bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical anatomy of the external branch of the superior laryngeal nerve
Authors: Whitfield Patricia , Morton Randall P. , Al‐Ali Saad 
Published: August 2010

AbstractBackground:  The variations in the anatomy of the external branch of the superior laryngeal nerve (EBSLN) are generally classified according to the relationship of the nerve to the superior thyroid artery, or the superior pole of the thyroid. Both artery and superior pole are themselves variable landmarks, and therefore are not consistent between subjects. We sought to examine EBSLN anatomy in relation to alternate, more consistent surgical landmarks.Methods:  Fifteen hemi‐larynges from 20 embalmed human cadavers were dissected anatomically. Each nerve was categorized using established classification systems, and terminal branching patterns were also noted. Nerve location was recorded in relation to three different constant anatomical structures: the laryngeal prominence, midline junction of the cricothyroid muscles and ipsilateral cricothyroid joint.Results:  All cadavers were of European descent. The EBSLN had two branches to the cricothyroid muscle in 34% of cases. The EBSLN anatomical types found were mainly Cernea type 1 (80%), with 7% type 2a and 13% type Ni. An EBSLN was more likely to lie in an ‘at risk’ location if the subject was less than 160 cm tall. The EBSLN entered the crico‐thyroid muscle at a median distance of 14 mm lateral from the laryngeal prominence and 8 mm inferiorly. The median distance from the medial‐most point of the cricothyroid muscle junction was 14 mm laterally and 14 mm superiorly, and from the cricothyroid joint the entry lay a median distance of 10 mm superiorly and 11 mm medially.Conclusions:  The variability of EBSLN anatomy is again evident, as is the need for careful and knowledgeable surgical technique. New surgical landmarks for the relations of the insertion of the EBSLN reveal a deployment range for each, but one of more of these landmarks may prove useful in thyroid surgery.
INSULIN SECRETORY CAPACITY, β‐THROMBOGLOBULIN and BLOOD VISCOSITY IN LONG STANDING, NON‐INSULIN DEPENDENT DIABETICS WITH and WITHOUT MICROANGIOPATHY
Authors: BARNETT A. H. , SMITH J. R. 
Published: August 2010

Abstract:A comparison was made of insulin secretion in response to i.v. glucose between non‐insulin dependent diabetics with and without severe microangiopathy. During i.v. glucose tolerance testing those with complications had significantly lower serum insulin concentration (at 40 and 60 min 15.2 ± 2.9 and 11.7 ± 2.5 mll‐1 respectively) than those without (26.1 ± 4.7 and 24.3 ± 3.6 mU‐1, p <0.01). The differences were also significant when insulin increment above basal was determined. All subjects had raised plasma beta‐thromboglobulin concentration (indicating increased tendency to platelet aggregation), but with no significant difference between the two groups. There was also no difference in fasting glucose, kg values, HbAI or blood viscosity. We conclude that non‐insulin dependent diabetics with severe microangiopathy have significantly reduced insulin secretory capacity in response to i.v. glucose when compared with those without.
A RADIOIMMUNOASSAY FOR THE DETECTION OF CIRCULATING ANTI‐GLOMERULAR BASEMENT MEMBRANE ANTIBODIES
Authors: HOLDSWORTH S. R. , WISCHUSEN N. J. , DOWLING J. P. 
Published: August 2010

Abstract:A fluid phase radioimmunoassay (RIA) has been established for the detection of circulating anti‐glomerular basement membrane (GBM) antibodies. Antibodies were detected by binding with a collagenase solubilised, immunochemically purified, radiolabeled extract of human particulate GBM. Sera from 108 patients with a variety of histological types of glomerulonephritis (GN) were assessed for the presence of antibodies. Likely positive sera were those from patients with clinical features of rapidly progressive glomerulonephritis (RPGN) with crescentic or diffusely proliferative GN and linear staining of their GBM's with IgG. Thirty one of 35 sera from such patients were positive in the RIA. Sera from 14 patients with RPGN but with granular IgG deposition (i.e. immune complex related GN) were all negative for anti‐GBM antibodies as were sera from 59 patients with a variety of non‐crescentic non RPGN without linear IgG. Comparison of the RIA with conventional indirect immunofluorescence (IIF) showed that the RIA had a higher detection rate of antibodies in likely positive sera (19/21 RIA: 16/21 IIF) lower false positive detection rate with sera from patients without GN (0/26 RIA: 2/26 IIF) and was three to four times more sensitive in serial dilution studies.
EARLY CROSSOVER OF INDUCTION CHEMOTHERAPY IN SMALL CELL LUNG CARCINOMA
Authors: ROBINSON P. C. , DREW M. J. R. , GILL P. G. , McLENNAN G. , ANTIC R. 
Published: August 2010

Abstract:The aim of this trial was to assess whether early crossover induction chemotherapy would improve the complete response rate in patients with small cell lung carcinoma. Tumour markers were defined in all 48 patients at diagnosis. The patients were reassessed after three and six cycles of chemotherapy and classified as having either complete, partial or non response of tumour on each occasion.Initial induction therapy consisted of cyclophosphamide, vincristine and adriamycin (T1). The therapy of the patients with no tumour response was changed to a regimen (T2) consisting of VP16‐213, procarbazine, CCNU and high dose methotrexate with folinic acid rescue. The patients with partial tumour response were randomised to receive either T1 or T2, while patients with complete tumour response continued with T1.In those patients classified initially as having partial tumour response, crossover chemotherapy did not improve tumour response or survival. Similarly, in patients with no tumour response there was not an acceptable improvement.We conclude that non cross resistant crossover chemotherapy using these drug regimens confers no added benefit when compared with continuing the initial therapy.
COMPARISON OF WET and DRY AEROSOL SALBUTAMOL
Authors: HARRISON B. A. , PIERCE R. J. 
Published: August 2010

Abstract:Wet aerosol and metered dose inhaler (MDI) modes of inhalation of salbutamol were compared in ten asthmatic patients with severe, reversible airways obstruction and in ten chronic bronchitic patients with severe, poorly reversible airways obstruction. The responses to cumulative doses to 800 μgm (8 times 100 μgm) by MDI and 10 mg (4 times 0.5 ml of 0.5% standard solution) by wet aerosol were studied. From maximum expiratory flow‐volume curves, measurements were made of FEV1, FVC, PEFR, Vmax 50% and Vmax 75%, and pulse and blood pressure responses to cumulative doses of salbutamol were measured. In both groups of patients there was no significant difference between the two modes of inhalation either for each treatment interval or for the maximal response in any of these indices.
THIAMIN INADEQUACY IN INFANTS: LACK OF EVIDENCE OF AMPROLIUM IN EGG YOLK
Authors: THORNBER E. J. , MARRIOTT J. M. L. , ELLIOTT L. E. , MASSERA F. C. , KERR D. 
Published: August 2010

Abstract:This study investigated the hypothesis that the consumption of egg yolks might lead to thiamin inadequacy in infants because of the possible contamination of the egg yolks with amprolium. Earlier workers showed that the presence of amprolium in the diet inhibits the absorption of thiamin. Amprolium is added to some poultry feeds to control coccidiosis: it is readily incorporated in the egg yolk and egg yolk is one of the solid foods offered to infants at weaning. We found that under current commercial poultry feeding practices in WA it is extremely unlikely that any amprolium would be present in commercial eggs or poultry. Amprolium was undetectable in eggs purchased at several retail outlets. Thus there is no evidence that consumption of egg yolk contributes to thiamin inadequacy in infants.
PATTERNS OF STROKE: AN ANALYSIS OF THE FIRST 700 CONSECUTIVE ADMISSIONS TO THE AUSTIN HOSPITAL STROKE UNIT
Authors: CHAMBERS B. R. , DONNAN G. A. , BLADIN P. F. 
Published: August 2010

Abstract:An analysis is presented of the first 700 admissions to the Austin Hospital Stroke Unit with special emphasis on the incidence of the various patterns of stroke and the underlying mechanisms involved. There were 616 admissions for confirmed stroke events–the remainder were for events simulating stroke. Three hundred and fifty‐three (57.3% of stroke events) were for cortical (including retinal) ischaemic events. Of these, arterial lesions were demonstrated in 55% and suspected in 20% whilst embolism from the heart probably accounted for 14% of events. No cause was determined in 11% despite complete investigation. Where arterial lesions were found, they were extracranial in 85%. There were 140 cases of internal capsular ischaemia (22.7% of stroke events) and 16 cases (2.6%) for which the exact site of ischaemia was not determined, although it was presumed to have occurred within the carotid territory. Vertebrobasilar ischaemic events were responsible for 71 admissions (11.5%). There were 36 cases of primary intracerebral haemorrhage (5.8%).This survey has highlighted some aspects of stroke requiring further research. These include the elucidation of cortical and retinal ischaemic events of unknown aetiology, the possible role of large vessel lesions in the pathogenesis of capsular ischaemic events and pathologic mechanisms involved in ischaemic events of the vertebrobasilar territory.
The efficacy of chelation therapy and factors influencing mortality in lead intoxicated petrol sniffers
Authors: Burns C. B. , Currie B. 
Published: August 2010

AbstractBackgmund:The use of chelating agents to treat patients with petrol sniffing encephalopathy has been controversial, since alkyllead additives in petrol are not chelatable. A high mortality has also been reported in hospitalised petrol sniffers.Aims: (i) Evaluate the efficacy of chelating agents in mobilising lead for excretion and lowering blood lead; (ii) Review factors contributing to mortality in hospitalised petrol sniffers.Methods: All males chelated between 1992–1993 were studied (n = 20). Blood and urinary lead were measured daily before and during chelation then twice weekly until discharge. Parenteral calcium disodium edetate (EDTA) and dimercaprol (BAL) were administered together, every six hours for five days, seven patients subsequently received oral D‐penicillamine until discharge. Clinical details were reviewed for eight patients with petrol sniffing encephalopathy who died between 1990–1994.Results: Urinary lead excretion substantially increased during parenteral chelation (median excretion=I13 μM/L days, compared with pre‐chelation excretion =1.1 μM/day). Median blood lead concentration fell from 4.83 μM/L (pre‐chelation) to 1.91 μM/L (post‐chelation). D‐Penicillamine did not appear to increase urinary lead excretion appreciably. All eight deaths followed sepsis; five from complications of aspiration pneumonia.Conclusions: Airway maintenance and management are crucial for survival in these patients. In the short‐term, parenteral chelation was effective in mobilising lead for excretion and reducing blood lead in encephalopathic petrol sniffers and was comparable to cases of inorganic lead intoxication. However, as in the treatment of inorganic lead intoxication, the long‐term efficacy of chelation for petrol sniffers remains controversial. Prevention strategies against petrol sniffing at a community level are recommended.
Focal segmental glomerulosclerosis and Guillain–Barre syndrome associated with Campylobacter enteritis
Authors: Lim A. , Lydia A. , Rim H. , Dowling J. , Kerr P. 
Published: August 2010

AbstractPrevious reports have noted an association between membranous nephropathy and focal segmental glomerulosclerosis with Guillain–Barre syndrome. We report a case of Campylobacter enteritis, which was complicated by both focal segmental glomerulosclerosis of the collapsing variety and Guillain–Barre syndrome, and propose that Campylobacter may be the common link between the glomerular disease and Guillain–Barre syndrome. We also briefly review previous reports of kidney disease associated with Campylobacter infection.
Hepatitis B virus reactivation following immunosuppressive therapy: guidelines for prevention and management
Authors: Lubel J. S. , Testro A. G. , Angus P. W. 
Published: August 2010

AbstractIt is well known that immunosuppressive drugs or cancer chemotherapy can stimulate replication of hepatitis B virus (HBV) and precipitate severe flares of HBV infection. The risk of this syndrome of ‘reactivation hepatitis B’ is highest in haematopoietic stem cell or solid organ transplant recipients and in those undergoing chemotherapy for haematological malignancies; however, it has been described following almost any form of immunosuppressive treatment. Fortunately, it can be largely prevented by prophylactic therapy with oral anti‐HBV nucleoside/nucleotide analogues. Importantly, chronic HBV infection is usually asymptomatic, and most patients at risk are likely to be unaware that they carry the infection. Thus, the key to avoiding this potentially fatal complication of immunosuppressive treatment is to ensure that all patients at risk of chronic HBV infection are screened for the disease before commencing immunosuppressive treatment or chemotherapy.
Two rare severe and fulminant presentations of Q fever in patients with minimal risk factors for this disease
Authors: Munckhof W. J. , Runnegar N. , Gray T. J. , Taylor C. , Palmer C. , Holley A. 
Published: August 2010

AbstractWe described two rare severe and fulminant clinical presentations of acute Q fever. The first patient had severe multiorgan failure. The second patient had fever and severe cholera‐like diarrhoea. Coxiella burnetii polymerase chain reaction on blood or serum can be clinically useful in the diagnosis of acute Q fever before seroconversion.
Exploring pathways to improve indigenous organ donation
Authors: Stephens D 
Published: August 2010

AbstractAustralia has one of the worst organ donation rates in the western world. The consequence of this is that the waiting list for life‐saving transplants is increasing. Australia has a highly successful transplant programme, but a limited number of organs are donated. Unfortunately, Aboriginal people are over‐represented in the organ‐failure patient group – particularly in end‐stage renal disease. Renal transplantation has the potential to improve quantity and quality of life for Aboriginal people with renal failure. Aboriginal people have a right to be given the same opportunities as non‐indigenous people to donate their organs at the end of life and improve the transplantation rates among their own people. The most effective way to improve indigenous donation rates will be through improving the knowledge of Aboriginal people about organ donation. There are cultural complexities and end‐of‐life rituals that make the decision to donate organs difficult, but these issues do not preclude a family from making the decision to donate organs at the end of life. We need to provide Aboriginal communities with appropriately presented information to give them a basis for making an informed decision about organ donation. Equity of access is important. Cultural competence of requestors is important. Consultation, communication and education are the way forward.
Managing confidentiality in illicit drugs research: ethical and legal lessons from studies in remote Aboriginal communities
Authors: Clough A. , Conigrave K. 
Published: August 2010

AbstractAssuring participant confidentiality in illicit drugs research has raised legal questions and challenges both for researchers and ethics committees. There are similar challenges for clinicians. To study cannabis use in Aboriginal people in Arnhem Land (Northern Territory), a risk‐management approach was successful. Aboriginal participants were informed in their own language that confidentiality could not be assured if they disclosed information about illegal behaviours. Researchers avoided questions of intrinsic interest to law enforcement. Relationships between researchers and study participants and the integrity of the study were preserved. These considerations have relevance for clinicians as well as researchers dealing with the influence of illicit behaviours on health.
Deviation from published guidelines in the management of primary spontaneous pneumothorax in Australia
Authors: Kelly A.‐M. , Clooney M. ,   Spontaneous Pneumothorax Australia Study Group
Published: August 2010

AbstractThere are a several published guidelines recommending treatment pathways for patients with primary spontaneous pneumothorax (PSP). Little is known about how these patients are actually treated in Australia. The aim of this study was to establish treatment patterns for Australian patients with PSP. This was a multicentre retrospective observational study conducted at 19 emergency departments across Australia of adult patients with PSP presenting in the calendar year 2005. In Australia, there is considerable deviation from published guidelines for the management of PSP. In light of the lack of high‐quality evidence to assist in choosing treatment approaches, a randomized controlled trial of management strategies is recommended.
Advances in percutaneous treatment for adult valvular heart disease
Authors: Wong M. C. G. , Clark D. J. , Horrigan M. C. G. , Grube E. , Matalanis G. , Farouque H. M. O. 
Published: August 2010

AbstractValvular heart disease occurs in 2–3% of the general population with an increase in prevalence with advancing age. The aetiology of valvular heart disease has evolved in recent decades with degenerative aortic and mitral valve disease supplanting rheumatic heart disease as a primary cause. The common valve lesions to be discussed in this article are aortic stenosis and mitral regurgitation. The traditional approach to calcific aortic stenosis when either symptoms or left ventricular impairment develops is surgical aortic valve replacement and it remains a treatment with excellent outcomes. In recent years there has been interest in less invasive approaches, including percutaneous and transapical aortic valve implantation. With refinements in technology these approaches are becoming a potential treatment option, primarily for high‐risk patients who may otherwise be unsuitable for traditional open surgical treatment. Catheter‐based approaches for mitral valve disease are also evolving. Mitral regurgitation may often be the result of mitral annular dilatation seen in patients with an enlarged left ventricle or left atrium. Percutaneous implantation of a constricting device in the coronary sinus, which lies in close proximity to the mitral annulus, results in a change to the geometry of the mitral valve and reduced regurgitation. Another technique in patients with degenerative mitral regurgitation is the endovascular edge‐to‐edge repair in which coaptation of the mitral valve leaflets can be improved with a percutaneously deployed clip. Small patient series indicate that these new techniques are promising. As such, advances in percutaneous interventional and surgical approaches have the potential to further improve outcomes for selected patients with valvular heart disease.
A fatal case of phlegmonous colitis in chronic hepatitis C receiving combination interferon and ribavirin therapy
Authors: Pang S. H. , De Silva K. , Napoli J. , Jones B. E. 
Published: August 2010

AbstractPhlegmonous colitis is an acute suppurative infection of the large bowel that is rarely described, rapidly fatal and often escapes clinical attention. Patients with chronic hepatic diseases appear to be predisposed to this condition. We report a novel case of fatal phlegmonous colitis in a cirrhotic patient receiving combination pegylated interferon and ribavirin for chronic hepatitis C, highlighting the importance of early recognition of this aggressive infectious entity.
Acute Q fever in pregnancy: report and literature review
Authors: Denman J. , Woods M. 
Published: August 2010

AbstractAcute Q fever in pregnancy is uncommon, but is probably underrecognized. It results in a significant risk of adverse pregnancy outcome and also predisposes to the development of chronic Q fever in the mother. Here, we review the clinical features, epidemiology, treatment and follow‐up of acute Q fever in pregnancy. The potential for transmission of Coxiella to the neonate and birthing suite staff will also be highlighted.
EFFECT OF RE‐COLD WORKING ON FATIGUE LIFE ENHANCEMENT OF A FASTENER HOLE
Authors: Bernard M. , Bui‐Quoc T. , Burlat M. 
Published: August 2010

Abstract The present study aims to assess the additional fatigue life enhancement obtained by coldworking a previously cold expanded plate hole. Two different methods of performing the second coldworking were considered, i.e. moving the mandrel in the same direction as for the first coldworking or moving it in the opposite direction. A three dimensional finite element analysis for establishing the residual stress field induced by two successive coldworkings (5.58% then 4.8%) was carried out. Al 7475‐T7351 specimens with a central hole were cold expanded at 5.58%, subjected to cyclic loading at constant amplitude for a predetermined life fraction (on the basis of 5.58% cold expanded hole fatigue life) and then re‐coldworked at 4.8%. After this rework, the specimens were again subjected to the same fatigue loading conditions until failure. During cycling, the fatigue crack extension was monitored using a video‐camera in order to determine the coldworking effect on both the initiation period and the propagation life.The fatigue test results have shown that a second coldworking may enhance the fatigue life of an already coldworked hole. For a given cyclic loading level, the beneficial effect depends upon the applied life fraction before reworking. The direction of the mandrel movement during the second coldworking has no noticeable influence on the additional fatigue life improvement. These experimental results have been analyzed with reference to the calculated residual stress field.