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- Husberg, Britt, et al.
(författare)
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Treatment with botulinum toxin in children with chronic anal fissure.
- 2009
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Ingår i: European journal of pediatric surgery. - : Georg Thieme Verlag KG. - 0939-7248 .- 1439-359X. ; 19:5, s. 290-292
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Chronic anal fissures with painful defecation and bloodstained stools can be seen in children of all ages. Constipation may precede or appear in connection with the symptoms. Adult patients with anal fissures have been treated successfully with the injection of botulinum toxin into both the internal and external sphincter. The effect of botulinum toxin is reversible and lasts for 3-4 months. This pilot study attempted to examine whether botulinum toxin is also effective in paediatric cases of anal fissure, a treatment which not yet has been reported in the literature.MATERIAL AND METHODS: Six boys and seven girls aged 1-10 years were treated with botulinum toxin (Botox ((R))) during 2002-2005 due to chronic anal fissure. Conventional treatment with laxatives and local anaesthetics had been unsuccessful in all cases. The treatment was given to five children under 2 years of age in a dosage of 1.25 Ux2. Eight children over 2 years of age were given 2.5 Ux2. The injections were given in the external sphincter on both sides of the fissure using EMG-stimulation for guidance and were performed under light anaesthetics (Diprivan ((R))). Follow-up was conducted at 1 and 3 months after treatment.RESULTS: Within one week, 11 of the children were free from pain and blood stained stools, according to their parent's observations. One 10-year old patient initially showed some improvement but soon experienced a recurrence. After another injection with a higher dosage 2 months later, the fissure healed. One 4-year old patient did not show any signs of improvement. The laxatives, which had been withdrawn after the injection treatment, were then reinstated. At the 3 month post-treatment examination the patient was finally symptom-free with no signs of a fissure. There were no negative side-effects detected in any of the cases. Seven recurrences were noted in 6 of the patients after 3-30 months, often in connection with an episode of constipation. Repeat injections were offered and accepted by four of these patients, once more producing good immediate results.CONCLUSION: Treatment with botulinum toxin in the external sphincter produces a quick and effective alleviation of pain with healing of chronic anal fissures in children. The treatment is not considered to carry any risks but requires light anaesthesia. Recurrences are common after the pharmacological effect has receded but can be cured with an additional injection.
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| 3. |
- Strachan, P.A., et al.
(författare)
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The evolving UK wind energy industry : Critical policy and management aspects of the emerging research agenda
- 2006
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Ingår i: European Environment. - : Wiley. - 0961-0405 .- 1099-0976. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- In recent years, renewable energy - and in particular wind power - has come to the fore of both international and UK national environmental policy debates. In addition to helping to meet its Kyoto obligations, the British Government has indicated its desire For a much larger slice of the international wind energy market, and has consequently developed a national strategy to stimulate a more vibrant UK wind energy industry. With this in mind, the British Government's Climate Change Programme (DETR, 2000) and more recent Energy White Paper (DTI, 2003) outline the UK energy strategy for the coming two decades, with wind power featuring as a core component. This article critically considers the prospects for the development of a wind energy industry in the UK and introduces five strategic opportunities and five strategic barriers in this evolving segment of the energy market. The article concludes with recommendations to enhance public acceptance of wind energy and four important areas for future research are outlined. Copyright © 2006 John Wiley & Sons, Ltd and ERP Environment.
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| 5. |
- von Malmborg, Fredrik, et al.
(författare)
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Climate policy, ecological modernization and the UK emission trading scheme
- 2005
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Ingår i: European Environment. - : Wiley. - 0961-0405 .- 1099-0976. ; 15:3, s. 143-160
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Tidskriftsartikel (refereegranskat)abstract
- Since the election of the Labour government in 1997, leading to a flurry of policy documents utilizing ecological modernization language, the UK has seen a steady growth in the use of new environmental policy instruments, with the British government having launched in 2002 the world's first national economy-wide emission trading scheme for greenhouse gases. Among other things, the UK Emissions Trading Scheme aims at stimulating a transition of the UK towards a low-carbon economy. Reporting findings of a recent survey of those 31 organizations participating directly in the scheme, this article critically examines the effectiveness of the scheme as an instrument in climate policy and ecological modernization. The study reveals a number of issues that appear to have been 'glossed over' by recent Government reports, and questions whether the UK ETS and climate policy in practice are vehicles for ecological modernization. Copyright © 2005 John Wiley & Sons, Ltd and ERP Environment.
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