bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non‐invasive positive pressure ventilation in patients with acute respiratory failure
Authors: Hore Craig T 
Published: March 2003

AbstractNon‐invasive positive pressure ventilation is an emerging modality in contemporary critical care practice. Perhaps the most widely utilized and familiar form of non‐invasive positive pressure ventilation is mask continuous positive airway pressure. Other common modes include mask Bi‐level positive airway pressure and mask pressure support ventilation. All feature the delivery of positive airway pressure via a mask (full‐face, naso‐oral or nasal), and a patient‐controlled respiratory cycle. The physiological benefits of non‐invasive positive pressure ventilation suggested by a number of studies include improved oxygenation, decreased work of breathing, improved ventilation and perfusion matching, decreased fatigue, and increased minute ventilation. The utilization of non‐invasive positive pressure ventilation has now been reported for a variety of clinical indications. In most, randomized trials are lacking, and the benefits and preferred mode of non‐invasive positive pressure ventilation are still to be elucidated. In general, in patients that are candidates for endotracheal intubation, non‐invasive positive pressure ventilation should be used as a way to possibly avoid endotracheal intubation rather than as an alternative to endotracheal intubation. Whilst the benefit of non‐invasive positive pressure ventilation appears to be established in patients with chronic obstructive airways disease with hypercapnic acute respiratory failure, one of the major unresolved issues is whether one modality is significantly better than the others. Unfortunately, the question of whether Bi‐level positive airway pressure is better than continuous positive airway pressure in this clinical scenario has not been satisfactorily addressed in any large randomized and controlled clinical trial. Further, there is no ‘gold standard’ for predicting success with non‐invasive positive pressure ventilation, although several studies have looked at this aspect.
Unexplained drowsiness and progressive visual loss: Methanol poisoning diagnosed at autopsy
Authors: Weinberg Laurence , Stewart Jonathan , Wyatt Jonathan Paul , Mathew Joseph 
Published: March 2003

AbstractA patient was admitted to the emergency department with a reduced level of consciousness and deteriorating vision. Her pupils became fixed and dilated and she developed a third nerve palsy with extensor posturing of her limbs. Biochemistry profile showed an increased serum osmolar gap with a raised anion gap metabolic acidosis. Supportive treatment was instituted, but she made no recovery and brainstem death was later confirmed. Post mortem examination and toxicology screen confirmed the cause of death as methanol poisoning leading to cerebral oedema and transtentorial herniation. We highlight some of the diagnostic difficulties associated with treating a patient with a reduced level of consciousness. The clinical and biochemical findings that are critical in establishing a diagnosis of methanol intoxication are discussed. The definitive management of methanol poisoning is reviewed.
Collecting duct carcinoma presenting as a bleeding complicated renal cyst
Authors: Cheung() Man‐Chiu , Lo () Siu‐Hung , Khoo () Ui‐Soon , Tam () Po‐Chor 
Published: March 2003

Collecting duct carcinoma is a rare type of renal cell carcinoma. It is usually diagnosed pathologically and carries a poor prognosis. Renal cell carcinoma arising within a cyst is also rare. We report a case of collecting duct carcinoma presenting as a giant, bleeding complicated renal cyst with minimal solid component. The patient had a relatively long survival after nephrectomy.
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Laparoscopic resection of gallbladder remnant: Case report
Authors: Lee Kit‐Fai , Lee Shin‐Cheung , Leong Heng‐Tat 
Published: March 2003

Recurrent symptomatic cholelithiasis can arise from residual gallbladder after a previous incomplete cholecystectomy. Diagnosis relies on a high index of suspicion and appropriate investigations such as ultrasound, computed tomography scan, endoscopic retrograde cholangiopancreatography or magnetic resonance cholangiopancreatography (MRCP). A case of symptomatic gallbladder remnant with gallstone 3 years after a previous laparoscopic cholecystectomy, which was managed successfully with laparoscopic resection, is described. The predisposing factors and preventive measures for such a rare complication are discussed. Chinese Abstract imageimage
Adult interhemispheric subdural haematoma: A simple option for an uncommon problem
Authors: Datta Narendra Nath , Rehman Safi‐Ur , Chan Kwong‐Yau , Chan Kin‐Wai , Poon Christopher Yee‐Fat , Kwok John Ching‐Kwong 
Published: March 2003

Two cases of interhemispheric subdural haematoma are presented. None of the patients had any neurological deficit on admission. They developed progressive neurological deficits within a day or two. Surgical treatment was by a large convexity craniectomy and a wide opening of the dura. The dura was left open in one case and primary duroplasty was done in the other. No deliberate attempt was made to remove the interhemispheric clot. Both patients made a quick and complete recovery by this simple procedure. Cranioplasty was carried out subsequently. Chinese Abstract imageimage
The cutaneomarginal eyelid graft
Authors: O’Donnell Brett A 
Published: March 2003

Abstract Purpose: To assess the effectiveness of the cutaneomarginal graft. Methods: The cutaneomarginal graft consists of eyelid margin tissue with anterior lamella skin. The tarsal plate is resected following harvesting of a wedge of eyelid tissue. The graft is used to repair eyelid defects following excision of neoplasms which spares the posterior lamella. The graft is principally used at the lateral most part of the lower eyelid following Mohs surgery. A case series of five patients are reviewed to assess the effectiveness of the technique. Results: All patients achieved a satisfactory result following grafting and there were no donor site complications. Conclusions: The cutaneomarginal graft is an effective means of repair, although with limited indications.
Adverse effects of topical antiglaucoma drugs on the ocular surface
Authors: Arıcı Mustafa Kemal , Arıcı Dilek Sema , Topalkara Ayşen , Güler Cenap 
Published: March 2003

ABSTRACT Purpose: This study was designed to determine the effect of long‐term antiglaucoma topical medication on the ocular surface; measuring basal Schirmer’s and tear break‐up time tests using conjunctival impression cytology. Methods: The ocular surfaces of 30 control subjects (group 1), 24 primary open‐angle glaucoma patients treated with 0.5% betaxolol hydrochloride (group 2), 27 primary open‐angle glaucoma patients treated with 0.5% timolol maleate (group 3) and 26 primary open‐angle glaucoma patients treated with 0.5% betaxolol and 1% dipivefrin hydrochloride (group 4) were evaluated. Basal Schirmer’s and tear break‐up time tests were measured and ocular surface changes were determined by impression cytology. Impression cytology specimens of each group were graded and scored in the range 0–3 according to Nelson’s method. Results: Patients in groups 2, 3 and 4 showed statistically significant fewer normal basal Schirmer’s tests (wettability) and tear break‐up time tests (P < 0.01). Also, the conjunctival impression cytology scores were significantly higher in groups 2, 3 and 4 than in group 1 (P < 0.01). Conclusions: The conclusion was that it is possible that conjunctival surface and tear film function change after the long‐term use of antiglaucoma medication.
Secondary haemorrhage after dacryocystorhinostomy
Authors: Tsirbas Angelo , McNab Alan A 
Published: March 2003

ABSTRACT Objective: To describe the incidence, clinical features, possible risk factors and outcome of patients suffering secondary haemorrhage after dacryocystorhinostomy (DCR). Methods: Records of all patients undergoing external DCR by one surgeon (AAM) over a 6‐year period were analysed retrospectively. Results: After 293 DCR operations in 260 patients, 10 patients had a secondary haemorrhage (one after bilateral DCR), usually between days 4 and 10 post‐operatively (mean 6.8 days). Six of the 10 were hospitalized for 2–5 days (mean 2.8 days), all of whom had nasal packing, intravenous antibiotics and intravenous fluids; none required blood transfusion. Three patients had immune system defects, three had used non‐steroidal anti‐inflammatory drugs (NSAID) and four had no obvious risk factors. All 10 had a successful outcome following DCR (compared to an overall failure rate of 25/293 (8.5%): 16 anatomical and nine functional). Conclusions: Secondary haemorrhage after DCR was found to occur after 3.8% of DCR. Risk factors include being immunocompromised and taking NSAID prior to surgery. The haemorrhage did not adversely affect surgical outcome.
Symptomatic intraocular inflammation in multiple sclerosis
Authors: Towler Hamish MA , Lightman Susan 
Published: March 2003

ABSTRACT Purpose: The aim of this study was to determine the type and outcome of uveitis in patients with multiple sclerosis. Methods: A retrospective study of 16 patients attending the uveitis clinic who had a clinically definite diagnosis of multiple sclerosis and symptomatic intraocular inflammation. The type of uveitis and complications present as well as the outcome of therapeutic intervention, either medical or surgical, was determined. Results: Chronic, bilateral anterior uveitis was present in six patients. Secondary cataracts requiring surgery occurred in 10 eyes, and trabeculectomy was done on five eyes for secondary glaucoma. Symptomatic vitritis (visual blurring and/or visually significant floaters) occurred in eight patients and was bilateral in four. Occlusive peripheral retinal vasculitis with subsequent areas of ischaemia and neovascularization requiring panretinal laser photocoagulation developed in eight eyes, five of which also required vitrectomy. Other posterior segment complications included macular oedema (four) and epiretinal membrane involving the macula (two). Five patients required systemic steroids for control of posterior uveitis. The median visual improvement following cataract surgery or vitrectomy was 3 Snellen lines to a median visual acuity of 6/18. Conclusions: A wide range of clinical patterns of uveitis, which may be both symptomatic and sight‐threatening, occur in patients with multiple sclerosis. In addition, the complications of uveitis may cause significant visual morbidity, much of which is amenable to appropriate surgical intervention. It is important that these potentially remediable conditions are recognized and treated to ensure that patients with multiple sclerosis retain optimum visual function.
Cataract extraction in a major ophthalmic hospital: Day‐case or overnight stay?
Authors: Atalla Maged L , Wells Kristen K , Peucker Nicole , Yi Qing , McCarty Daniel J , Louis Damien , Taylor Hugh R 
Published: March 2003

ABSTRACT Purpose: Cataract surgery is increasing in Australia and represents a significant burden on limited health resources. This study examines the frequency and outcomes of cataract surgery for patients who were hospitalized overnight compared with those treated as day surgery cases. Methods: Medical records of 671 consecutive admissions for cataract surgery at the Royal Victorian Eye and Ear Hospital were reviewed. Data analysed included demographic features, insurance status, length of hospitalization, ophthalmic conditions, medical conditions, social problems and planned surgical technique. Ophthalmic and anaesthetic complications, active ophthalmic and medical interventions were also studied. Results: Of the 671 patient admissions for cataract during the study period, 226 (33.4%) were hospitalized overnight. Factors significantly associated with overnight hospitalization in univariate analyses include older age, female sex, country residence, Veterans’ Affairs insurance, monocular vision status, pre‐existing ischaemic heart disease, pre‐existing asthma/chronic obstructive lung disease, absence of carer, transportation problems, planned extra‐capsular cataract extraction technique, ophthalmic complications and active ophthalmic and/or medical interventions. After adjusting for possible confounding factors using backwards stepwise multivariate logistic regression models all except pre‐existing ischaemic heart disease and opthalmic complications were significantly associated with overnight admission for cataract surgery. In total, 14 cases (2.1%) needed active ophthalmic and/or medical interventions, 13 overnight cases and one day case. Conclusions: These data suggest that many patients who are hospitalized overnight for cataract surgery could be safely treated as day cases. Such a shift in the pattern of care for cataract surgery could provide a significant potential for health care savings.
Projected number of Australians with visual impairment in 2000 and 2030
Authors: Foran Suriya , Wang Jie Jin , Rochtchina Elena , Mitchell Paul 
Published: March 2003

ABSTRACTThis study aimed to project population‐based prevalence data associated with visual impairment, in order to estimate the number of affected older Australians (aged 50 or older) in the years 2000 and 2030. We used data from the Blue Mountains Eye Study (BMES) and Melbourne Visual Impairment Project (MVIP), together with Australian Bureau of Statistics population projections. Similar definitions for moderate (6 / 24–6 / 60 visual acuity) and severe (< 6 / 60 visual acuity) visual impairment were used. Combining age‐standardized data, we estimated that in the year 2000, 38 820 (0.73%) and 25 590 (0.48%) Australians aged 50 years or older will have moderate and severe visual impairment, respectively. By 2030, these rates will have more than doubled, to an estimated 85 910 (0.92%) and 57 930 (0.62%) Australians with moderate and severe visual impairment, respectively. Women aged 50 years or older will have a 1.8‐fold and four‐fold risk, respectively, of moderate and severe visual impairment compared to men. Visual impairment will affect an increasing proportion of older Australians. Newer approaches to therapy, rehabilitation and community support for persons with visual impairment will be needed to meet this challenge.
Effect of stimulus duration in flicker perimetry
Authors: Anderson Andrew J , Vingrys Algis J 
Published: March 2003

ABSTRACTWe investigated the relationship between stimulus duration and flicker thresholds when flickering stimuli were presented on luminance pedestals. Mean‐modulated flicker thresholds remained constant with changes in stimulus duration. However, flicker presented on a luminance pedestal gave masking at short durations, decaying exponentially to stable thresholds with time. These stable thresholds were elevated when compared with the mean‐modulated condition. The lowest threshold in a stimulus onset asynchrony function predicted the threshold obtained from a luminance‐pedestal flicker stimulus of the same duration. This suggests that luminance‐pedestal flicker thresholds are determined by the most detectable cycle in a multiple cycle stimulus. We find that the 800 ms stimulus duration used in the Medmont™ M600 perimeter (Medmont, Camberwell, Australia) is suitable to determine stable flicker thresholds.
Streaming and bouncing: observations on motion defined objects
Authors: Burns Nicholas R , Zanker Johannes M 
Published: March 2003

ABSTRACTWhen two identical objects move in opposite directions on the same path and at the same speed, they can appear, after crossing over, to continue in their original directions (streaming), or to reverse direction (bouncing). In order to be able to manipulate visibility by adding noise, we used objects defined by contrast, flicker, or motion, and thereby extended previous findings on luminance‐defined objects. Two identical rectangles (1.1 × 1.4°) composed of random dot patterns moved toward each other at a speed of 3.5°/s. In experiment 1 we used backgrounds of a grey field, static random dots, or dynamic noise, and examined the effect of introducing a pause in motion and a visual distractor. In experiment 2 we introduced visual noise at four levels. For all three types of motion display, we found an increase in the proportion of the bouncing percept when either a pause in motion or an attentional distractor was introduced. Experiment 2 showed that neither of these effects depends on the visibility of the moving objects. An increase in the bouncing percept, due to a pause in motion or the distraction of attention, can be observed for all types of object definition, and is not affected by decreasing the visibility of the motion‐defined objects. This finding suggests that the role of attention in determining the perception of bouncing does not lie in the modulation of object visibility.
Functional implications of vision impairment
Authors: Weih LeAnn , McCarty Catherine A , Taylor Hugh R 
Published: March 2003

ABSTRACTThis study investigated the functional implications of vision impairment. A total of 508 participants in the Visual Impairment Project completed the VF‐14 questionnaire, vision‐related functional tasks, an interview, and the ophthalmic examination. Participants with less than 6 / 12 presenting acuity were more likely to report a moderate to high degree of difficulty performing VF‐14 items (odds ratios from 6 to 44). They were also more likely to be unable to recognize a 10 cent coin (OR; 7.0, 95% CL; 2.6, 19.3) or correctly read a telephone number (OR; 10.1, 95% CI; 5.6, 18.1). As demonstrated by the VF‐14 and the functional tasks administered in this study, visual impairment affects the ability of people to conduct a variety of common daily tasks.
Topical anaesthesia for phacoemulsification surgery
Authors: Lindley‐Jones MFH 
Published: March 2003

ABSTRACT Aim: To assess the discomfort experienced by patients undergoing phacoemulsification under topical anaesthesia. Methods: Thirty patients had a collagen contact lens, soaked in 4% lignocaine, placed on the cornea 23–89 min preoperatively. Immediately preoperatively, additional ophthetic drops were inserted. The patients underwent phacoemulsification surgery with the insertion of a foldable intraocular lens. This group was compared with 30 age‐ and sex‐matched controls who underwent phacoemulsification and the insertion of a non‐foldable lens under peribulbar anaesthesia. (8 mL of an 80 : 20 mix of 0.5% bupivacaine, 4% lignocaine and hyaluronidase). The pain perceived by patients was assessed on a verbal analogue scale (0–10) at administration of anaesthesia, perioperatively and 3–6 h postoperatively. Results: Topical anaesthesia was less painful than peribulbar anaesthetic at administration (difference in mean pain score 1.2, P < 0.05, Wilcoxon paired signed rank test). Patients experienced more pain during the operation under topical anaesthesia (difference in means 0.63, P < 0.05). There was no difference between the groups postoperatively. Conclusion: Topical anaesthesia does not carry the risk of injection into, or injury of, the many delicate structures of the orbit. Because it provides acceptable levels of anaesthesia for phacoemulsification, it could be used more frequently.
Eyelid retractor surgery as an adjunct to cicatricial ectropion repair
Authors: O'Donnell Brett A 
Published: March 2003

ABSTRACT Purpose: To evaluate the effectiveness of eyelid retractor repair in cicatricial ectropion of the lower eyelid. Methods: The study design was a prospective case series. One hundred and twenty eight eyelids were operated on in 100 consecutive patients with cicatricial ectropion. All patients underwent lower eyelid retractor repair via a conjunctival approach combined with skin replacement to the anterior lamella with or without a horizontal lid tightening procedure. When only medial ectropion was present, a medial‐based transpositional skin flap was used to repair the anterior lamella (26 eyelids). The remaining eyelids with ectropion involving all or most of the eyelid underwent upper‐to‐lower eyelid lateral‐based transpositional skin flap repair (92 eyelids), or full thickness free skin grafting (10 eyelids). Horizontal lid tightening was performed by lateral canthoplasty in 123 eyelids. Results: Relief of cicatricial ectropion symptoms was reported in 90% of patients overall. A normal punctum position was achieved in 70% of eyelids, overall, and was highest (88%) with a medial‐based transpositional skin flap. Conclusions: Eyelid retractor repair combined with skin replacement and horizontal lid shortening is an effective procedure for cicatricial ectropion.
Sino‐orbital fistula: two case reports
Authors: McNab Alan A 
Published: March 2003

ABSTRACTA fistula between the paranasal sinuses and the orbit as a late complication of orbital fractures is rare and may present with intermittent symptoms due to air passing into the orbit. A case note review of two patients with sino‐orbital fistula is presented. Two patients, 23‐ and 30‐year‐old males, presented with intermittent symptoms of globe displacement, diplopia or discomfort months after repair of an orbital floor fracture with a synthetic orbital floor implant. The symptoms occurred after nose blowing. They were both cured by removal of the implant and partial removal of the tissue surrounding the implant. A sino‐orbital fistula may complicate the otherwise routine repair of an orbital floor fracture, but may be cured by removal of the implant and part of the surrounding pseudocapsule.
Central serous retinopathy complicating systemic lupus erythematosus: a case series
Authors: Khng CGYW , Yap EY , Au‐Eong KG , Lim TH , Leong KH 
Published: March 2003

ABSTRACTSystemic lupus erythematosus (SLE) is a chronic autoimmune disorder with widespread manifestations including the eye. Central serous retinopathy (CSR) has been associated as a complicating event in SLE, although it is uncommon. We present a case series of four female Chinese SLE patients who developed CSR during the course of their systemic disease. All four presented clinically with typical CSR. Angiographic findings did not show evidence of choroidal ischaemia or delayed choroidal filling. Resolution of the serous retinal detachment occurred in all four patients. Recovery of vision was seen in three patients. The clinical outcome was similar to that occurring in the usual male population. Central serous retinopathy as a manifestation of SLE may be caused by various factors. These include SLE‐associated choroidopathy, systemic hypertension, renal disease, retinal pigment epithelial dysfunction and glucocorticoid therapy.