bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHARACTERISTICS AND OUTCOMES OF INJURED PATIENTS TREATED IN ONE OF THE MAJOR REGIONAL HOSPITALS IN HONG KONG
Authors: Ng K.C.K. , Ho W. , Yuen W.K. 
Published: September 2009

We aim to review the characteristics and outcomes of all trauma team activated patients admitted to Queen Mary Hospital. Trauma registry data collected from January 1998 to December 2000 were analyzed in terms of demographics, resuscitative interventions, and progress.There were 351, 285 and 236 trauma admissions in 1998, 1999 and 2000 respectively, with an average 3:1 male:female ratio. Forty four percent of patients were in age group 21–40 years. Road traffic accidents were most frequent (46.4%) followed by Industrial (21.3%), then domestic accidents (15.5%). Head injury was the most common (60.8%) involved system; 40.1% sustained some form of extremity injury, whereas only 12.8% patients sustained abdominal injury. The appropriateness of trauma team activation was shown to have improved during the three‐year period, but the trauma team response remained similar. A strong correlation was found between the Injury Severity Score with the final patient outcome. 50% patients were discharged directly home; 34.4% transferred to convalescence and 3.2% D.A.M.A. Mean hospital mortality was 11.2%.Analysis of the data has given us a better understanding of the patient population that we are facing and has lead us to important changes in the way we manage our trauma patients.
POSTURE AND VOIDING FUNCTION
Authors: Ng M.T. , Sun W.H. , Leong H.T. 
Published: September 2009

Background: Urodynamic studies like uroflowmetry and pressure flow study can be performed in various postures although the natural posture for male subjects is standing. Difference in posture may affect voiding performance and make comparison of results from different centers difficult.Aim: To evaluate whether posture (sitting and standing) in male patients would significantly affect the parameters of uroflowmetry and voiding efficiency.Patients and Method: This was a prospective randomized study. Consecutive male patients attending outpatient uroflowmetry from June to August 2000 were recruited. Uroflow was performed in sitting and standing posture. In order to eliminate accustomisation, they were randomized into first sitting or first standing. Uroflow parameters like voided volume, residual urine, voiding efficiency, peak and mean flow rate were analysed by 2‐tailed paired t‐test.Results: There were 74 subjects (first sitting 35, first standing 39) and age was comparable. There was no statistically significant difference among all the parameters with respect to posture. To our surprise there was also no accustomisation effect, probably due to adequate patient instruction.Conclusion: Uroflow parameters and voiding function are the same in sitting or standing position for male subjects.
HYPERAMYLASEMIA AFTER CARDIAC SURGERY IS NOT RELATED TO THE USE OF CARDIOPULMONARY BYPASS
Authors: Wan I.Y.P. , Wan S. , Arifi A. , Chan C.S.Y. , Lee T.W. , Yim A.P.C. 
Published: September 2009

Background: Although hyperamylasemia has been reported in a large proportion of patients undergoing cardiopulmonary bypass (CPB), its clinical significance as well as the pathogenic mechanism remain poorly understood. Apart from pancreatic cellular injury, impaired renal function or hypercalcemia after CPB was also proposed to play a possible role in the etiology of postoperative hyperamylasemia. The study was designed to investigate whether avoidance of CPB would limit amylase elevation.Methods: Serum levels of amylase and lipase were measured before operation, 24 and 48 hours after surgery in 58 patients undergoing elective coronary artery bypass grafting (CABG) with or without the use of CPB over a 10‐month period. The choice of procedure was based mainly on the native coronary anatomy and left ventricular function. Postoperative complications as well as the plasma levels of creatinine and calcium were also carefully monitored.Results: Three surgical approaches were used for CABG: CPB (conventional on‐pump through median sternotomy, n = 32), OPCAB (off‐pump through median sternotomy, n = 14), and MIDCAB (off‐pump through left minithoracotomy, n = 12). There was no hospital mortality. No patient had postoperative abdominal complications. Transient hyperamylasemia occurred in 14 patients, 7 in the CPB group (22%), 5 in the OPCAB group (36%), and 2 in the MIDCAB group (17%). The increase in amylase levels was similar among groups. However, no lipase elevation was detected in any patient. There was no clear correlation between hyperamylasemia and an increased creatinine level. Perioperative plasma calcium levels were normal in patients who had hyperamylasemia.Conclusion: There is no significant difference in the incidence of hyperamylasemia among patients undergoing myocardial revascularization with or without the use of CPB and irrespective of mode of surgical access. Hence, CPB is not the major factor responsible for hyperamylasemia, as previously believed.
THE NEED FOR CHOLECYSTECTOMY AFTER ENDOSCOPIC SPHINCTEROTOMY (ES) FOR BILE DUCT STONE IN ELDERLY PATIENTS: A RANDOMIZED STUDY
Authors: Fung T.M.K. , Lau J.Y.W. , Suen R.B.Y. , Wong S.K.H. , Lee D.W.H. , Sung J.J.Y. , Chan A.C.W. , Chung S.C.S. 
Published: September 2009

Background: Long‐term biliary complications after ES for bile duct stones are infrequent. In the elderly, the role of routine cholecystectomy after ES is unclear.Patients and Methods: Between September 1997 and December 2000, patients (age >60) with bile duct stones and gall stones presenting with obstructive jaundice, cholangitis or pancreatitis were randomized to receive early elective cholecystectomy (LC) or expectant management after clearance of bile duct stones with ERCP + ES. Exclusion criteria included severe co‐morbidity, concomitant intrahepatic duct stones, recurrence pyogenic cholangitis, cholecystitis and failure to clear bile duct stones endoscopically. They were then seen at regular intervals. Outcome variables included further biliary complications defined as: cholangitis, pancreatitis, obstructive jaundice, cholecystitis and severe biliary colic.Results: 165 patients, aged 60–89 years were randomized (85 in LC group & 80 in expectant group). Both groups were similar in age (60–87 vs. 60–89), ASA grading and mode of presentation. Median follow‐up period was 24 months. 9 patients developed biliary complications in the expectant group (5 cholangitis, 3 cholecystitis and 1 severe biliary colic) while 1 patient in the LC group refused surgery and developed cholangitis. By intention‐to‐treat analysis, the expectant group shows higher incidence of biliary complications than the LC group: (9/80 vs. 1/85, p = 0.008; Difference in probability of complications = 13%, 95% C.I. = 4.8%, 21.2%)Conclusion: With higher incidence of biliary complications in the expectant group, cholecystectomy should be offered to patients whenever is possible after endoscopic clearance of bile duct stones.
TO REVIEW THE CARDIOTHORACIC TRAUMA AT QUEEN ELIZABETH HOSPITAL 1995–2000
Authors: Ho K.K. 
Published: September 2009

Purpose: All cardiothoracic consultations initiated at Accident and Emergency Department for period February 1995 to November 2000 were reviewed.Methods: Information was extracted from Trauma Registry of over 1000 cases.Results: 61 consultation was recorded. There were 33 blunt injury and 28 penetrating injury. 21 cases were of ISS 15 or less. Surgery for thoracic injury was performed in 13 cases of blunt injury (40%) and 20 cases of penetrating injury (70%). Majority of surgery was related to chest wall and lung injury. In addition there were 3 major intrathoracic vessel, 6 cardiac, 3 diaphragmatic and 1 major airway injury. 20 deaths were recorded with 4 deaths at A&E department. Mortality is related to severity of ISS and age >70. 4 ER‐thoracotomy was performed with 3 deaths. There were related to heart and aorta injury with average ISS≥50.Conclusion: 1. Major cardiothoracic trauma is not common. 2. When present, it is associated with severe injury. 3. The outcome is related to severity of ISS and old age.
Anterior chamber volume measurements with Visante optical coherence tomography and Pentacam: repeatability and level of agreement
Authors: Labiris Georgios , Gkika Maria , Katsanos Andreas , Fanariotis Michael , Alvanos Efstratios , Kozobolis Vassilios 
Published: September 2009

AbstractBackground:  The purpose of this study is to examine the repeatability of Pentacam‐derived anterior chamber volume measurements, and assess the level of agreement of anterior chamber volume measurements obtained with the Visante and the Pentacam imaging devices.Methods:  Anterior chamber volume was calculated with the Pentacam device and the Visante using the Wang formula. Results were analysed by means of the Wilcoxon signed rank test, Bland‐Altman analysis, Cronbach's alpha test and intraclass correlation coefficient. P‐values <0.01 were considered statistically significant.Results:  One randomly selected eye from each of 20 persons was analysed. Spherical equivalent ranged between −2.50 and +1.50 D, and their age ranged from 25 to 79 years (mean ± SD: 54.4 ± 19.2 years). Mean anterior chamber volume measured with Pentacam was 171.1 ± 39.6 µL (minimum: 103.0 µL, maximum: 236.0 µL), and mean anterior chamber volume measured by Visante was 171.4 ± 42.4 µL (minimum: 96.4 µL, maximum: 245.5 µL). There was no statistically significant difference between Pentacam and Visante measurements of the anterior chamber volume (P = 0.691, Wilcoxon signed rank test). Cronbach's alpha and intraclass correlation coefficient for Pentacam were 0.998 and 0.991, respectively.Conclusions:  Anterior chamber volume measurements obtained with the Visante using the Wang formula were in good agreement with the corresponding ones obtained with Pentacam. This recently described method is easy to perform and might contribute to both clinical and research settings.
Catquest questionnaire: re‐validation in an Australian cataract population
Authors: Gothwal Vijaya K , Wright Thomas A , Lamoureux Ecosse L , Lundström Mats , Pesudovs Konrad 
Published: September 2009

AbstractBackground:  The Catquest questionnaire was developed using traditional methodology to enable cataract surgery outcomes assessment in European countries. Recently, it has been validated using Rasch analysis in a Swedish population resulting in the Catquest‐9SF. The aim of the present study was to assess the performance of the Catquest and the Catquest‐9SF questionnaires using Rasch analysis in Australian cataract patients.Methods:  A total of 217 cataract patients awaiting surgery at Flinders Medical Centre, Adelaide, South Australia self‐administered the Catquest questionnaire. This is a 19‐item instrument containing frequency, difficulty, symptoms and global rating items. Rasch analysis was undertaken to assess the unidimensionality (whether all the items are measuring a single underlying construct using principal components analysis or PCA), person separation (ability of the questionnaire to distinguish between strata of patient ability) and targeting of item difficulty to person ability.Results:  Similar to the previous validation study, the original Catquest questionnaire required revision because of misfit and multidimensionality necessitating removal of the frequency items. The revised version was similar to the Catquest‐9SF although an extra driving item was a valid optional inclusion. The Catquest‐9SF performed well in the Australian cohort satisfying all criteria for valid measurement including unidimensionality. However, targeting of item difficulty to person ability was marginally worse compared with the Swedish cataract population indicating the Australian cataract patients present for surgery at lower levels of visual disability.Conclusions:  The Catquest‐9SF is a reliable and valid measure of visual disability in the Australian cataract population.
Effects of postoperative cyclosporine ophthalmic emulsion 0.05% (Restasis) following glaucoma surgery
Authors: Fakhraie Ghasem , Lopes Joao F , Spaeth George L , Almodin Juliana , Ichhpujani Parul , Moster Marlene R 
Published: September 2009

AbstractPurpose:  To determine if postoperative topical cyclosporine 0.05% has any beneficial effect following trabeculectomyMethods:  This was an interventional, randomized, prospective, double‐masked clinical trial of 44 consecutive patients with uncontrolled glaucoma requiring filtration surgery. Ocular surface disease index questionnaire and comprehensive ocular exam, including Schirmer's tear test 1, were performed. Patients underwent routine trabeculectomy, with or without phacoemulsification. The study group (n = 22) received cyclosporine 0.05%, and the control group (n = 22) received artificial tears. Patients were evaluated at 1 and 6 months post surgery. Outcome measures were intraocular pressure, success rate, bleb appearance, ocular surface disease index, Schirmer's tear test 1 and conjunctival inflammation.Results:  Thirty‐nine patients completed the study (19 in the study group, 20 in the control group). The mean baseline intraocular pressure was 23.8 ± 12.6 mmHg in the study group and 25.9 ± 10.6 mmHg in the control group (P = 0.513). Mean intraocular pressure at postoperative month 6 was 14.88 ± 6.2 and 14.62 ± 5.46 mmHg in the study group and control group, respectively (P = 0.837). There was no statistically significant difference in the mean values of Schirmer's tear test 1 and the level of conjunctival hyperaemia between the two groups at baseline, months 1 and 6 post surgery. The treatment group had a statistically significant decrease in ocular surface disease index score at 6 months (P = 0.003), indicating less severity of dry eye symptoms and significant reduction in ocular pain.Conclusions:  Topical cyclosporine 0.05% had no effect on postoperative bleb function and intraocular pressure following trabeculectomy, but improved subjective ocular surface symptoms in these patients.
New era for personalized medicine: the diagnosis and management of age‐related macular degeneration
Authors: Baird Paul N , Hageman Gregory S , Guymer Robyn H 
Published: September 2009

AbstractIt can be argued that age‐related macular degeneration is one of the best characterized complex trait diseases. Extensive information related to genetic and environmental risk factors exists, and a number of different biological pathways are strongly implicated in its aetiology. Along with recent improvements in high throughput and relatively inexpensive genetic technologies, we are now in a position to consider developing a presymptomatic, personalized approach towards the assessment, management and treatment of this disease. We explore the applicability and challenges of this approach if it is to become commonplace for guiding treatment decisions for individuals with pre‐existing disease or for those at high risk of developing it.
Persistent hyperplastic primary vitreous: congenital malformation of the eye
Authors: Shastry Barkur S 
Published: September 2009

AbstractPersistent hyperplastic primary vitreous (PHPV), also known as persistent fetal vasculature, is a rare congenital developmental malformation of the eye, caused by the failure of regression of the primary vitreous. It is divided into anterior and posterior types and is characterized by the presence of a vascular membrane located behind the lens. The condition can be of an isolated type or can occur with other ocular disorders. Most cases of PHPV are sporadic, but it can be inherited as an autosomal dominant or recessive trait. Inherited PHPV also occurs in several breeds of dogs and cats. In a limited number of cases, Norrie disease and FZD4 genes are found to be mutated in unilateral and bilateral PHPV. These genes when mutated also cause Norrie disease pseudoglioma and familial exudative vitreoretinopathy that share some of the clinical features with PHPV. Mice lacking arf and p53 tumour suppressor genes as well as Norrie disease pseudoglioma and LRP5 genes suggest that these genes are needed for hyaloid vascular regression. These experiments also indicate that abnormalities in normal apoptosis and defects in Wnt signalling pathway may be responsible for the pathogenesis of PHPV. Identification of other candidate genes in the future may provide a better understanding of the pathogenesis of the condition that may lead to a better therapeutic approach and better management.
Survey on the knowledge of age‐related macular degeneration and its risk factors among Singapore residents
Authors: Sanjay Srinivasan , Neo Hui Yee , Sangtam Tiakumzuk , Ku Jae Yee , Chau Shirley YM , Rostihar Abdul Karim , Au Eong Kah‐Guan 
Published: September 2009

AbstractPurpose:  To assess the awareness of age‐related macular degeneration (AMD) and its risk factors among Singapore residents.Methods:  A cross‐sectional questionnaire‐based telephone survey was conducted to ascertain the awareness of AMD with regards to knowledge of the disease entity and possible risk factors among Singapore residents. A Singapore residential telephone directory was used to identify potential households by choosing the first and last entries on randomly selected pages. Respondents included individuals from households with landline telephone connection who were willing to participate in the study after a brief introduction about the study. Verbal consent was sought before proceeding with the interview. Interpreters were used for respondents whose ability to converse in English was limited. Prior to commencement of the study, the protocol was reviewed and approved by Ethics committee of the Domain Specific Review Board.Results:  The interviewers contacted 796 subjects from different households, of which 520 participated (response rate, 65.3%). The age of the respondents ranged from 18 to 85 (median 41) years. Only 38 (7.3%) of them were aware of AMD, the majority of whom had completed secondary or higher education. Two hundred (38.5%) and 191 (36.7%) of the respondents considered age and smoking, respectively, to be risk factors for AMD.Conclusions:  The awareness of AMD among Singapore residents is low. AMD awareness needs to be improved by educational programmes designed for this specific purpose.
Spectrum of fungal keratitis in central China
Authors: Wang Liya , Sun Shengtao , Jing Yang , Han Lei , Zhang Hongmin , Yue Juan 
Published: September 2009

AbstractPurpose:  To investigate the epidemiology, risk factors, fungal spectrum and to test antifungal drug susceptibility of these isolates at a tertiary eye care referral centre in central China.Methods:  The medical and microbiology records of 2064 culture‐proven cases (2064 eyes) of fungal keratitis diagnosed at Henan Eye Institute between January 2000 to March 2009 was retrospectively reviewed. The fungal isolates were identified and a subgroup of 103 isolates were subjected to drug susceptibility tests for amphotericin B, fluconazole and ketoconazole by broth microdilution method.Results:  A total of 2064 cases of confirmed fungal keratitis were identified. The predominant fungal species isolated was Fusarium spp. followed by Aspergillus spp. Alternaria spp. were another most common fungi in central China. Fungal keratitis was more common among men. A large proportion of the patients were middle‐aged adults, and most were farmers. Ocular trauma was a highly significant risk factor and vegetative injuries were identified as a significant cause for fungal keratitis. Greatest number of cases of fungal keratitis was higher between September and December. Fusarium was mostly sensitive to amphotericin B, next to ketoconazole. Aspergillus was sensitive to amphotericin B and ketoconazole. Relatively, both Fusarium and Aspergillus were insensitive to fluconazole.Conclusion:  Fusarium and Aspergillus are always the most isolated pathogens of fungal keratitis in central China, followed by Alternaria. Document available on the epidemiological features of a large series would greatly help ophthalmologists at primary and second health care centres in the management of this disease.
Selection of medical patients for prophylaxis of venous thromboembolism based on analysis of the benefit–hazard ratio
Authors: Millar J. A. 
Published: September 2009

AbstractBackground:  Medical patients may benefit from anticoagulant prophylaxis of venous thromboembolism (VTE), but assessment of thrombotic risk is complex. I describe a method for estimating the minimum thrombotic risk required to ensure that a reasonable benefit–hazard ratio is maintained.Methods:  An equation was derived relating baseline VTE risk and a minimum acceptable benefit–hazard ratio (R), defined as ‘pulmonary embolus (PE) alone’, ‘PE or symptomatic proximal deep venous thrombosis (DVT)’, or ‘PE or any symptomatic DVT’ prevented per major bleeding. The equation was used to estimate the relative risk (RR) of thromboembolism required for net benefit (main outcome measure). The PREVENT study was the primary data source, backed by data from two meta‐analyses.Results:  For R ranging from 3 to 10, the RR required for net beneficial prophylaxis was 6.5–21.6 (PE alone); 3.0–9.9 (PE or symptomatic proximal DVT); and 2.3–7.6 (PE or any symptomatic DVT), respectively. These RR are possible only in the presence of risk factors of high weighting. Sensitivity analysis showed that the findings were robust to changes in baseline assumptions related to thrombosis and bleeding rates.Conclusion:  A method for risk assessment for medical thromboprophylaxis has been developed. The results suggest that only a minority of medical patients with high RR should receive prophylaxis.
Malignant fibrous histiocytoma complicating nephrogenic systemic fibrosis post liver transplantation
Authors: So K. , MacQuillan G. C. , Adams L. A. , Delriviere L. , Mitchell A. , Moody H. , Wood D. J. , Junckerstorff R. C. , Jeffrey G. P. 
Published: September 2009

AbstractA 46‐year‐old man with cirrhosis secondary to hepatitis C virus infection and alcohol underwent orthotopic liver transplantation, which required urgent re‐grafting because of biliary sepsis from necrosis of the left liver lobe. Recovery was complicated by renal failure and nephrogenic systemic fibrosis (probably related to intravenous gadolinium exposure). He subsequently developed a malignant fibrous histiocytoma. We present this case highlighting the occurrence of two rare conditions in the same patient following liver transplantation. We believe this is the first case of its kind to be reported.
Evaluation of different modes of combined therapy in children with monosymptomatic nocturnal enuresis
Authors: Vogt Mandy , Lehnert Thomas , Till Holger , Rolle Udo 
Published: September 2009

Study Type – Therapy (RCT) Level of Evidence 1bOBJECTIVETo evaluate the efficacy of different modes of combined therapy in children with monosymptomatic nocturnal enuresis (MNE).PATIENTS AND METHODSA randomized prospective study was performed to compare the order of two types of combined therapy in children with MNE. Group A was treated with primary desmopressin treatment that was combined with alarm treatment after 3 months, while group B was treated with primary alarm treatment that was combined with desmopressin after 3 months.RESULTSWithin a period of 18 months, 43 previously untreated children fulfilled the inclusion criteria. Thirteen children achieved dryness after initial monotherapy or discontinued the study. Group A consisted of 16 children and group B of 14 children. After the standardized treatment course of 6 months, 11/16 children in group A and 11/14 children in group B became dry (<3 wet nights/month). Altogether, 22/30 (73%) children were dry after combined treatment, consisting of 12/18 boys and 10/12 girls. Of the children with a normal maximum voided volume, 79% (19/24) achieved dryness, whereas only three of six children with small maximum voided volumes became dry. In all, 13/19 (68%) children with nocturnal polyuria and nine of 11 without nocturnal polyuria became dry. Only one child relapsed (group A).CONCLUSIONSCombined therapy proved effective in children with MNE after 6 months, with no statistically significant differences between the two different orders of treatment.