bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post‐operative analgesia following total knee replacement: an evaluation of the addition of an obturator nerve block to combined femoral and sciatic nerve block
Authors: McNamee D. A. , Parks L. , Milligan K. R. 
Published: July 2002

Background: Femoral and sciatic nerve block may not provide complete post‐operative analgesia following total knee replacement. This study was designed to evaluate whether the addition of an obturator nerve block to combined femoral and sciatic nerve block improves the quality of post‐operative analgesia following primary total knee replacement.Methods: Sixty patients were randomised into one of two groups: combined femoral and sciatic nerve block with 15 ml 0.75% ropivacaine to each nerve or combined femoral and sciatic nerve block with 15 ml 0.75% ropivacaine to each nerve and an obturator nerve block with 5 ml 0.75% ropivacaine.Results: Peripheral nerve blocks were successful in 85% of patients. The group which received the obturator nerve block showed a significant increase in the time until their first request for analgesia (mean 257.0 vs. 433.6 min) and a significant reduction in the total requirements for morphine throughout the study period (mean 83.8 vs. 63.0 mg) (P<0.05). There were no systemic or neurological sequelae in any of the groups.Conclusions: The addition of an obturator nerve block to femoral and sciatic blockade improved post‐operative analgesia following total knee replacement.
Experimental colitis induced by dextran sulphate sodium in mice: beneficial effects of sulphasalazine and olsalazine
Authors: Axelsson L.‐G. , Landström E. , Bylund‐Fellenius A.‐C. 
Published: July 2002

Background:Animal models of inflammatory bowel disease are artificial and more or less representative of human disease. However, the dextran sulphate sodium (DSS) induced intestinal inflammation model has recently been shown to fulfil some pathological criteria for an adequate experimental model.Aim:To determine whether this form of experimental intestinal inflammation responds to established therapy used for human inflammatory bowel disease.Methods:DSS was used to induce intestinal inflammation in conventional Balb/c mice and athymic nu/nu CD‐1(BR) mice, and the well‐documented 5‐aminosalicylic acid (5‐ASA) based anticolitis drugs sulphasalazine (SASP) and olsalazine (OLZ) were used to study therapeutic effects. Parameters which have been shown to reflect DSS‐induced intestinal inflammation (body weight, colon length, spleen weight, diarrhoea, and rectal bleeding) were measured in the Balb/c mice.Results:Significant amelioration was seen on these parameters after different treatment protocols. Survival in nu/nu CD‐1 mice was studied, and after 16 days a death rate of 50% was noted in the DSS group. SASP (100 mg/kg/day) and OLZ (50 mg/kg/day) significantly prolonged the survival to 29 and 38 days, respectively. SASP and OLZ showed a dose‐dependent effect in the range between 10 and 100 mg/kg/day, doses closely corresponding to those used in humans.Conclusions:SASP and OLZ are able to ameliorate the DSS‐induced intestinal inflammation. The dose‐response patterns suggested that the active therapeutic moiety for the two drugs appears to be mainly the liberated 5‐ASA molecule.
Graduated compression stockings in the prevention of venous thromboembolism
Authors: Agu O , Hamilton G , Baker D 
Published: July 2002

Abstract

Background
Surveys still show a wide variation in routine use of deep vein thrombosis (DVT) prophylaxis despite its established place in current patient management. This article reviews the mechanism of action, efficacy and complications of stockings in preventing DVT.

Methods
Relevant publications indexed in Medline (1966–1998) and the Cochrane database were identified. Appropriate articles identified from the reference lists of the above searches were also selected and reviewed.

Results and conclusion
Graduated compression stockings reduce the overall cross-sectional area of the limb, increase the linear velocity of venous flow, reduce venous wall distension and improve valvular function. Fifteen randomized controlled trials of graduated compression stockings alone were reviewed. Stockings reduced the relative risk of DVT by 64 per cent in general surgical patients and 57 per cent following total hip replacement. The effect of stockings was enhanced by combination with pharmacological agents such as heparin; the combination is recommended in patients at moderate or high risk of DVT. Knee-length stockings are as effective and should replace above-knee stockings. Complications are rare and avoidable.
Effect of propanolol on the expansion of abdominal aortic aneurysms: a randomized study
Authors: Wilmink A B M , Hubbard C S F F , Day N E , Quick C R G 
Published: July 2002

Abstract

Background
This study investigated whether propanolol reduces the growth rate of small screen-detected abdominal aortic aneurysms (AAAs).

Methods
This was a prospective blinded randomized study of men with an aneurysm between 3 and 4·5 cm detected in a community-based screening programme.

Results
Some 477 patients were randomized: 256 to take propanolol 40 mg and 221 controls. The mean growth rate in the propanolol group was 0·06 (95 per cent confidence interval 0–0·14) versus 0·1 (0·02–0·19) mm in the control group (P = 0·48). Propanolol decreased growth in 59 patients with an AAA larger than 3·9 cm (0·13 (0–0·31) versus 0·43 (0·26–0·60) mm in controls; P = 0·02). Compliance with propanolol treatment was poor: 31 per cent of the active treatment group were on beta blockers compared with 15 per cent in the control group. The growth in patients actually taking beta blockers was 0·24 (0·11–0·38) versus 0·25 (0·17–0·33) mm (P = 0·91). Stiffness measurements did not differ significantly between patients taking beta blockers and controls. Subgroup analysis showed an increased stiffness in the patients on beta blockers (mean(s.d.) 31·1(4·2) versus 23·4(1·9) in controls in aortas larger than 3·4 cm; P = 0·057).

Conclusion
Propanolol is not associated with a significant reduction in the growth of small aneurysms. Propanolol reduces the growth of aneurysms larger than 4 cm. Compliance with propanolol treatment for small aneurysms is low. Treatment of small screen-detected aneurysms with propanolol cannot be recommended.
Severe dietary restriction initiated in aged rats: evidence for poor adaptation in terms of protein metabolism and intestinal functions
Authors: Chambon‐Savanovitch C. , Felgines C. , Farges M.‐C. , Pernet P. , Cézard J.‐P. , Raul F. , Cynober L. , Vasson M.‐P. 
Published: July 2002

BackgroundProtein energy malnutrition is a common finding in elderly people, increasing morbidity and mortality in aged inpatients. Investigations need to be developed to counteract malnutrition‐induced alterations early and to avoid potential irreversible lesions. The aim of this experimental study was to evaluate time‐response to severe dietary restriction (DR) initiated in aged rats in terms of protein metabolism and digestive trophicity.Materials and methodsAfter the acclimatization period, 22‐month‐old male rats were randomized into six groups: three control groups, fed ad libitum for 3, 6 or 12 weeks with a standard diet and three corresponding dietary‐restricted groups fed for the same periods with only 50% of the spontaneous intake. Intestinal mucosa, liver and skeletal muscles (soleus, extensor digitorum longus and tibialis anterior muscle) were removed when the rats were killed.ResultsDR induced dramatic body weight loss (up to 50% of initial body weight after 12 weeks DR). Protein metabolism was affected in terms of nitrogen balance (P < 0.01) and protein content, in particular at the splanchnic level. Morphometrically, the intestine structure was altered after 12 weeks of DR (P < 0.01), and this atrophy was correlated with malabsorption of mannitol (P < 0.01). Ileal hydrolase activities were decreased throughout the 12 weeks of DR.ConclusionsAged rats clearly exhibit a defect of adaptation to long‐term DR initiated at an advanced age. Severe DR leads to malnutrition, which becomes of major importance after 12 weeks, in particular at the intestine level. Hence, application of these experimental results to elderly, malnourished people may contribute to a better knowledge of denutrition‐induced disorders.
Stages in coming to terms with reflection: student advanced nurse practitioners' perceptions of their reflective journeys
Authors: Glaze Jane E. 
Published: July 2002

Stages in coming to terms with reflection: student advanced nurse practitioners' perceptions of their reflective journeys Aim of the study. To explore student Advanced Nurse Practitioners' (ANPs) experiences of reflection. Background. The development of student ANPs' reflective abilities as part of the implementation of a Master's Course in Advanced Nursing Practice at Wolverhampton University provided the background to the study. Developing reflective abilities was seen as an essential component of ANP development. To facilitate this process a preentry degree level reflective practice module and a reflective component for the level 4 (Master's level) practice module were devised. Rationale. This was a new educational initiative and this study provided the opportunity to explore students' experiences of it following completion of the reflective modules. Design/methods. A qualitative methodology was used. Fourteen ANP students were interviewed and their reflective learning contracts were analysed. Colaizzi's (1978) seven‐stage model guided data analysis. Findings. The findings were categorized under the headings of: (i) reflection as a transforming process, (ii) reflective journeys, (iii) worldviews. This paper presents an analysis of the second category reflective journeys. It identifies a number of stages in the development of students' reflective abilities. Conclusions. The conclusions have implications for those involved in reflective curriculum development, and for those seeking to develop reflective abilities in students.
Soil seed banks and the effects of meadow management on vegetation change in a 10‐year meadow field trial
Authors: Smith R.S. , Shiel R.S. , Millward D. , Corkhill P. , Sanderson R.A. 
Published: July 2002

Summary

Enhancement of plant species diversity is often an objective in grassland management for wildlife conservation. Such management regimes may also change the species composition of soil seed banks, which may themselves affect future vegetation change. We compared soil seed banks and vegetation from a long‐term meadow management trial and from a series of traditionally managed species‐rich meadows in northern England, UK.
The management trial used three hay‐cut date treatments (14 June, 21 July and 1 September), two fertilizer treatments [no fertilizer or 25 kg nitrogen ha−1 plus 12·5 kg ha−1 phosphate (P2O5) and potash (K2O)] and two seed‐addition treatments (no seed, seed of many species sown 1990–92). Soil seed banks were assessed in 1998. Subsequent vegetation development under these treatments, and under an additional farmyard manure treatment, was assessed in 2000.
Most seed was in the 0–5‐cm soil layer and most of the frequent species germinated in the autumn. Short‐ and long‐term persistent seed banks were most abundant. The species composition of the seed banks and the vegetation in the trial, and in the traditionally managed meadows used as a control, were distinctly different, the meadow trial seed bank being the most uniform.
An ordination of simulated plant communities based on the UK National Vegetation Classification provided a wider framework for comparing vegetation and seed banks with the species composition of British meadow communities, some of which are also found in Europe. The soil seed banks throughout the meadow trial plots and the control fields were very similar in species composition to that of the vegetation in agriculturally improved meadows. However, there were many more species in the soil seed bank of the traditionally managed control meadows.
In 2000, only the seed‐addition treatment increased the species richness of the vegetation. Farmyard manure and mineral fertilizer had similar effects, increasing the cover of Poa trivialis and Rumex acetosa and decreasing the cover of Rhinanthus minor and Anthoxanthum odoratum.
It was concluded that the development of the soil seed bank probably lags behind increases in vegetation diversity initiated by seed sowing. This emphasizes the need to introduce additional species as seed when increased diversity is a target for the restoration management of previously intensively managed grasslands.
Conservation of the Juan Fernandez firecrown and its island habitat
Authors: Roy Michael S. , Torres-Mura Juan Carlos , Hertel Fritz , Lemus Marina , Sponer Renate 
Published: July 2002

AbstractThe Juan Fernandez Islands constitute two distantly separated (182 km) major islands, of which Isla Robinson Crusoe is the closest (667 km) to the Chilean mainland, and a number of smaller surrounding islets. The endemic Juan Fernandez firecrownSephanoides fernandensisonce inhabited both major islands and numbered many thousands. Today it exists only on Isla Robinson Crusoe and numbers just a few hundred. Another hummingbird, the green-backed firecrownS. sephaniodes, inhabits this island but also occurs on the mainland. The islands are in ecological meltdown as a result of the removal of much of the native (largely endemic) biota. This degradation has been exacerbated by introduced herbivorous and carnivorous mammals, which are extirpating all that remains. In a previous investigation the authors assessed the evolutionary relationships and genetic variation in the Juan Fernandez firecrown population. They showed that the species: (i) is a relative of the high Andean hummingbirds; (ii) is a close sister species of the green-backed firecrown; (iii) dispersed to the islands approximately 0.5–1 million years ago, unlike the green-backed firecrown, which is probably a very recent invader; (iv) maintains some genetic variation, although significantly lower than that found in the green-backed firecrown island population. Because of their relatively recent divergence the authors aimed to find out if the two species compete for resources. In addition, they assessed the conservation options for the Juan Fernandez firecrown and provided recommendations for its management. They concluded that the survival of the Juan Fernandez firecrown is inextricably linked to the holistic restoration of ecosystem/ community function of the island. The initial step must involve the removal of introduced mammals, followed by replanting of native flora. Although the authors do not support the use of captive propagation as a general conservation tool, they believe that, because the Juan Fernandez firecrown is composed of only one small population that is under extreme threat of extinction, a captive population should be established.
Development and survivorship of Carpophilus hemipterus (L.), Carpophilus mutilatus Erichson and Carpophilus humeralis (F.) (Coleoptera: Nitidulidae) over a range of constant temperatures
Authors: James David G , Vogele Beverley 
Published: July 2002

AbstractEggs of Carpophilus humeralis (F.) and Carpophilus mutilatus Erichson developed at constant temperatures from 20–37.5°C, while Carpophilus hemipterus (L.) completed development at temperatures from 20–42.5°C. Carpophilus hemipterus completed larval and pupal development at all temperatures up to and including 40°C. Carpophilus mutilatus reached adulthood at 37.5°C, but C. humeralis was only able to complete egg to adult development at temperatures up to 32.5°C. Rates of development changed in a linear fashion with temperature. The development of C. hemipterus eggs and larvae was faster at all temperatures than the other two species (P < 0.05). Developmental duration from egg to adult for the three species ranged from 47–65 days at 20°C to 14–18 days at 32.5°C. The fastest development was recorded for C. hemipterus at 37.5°C (13.4 days). Lower developmental zeroes (DZ) were similar for the eggs, larvae and pupae of each species, ranging between 14.0–16.0°C. Estimates of DZ for egg–adult development were 15.3°C (mutilatus), 15.4°C (humeralis) and 14.6°C (hemipterus). Egg to adult development required 260.4 (hemipterus), 297.6 (humeralis) or 320.0 (mutilatus) degree‐days. Survivorship was greatest for all species at temperatures between 25–30°C, with the larval stage suffering most mortality from higher or lower temperatures. The use of degree‐day estimates to predict timing of adult generations of Carpophilus spp. is discussed with respect to the management of these pests in stone fruit orchards in southern Australia.
A systematic review of foot ulcer in patients with Type 2 diabetes mellitus. II: treatment
Authors: Mason J. , O’Keeffe C. , Hutchinson A. , McIntosh A. , Young R. , Booth A. 
Published: July 2002

Summary Aim To assess the value of treatments for foot ulcers in patients with Type 2 diabetes mellitus. Methods A systematic review of interventions to treat diabetic foot ulcers. Results The evidence base for treating infections and dressing wounds is poor. A number of new and potentially promising treatments are being developed but currently available studies are often small, inadequately powered and use different methods and outcomes. Conclusions Given the prevalence, morbidity and healthcare costs of diabetic foot disease, it is surprising that available trials provide inadequate evidence to improve upon current empirically based treatment approaches. Substantial effort and resources should be deployed in order to investigate both new and existing treatments in a co‐ordinated, systematic and consistent manner, so that a proper evidence base can be established for this important disease area.
Prevalence of gestational diabetes mellitus – do the new WHO criteria make a difference?
Authors: Schmidt M. I. , Matos M. C. , Reichelt A. J. , Forti A. Costa , De Lima L. , Duncan B. B. , Group For The Brazilian Gestational Diabetes Study 
Published: July 2002

Summary Aims To describe the prevalence of gestational diabetes mellitus (GDM) according to the 1998 WHO provisional recommendations and compare it to that found with previous 1985 WHO criteria. Methods A total of 5564 consecutive women aged 20 years or more without diagnosis of diabetes mellitus outside of pregnancy in general prenatal care clinics of the National Health Service in 6 state capitals of Brazil, between their 20th and 28th gestational weeks were enrolled. Results Of the 5004 women who completed a 75‐g oral glucose tolerance test, 379 (7.6%, 95% confidence interval (CI) 6.9% to 8.4%) had GDM by the 1998 criteria (fasting glucose  7.0 mmol/l or 2 h glucose  7.8 mmol/l). Of these 379 cases, only 21 (5.5%) had hyperglycaemia in the range considered diabetes mellitus outside pregnancy (fasting glucose  7.0 mmol/l or 2 h glucose  11.1 mmol/l); the remaining 358 (94.5%) had hyperglycaemia in the impaired glucose tolerance range (fasting glucose < 7.0 and 2 h glucose  7.8 mmol/l and < 11.1 mmol/l). Using the 1985 criteria (fasting or 2 h glucose  7.8 mmol/l), 378 cases of GDM were found, 15 in the diabetes range and 363 in the impaired glucose tolerance range. Conclusions Prevalence of GDM is minimally altered by the new WHO definition. Although GDM is a common condition, the vast majority of the cases have hyperglycaemia in the range considered impaired glucose tolerance outside pregnancy.
Video‐photorefraction: the relationship between blur circle diameter and refractive error
Authors: Jennings Deborah S. , Jennings J. A. M. 
Published: July 2002

SummaryWhen using a videorefractor (VPR‐1) the margins of the defocused blur circles are sometimes poorly defined and difficult to locate. To investigate the effect this may have on the apparent refractive error, the relationship between blur circle diameter and refractive error was found by videoing circles of known size and inputting these data as pupil and blur circle diameters. The results indicate that for accuracy of 0.50 D blur circles need to be defined to ≃ 1 mm.
The presbyopic add. II. Age‐related trend and a gender difference
Authors: Pointer Jonathan S. 
Published: July 2002

SummaryNew transverse clinical data are presented which confirm and extend earlier results to be found in the literature describing the time course of presbyopia–as indicated by the magnitude of the binocular spectacle add–in normally sighted male and female Caucasian subjects. An initial steep increase in add requirement beginning in the early forties becomes relatively slower but still of significance beyond the mid‐fifties. This observation is correlated with the age‐related progressive decline in the amplitude of accommodation, itself a consequence of physiological changes in the crystalline lens and capsule. The continuing need for an increase, albeit at a reduced rate, in the positive near supplement beyond the mid‐to‐late fifties–by which time little or no useful accommodation is available–is now attributed to the visually disruptive effects within the high spatial frequency domain of progressive age‐related lenticular changes. The magnification afforded by the positive add increases spatial grain and thereby enhances visibility of detail in an ageing visual system free of any gross senile visual pathology. A small but consistent gender difference is revealed in presbyopic corrections: physiological and physical bases are suggested for the observation that females require an add of greater magnitude than their age‐matched male counterparts.
Evaluation of the effects of saline versus bicarbonate‐containing mixed salts solutions on rabbit corneal epithelium in vitro
Authors: Doughty Michael J. 
Published: July 2002

SummaryRabbit corneas were incubated, over 4 h in vitro, with the corneal epithelial surface exposed to various solutions to assess their utility as incubation solutions for physiological, pharmaceutical or toxicological studies. The corneal endothelium was perfused with a 35 mm bicarbonate–mixed salts solution equilibrated at 36°C. Corneal thickness, corneal hydration or epithelial cell appearance (as assessed by scanning electron microscopy) were found to be similar to in vivo if a 35 mm bicarbonate, mixed salts solution (equilibrated with 5% CO2–air) was used for the epithelium. Some swelling (14 μmh−1), increased hydration and minor cell exfoliation were seen if this 35 mm bicarbonate solution was equilibrated with 5% CO2–95% O2 (hyperoxia). Solutions with only 5 mm bicarbonate (0.5% CO2–air) produced rapid swelling, large increases in hydration and marked cellular damage. Slightly hypertonic (310 mOsm kg−1) solutions containing 5 mm bicarbonate caused some swelling at 15 μm h−1, small increases in hydration and some cell damage but the swelling and cellular damage were further reduced by making the solution slightly more hypertonic (325 mOsm kg−1) by addition of NaCl and KCl. Saline (NaCl 0.9% or 0.97%) or phosphate‐buffered saline (PBS) (300 mOsm kg−1) produced swelling at 21–28 μm h−1, 30% increases in hydration and almost total destruction of the superficial cell layers. These studies confirm in vivo experiments that saline (and also buffered saline solutions) are rather toxic to the corneal epithelium and thus should not be used as epithelial incubation solutions. Even when using mixed salts solutions and even with bicarbonate present, small differences in composition can have marked effects on corneal thickness, hydration or cell appearance. Hyperoxic solutions appear to be mildly cytotoxic compared with normoxic solutions.