bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bioactive proteins from stonefish venom
Authors: Khoo Hoon Eng 
Published: March 2003

Summary1. Of all the venomous fish known, the stonefish is one of the most commonly encountered by man. Studies on its venom started in the 1950s, but little work was performed after that until several groups revived interest in the venom in the 1980s after easier accessibility to the fish.2. Stonefish venom is a mixture of proteins, containing several enzymes, including hyaluronidase of high specific activity. A purified stonefish hyaluronidase has been characterized.3. Several of the effects of the crude venom have been isolated to a protein lethal factor that has cytolytic, neurotoxic and hypotensive activity. This protein is stonustoxin from Synanceja horrida, trachynilysin from Synanceja trachynis and verrucotoxin from Synanceja verrucosa.4. The biochemical properties and activities of these protein lethal factors are reviewed.
Effects of sustained‐release tulobuterol on asthma control and β‐adrenoceptor function
Authors: Kume Hiroaki , Kondo Masashi , Ito Yasushi , Suzuki Ryujiro , Yamaki Kenichi , Takagi Kenzo 
Published: March 2003

Summary1. Recently, a patch formulation of tulobuterol, a β‐adrenoceptor (AR) agonist, has been developed using a transdermal delivery system. The present study was designed to determine whether β‐AR function and asthma control were affected by the sustained‐released β‐AR agonist.2. Tulobuterol (2 mg) was applied daily for 8 weeks to seven patients with bronchial asthma in whom the morning dip in the peak expiratory flow (PEF) rate developed even though inhaled glucocorticoids were being taken. After treatment with tulobuterol, the early morning reduction in PEF was suppressed and PEF values were increased from 367 ± 35 to 439 ± 38 L/min (P < 0.05). The rescue use of inhaled β‐AR agonists was decreased from 6.9 ± 2.0 to 1.0 ± 0.7 puffs/week (P < 0.01). Symptom scores also decreased from 8.3 ± 3.4 to 2.1 ± 1.4 score/week (P < 0.01).3. Next, we sought to examine the effects of exposure to tulobuterol on β‐AR function in guinea‐pig tracheal smooth muscle. After exposure of tissues to tulobuterol (0.01–10 µmol/L) for 45 min, the inhibitory effects of tulobuterol on methacholine‐induced contractions were attenuated in a concentration‐dependent manner. However, the inhibitory effects of tulobuterol were not affected after exposure to 0.01 µmol/L tulobuterol (a concentration greater than serum levels in clinical use). In contrast, the inhibitory effects of procaterol were not affected after exposure to tulobuterol under the same experimental conditions.4. These results indicate that the combination of sustained‐released tulobuterol with inhaled glucocorticoid therapy is beneficial to patients with bronchial asthma who suffer from symptoms induced by the morning dip in PEF. Moreover, chronic exposure to lower concentrations of tulobuterol does not lead to desensitization of β‐AR in airway smooth muscle.
Augmentation of the assassin bug Pristhesancus plagipennis (Walker) (Hemiptera: Reduviidae) as a biological control agent for Helicoverpa spp. in cotton
Authors: Grundy Paul R , Maelzer Derek A 
Published: March 2003

AbstractThird‐instar nymphs of the Australian assassin bug, Pristhesancus plagipennis
(Walker), were released into cotton plots at two release densities and two crop growth
stages to test their biological control potential. Release rates of 2 and 5 nymphs
per metre row resulted in field populations of 0.51 and 1.38 nymphs per metre row,
respectively, indicating that over 70% of nymphs died or emigrated within
two weeks of release. Effective release rates of 1.38 nymphs per metre row reduced
the number of Helicoverpa spp. larvae in the plots for a 7‐week period. Crop
yields were significantly greater in the plots to which P. plagipennis nymphs
were released, with the effective release rate of 1.38 nymphs per metre row providing
equivalent yields as insecticide treated plots. The data suggest that P. plagipennis
has the capacity to reduce Helicoverpa spp. larvae densities in cotton crops when augmented through inundative release.
Emergency medicine: Where to from here? The College
Authors: Baggoley Christopher J 
Published: March 2003

AbstractThis paper describes two group presentations of intoxicated patients to the Emergency Department of Gold Coast Hospital in October 1996 and July 1997 respectively. A total of 14 patients received treatment. The clinical features, investigation findings and clinical course of each patient are outlined. A discussion is undertaken of the literature surrounding the emergence of gamma hydroxybutyrate (GHB) as a drug of abuse, and of the major issues involved in the emergency department management of such patients.
An introduction to statistics, significance testing and the P value
Authors: Chu Kevin 
Published: March 2003

Abstract P values come from statistical tests used for testing the null hypothesis (Ho) which states that there is no difference between treatment outcomes. If the P value is less than 0.05 there is a less than 5% probability that the difference is due to chance if the Ho is true. Given this low chance, the Ho is rejected and the alternate hypothesis (Ha) that there is a difference between treatment outcomes is accepted. In hypothesis testing, there is a risk of wrongly rejecting a true Ho (α error) and wrongly not rejecting a false Ho (β error). The t‐ and Chi‐squared tests are the two most commonly used statistical tests for clinical hypothesis testing. Statistical significance derived from such tests, needs to be clinically significant for the finding to be relevant. P values need to be interpreted with the knowledge of several statistical concepts including sample size, multiple comparisons and the validity of the study.
Adding value to the patient experience in emergency medicine: What features of the emergency department visit are most important to patients?
Authors: Holden David , Smart David 
Published: March 2003

AbstractObjectives: To identify the features of the emergency department visit most important to patients, and to compare emergency staff ranking of the same features.Setting: The Royal Hobart Hospital, Tasmania is a 520‐bed public hospital with an annual department of emergency medicine census of 33 000.Methods: Five hundred and fifty‐five emergency patients, and 60 emergency department medical and nursing staff were surveyed, asking each to rank 10 features of the emergency department visit in order of importance to patients. Analysis was by Chi‐squared test and Mann –Whitney U‐test to compare survey responses between the patient and staff populations.Results: Response rates were 36% for patients and 78% for staff. Patients ranked waiting time as most important, followed by symptom relief, a caring and concerned attitude from staff and diagnosis of the presenting complaint. Staff identified the same four factors as important but ranked waiting time fourth. Waiting times during the survey week were within Australian College for Emergency Medicine performance benchmarks of 84% of the emergency department census.Conclusions: This survey identified a mismatch between patient concerns and emergency staff perceptions, particularly with regard to waiting times. The results justify the use of waiting times as a performance indicator for emergency medicine.
The Auckland acute referral process: A survey
Authors: Peak Stephen , Maclaren Hamish 
Published: March 2003

Abstract Objectives: To assess current Auckland general practitioners’ workload regarding acute referrals, perceived problems with the referral process and possible alternative methods of referral. Methods: Data were collected by a postal questionnaire survey of 200 central Auckland general practitioners. Results: A total of 150 responses (75%) were received. General practitioners saw, on average, 120 patients per week (range 10–300) and 1.7 patients per general practitioner per week were sent, as acute referrals, to hospital. Ninety‐two per cent of acute general practitioner referrals were preceded by a telephone call to a hospital registrar. The most common problem relating to the telephone call was the length of time the general practitioner spent waiting to speak to the registrar. The call was regarded by many general practitioners as stressful and difficult. In 19% of referrals the general practitioner felt that the patient’s diagnosis was unclear and that further investigations were needed to determine it. Ninety‐three per cent of general practitioners regarded an accompanying letter of referral as essential. Forty‐eight per cent considered a telephone call to be essential, and 60% believed the call gave added value to the referral letter. Seventy‐two per cent of the general practitioners preferred that the acutely ill patients they refer be seen by an in‐patient specialty first, rather than by emergency department medical staff. Conclusions: While the general level of general practitioner satisfaction with the current acute referral process in Auckland is not high, there is no consensus among general practitioners about how the process could be improved.
Emergency departments have a role in the prevention of suicide
Authors: Salter Andrée , Pielage Paul 
Published: March 2003

Abstract Objectives : The aims of the study were to determine whether emergency departments in Tasmania were managing patients at risk of suicide adequately, and to identify factors that may help to prevent suicide in patients who present to an emergency department. Method
: Retrospective review of case notes of patients who had presented to Tasmanian public hospitals and were on a Coroner's list as having committed suicide in Tasmania 1995–1997 (
n = 196). Results : This descriptive analysis of a population showed 58.7% had presented to an emergency department. Psychiatric problems were common. On the last emergency department presentation prior to death, 36.5% were admitted, with 95% of these having an admission for drug and alcohol or psychiatric problems. Conclusions : The majority of patients seen prior to death with suicide risk were correctly identified by emergency department staff and appropriately referred. Single‐vehicle motor vehicle accident victims and patients who present on multiple occasions with psychiatric or drug and alcohol problems are at risk.
The case for prehospital thrombolysis in acute myocardial infarction
Authors: Cooke Matthew 
Published: March 2003

AbstractThrombolysis is of proven benefit in improving survival after acute myocardial infarction. The benefit decreases with time after the onset of pain; the first 2 h appear to be important. Reduction of thrombolysis times must be undertaken as a whole‐systems approach. Delays in the patient contacting assistance services are unavoidable, but once contact is made the system should ensure attendance of a qualified person within 8 min. In‐hospital delays should be decreased, aiming for a door‐to‐needle time of less than 30 min. Prehospital electrocardiographs are accurate and can help reduce in‐hospital delays. Some trials have shown that prehospital administration of thrombolysis can lead to reduced thrombolysis times. Angioplasty with or without stenting for those with contraindications to thrombolysis and as a rescue procedure needs to be considered in deciding the destination of AMI patients. More evidence is needed to support this aspect of care. Prehospital thrombolysis has an important role to play, especially when time to hospital may be prolonged.
Mild snake envenomation
Authors: Fatovich Daniel M , Hitchcock Thomas , White Julian 
Published: March 2003

AbstractSnake bite envenomation typically requires treatment with effective first aid and antivenom. There is a spectrum of envenomation seen, which includes mild envenomation, but this has not been reported previously. We report two cases of mild envenomation and describe the changes in laboratory coagulation values. The patients had a benign clinical course without receiving antivenom. We strongly recommend that if clinicians are considering not treating any envenomated patients with antivenom, they do so only on expert advice.
Hospital and emergency department crowding in the United States
Authors: Schafermeyer Robert W , Asplin Brent R 
Published: March 2003

AbstractEvery emergency physician in the United States and, for that matter, in many countries around the world recognizes that the demand for timely access to quality emergency care is one that patients highly value. Unfortunately, hospitals in the USA have become stretched beyond capacity, resulting in overloaded emergency departments, diverted ambulances, and greater risks for patients and providers. Some of the causes and consequences of emergency department crowding are unique to the USA health care system, while others are common to countries throughout the world. The goals for this paper are to provide a brief overview of hospital and emergency department crowding in the USA, to identify commonly cited causes of the problem, and to outline future directions in the search for solutions. A large number of hospitals, inpatient beds, and emergency departments have closed during the past 10 years in the USA. In 1992 there were around 6000 hospitals with emergency departments and there are now less than 4000. While hospitals scrambled to decrease an excess supply of inpatient beds, the demand for emergency department care steadily rose. Between 1992 and 2000, the annual number of emergency department visits in the USA increased from 89.8 to 108 million. While some areas of the USA have been affected more seriously than others (particularly the coasts), almost every state has reported problems with boarding of inpatients in the emergency department. Inpatient boarding is the most frequently cited reason for emergency department crowding within the emergency medicine community. United States hospitals are also struggling with a shortage of health care professionals, particularly registered nurses. There are several policy issues that must be addressed to alleviate hospital and emergency department crowding over the long term. We list these as ‘long‐term’ goals simply because policy changes, in the USA, are often incremental and rarely occur quickly. In order to achieve any of these changes in policy over the long term, advocates for reform must aggressively pursue them today.
Unusual multiple endocrine neoplasia
Authors: Artioukh Dmitri , Al‐Jafari Mohammad , Wake Phillip 
Published: March 2003

An unusual case of multiple endocrine neoplasia (MEN) is reported. A 64‐year old male was found on investigation to have neoplastic lesions involving thyroid, parathyroid, pituitary and adrenal glands. The adrenal neoplasm shared features of a biochemically silent phaeochromocytoma and an oestrogen‐secreting cortical tumour. This association in the same neoplastic mass has not previously been described in conjunction with MEN syndrome.
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Does appendix position affect the clinical outcome of acute appendicitis?
Authors: Chan Wai‐To , Cheng Naomi Hau‐Yin , Cheng Kwan‐Chui , Cheung Kitty Kit‐Ting , Cheung Mam‐Hung , Ho Karin Kar‐Huen , Huen Lok‐Lam , Lee Janet Fung‐Yee , Leung Ka‐Lau 
Published: March 2003

Objective: To elucidate if the course of acute appendicitis is influenced by the variable positions of the appendix. The appendix positions were divided into two groups: (i) the anterior group, which included the anterior, the pelvic and the paracaecal positions; and (ii) the posterior group, which included the retrocaecal and retroileal positions.Method: The hospital records of 161 patients who underwent appendectomy for acute appendicitis from January 2000 to June 2001 at Prince of Wales Hospital were reviewed retrospectively.Results: Clinicians’ delay in reaching the diagnosis was longer in the posterior group (9.9 h vs 5.8 h; P=0.043). However, complicated appendicitis (gangrenous changes, perforation or abscess formation) was not associated with the appendix location (P = 0.078). The median operating time for laparoscopic appendectomies lasted longer in the posterior group (77.5 min vs 60 min; P = 0.02). These patients also had a longer hospital stay (6 days vs 4 days; P = 0.049). No difference was observed among patients who underwent open surgery.Conclusion: Appendices in the ‘hidden’ position did not translate into a higher incidence of complicated appendicitis or postoperative complications except for the slightly longer hospital stay in patients treated by laparoscopy. Therefore, we concluded that the location of appendices does not affect the clinical course of appendicitis in the locality studied.
The effect of water content on the 193 nm excimer laser ablation
Authors: Feltham Mark H , Stapleton Fiona 
Published: March 2003

Abstract Background: Water content of the corneal stroma may influence
excimer laser ablation and may therefore affect residual refractive
error following laser in situ keratomileusis. This study reports associations between water content of hydrogel materials and laser ablation depth. Methods: Hydrated (n = 4)
and dehydrated (n = 4) hydrogel buttons of 38%, 45%, 55% and 69% water content were ablated with the Nidek EC‐5000 ArF 193 nm excimer laser, set to deliver a ‐6.00 DS curvature. Central curvature, optical quality and water content were measured before and after ablation. Hydrated buttons were rehydrated postablation and prior to measurement, to eliminate the effect of water removal during the procedure. The ablation depth per pulse was calculated. Results: The average ablation rate for fully hydrated
buttons was 0.51 ± 0.17 µm.
The ablation rate for hydrated mat­erials (dry component
ablation) reduced with increasing water content (P < 0.001). Dry hydrogel materials (0% water content) had an average ablation rate of 0.23 ± 0.06 µm per pulse. Conclusions: For a constant laser energy output, lower water
content materials ablated to a greater extent than higher water
content materials. This model provides a simple way to assess the
effect of water content and dehydration on myopic laser in situ keratomileusis.
Quantitative analysis of apoptosis in retinoblastoma
Authors: Tatlipinar Sinan , Söylemezoglu Figen , Kiratli Hayyam , Bilgiç Sevgül 
Published: March 2003

Abstract Purpose: The rate of apoptosis in retinoblastoma (Rb) and the factors that may influence this rate, such as therapy prior to surgery, amount of necrosis in tumour tissue, differentiation and laterality of the tumour, were investigated. Methods: Thirty‐one specimens (25 enucleation, six exenteration) with Rb were studied. Prior to final surgery, three patients received systemic chemotherapy, one intravitreal chemotherapy, one transpupillary thermotherapy, one external beam radiotherapy and one high‐dose oral methylprednisolone therapy. The apoptotic index (AI,%) was calculated by counting at least 1000 cells under light microscopy (× 100) using TUNEL (terminal deoxynu­cleotidyl transferase‐mediated dUTP nick‐end labelling) method. Results: The mean AI was 2.75 ± 1.2. No statistically significant association was observed between rate of apoptosis and the presurgical treatment, extent of necrosis, tumour differentiation and laterality. Conclusion: Apoptosis is an important mechanism of cell death, and may be a limiting factor for tumour progression. In this study, the rate of apoptosis was not affected by any of the studied parameters.
Delivery of photocoagulation treatment for diabetic retinopathy at a large Australian ophthalmic hospital: comparisons with national clinical practice guidelines
Authors: Bamroongsuk Parapun , Yi Qing , Harper C Alex , McCarty Daniel J 
Published: March 2003

Abstract Objective: To determine if the delivery of photocoagulation for diabetic retinopathy at a large Australian ophthalmic hospital conforms with Australian National Health and Medical Research Council clinical practice guidelines. Methods: A retrospective medical record review was conducted of all patients who had initial laser treatment for diabetic retinopathy at the Royal Victorian Eye and Ear Hospital from January 1997 to December 1998. Results: The study included 322 eyes from 203 patients. The mean age was 65.8 years (range 18−89 years) and the mean duration of diabetes was 14.7 years (range 1−40 years). Panretinal photocoagulation (PRP) alone was performed in 37 eyes over a mean number of 2.6 sessions. The median waiting time for these procedures was 14 days (range 0−146 days) and the median follow‐up time was 7.1 weeks (range 1−25 weeks). Focal treatment was performed (without PRP) in 238 eyes and 55.5% of these cases required repeat focal treatment for persistent clinically significant macular oedema. Median waiting time for focal treatment was 20 days (range 0−302 days) and the median follow‐up time after treatment was 12.1 weeks (range 1.7−42.0 weeks). Focal and PRP treatment was used in 47 eyes that had maculopathy concurrently with proliferative retinopathy. Focal treatment was applied before (or at the same session as) the PRP wherever possible. Conclusions: The study indicates that the application of photocoagulation and follow up for diabetic retinopathy at this tertiary referral institution conforms closely with Australian clinical practice guidelines.
Vitreal macrophages express vascular endothelial growth factor in oxygen‐induced retinopathy
Authors: Naug H L , Browning J , Gole G A , Gobé G 
Published: March 2003

ABSTRACT Purpose: The possibility of vitreal macrophages playing an angiogenic role in oxygen‐induced retinopathy (OIR) was investigated. Oxygen‐induced retinopathy was produced in newborn animals with the purpose of modeling the proliferative phase of human retinopathy of prematurity (ROP). Materials and Methods: To produce OIR in neonatal mice, litters at postnatal day 7 were placed in 80–90% oxygen for a period of 5 days and then returned to room air. Pups were killed on days 7, 12, 15, 17 and 20 over the postnatal period and were perfusion‐fixed using a saline wash‐out, followed by 4% paraformaldehyde and then India Ink. Eyes were enucleated and either whole‐mounted, or snap‐frozen and cryosectioned. Immunostaining procedures were used to visualize macrophages and vascular endothelial growth factor (VEGF) protein. The primary antibodies used were anti‐F4/80 and antimouse VEGF, respectively. Vitreal macrophages closely associated with the vitreo–retinal interface (within 25 μm of the inner limiting membrane) were counted. In situ hybridization procedures were used to analyse for the presence of VEGF mRNA transcript in vitreal macrophages. Results: Macrophage numbers were found to significantly increase (P < 0.05) in eyes from oxygen‐treated animals compared with those from age‐matched controls. A close spatial relationship was observed between macrophages and vitreal neovascular sprouts. In addition, vitreal macrophages were also found to transcribe and express VEGF in the oxygen‐treated animals during the vasoproliferative phase. Conclusions: Our results raise the possibility that vitreal macrophages play a role in the pathogenesis of OIR and by inference, ROP.