bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mixed Singing in European Songbirds — a Review
Authors: Helb Hans‐Wolfgang , Dowsett‐Lemaire Françoise , Bergmann Hans‐Heiner , Conrads Klaus 
Published: August 2010

Abstract and SummaryThe phenomenon of mixed singing in songbirds has recently been interpreted as one of vocal convergence facilitating interspecific competition. This paper examines the welldocumented cases of mixed singing in European songbirds with regard to the relationships between mixed singers and their models, and the frequency of occurrence of such behaviour.Mixed singers are individual members of songbird species which in their full song extensively copy vocal patterns of an alien species and reproduce them next to their own. Models are, in most cases, taken from congeneric species, usually sibling species (Table 2). A few species, however, copy totally unrelated songbirds but some structural resemblance is often found between the vocalizations of model and imitator.Mixed songs are usually rare, found in isolated individuals. Mixed songs can be adopted in some populations by a large proportion of the birds in situations of isolation or in small areas of overlap between largely allopatric species.Some mixed singers of several species remain unmated or hybridize with the model species. Discounting a small number of possible exceptions, e. g. blackcap Sylvia atricapilla and garden warbler S. borin, mixed songs are best regarded as the result of misdirected song learning. There is no justification for categorizing mixed singing as an example of vocal convergence, as has been done by Dobkin (1979).ZusammenfassungAls Mischsänger werden Singvogelindividuen definiert, die in ihrem Vollgesang regelmäßig Lautmuster einer anderen Art imitieren. Das artfremde Muster wird entweder wechselnd mit dem eigenen vorgebracht, oder beide werden zu einem einheitlichen Gebilde kombiniert.In den meisten Fällen gehören die gewählten Vorbilder nächstverwandten Arten an, normalerweise Schwesternarten (Tab. 2). Nur selten werden nicht verwandte Vorbilder imitiert, die aber strukturelle Übereinstimmungen mit dem Gesang des Nachahmers aufweisen.In der Mehrzahl der Fälle werden nur einzelne Individuen einer Population zu Mischsängern. Ausnahmsweise gibt es mischsingende Populationen oder Teilpopulationen, so bei Isolation oder in schmalen Überlappungszonen allo‐patrischer Arten.Mischsänger verschiedener Arten blieben unverpaart oder gingen eine Bindung mit der Vorbildart ein. Mit wenigen möglichen Ausnahmen (z. B. Sylvia atricapilla — S. borin) muß man annehmen, daß Mischgesang auf Tradierungsfehler beim Gesangslernen zurückgeht. Es gibt bislang keinerlei Berechtigung, Mischsingen im Sinne von Dobkin(1979) als ein Beispiel akustischer Konvergenz einzustufen.
The laryngeal mask airway in emergency medicine
Authors: KENNEDY MARCUS P , HIGGINS DAVID 
Published: August 2010

ABSTRACTThe Laryngeal Mask Airway (LMA) is an upper airway adjunct lying intermediate in function between the endotracheal tube and the oropharyngeal airway. It has gained wide acceptance since its introduction into United Kingdom anaesthetic practice in 1988.We review the principles of advanced airway management in the emergency department and examine the application of the LMA to this area. We conclude that the LMA may have a small role in pre‐hospital and CPR airway management, and a very significant role in the management of difficult or failed endotracheal intubation.
Intravenous magnesium in hyperacute fulminating asthma
Authors: WEBB MARK 
Published: August 2010

ABSTRACTIntravenous magnesium is an effective bronchodilator. Its efficacy in the treatment of clinical asthma however is unproven.In this case, a 19 year old man presented with hyperacute fulminating asthma. Intubation was avoided after intravenous magnesium sulphate 20 mmol.This case provides further evidence that intravenous magnesium may have a role in acute severe asthma.
Blunt carotid trauma following a rugby match
Authors: CLEARY MICHAEL I , ASHBY RICHARD H , PILLAY ROOKMANGITHAN 
Published: August 2010

ABSTRACTObjective: To describe an association between rugby and blunt trauma to the carotid artery.Clinical features: A 15 year old male presented with neurological signs following a rugby match. Blunt dissection of the carotid artery was confirmed by angiography.Intervention and outcomes: Vigorous non‐operative management including anticoagulation was undertaken. A good clinical outcome was obtained.Conclusion: Blunt trauma to the carotid artery should be suspected in patients who develop neurological symptoms and signs in association with rugby.
Reduction of acute patellar dislocation under femoral nerve blockade
Authors: HOY GREGORY , WALPOLE BRYAN 
Published: August 2010

ABSTRACTComplications of traumatic reduction of the acutely dislocated patella may be significant, including osteochondral and chondral defects of either patella or lateral femoral condyle. The true incidence of chondral damage due to traumatic reduction both before presentation and in emergency departments is unknown. Femoral nerve block can produce good analgesia and excellent muscle relaxation with an effective block, allowing early atraumatic reduction if spontaneous reduction has not already occurred. This method was employed in three cases, using prilocaine 1.5% solution with adrenaline 1:200,000 via the single injection technique, with good results. Femoral nerve block is a feasible and well tolerated procedure in our experience, and may help reduce complication rates in patellar dislocations.
Chemically induced or inherited myotonia?
Authors: COYNE BEVERLEY A 
Published: August 2010

ABSTRACTObjective: To present a case of chemically induced myotonia occuring as a result of intentional ingestion of trifluoperazine and Defender Australia Bindi plus Clover Lawn WeederR (chlorophenoxy compounds present as 4‐chloro‐2‐methylphenoxyacetic acid (MCPA) as a dimethylamine salt 15% W/V and 3,6‐dichloro‐2‐methoxybenzoic acid (dicamba) 2.5% W/V). To discuss myotonia.Clinical features: A 38 year old man with features suggestive of dystrophia myotonica presented with severe myotonia, urinary retention and dry lips. There was no personal or known family history of this muscular disorder.Intervention: He was treated with 2mgs of intravenous benztropine mesylate, and 50 grams of activated charcoal and 150 mls of 70% sorbitol orally. An indwelling catheter was inserted. Laryngoscopy and upper gastrointestinal tract endoscopy were performed. The myotonia was managed conservatively and complete recovery occurred as evidenced by normal electromyography on day six of his admission.Conclusion: Myotonia is a rare complication of toxin ingestion. In this case, the toxins may have unmasked subclinical dystrophia myotonica or induced myotonia de novo.
Investigation of patients with haematuria following trauma
Authors: SAMMUT J F C , GAUDRY P L 
Published: August 2010

ABSTRACTStudy objective: To evaluate the effect of applying a protocol for radiological investigation of patients with traumatic haematuria.Design: Retrospective review of admitted patients in a two year period who had traumatic haematuria. Clinical findings, radiological investigation and outcome were evaluated.Setting: Westmead Hospital, an urban Australian teaching hospital.Results: Among 186 patients with traumatic haematuria, a total of 13 renal injuries were diagnosed (eight minor contusions, five major injuries). Of 133 patients who had radiological investigations, 58 satisfied the protocol and these included all the five major injuries. There were 75 patients who had radiological investigation outside the protocol and no significant injuries were detected.Conclusion: Patients with blunt trauma, microscopic haematuria without shock and no suspicion of intra‐abdominal injury do not warrant further investigation to elucidate the cause of their haematuria.
Use of the oesophageal Doppler to facilitate resuscitation
Authors: ADDY E V , HIGGINS D J , SINGER M 
Published: August 2010

ABSTRACTTwo cases are presented where a transoesophageal Doppler probe was used to measure aortic blood flow during resuscitation. This technique allowed rapid and continuous assessment of cardiac output, myocardial contractility and volume status. Using this information, therapy during resuscitation was optimised for these patients in whom insertion of a pulmonary artery catheter was considered hazardous.
Dangerous interaction between amitriptyline and pimozide in the presence of hypokalaemia
Authors: Leach Deborah S , Levinson Michele 
Published: August 2010

AbstractA 23 year old woman on pimozide 4mg mane and amitriptyline 50mg mane and 100mg nocte developed ventricular tachycardia following ingestion of twice her usual evening dose of amitriptyline. Serum K+ was 3.0mmol/L. There were no other obvious contributory factors. Pimozide has previously been linked with sudden death and a variety of ECG changes. This report raises the possibility that interaction between pimozide and amitriptyline may cause ventricular tachycardia, particularly in the presence of hypokalaemia.
Two cases of acute renal failure after brown snake bite
Authors: KRUK CHRISTOPHER , SPRIVULIS PETER , JELINEK GEORGE A 
Published: August 2010

ABSTRACTTwo patients from southern metropolitan Perth presented to Fremantle Hospital within a three week period with brown snake (genus Pseudonaja) envenomation, resulting in coagulopathy, thrombocytopaenia, anaemia and acute renal failure. Coagulopathy and thrombocytopaenia are well recognised complications of brown snake bite. However acute renal failure from brown snake bite has been described on only six previous occasions in the Australian literature, three from Western Australia in 1976. In these three cases, the genus of snake was not confirmed and the atypical envenomation syndromes suggested that other genera may have been responsible.In our patients, brown snake envenomation was confirmed with the Commonwealth Serum Laboratories Venom Detection Kit. The renal failure was self‐limiting in both cases though one patient required dialysis for 12 days. Neither patient developed rhabdomyolysis or myoglobinuria. These are the first cases of acute renal failure complicating definite brown snake envenomation reported from Western Australia. The most likely snake in both cases was the dugite (P affinis), however gwardar (P nuchalis) envenomation could not be excluded. Renal failure after brown snake bite is a rare but important complication.
Publications by Fellows of the Australasian College for Emergency Medicine in the Medline®‐indexed medical literature, 1984–1993
Authors: Jelinek George A , Sprivulis Peter C 
Published: August 2010

AbstractAll articles published from 1984 to 1993 by Fellows of the Australasian College for Emergency Medicine in journals indexed by Medline® were analysed according to journal, type of article, methodology, topic, and authors.One hundred and sixty four articles were published overall, increasing from nine in 1984 to a peak of 33 in 1991. The topics were injury in 44 papers (27%), illnesses 34 (21%), poisoning 21 (13%), administration 20 (12%), envenomation 16 (10%), technology 14 (9%), disaster/prehospital six (4%), CPR five (3%) and other subjects in four (2%). The number of authors per paper averaged 2.6 and did not increase significantly over the ten years, in contrast to international trends.There were 68 original research articles, 36 review articles, 29 case reports, 28 letters and three editorials. Original articles were principally descriptive with 31 retrospective and 19 prospective surveys; there were nine controlled and eight uncontrolled clinical trials, and one laboratory research project. The majority of papers (71%) were published in journals based in Australasia, with the remainder (29%) in international journals.Australasian emergency physicians are making an increasing contribution to the wider medical literature.
Blood conservation in elective surgery
Authors: Davies Michael 
Published: August 2010

AbstractThe primary aim of blood conservation is to reduce blood loss during major surgery. Some surgery however inevitably involves blood loss and in this situation blood conservation techniques are indicated. These techniques include preoperative donation, simple haemodilution, combined haemodilution and intraoperative autologous blood transfusion and blood scavenging during and after surgery.Simple haemodilutionSimple haemodilution involves the use of a suitable colloid for blood replacement during surgery until the patient's haemoglobin falls below 8–10g/dl. This technique is widely practised and can only be safe if repeated haemoglobin measurements are made throughout the operation and postoperative course.Combined intraoperative haemodilution and autotranfusionIn this process two units of blood are taken from the patient after induction of anaesthesia and are replaced with a suitable colloid. Our preference is to use polygeline because it is relatively cheap, has a low reaction rate and its short half‐life is an advantage. The two units of blood collected are retransfused at the end of surgery, thus boosting the patient's haemoglobin and supplying a significant amount of platelets and coagulation factors. Blood that is lost during surgery has a lower haemoglobin and therefore the net loss in red cells is less with the process than if the patient's haemoglobin was left at a normal level.Intraoperative scavengingThis involves the collection of blood from the operative site during surgery in a sterile fashion. The blood can then either be retransfused as whole blood or processed using a cell processor, washing the red cells and supplying washed packed red cells. These techniques have become more practical with the advent of cheaper disposable equipment and have some place in major surgery.ConclusionBlood conservation techniques involve a number of different approaches, each of which can be applied in a specific situation provided one has sufficient experience in their application.
A new clinical sign to aid the diagnosis of locked posterior dislocation of the shoulder
Authors: Mah Edward T , Wang Allan W , Atkinson Robert N 
Published: August 2010

AbstractWe have observed a new clinical sign in three cases of locked posterior dislocation of the shoulder. The diagnosis was missed initially in all three cases with the standard clinical and radiographic examinations. This sign, a prominent superior angle of the scapula in the posterior triangle of the neck raises the possibility of a locked posterior shoulder dislocation. The diagnosis can then be confirmed by selective radiological investigations, thus avoiding the common occurrence of a missed or late diagnosis.
Protecting privacy during video recording resuscitations
Authors: Gaudry Paul L , Ryan John M , Aders Hugh P 
Published: August 2010

AbstractThe practice of video recording resuscitations is reviewed with respect to the following issues:

the protection of patients' rights to privacy during and after recordings
the non status of recordings as a medical record
the need for staff acceptance and institutional approval prior to beginning recordings
the use of recordings for quality improvement audit, critical incident monitoring, instructional feedback and resuscitation review conferences
the recommendation that recordings are then erased, and
the utility of legislative protection to facilitate the process of quality improvement.
Is the adult emergency department really adults only?
Authors: Levick Nadine , Lorchirachoonkul Thanaporn 
Published: August 2010

AbstractObjectivesTo quantify the use of an adult emergency department (ED) by paediatric patients and identify the acuity and spectrum of these presentations.To determine the seniority and paediatric experience of emergency department staff involved with these patients.To address the appropriateness of the paediatric guidelines in an ‘adult only’ emergency department.SettingThe Royal Melbourne Hospital, an ‘adult only’ metropolitan tertiary hospital with 40,000 ED presentations annually and an admission rate of 30%.MethodsPaediatric (18 years and under) ED attendances were recorded retrospectively over 12 months. Prospective data were then gathered for two weeks on acuity, clinical data and disposition for each patient as well as seniority and extent of paediatric training of medical staff involved.ResultsPaediatric patients accounted for 3.9% of presentations in the retrospective study and 2.8% in the prospective study. In the younger age groups, paediatric patients were of higher acuity, with greater admission rates and less trauma than average, with opposite trends in adolescents. Amongst the adolescent group the rate of patients ‘who did not wait’ was double that of the general ED population. Most patients (74%) were managed by staff with no paediatric training. Australasian College for Emergency Medicine (ACEM) advanced trainees were the most confident in managing children.ConclusionsPaediatric patients do present to this ‘adult only’ ED. In this setting medical staff experience and training in paediatric management is variable. Suitable training and guidelines should be considered to address this issue. This study supports the ACEM requirement for paediatric training and has implications for emergency medicine paediatric training and Continuing Medical Education programs in the future. Multicentre studies, incorporating patient outcome data, would further clarify these issues.
The role of the emergency department in the management of patients with atypical chest pain
Authors: Bryant Michael 
Published: August 2010

AbstractThere is often an inconsistent approach to the management of patients with chest pain which is not due to myocardial infarction. The stratification of risk groups, utility of diagnostic tests and current practice in the USA are discussed. Recommendations for a change in our current practice are:

Patients with unstable angina, acute myocardial infarction and those with a high suspicion of acute myocardial infarction should be admitted to hospital.
Those patients with atypical chest pain should be considered for early exercise testing in or from the emergency department.
In the absence of the facility for exercise testing in or from the emergency department, patients with atypical chest pain should be admitted to hospital.
The impact of violence on emergency department staff
Authors: Brookes Jennifer G 
Published: August 2010

AbstractThe impact of violence on the carers has yet to be clearly defined and explored. Research has shown that there is significant under‐reporting of violence against emergency department personnel.There exist published reports of serious injury or death to staff due to violence occurring in the emergency department. Physical violence occurs in about 50% of violent incidents. The occurrence of threats, assault not resulting in injury, and the psychological impact of such violence need further examination. The part workplace violence has to play in occupational stress and ‘burnout’ are all issues yet to be comprehensively studied and reported.One study has shown a significant reduction in assault and injury in staff trained in aggression control techniques. Further evaluation of aggression control training and psychological debriefing are needed to determine the effect of such measures on the incidence of violence and its sequelae on care givers.Only when there is further research to determine the physical, emotional and financial impact on the carer can the cost of violent events be defined and give financial justification to employers for investing in measures aimed at reducing the impact of these events on the carer.
Cardiac tamponade
Authors: Hayes James E 
Published: August 2010

AbstractCardiac tamponade is a life threatening condition that results from accumulation of intrapericardial fluid or air, leading to impaired cardiac filling and consequent reduction of cardiac output. There are many causes, best categorised as non‐traumatic and traumatic.The diagnosis is most commonly made on echocardiographic evidence of effusion together with the clinical findings. Clinical findings, however, are non‐specific and often unreliable especially early in the process of cardiac tamponade. A high index of suspicion must therefore be maintained.Definitive treatment consists of pericardiocentesis or surgical drainage, the choice of which will depend upon the urgency of the situation, the aetiology and the available facilities and personnel.
Computerising emergency department guidelines with an Intranet
Authors: Waller Richard H 
Published: August 2010

AbstractAn emergency department's guidelines/protocols can be transferred simply and cheaply to a secure ‘intranet’ using readily available software and hardware. This format facilitates revision and distribution of the protocols and provides access at the clinical workstation. The use of hypertext links facilitates access and allows incorporation of video, graphic and audio files to the protocols.
A triage observation scale improves the reliability of the National Triage Scale in children
Authors: Browne Gary J , Gaudry Paul L , Lam Lawrence 
Published: August 2010

AbstractAimTo test the reliability of the National Triage Scale in children.SettingAn emergency department in a metropolitan university hospital.MethodsProspective study of 13,923 emergency department presentations. During phase one standard triage was performed using the National Triage Scale. During phase two triage was performed utilising a triage observation tool. Critical incidents and complaint reports were monitored during both phases.ResultsDuring phase one, correlation between triage category and admission rate was weak but statistically significant (r = ‐ 0.47; p = 0.04). During phase two, triage category had a far stronger correlation with admission rate (r = ‐ 0.99; p < 0.0001). Critical incidents and complaint reports decreased significantly in phase two compared with phase one by 95% and 94% respectively.ConclusionA triage observation tool (TOT) gives more reliable assignment of triage category, in particular more reliable recognition of children at high risk of serious illness.
Trial participation leads to a delay in thrombolysis for acute myocardial infarction
Authors: Aitken Peter , Green David 
Published: August 2010

AbstractObjectiveTo determine if there is a significant delay in time to thrombolytic administration for patients participating in clinical trials.MethodsA retrospective audit of all patients given a thrombolytic agent for acute myocardial infarction in the Emergency Department of the Gold Coast Hospital in 1995.ResultsTrial participants (n=17) had a mean door to needle time of 61.9 minutes compared with non trial participants (n=66) whose mean door to needle time was 43.2 minutes. This was found to be statistically significant (p<0.05) and equated to a 43% increase in time to thrombolysis for trial participants.ConclusionParticipation in clinical trials leads to a delay in time to thrombolysis for the individual patient which must be weighed against the potential benefit of research trials to the community.
Starvation and the refeeding syndrome — food for thought
Authors: Hollis Gregory , Holdgate Anna 
Published: August 2010

AbstractThe refeeding syndrome is an uncommon multisystem disorder which may occur when feeding is reintroduced following a period of starvation. It may be rapidly fatal due to cardiorespiratory failure or neurological complications. A large number of patients presenting to an emergency department may be at risk, including those with anorexia nervosa, chronic alcoholism and malnutrition.Prevention involves recognition of the syndrome and identification of patients at risk. It is important to be aware of the usual clinical vital signs of a starved patient. Management, which may require admission to an intensive care unit, consists of regular electrolyte monitoring, careful attention to fluids, slow introduction of carbohydrate loading and thiamine supplementation. As depletion of phosphate stores plays a central role in the refeeding syndrome, treatment also includes phosphate replacement.