ± 5 min, P<0.01; Aldrete’s score at 0 min was 5.5 ± 1.5 and 7.4 ± 1.8, P<0.001, respectively). But the time to be fit for discharge from recovery room was similar at 136 ± 18 min and 140 ± 20 min, respectively. Conclusions: After intermediate duration of anaesthesia administered to children for up to 90 min, isoflurane and sevoflurane allow recovery after approximatively the same lapse of time.
Effect of oral midazolam premedication on the awakening concentration of sevoflurane, recovery times and bispectral index in children
Authors: Brosius Keith K. , Bannister Carolyn F. 
Published: March 2003

Background: We sought to determine the influence of preoperative oral midazolam on: (i) measures of anaesthetic emergence; (ii) recovery times and (iii) intraoperative bispectral index (BIS) measurements during sevoflurane/N2O anaesthesia in paediatric patients. Methods: Fifty‐two patients, aged 1–10 years, ASA I–II, were enrolled in a prospective double‐blinded study. Patients were randomized to receive either midazolam 0.5 mg·kg–1 (M) or midazolam vehicle (P) as premedication. After inhalation induction and intubation, expired sevoflurane was stabilized at 3% in 60% N2O and the corresponding BIS (BIS I) recorded. At the completion of surgery, sevoflurane was stabilized at 0.5% and the BIS (BIS E) again recorded. Awakening time, expired sevoflurane/N2O awakening concentrations and recovery times were recorded. Results: There were no significant differences between groups in awakening time, sevoflurane or N2O awakening concentrations, time to PACU discharge, time to hospital discharge or in BIS I and BIS E measurements.
Pressure versus volume‐controlled ventilation with a laryngeal mask airway™ in paediatric patients
Authors: Keidan I. , Berkenstadt H. , Segal E. , Perel A. 
Published: March 2003

Background: The utility of positive pressure ventilation with the laryngeal mask airway (LMA™) in children was described previously, but the possibility of gastric insufflation, related to high peak airway pressure, continues to be a disadvantage. In this prospective study, inspiratory pressures, air leak and signs of gastric insufflation were compared between volume‐controlled ventilation (VCV) and pressure‐controlled ventilation (PCV) using an LMA. Methods: Thirty‐two ASA I patients, aged 4.5 ± 4 years, who were scheduled for elective procedures under combined general anaesthesia and caudal analgesia, were enrolled. After inhalation induction and LMA insertion, each patient was randomly assigned to receive successively PCV and VCV. Peak pressures (PCV) and tidal volumes (VCV) were changed in order to achieve adequate ventilation [endtidal CO2 5–5.4 kPa (38–42 mmHg)]. Results: Peak airway pressures were significantly lower with PCV than VCV (14.1 ± 1.6 cmH2O versus 16.7 ± 2.3 cmH2O, P < 0.001). No patient ventilated with PCV required peak pressure higher than 20 cmH2O compared with six patients ventilated with VCV (P < 0.05). Haemodynamic parameters, expiratory tidal volume and percent of leak were similar in both ventilatory modes and no signs of gastric insufflation were detected. Conclusions: During general anaesthesia in children using an LMA, PCV offers lower peak inspiratory airway pressures while maintaining equal ventilation compared with VCV. Although no signs of gastric insufflation were detected in both groups, the lower pressures might be significant in patients with reduced chest wall or lung compliance.
A survey of practice of tracheal intubation without muscle relaxant in paediatric patients
Authors: SIMON LIONEL , BOUCEBCI KARIM J , ORLIAGUET GILLES , AUBINEAU JEAN‐VINCENT , DEVYS JEAN‐MICHEL , DUBOUSSET ANNE‐MARIE 
Published: March 2003

Background: Because of the renewed interest in intubation in children without relaxants, over a period of 1 month, the anaesthesiologists of five paediatric universitary teaching hospitals were asked to complete a questionnaire each time they performed a tracheal intubation without muscle relaxant. Methods: Intubating conditions were assessed with five items. Each item was graded on a four‐point scale. Intubating conditions were judged acceptable when all items scored 2 or less. Episodes of oxygen desaturation and failed intubations were noted. Data are expressed as mean ± SD (extremes). Results: Five hundred and two questionnaires were completed during the study period. Children were aged 61 ± 50 (1–180) months old. Induction of anaesthesia was performed with sevoflurane for 62.6% of the children (endtidal concentration 5.9 ± 1.5%) and propofol for 28.9% (dose 5.8 ± 4.2 mg·kg–1). Opioids were associated with these hypnotics in 53.2% of the children. Tracheal intubation was successful in 87.1% of the children. Sevoflurane produced better intubating conditions than propofol. Sevoflurane requirements for tracheal intubation may be higher in infants aged less than 6 months old than in older children. A severe decrease in SpO2 (≤ 90%) was observed in 15.9% of the infants aged less than 1 year old and in 1.7% of the children, respectively (P < 0.0001). Conclusions: Sevoflurane is the most commonly used agent for tracheal intubation without relaxants with higher doses being required in infants aged less than 6 months. Propofol, even with opioids, was not so successful.
Interleukin‐8 secretion following cardiopulmonary bypass in children as a marker of early postoperative morbidity
Authors: BEN‐ABRAHAM RON , WEINBROUM AVI A. , LOTAN DANNY , DAGAN OVDI , SCHRERIBER‐SCHEFFER RIVKA , MISHALI DAVID , HAREL RAN , VISHNE TALI , BARZILAY ZOHAR , PARET GIDEON 
Published: March 2003

Background: Interleukin (IL)‐8, an 8 kDa peptide, is the first chemoattractant identified as being specific for neutrophils. Its possible association with early postoperative morbidity following cardiopulmonary bypass (CPB) in infants and children is unknown. This prospective cohort study sought possible roles of IL‐8 in the inflammatory response to CPB and investigated if changes in IL‐8 levels and clinical course and outcome were related. Methods: IL‐8 levels were measured in 16 children undergoing CPB. Systemic blood was collected after induction of anaesthesia (baseline), at 15 min after CPB onset and cessation, and at 1, 4, 8, 12 and 24 h thereafter Results: Correlation coefficients between IL‐8 levels and CPB time ranged from 0.45 to 0.55, heart rate 0.41–0.44, surgical time 0.41–0.63 and pH –0.56 to –0.50 (P < 0.05 for all parameters). Univariate analyses showed that patients requiring inotropic support and those with tachycardia had significantly higher postoperative IL‐8 levels (P < 0.05). Furthermore, IL‐8 levels were significantly higher in patients with surgical times > 200 min and in patients with an aortic clamp in place for > 65 min. Conclusions: There was an association between IL‐8 and early postoperative heart rate, and the need for inotropic support IL‐8 correlated positively with surgical time, CPB time and heart rate and negatively with pH. IL‐8 release may be related to some of the haemodynamic changes in the early postoperative course following CPB. The relationship between IL‐8 and late markers of patient outcome in high‐risk infants awaits further studies.
The analgesic efficacy and neuroendocrine response in paediatric patients treated with two analgesic techniques: using morphine‐epidural and patient‐controlled analgesia
Authors: Bozkurt Pervin 
Published: March 2003

Background: Pain treatment is one of the main concerns of paediatric anaesthesiologists. The purpose of this study was to assess and compare the quality of analgesia and stress suppression by morphine when used [epidural (single shot) (EP) or with intravenous (i.v.) for patient‐controlled analgesia (PCA) in children].Methods: Forty‐four children, aged 5–15 years, and who were undergoing major genitourinary or lower abdominal surgery with a standardized general anaesthesia technique, were included in this study. In the EP group (n=24) 0.1 mg·kg–1 morphine in 0.2 ml·kg–1 saline were given epidurally at the L3–4 level and in the PCA group (n=20) 0.1 mg·kg–1 morphine was given i.v. immediately after intubation. Postoperative PCA bolus doses were 0.5 mg for patients weighing less than 20 kg, 1 mg for children weighing 20–30 kg and 1.5 mg for children weighing 30–40 kg. Blood samples were withdrawn following induction and at 1, 8, 12 and 24 h after morphine administration for measurement of blood glucose, insulin, cortisol and morphine levels. Patients were observed for 24 h postoperatively; heart rate, systolic blood pressure, respiratory rate, FACES pain scores, sedation scores and complications were recorded.Results: The PCA group received 0.56 ± 0.33 mg·kg–1·day–1 morphine. The FACES pain scores, sedation scores, cortisol, blood glucose and insulin levels were similar in both groups. Haemodynamic and respiratory evaluations and cortisol levels were stable but blood glucose and insulin changes at certain time periods were significant (P < 0.05). Serum morphine levels and incidence of vomiting were different between groups (P < 0.05). Serum morphine levels were similar at the first hour.Conclusions: Both techniques provided sufficient pain relief and attenuated the hormonal response without life‐threatening complications.