The effect of short-term prophylactic methylprednisolone on the incidence and severity of postpericardiotomy syndrome in children undergoing cardiac surgery with cardiopulmonary bypass.

Objective: The aim of this study was to determine the effect of prophylactic immune suppression on the incidence and severity ofpostpericardiotomy syndrome (PPS) in children after cardiac surgery with cardiopulmonary bypass (CPB).

Background: Prophylactic suppression of the inflammatory response has an unknown effect on the incidence and severity of PPS in children undergoing surgery with CPB.

Methods: This randomized double-blind placebo controlled trial included two study groups.

Improved early results with cavopulmonary connections.

Background: We describe the recent results in a large cohort of patients with functionally single ventricle who underwent various modifications of cavopulmonary connections.

Methods: Using the database at our institution, we identified all children who underwent cavopulmonary connection operations between June 1995 and June 1997. Demographic data, surgical history, and perioperative course were reviewed.

Psychologic preparation to decrease anxiety associated with cardiac catheterization.

Undergoing a cardiac catheterization arouses anxiety of most patients. Coronary angiography plays an essential role in the diagnostic evaluation of the patient with suspected or known cardiac disease, and it is an important preoperative cardiac screening protocol for vascular surgery patients. Studies on psychologic preparation have concluded that preparatory techniques--specifically, sensory-perceptual informational and modeling--are beneficial in reducing patients' anxiety in various situations, including cardiac catheterization.

Heart/single-lung transplant for a "failed Fontan" with pulmonary A-V malformation.

Pulmonary arteriovenous malformation can occur in patients with functional single ventricle after a cavopulmonary connection. There is no effective medical treatment for this complication. Pulmonary arteriovenous malformations may regress over time after heart transplantation, but may be a source of significant perioperative morbidity.

The effects of topical anesthesia on oral burning in burning mouth syndrome.

Burning mouth syndrome (BMS) is an oral pain disorder of uncertain origin. Central or peripheral pain mechanisms may play a role in the oral burning of BMS. We tested the effect of a topical anesthetic (dyclonine HCl) on patients' intensity ratings for oral burning, taste dysgeusia and the taste of two chemical stimuli (1.

An open-label, dose escalation pilot study of the effect of clonazepam in burning mouth syndrome.

Objective: Current treatment for burning mouth syndrome is usually directed at correction of detected organic causes or is empiric, and it often involves the use of tricyclic antidepressants. Recently, there has been renewed interest in the use of benzodiazepines for burning mouth syndrome. The present study was designed to assess the effect of clonazepam in burning mouth syndrome.

Safety of surfaces and equipment for children in playgrounds.

Background: The safety of playgrounds is important to protect children from injury, but studies are mostly done mainly under laboratory conditions without epidemiological data. We investigated the safety of different playground surfaces, and types and heights of equipment in public playgrounds in the City of Cardiff, UK.

Methods: We did a correlational study of 330 children aged between 0 and 14 years.

Topical corticosteroid treatment of anosmia associated with nasal and sinus disease.

Objective: To establish the efficacy of topical corticosteroid nasal spray treatment of severe olfactory loss associated with severe nasal and sinus disease.

Design: Efficacy before and after open-label trial of topical corticosteroid nasal spray used exclusively in the head-down-forward position.

Setting: Taste and smell clinic of a university teaching hospital and research facility.

Nitric oxide for the evaluation and treatment of pulmonary hypertension in congenital heart disease.

The use of inhaled nitric oxide as a selective pulmonary vasodilator has expanded to include patients with congenital heart disease and pulmonary hypertension. The therapeutic and diagnostic roles of inhaled nitric oxide offer additional alternatives and benefits to these patients with pulmonary hypertension, particularly in the postoperative setting. This article reviews the background, mechanism of action, toxicities, and current clinical applications of inhaled nitric oxide in the child with congenital heart disease and pulmonary hypertension.

Differential effects of cocaine, alcohol, and nicotine dependence on olfactory evoked potentials.

Olfactory evoked potentials (OEP) were elicited by odorous and nonodorous stimuli in 50 adult subjects: 26 subjects with histories of either cocaine (n = 19) or alcohol (n = 7) dependence, 10 with histories of nicotine but no other drug dependence, 2 with clinical anosmia of peripheral origin, and 12 subjects without drug or olfactory disorders. The presentation of nonodorous stimuli (i.e.

Quantitative echocardiographic analysis of the aortic arch predicts outcome of balloon angioplasty of native coarctation of the aorta.

Background: The use of balloon angioplasty for treatment of native aortic coarctation is controversial. Cineangiographic data suggest that aortic arch hypoplasia and isthmic narrowing are associated with angioplasty failure. This study of echocardiographic measurements of preangioplasty aortic arch morphology was performed to identify potential anatomic predictors of outcome noninvasively.

EEG power spectral densities during and after cycle ergometer exercise.

This study examined the effects of aerobic exercise on spontaneous electroencephalographic (EEG) activity. Participants (N = 34) were asked to (a) sit quietly for a 10-min adaptation period, (b) either exercise on a cycle ergometer (n = 18) or watch a videotape (n = 16) for 15 min, and (c) sit quietly for a 10-min recovery period. EEGs were collected during the last 2 min of the adaptation period, the last 2 min of each 5-min stage of the exercise/videotape period, and the last 2 min of the recovery period.

Effects of chlorhexidine on human taste perception.

Chlorhexidine gluconate at a dose used to control bacteria in the mouth has a reversible effect on taste perception. Taste-intensity ratings and taste-quality identification for concentration series of sucrose, sodium chloride, citric acid and quinine hydrochloride were obtained from 15 healthy humans. The participants rinsed with 0.

Allergic rhinitis and olfactory loss.

Background: Allergic rhinitis is associated with reports of olfactory loss, but there are few formal investigations. Patients with diminished smell function frequently have nasal polyps or sinusitis, making it difficult to separate the impact of allergic rhinitis from the effects of these other problems.

Objective: The goals of this descriptive study were to establish the prevalence of positive skin tests in patients reporting rhinitis and olfactory deficiency, and to assess olfactory function and the results of skin testing in a patient group with chronic rhinitis but without concomitant sinusitis or nasal polyps.

Burning mouth syndrome: an update.

Though it has been the subject of much research, burning mouth syndrome--a chronic oral-facial pain condition that affects many U.S. adults--remains poorly understood.

Effects of exercise on the coherence of human EEG signals at selected hemispheric sites.

This study investigated the effects of exercise on the intrahemispheric coherence of human electroencephalographic (EEG) signals. The frontal and temporal sites of each hemisphere (left: F3, T3; right: F4, T4) were selected as the sites to be compared. The subjects were divided into an exercise group and a control (nonexercise) group.

Patterns of injuries to children on public playgrounds.

The incidence and pattern of injuries to children in public playgrounds presenting to the accident and emergency department were reviewed over two six month summer periods in Cardiff. A total of 178 children (mean age 7.5 years) attended with a playground injury representing 1.

Angiotensin-converting enzyme inhibition in infarct-induced heart failure in rats: bradykinin versus angiotensin II.

Background: The beneficial effects of angiotensin-converting enzyme (ACE) inhibitors in the prevention of heart failure following myocardial infarction are widely accepted. However, the underlying mechanisms are still a matter of discussion. We therefore investigated the relative contribution of the breakdown of bradykinin and of the inhibition of angiotensin-II synthesis to the beneficial actions of ACE inhibitors in chronic heart failure following myocardial infarction.

Accidents and child abuse in bathtub submersions.

Non-accidental bath drowning is an infrequently reported form of child abuse. Details of 44 children who suffered from drowning or near drowning in the bath were analysed from a two year (1988-9) UK study to investigate factors that might point to abuse. Cases of near drowning were notified through the British Paediatric Surveillance Unit inquiry system and drowning cases from the Office of Population Censuses and Surveys, the Scottish Government Record Office, and the Northern Ireland Office.

What is the role of the distraction test of hearing?

The use of the distraction test as a screen for hearing loss in infancy was reviewed in the Bristol and District Health Authority. Inaccuracies in data recording were found which challenged the screening and referral rates produced by the National Child Health Computer. Representative samples of children failing the distraction test and children needing hearing aids were followed up through the screening process.

Diagnosis and management of taste disorders and burning mouth syndrome.

Clinically significant taste loss is less common than abnormal tastes (dysgeusias). Both may be caused by a previous viral upper respiratory infection, head trauma, iatrogenic causation (medication, irradiation, surgery), neurologic or psychiatric disorders, toxic chemical exposure, systemic conditions, xerostomia, severe nutritional deficiencies, and some oral or dental disorders. Beyond treatment targeted toward causative conditions, there is no proven intervention to either enhance taste acuity or abolish dysgeusia.

Olfactory loss and allergic rhinitis.

Olfactory loss is of importance for allergists to investigate in their patients, because if it is due to either allergic rhinitis or nonallergic rhinitis, it is potentially reversible. One should be sure to consider nasal polyposis and inflammation from chronic sinusitis, especially of the ethmoidal sinuses. Simple screening in the office can be achieved with an odor identification test of widely available substances as described above.

3',3'-Difluoro-3'-deoxythymidine: comparison of anti-HIV activity to 3'-fluoro-3'-deoxythymidine.

3',3'-Difluoro-3'-deoxythymidine (3) has been synthesized in four steps from thymidine, and characterized by 1H NMR and NOE experiments. The JHF coupling constants support a conformation in solution that is predominantly 2'-endo (S). Although conformationally and sterically nucleoside 3 may resemble other thymidine analogs which are active against HIV-1, 3 is virtually inactive.