bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adverse skin and joint reactions associated with oral antibiotics in children: The role of cefaclor in serum sickness‐like reactions
Authors: King BA , Geelhoed GC 
Published: November 2003

Objective:  To review presentations to Princess Margaret Hospital Emergency Department (PMH ED) with adverse joint and skin reactions associated with the use of oral antibiotics, to describe the clinical course of children with cefaclor‐related serum sickness‐like reactions (cefaclor SSLR) and compare these with cases reported to the Adverse Drug Reactions Advisory Committee (ADRAC).Methods:  Twelve‐month retrospective review of presentations to a tertiary paediatric ED (42 000 visits annually) via an ED computer database search and review of medical charts of children presenting with joint or skin reactions. Telephone interviews were conducted with the caregivers of children with cefaclor SSLR.Results:  Adverse skin or joint reactions occurred in 150 children; 70 after cefaclor alone, 10 after cefaclor in combination with other antibiotics and 70 after other antibiotic courses. SSLR occurred in 44 children; 32 after cefaclor alone, five after cefaclor in combination with other antibiotics and seven after other single antibiotics. In children with cefaclor SSLR, otitis media was the most common indication (59.4%), another 18.8% had viral illnesses. Prolonged sequelae occurred in four children, a situation not previously reported. Sixty reports of paediatric cefaclor SSLR were made to ADRAC during the study period, none originated from PMH ED.Conclusions:  Cefaclor was associated with 53.3% of oral antibiotic related skin and joint adverse reactions and 84.1% of SSLR. The indications for its use in paediatric illness require careful reconsideration. ADRAC data under‐represents the incidence of cefaclor SSLR.
Oesophageal perforation in preterm neonates: Not an innocent bystander
Authors: Shah PS , Dunn MS , Shah VS 
Published: November 2003

Objective:  To compare the clinical course and neonatal outcomes of preterm infants with oesophageal perforation (OP).Methods:  Retrospective case control study of infants admitted between 1994 and 2001 and diagnosed with OP was performed at two tertiary care centres in Toronto, Canada. One control per case was matched by the gestational age and the month of birth. Occurrence of air leak syndrome/pleural effusion requiring drainage, the duration of supplemental oxygen and the time to attain full feeds were compared.Results:  Ten cases of OP were identified. The commonest clinical presentation was air leak syndrome/pleural effusion. There was a statistically significant increase in the time to attain full enteral feeds in OP group (P = 0.02). The duration of supplemental oxygen was prolonged in infants with OP, however, this was statistically insignificant (P = 0.20). The infants were managed conservatively and perforation healed in all.Conclusion:  Oesophageal perforation is a rare but important complication of modern neonatal intensive care setting. The diagnosis of OP should be considered in infants who present with sudden/acute deterioration in their respiratory status following procedures involving pharyngeal region. Conservative management in an otherwise uncomplicated case leads to complete recovery in neonates.
Operative experience in the Victorian general surgical training programme
Authors: Wong Kenneth , Birks David 
Published: November 2003

Background:  The Royal Australasian College of Surgeons recommends minimum operative and endoscopy training requirements for advanced trainees in general surgery. This study examines the influences of trainee seniority, geographical location of surgical rotation, and surgeons’ remuneration arrangements on the operative and endoscopy experiences of general surgical trainees in Victoria.Methods:  Trainee log books covering two 6‐month training periods in the year 2001 were analysed for depth and breadth of reported operative and endoscopy experience.Results:  A total of 81 trainee log books was reviewed. Senior trainees were significantly more likely to have a higher primary operator experience. Total operative caseload and primary operator experience, in terms of major operative cases, were greater in rural rotations. Endoscopy experience was significantly greater in rural rotations. Operative exposure to gynaecological, laparoscopic, orthopaedic, paediatric and plastic surgical procedures was significantly greater in rural rotations. Surgeons’ remuneration arrangements were not significantly related to trainee operative experience.Conclusions:  Rural surgical rotations enhance the depth and breadth of operative experience of Victorian general surgical registrars, allowing greater exposure to subspecialty surgical procedures.
Vascular complications of drug abuse: an Indian experience
Authors: Behera Arunanshu , Menakuru Somasekhar R. , Jindal Ravul 
Published: November 2003

Background:  Vascular complications resulting from i.v. drug abuse constitute a range of clinical problems from simple to serious. In addition, patients who present with these complications frequently have viral infections, which are a hazard to health care workers.Patients and Methods:  The present study is a retrospective review of 46 male drug addicts with 52 vascular complications (45 arterial, seven venous). Pseudoaneurysm of the femoral artery was the most common complication (n = 35). Fourteen of these patients underwent ligation of the common, superficial and deep femoral arteries above and below the pseudoaneurysm. Twenty‐one underwent bipolar ligation of the common femoral artery after complete excision of the pseudoaneurysm. The decision to revascularize was based on the presence or absence of postligation Doppler signal. Arterial reconstruction was performed in five patients. All eight brachial artery pseudoaneurysms were ligated and excised, and deep vein thrombosis was managed with anticoagulation.Results:  There was no mortality but three patients had to undergo late amputations of the lower limb after successful salvage following the initial surgery. The median postoperative ankle‐brachial indices, after bipolar and triple ligations were 0.51 and 0.46, respectively. Positive blood cultures were present in 30% of patients and tissue cultures were positive in 72%, the most common organism isolated was methicillin‐sensitive Staphylococcus aureus. Six patients were positive for viral markers. The median hospital stay was 43 days.Conclusion:  Ligation and excision of pseudoaneurysms without revascularization is safe for drug addicts provided it is based on the presence of a postligation Doppler signal.
Adult intussusception: experience in Singapore
Authors: Tan Kok Yang , Tan Su‐Ming , Tan Andrew G. S. , Chen Cosmos Y. Y. , Chng Hong‐Chee , Hoe Michael N. Y. 
Published: November 2003

Introduction:  Gastrointestinal intussusception is an uncommon clinical entity in adults and is interestingly distinct from its paediatric form. In adults an identifiable lead lesion is found in the majority of cases, of which a significant percentage are malignant. Its treatment is thus different from that of paediatric intussusception. The present study reviews our experience of treating adult intussusception.Methods:  A retrospective review of patients with a postoperative diagnosis of gastrointestinal intussusception between January 1997 and December 2002 was conducted. All patients under the age of 18 and cases of rectal prolapse were excluded.Results:  During the 5‐year period, there were nine cases of intussusception. There were four male and five female patients, with a mean age of 63.8 years (range 37−85 years). Less than half of the patients (44.4%) presented with acute symptoms. The most common symptoms were abdominal pain and distension. The symptoms were intermittent in 77.8% (7 of 9) of patients. Only two patients had a palpable abdominal mass, while another had signs of acute intestinal obstruction. Computed tomography was the most useful imaging modality, identifying intussusception in six out of six patients. Eight patients had lead lesions occurring at the ileocaecal junction resulting in ileo‐colonic intussusception. Of these eight, four were malignant (two adenocarcinomas and two lymphomas). There was one sigmoid‐rectal intussusception secondary to adenocarcinoma. All patients were treated operatively. Seven patients were treated with en bloc resection.Conclusion:  Although uncommon, surgeons need to be aware of the epidemiology and treatment options for adult intussusception. The symptoms and signs are often non‐specific and the surgeon might be faced with the diagnosis only at laparotomy. Computed tomography is the most useful imaging modality. An identifiable organic lesion is present in most cases, of which more than 50% are malignant (especially in the large bowel). Operative treatment is thus prudent. En bloc resection is recommended for ileo‐colonic and colo‐colonic intussusception. There is, however, a role of initial reduction in selected patients with ileo‐ileal intussusception.
Gastroenterologists’ views of symptoms following laparoscopic fundoplication: anecdotally based medicine?
Authors: Ludemann Robert , Watson David I. , De Beaux Andrew C. , Jamieson Glyn G. 
Published: November 2003

Background:  Currently gastro‐oesophageal reflux disease (GORD) can be managed either medically or surgically. The management decision is often based on the referring doctor's perception of the pros and cons of surgical management versus the medical alternative. A large group of gastroenterologists was surveyed to determine their understanding of the common outcomes of surgical management of GORD.Methods:  A 15‐question survey was sent to all gastroenterologists in Australia who were members of the Gastroenterology Society of Australia. Questions centred on management decisions and postoperative symptoms in fundoplication patients. The findings were compared to current published outcome data.Results:  One hundred and thirty‐four gastroenterologists responded anonymously to the survey. More than 75% described fundoplication as a safe and established procedure, and 80% had referred patients who were well controlled on medication for surgical management. The gastroenterologists’ perceptions of the problems of postoperative dysphagia and bloating differed from published outcomes.Conclusions:  Gastroenterologists are often the gatekeepers for the management of patients with GORD. The understanding that this group has about surgical outcomes is important so that patients can make well‐informed management decisions. The present study found that gastroenterologists are likely to convey to their patients higher degrees of postoperative dysphagia and bloating following fundoplication than is actually reported. This may deter some patients who would benefit from fundoplication from consulting a surgeon.
Social environment affects female and egg testosterone levels in the house sparrow (Passer domesticus)
Authors: Mazuc Jérémy , Bonneaud Camille , Chastel Olivier , Sorci Gabriele 
Published: November 2003

AbstractMaternal effects can have an adaptive value if they improve the performance of offspring. As such, the transfer of maternal testosterone (T) to the eggs has been suggested as a mechanism for adaptive maternal control of offspring phenotype in birds, although recent studies have shown negative effects of testosterone on hatching rate and chick survival. Here, we experimentally investigated whether socially stressful conditions experienced by female house sparrows during egg laying affected their circulating levels of androgens and the amount transferred to the eggs. Social stress was simulated by the intrusion of a foreign male placed near the nest box during the egg‐laying sequence. We found that (1) both female and yolk testosterone titres were positively related to breeding density; (2) yolk testosterone was negatively correlated with maternal testosterone; (3) yolk testosterone was positively correlated with the behavioural response of females towards the intruder and (4) the interaction between social intrusion and breeding density affected the amount of testosterone transferred to the eggs. Altogether, our results suggest that females may be able to modulate the amount of testosterone they allocate to their eggs according to the social environment they experience during egg laying.
Nutrient enrichment can increase the severity of coral diseases
Authors: Bruno John F. , Petes Laura E. , Drew Harvell C. , Hettinger Annaliese 
Published: November 2003

AbstractThe prevalence and severity of marine diseases have increased over the last 20 years, significantly impacting a variety of foundation and keystone species. One explanation is that changes in the environment caused by human activities have impaired host resistance and/or have increased pathogen virulence. Here, we report evidence from field experiments that nutrient enrichment can significantly increase the severity of two important Caribbean coral epizootics: aspergillosis of the common gorgonian sea fan Gorgonia ventalina and yellow band disease of the reef‐building corals Montastraea annularis and M. franksii. Experimentally increasing nutrient concentrations by 2–5× nearly doubled host tissue loss caused by yellow band disease. In a separate experiment, nutrient enrichment significantly increased two measures of sea fan aspergillosis severity. Our results may help explain the conspicuous patchiness of coral disease severity, besides suggesting that minimizing nutrient pollution could be an important management tool for controlling coral epizootics.
Quality of Life of Patients With Cervicogenic Headache: A Comparison With Control Subjects and Patients With Migraine or Tension‐type Headache
Authors: Suijlekom Hans A. van , Lamé Inge , Stomp‐van den Berg Suzanne G. M. , Kessels Alfons G. H. , Weber Wilhelm E. J. 
Published: November 2003

Objective.—To establish the health‐related quality of life of patients with cervicogenic headache and to compare it with a random Dutch sample of control subjects and with patients with migraine without aura or with episodic tension‐type headache.Methods.—Thirty‐seven patients with cervicogenic headache, 42 patients with episodic tension‐type headache, and 39 patients with migraine without aura completed a Medical Outcomes Study 36‐Item Short Form questionnaire.Results.—Domain scores for “physical functioning” of patients with cervicogenic headache were worse than those of patients with migraine or tension‐type headache. Physical functioning scores were lower for patients with tension‐type headache than for those with migraine. Migraineurs reported a diminished score for “social functioning” compared to patients with tension‐type headache. All Medical Outcomes Study 36‐Item Short Form domain scores were significantly lower for patients with cervicogenic headache relative to the control group.Conclusions.—Patients with cervicogenic headache have a quality of life burden that is substantial. Although impairment in the quality of life of patients with cervicogenic headache is comparable to patients with migraine without aura and those with episodic tension‐type headache, there are some specific differences.
Regional Head and Face Pain Relief Following Lower Cervical Intramuscular Anesthetic Injection
Authors: Mellick Gary A. , Mellick Larry B. 
Published: November 2003

Background.—Although cervical trigger point intramuscular injections are commonly used to relieve localized neck pain, regional head pain relief from lower cervical paravertebral injections has not been reported previously.Purpose.—To evaluate the safety and efficacy of such injections in a selected group of patients with intractable head or face pain.Methods.—In a series of patients with chronic head or face pain, local anesthetic was injected into the lower cervical spine paravertebral musculature approximately 1 to 2 inches lateral to the seventh cervical spinous process.Results.—In addition to producing rapid relief of palpable scalp or facial tenderness (mechanical hyperalgesia and allodynia pain), this lower cervical intramuscular injection technique alleviated associated symptoms of nausea, photophobia, and phonophobia in patients with migrainous headache.Conclusion.—Our results suggest that lower cervical intramuscular anesthetic injection may be an effective treatment for head or face pain.
An Early Devonian arthropod fauna from the Windyfield cherts, Aberdeenshire, Scotland
Authors: Anderson Lyall I. , Trewin Nigel H. 
Published: November 2003

AbstractNew terrestrial and freshwater arthropods are described from the Windyfield cherts, a suite of silicified sinters deposited 700m north‐east of the Rhynie cherts and part of the same Early Devonian hot‐spring complex. The diverse assemblage consists of Heterocrania rhyniensis (Hirst and Maulik, 1926a), here recognized as a euthycarcinoid; scutigeromorph centipede material assigned to Crussolum sp.; the crustacean Lepidocaris; trigonotarbid arachnids; a new arthropod of myriapod affinities named Leverhulmia mariae gen. et sp. nov.; and the distinctively ornamented arthropod cuticle of Rhynimonstrum dunlopi gen. et sp. nov. The Leverhulmia animal preserves gut content identifying it as an early terrestrial detritivore. Abundant coprolites of similar composition and morphology to the gut contents of the euthycarcinoid crowd the matrix. Chert texture, faunal associations, and study of modern analogues strongly suggest that the terrestrial arthropods were ubiquitous Early Devonian forms with no particular special adaptation to localized conditions around the terrestrial hot‐spring vents. The aquatic arthropods represent biota from ephemeral cool‐water pools in the vicinity of the hot‐spring vents.
New information on cranial and dental features of the Triassic archosauriform reptile Euparkeria capensis
Authors: Senter Phil 
Published: November 2003

AbstractThe course of the nasolacrimal duct, interdental plate morphology, and most details of tooth and denticle morphology have not previously been described in non–archosauriform reptilkes. Here I describe these details in the Triassic archosauriform Euparkeria capensis. The nasolacrimal canal opens orbitally via a pair of foramina between the lacrimal and prefrontal. The canal arches over the antorbital fenestra, as in archosaurs. The term ‘interdental unit’ is introduced for the unit composed of an interdental septum and its accompanying interdental plate. There is no demarcation between interdental plate and septum in E. capensis. The interdental units are heavily pitted on exposed surfaces. Like teeth, they are implanted in the dental groove and are separate from the surrounding bone and from each other. They are well positioned to serve as spacers between teeth, and to resist sagittal forces on teeth during prey capture. The teeth of E. capensis are labiolingually compressed, except for the nearly conical premaxillary teeth and mesialmost dentary tooth. Lateral teeth are serrated on mesial and distal keels. The denticles are low, rounded, and separated by grooves, and are slightly larger on the distal keel. Tooth morphology suggests carnivorous habits for Euparkeria.
Shell repair and mode of life of Praenatica gregaria (Gastropoda) from the Devonian of Bohemia (Czech Republic)
Authors: Lindström Anna , Peel John S. 
Published: November 2003

AbstractRepaired shell injuries occuring in less than four per cent of examined specimens of the platyceratid gastropod Praenatica gregaria (Barrande, in Perner 1903) from the Lower Devonian (Pragian) of Bohemia probably result from non–lethal predatory attacks. The low frequency may reflect the resistance of the large, smooth, rapidly expanding shell to attack, but a high rate of fatal attacks could produce the same pattern. The habit of some platyceratid gastropods living on echinoderm calices may provide a refuge from benthic predators, but conclusive evidence for this mode of life in P. gregaria or the general assumption of platyceratid coprophagy is lacking.
Modified formulation of CPDA for storage of whole blood, and of SAGM for storage of red blood cells, to maintain the concentration of 2,3‐diphosphoglycerate
Authors: Kurup P. A. , Arun P. , Gayathri N. S. , Dhanya C. R. , Indu A. R. 
Published: November 2003

Background and Objectives  A dramatic decrease in the level of 2,3‐diphosphoglycerate (2,3‐DPG) takes place during the storage of whole blood (WB) in CPDA (citrate–phosphate–dextrose–adenine) and a similar decrease occurs during the storage of red blood cells (RBCs) in SAGM (saline–adenine–glucose–mannitol). The aim of the present study was to prevent this decrease by modifying CPDA and SAGM.Materials and Methods  The pH of WB anticoagulant or RBC preservative solution was maintained at 7·6 by autoclaving the dextrose solution separately, by incorporating ascorbic acid and nicotinic acid into both CPDA and SAGM (to produce modified CPDA and SAGM solutions), and by reducing the concentration of adenine and adding citrate to the modified SAGM solution. The concentration of 2,3‐DPG in WB after 28 days of storage in modified CPDA, and in RBCs stored in modified SAGM, was compared with that in WB or RBCs stored in unmodified solutions.Results  The initial 2,3‐DPG levels were maintained after 28 days in the modified formulations [10·63 ± 2·58 µm/g of haemoglobin (Hb) in the case of modified CPDA and 12·07 ± 1·47 µm/g of Hb in the case of modified SAGM], whereas in standard CPDA and SAGM solutions, the concentration of 2,3‐DPG decreased to very low levels (0·86 ± 0·97 µm/g Hb for CPDA and 0·12 ± 0·008 for SAGM).Conclusions  Our modification in the formulation of CPDA or SAGM is effective in arresting the dramatic decrease in the level of 2,3‐DPG that occurs during storage of WB and RBCs in unmodified solutions.
First comparison of productivity and citrate donor load between the Trima® version 4 (dual‐stage filler) and the Trima Accel® (single‐stage filler) in the same donors
Authors: Ringwald J. , Zingsem J. , Zimmermann R. , Strasser E. , Antoon M. , Eckstein R. 
Published: November 2003

Background and Objectives  Aside from new software the blood cell separator TRIMA (GambroBCT) also received a newly designed separation chamber offering a novel single stage separation technology, called Trima Accel. We evaluated this new system focusing on productivity and donor comfort by comparing it to the previous version (Trima version 4) in collecting single‐donor platelet concentrates (SD‐PCs) and plasma.Materials and Methods  Each of 20 donors underwent platelet apheresis using both devices. We compared the collection efficiency (CE), the collections rate (CR), the volume of the collected plasma and the residual leukocytes. Furthermore we compared donor comfort in terms of duration of the donation, flow of citrate back to the donor and platelet and whit blood cell (WBC) loss.Results  While the number of collected platelets and the platelet concentration did not differ significantly between both techniques the time of the procedure was reduced by 15.6% with Trima Accel. This results in an increase of the CR and CE of 25% and 15% respectively when using Trima Accel. Log normal probability plotting of WBC counts showed that both techniques complied with the European and the US leukoreduction guidelines. The mean flow of ACDA to the donor perminute and per litre blood volume was also reduced by 20%.Conclusion  These data show that the Trima Accel represents a further improvement in apheresis platelet production with a better productivity and donor comfort, especially regarding the mean flow of ACDA to the donor.