bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the prognosis of mild normocytic anaemia in older people?
Authors: Wilkinson T. J. , Warren M. R. 
Published: March 2003

Abstract Background:  There is reduced survival for people with all types of anaemia and it has been shown that there is a low yield from investigations for older people with normocytic anaemia. However, the longer‐term outcomes of people with mild normocytic anaemia are not known.Aims:  To determine the 5‐year prognosis of older people with mild normocytic anaemia, compared with non‐anaemic controls.Methods:  This was a prospective cohort study, with some retrospective data collection, comparing 52 people aged ≥65 years (haemoglobin 100−119 g/L; mean cell volume 80−99 fL) without an obvious cause at presentation with 52 non‐anaemic controls. The incidence of death, new malignancies and significant illnesses was compared between the two groups, 5 years later.Results:  Anaemic patients were less likely to be living at home at baseline. Although survival was lower for the anaemic group at all follow‐up times, these differences were not significantly different. Over 5 years, there were no significant differences between groups in the types of problems that developed.Conclusions:  A mild normocytic anaemia in older people, in the absence of an obvious cause, is not associated with significant differences in outcomes but is associated with poorer independence and a trend to lower survival. We suggest it may therefore be a marker of frailty in older people. (Intern Med J 2003; 33: 14−17)
Oliguria during corrective spinal surgery for idiopathic scoliosis: the role of antidiuretic hormone
Authors: Cregg Nuala , Mannion David , Casey William 
Published: March 2003

SummaryPatients undergoing surgery for idiopathic scoliosis were studied to determine the incidence and aetiology of oliguria during the perioperative period and to evaluate the efficacy of low dose dopamine in preventing its occurrence. Thirty patients, aged 6–18 years undergoing elective surgery were studied. Anaesthesia was standardized. Patients were randomized to receive either dopamine infusion (3 μg·kg−1·min−1) (Group A) (n=15) or dextrose infusion (control) (Group B) (n=15). Serum and urinary electrolytes and osmolalities and serum antidiuretic hormone (ADH) concentrations were measured. Urine output and haemodynamic parameters were recorded. Intraoperative oliguria occurred in 7% of patients in Group A and 47% in Group B (P < 0.05). Postoperative oliguria occurred in 20% of patients in Group A and 47% in Group B (P > 0.05). Urine and serum biochemical analysis revealed a statistically significant decrease in serum sodium and osmolality (P < 0.005) and an increase in urinary sodium and osmolality in both groups. Serum ADH concentrations were increased in both groups (P < 0.05), returning to baseline 18 h postoperatively. We conclude that oliguria during corrective spinal surgery occurs in association with excess ADH secretion as opposed to perioperative hypovolaemia. Dopamine increases urine output in the perioperative period but does not prevent the release of ADH and its subsequent biochemical effects.
The epidural dorsomedian septum as a possible cause for unilateral anaesthesia in an infant
Authors: Finkel Julia C. 
Published: March 2003

SummaryUnilateral epidural anaesthesia occurring in an infant is reported. An epidurogram revealed the presence of a midline structure suggestive of the dorsomedian septum. Epidural anatomy is reviewed and implications for threading epidural catheters in infants are discussed.
A comparison of two concentrations of bupivacaine and adrenaline with and without fentanyl in paediatric inguinal herniorrhaphy
Authors: Joshi Wandana , Connelly Neil R. , Dwyer Michael , Schwartz Donald , Kilaru Prasad R. , Reuben Scott S. 
Published: March 2003

SummaryThis study was designed to determine whether administration of caudal bupivacaine with fentanyl would have any effect on analgesia in paediatric patients undergoing inguinal herniorrhaphy repair. Fifty‐six outpatient paediatric patients undergoing inguinal hernia repair were evaluated. Patients received, in a randomized manner, 1 ml·kg−1 of either bupivacaine 0.25% or 0.125% with or without fentanyl 1 μg·kg−1. There was no difference in pain scores in the hospital, the night of surgery, or 24 h postoperatively nor was there a difference in the oral analgesics administered between any of the groups. There was a higher incidence of vomiting at home in both 0.25% bupivacaine groups irrespective of the use of fentanyl. The 0.125% bupivacaine group had significantly more patients who received intravenous fentanyl in the PACU than did the other three groups (P<0.001). Increasing the concentration of bupivacaine from 0.125% to 0.25% increased the incidence of postoperative vomiting. We recommend that clinicians utilize bupivacaine 0.125% with 1 μg·kg−1 fentanyl as the caudal injectate in paediatric patients undergiong inguinal hernia repair.
Brachial plexus birth injuries: anaesthesia for surgical nerve reconstruction and preoperative myelography and computed tomographic myelography
Authors: Hazama Ayako , Kinouchi Keiko , Kitamura Seiji , Fukumitsu Kazuo 
Published: March 2003

SummarySurgical nerve reconstruction for brachial plexus birth injuries and preoperative myelography and computed tomographic (CT) myelography require special anaesthetic considerations. Anaesthesia and medical records were retrospectively reviewed for the infants who underwent myelography, CT myelography (n=37) and microsurgical nerve reconstruction (n=34) at our institution from January 1993 to August 1996. Anaesthetic considerations include long duration of operation, perioperative respiratory complications and plaster application which makes reintubation difficult. Myelography for diagnosis requires a specific positioning of the patient with the head fixed in a midline and prone position.
Localized tracheomalacia as a complication of the Cole tracheal tube
Authors: Brewis C. , Pracy J.P. , Albert D.M. 
Published: March 2003

SummaryThe Cole tracheal tube is designed for use in neonates. Subglottic stenosis is a recognized complication of prolonged use of the tube. We report a case of tracheomalacia as a further complication of prolonged use of the tube. A 4‐month‐old infant with a history of repeated failed extubation and multiple medical problems was found to have an unusual region of severe inspiratory collapse localized to the upper 1 cm of the trachea. This was felt to be the result of pressure from the shoulder of the Cole tube which had been used for prolonged intubation. A tracheostomy was performed to bypass the collapse, but the infant subsequently died due to other medical problems.
Outcomes after single injection caudal epidural versus continuous infusion epidural via caudal approach for postoperative analgesia in infants and children undergoing patent ductus arteriosus ligation
Authors: LIN YUAN‐CHI , SENTIVANY‐COLLINS SANDRA K. , PETERSON KRISTI L. , BOLTZ M. GAIL , KRANE ELLIOT J. 
Published: March 2003

SummaryAdequate postoperative analgesia enhances deep breathing and minimizes respiratory complications after thoracotomy. This study compares postoperative outcomes after single injection caudal epidural vs continuous infusion epidural via caudal approach for postoperative analgesia in infants and children undergoing thoracotomy for patent ductus arteriosus (PDA) ligation. A retrospective chart review was performed for 27 children who had undergone PDA ligation. The children were divided into three groups. We compared patient demographics, surgical duration, anaesthesia duration, length of ICU stay, incidence of emesis requiring treatment, time required to establish regular oral intake, requirement for supplemental intravenous opioids during the first postoperative day, and length of hospital stay. For paediatric patients undergoing PDA ligation, postoperative analgesia with continuous infusion epidural via caudal approach produced shorter ICU stay, less occurrence of postoperative emesis, earlier oral intake, elimination of intravenous opioid supplementation, and shorter hospital stay compared with single injection caudal epidural techniques.
Laparoscopic fundoplication in children: anaesthetic experience of 51 cases
Authors: Rowney David A. , Aldridge Louise M. 
Published: March 2003

SummaryWe report the anaesthetic management and outcomes of our first 51 laparoscopic fundoplications. Case records of the 50 patients (one redo), median age 6 years (5 months to 20 years), were reviewed. Median duration of anaesthesia was 120 (60–300) min. During the procedure, the heart rate and blood pressure increased by more than 20% over baseline in 18% and 12% cases, respectively. Median increase in P ECO2 was 1.0 (0.3–2.3) kPa [7.6 (2.3–18) mmHg]. After surgery, all but one of the patients were managed on a normal surgical ward. Postoperative analgesia requirement was oral or rectal analgesics in 89% of patients and ceased within 48 h of surgery in 95% patients. Median time to discharge home from day of operation was 2 (
1–9) days. We conclude that laparoscopic fundoplication in children is well tolerated, there is no requirement for routine postoperative high dependency care and analgesic requirements are minimal.
Assessment of pain by parents in young children following surgery
Authors: Morgan Joanna , Peden Vanessa , Bhaskar Kanta , Vater Mair , Choonara Imti 
Published: March 2003

Background: We asked parents to assess pain in young children following surgery. Methods: Assessments were carried out by both parents and an independent assessor using a behavioural observational scale. Results: Forms were returned from the parents of 42 children aged 1–5 years. There were 123 joint assessments and there was a strong correlation between the scores by the observer and the parents (r2=0.84). Twenty‐nine children experienced pain following discharge from hospital. Conclusions: Our findings suggest that parents can assess pain in young children following surgery. The management of pain following discharge from hospital can be improved.
Cyanoacrylate tissue adhesive for treatment of refractory corneal ulceration
Authors: Bromberg Nancy M. 
Published: March 2003

AbstractIsobutyl cyanoacrylate tissue adhesive (BCTA) was used in the treatment of refractory superficial corneal ulcers in 17 dogs, one cat, and one rabbit, present 2 weeks to 7 months (mean 6.8 weeks ± 6.1) prior to referral. Little to no sedation was required in the majority of cases, with only topical anesthetic applied prior to debridement and BCTA application. The presence of the tissue adhesive caused mild discomfort for several days after application, as reported by the owners. The ulcers healed, and the tissue adhesive sloughed in approximately 3 weeks (± 1 week). Mild neovascularization of the cornea resolved with topical corticosteroids. The use of BCTA offers a simple, safe and noninvasive treatment for refractory corneal ulcers.
Phylogenetic position and description of a new species of subgenus Mus (Rodentia, Mammalia) from Thailand
Authors: Auffray Jean‐Christophe , Orth Annie , Catalan Josette , Gonzalez Jean‐Paul , Desmarais Eric , Bonhomme François 
Published: March 2003

Molecular, chromosomal and morphometric analyses of wild‐caught mice of subgenus Mus from the central plain of Thailand are presented. These specimens are distinct from all species previously described in the literature. This has led to the characterization of Mus fragilicauda sp. n., a new member of the set of closely related species encompassed by the subgenus. While this species may be considered as a sibling and sympatric species of the Asian M. cervicolor, M. fragilicauda sp. n. is phylogenetically closer to the M. musculus complex of species and to the other European species of Mus.
Electron microscopic analysis of the H2O2 accumulation preceding hypersensitive cell death induced by an incompatible strain of Pseudomonas avenae in cultured rice cells
Authors: Iwano Megumi , Che Fang‐Sik , Goto Kazunori , Tanaka Noriko , Takayama Seiji , Isogai Akira 
Published: March 2003

summaryInfection of cultured rice cells with an incompatible strain of Pseudomonas avenae induces a hypersensitive reaction of the host, while compatible strain infection produces no such reaction. The induction of H2O2 generation in cultured rice cells by the incompatible strain of P. avenae precedes cell death. To examine the distribution of H2O2 generation sites, cultured rice cells were incubated following infection with a cerium solution. Detection of the reaction product, Ce(OH)2OOH, was performed using energy disperse X‐ray microanalysis (EDX) fitted with a variable‐pressure scanning electron microscope (VP‐SEM). We determined that H2O2 accumulation is a local response, appearing as a circular region on the cell surface of only 10% to 15% of the total infected cells. Observation of cross‐sections localized cerium deposition to the plasma membranes of papillae, in the cell walls of a papilla and around the bacterium. Furthermore, immuno‐gold electron microscopy using antibodies for β‐1,3‐glucan suggested that callose synthesis also occurs at the generation site of H2O2. Therefore, H2O2 functions as an antibacterial agent, serving as a substrate for cell wall cross‐linking. Our detection system employs an EDX system fitted with SEM; this procedure will be useful to examine the function and mechanism of oxidative bursts in plant–pathogen interactions.
A host‐specific virulence protein of Erwinia herbicola pv. gypsophilae is translocated into human epithelial cells by the Type III secretion system of enteropathogenic Escherichia coli
Authors: Valinsky Lea , Nisan Israel , Tu Xuanlin , Nisan Gal , Rosenshine Ilan , Hanski Emanuel , Barash Isaac , Manulis Shulamit 
Published: March 2003

summaryHsvG is a virulence factor that determines the host specificity of Erwinia herbicola pathovars gypsophilae and betae on gypsophila. We used the calmodulin adenylate cyclase reporter (CyaA) to demonstrate that HsvG is secreted and translocated into HeLa cells by the type III secretion system (TTSS) of the enteropathogenic Escherichia coli (EPEC). A fusion of HsvG‐CyaA containing 271 amino acids of the N‐terminus of HsvG were introduced into a wild‐type EPEC, espB mutant deficient in translocation and an escV mutant deficient in secretion. A significant secretion was detected in EPEC/HsvG‐CyaA and its espB mutant, but not with the escV mutant. Translocation was only observed with the wild‐type EPEC, and not with the other two mutants. To localize the secretion and translocation signals of HsvG, fusions containing 39, 11 and 3 amino acids of the N‐terminus of HsvG were constructed and expressed in EPEC. A fusion containing the first 39 N‐terminal amino acids of HsvG was secreted and translocated at significant level (31–35%) as compared to the original fusion. In contrast, fusions containing the 3 and 11 amino acids failed to be secreted and translocated.
The Supervised Methadone and Resettlement Team nurse: an effective approach with opiate‐dependent, homeless people
Authors: Mistral W. , Hollingworth M. 
Published: March 2003

AbstractHomelessness and substance misuse have risen dramatically over the past 30 years in the UK. The role of the primary care nurse has been signalled as important in working with people who have drug and alcohol problems, and for improving the general health of homeless people. This article focuses on the role of the primary care nurse in a Supervised Methadone and Resettlement Team (SMART). The team works in central Bristol, in southwest England, with people who are homeless and using illegal opiates. The aim of this report is to provide descriptive information that demonstrates the value of the primary care nurse, working in a multiagency partnership, in dealing with the problems of this homeless population, many of whom have problems associated with illicit drug use. Client outcomes from a small sample of homeless persons are also described.
Negotiating the informed‐consent process in developing countries: a comparison of Swaziland and Pakistan
Authors: Upvall M. , Hashwani S. 
Published: March 2003

AbstractProtecting the rights of research participants when conducting studies within an international context presents many challenges. The purpose of this article was to compare and contrast the process of obtaining informed consent in two very different countries – Swaziland and Pakistan. Major aspects of the informed‐consent process presented included identification of gatekeepers, seeking permission from officials, negotiating with these officials and Institutional Review Board (IRB) committees in regard to the type of data to be collected, and explaining informed consent to participants in the field. Data for this article is based upon qualitative research of collaboration between nurses and healers in Swaziland and from a variety of studies completed in Pakistan. These studies demonstrate the inadequacy and complexity of applying western‐based concepts of informed consent to developing countries.
Compliance with hormone replacement therapy among Swedish women
Authors: Berterö C. , Johansson G. 
Published: March 2003

AbstractBy means of a simple postal questionnaire, all women registered as hormone therapy patients (n = 241) at a gynaecological clinic were screened for reasons for receiving hormone therapy. They were also screened for their compliance in following the midwife’s advice and information, as well as the gynaecologist’s prescriptions. The majority of the women participating in this study contacted the clinic for climacteric symptoms. The time duration for using hormone therapy ranged from 1 month to 6 years. Those using a plaster or gel were asked why they should take progesterone pills. Forty per cent gave erroneous answers or did not know. Of these, 62% reported that they understood the oral information, whereas 60% reported that they understood the written information. Fifty‐three per cent of the women stated that they would stop their hormone therapy if they did not feel well or increased in weight. New discoveries or information about benefits or risks were given by 22% as reasons affecting their decision. Compliance demands well‐motivated and well‐informed patients. The implication of the study result for practice is that there must be dialogue between the women and their midwife/ gynaecologist. It is important that the women feel they are receiving treatment which they have given their consent to, and that they feel and know that they are performing self‐care. Midwives have recurrent contact with women during their life and have already established a relationship with them, which facilitates an individualized communication.
Linking research and practice: participation of nurses in research to influence policy
Authors: Lee M. B. , Tinevez L. , Saeed I. 
Published: March 2003

AbstractIn this article, the authors describe research conducted by the Pakistan Nursing Council (PNC) in Islamabad, Pakistan. The research was carried out through collaboration of two components of a large multicomponent Canadian International Development Agency (CIDA)‐funded project – the Development of Women Health Professionals Program (DWHP) – with the Colleges of Nursing and the Pakistan Nursing Council. The research was guided by staff of the DWHP and performed by eight nurses undergoing a research course as part of a Diploma in Teaching Administration (DTA) at a postgraduate College of Nursing in the Northwest Frontier Province (NWFP), Pakistan. Research questions related to the collection and analysis of nursing workforce statistics were asked and partially answered, while students gained experience in conducting research. A description of the context in which the research was conducted is provided. Finally, results of the research and the potential benefits for influencing health workforce policy are discussed.
Government Chief Nursing Officers: a study of the key issues they face and the knowledge and skills required by their roles
Authors: Salmon Marla E. , Rambo Kirsten 
Published: March 2003

AbstractThe first Government Chief Nursing Officer (CNO) position was created in New Zealand over a century ago. Over the ensuing decades, the roles of these national nurse leaders have evolved and become a focal point for global nursing and midwifery development. Despite the important actual and potential roles of CNOs, very little work has been done to systematically study the key issues that they face and the skill sets needed to address them. Now, in the face of global cost‐driven health reform, the position of CNO is even more important than ever. This paper describes the only global systematic study of CNOs conducted since the beginning of health reform and lays a substantive foundation for the development of these key leaders and their positions. In addition, the research reported provides important groundwork for future studies and enhancement of the global literature relating to national nursing and midwifery leadership.
Measurement of total water and bound water contents in human stratum corneum by in vitro proton nuclear magnetic resonance spectroscopy
Authors: GILARD V. , MARTINO R. , MALET‐MARTINO M. , RIVIERE M. , GOURNAY A. , NAVARRO R. 
Published: March 2003

The reliability of in vitro proton nuclear magnetic resonance (NMR) spectroscopy to specifically measure the water content of rehydrated human stratum corneum samples was assessed by comparison with the previously validated thermal desorption‐mass spectrometry technique. The interest of proton NMR is that it can determine, in the same sample, both the amount of total water by recording the spectra at ambient temperature, and that of bound water (non‐freezing water) by recording the spectra below 0°C. Provided that enough samples of stratum corneum are analysed to average out the observed and well‐known sample‐to‐sample variation, proton NMR may be of value in the evaluation of hygroscopic properties of raw materials for moisturizer formulations.RésuméL'aptitude de la résonance magnétique nucléaire (RMN) du proton à déterminer le contenu en eau du stratum corneum in vitro a étéétablie en comparant la quantité d'eau présente dans divers échantillons provenant d'une même personne mesurée par cette technique avec celle mesurée par la technique déjà validée de désorption thermique couplée à la spectrométrie de masse. La RMN du proton est la seule méthode qui permette de mesurer dans un même échantillon à la fois sa teneur en eau totale en enregistrant le spectre à température ambiante, et sa teneur en `eau liée' (i.e. en eau 'non‐gelée') en enregistrant le spectre à une température inférieure à 0°C. A condition d'analyser un nombre suffisant d'échantillons de stratum corneum pour moyenner la variation importante observée et bien connue entre les échantillons, la RMN du proton pourra êtra utilisée pour déterminer les propriétes hygroscopiques de composés pouvant entrer dans la composition de formulations hydratantes. © Rapid Science Ltd. 1998
The Mechanics of Fracture of Human Hair
Authors: Swift J.alan 
Published: March 2003

Premature fracture and splitting of human head hair is cosmetically undesirable and at worse, unsightly. It is often regarded both by the hair’s owner and by others as indicative of hair in poor condition and attracts considerable expenditure on hair toiletry products in sometimes vague attempts to prevent or repair the damage.This paper defines the mechanical events which underlie the fracture of hairs as they occur on the head and insofar as they satisfy the different fracture morphologies seen under the scanning electron microscope. Factors affecting propensity for fracture are considered. A significant conclusion is that hair ’strength’, as might be assessed by the consumer, has little to do with the tensile mechanical properties of the fibres but that bending and associated longitudinal shear processes are of much greater relevance.