bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fluvastatin remodels resistance arteries in genetically hypertensive rats, even in the absence of any effect on blood pressure
Authors: Ledingham Janet M , Laverty Richard 
Published: March 2003

Summary1. The aims of the present study were, first, to determine whether, in the genetically hypertensive (GH) rat, fluvastatin would lower blood pressure and remodel mesenteric resistance arteries (MRA) and the basilar artery and, second, to see whether treatment with a combination of fluvastatin and the angiotensin receptor antagonist valsartan would have any extra beneficial effect on blood pressure and vascular remodelling.2. Male GH rats had tail‐cuff systolic blood pressure (SBP) monitored weekly from the age of 7 to 12 weeks. Groups (n = 12–14) were treated with fluvastatin (4 mg/kg per day), valsartan (5 mg/kg per day), both mixed in with chow, or a combination of fluvastatin 4 mg/kg per day + valsartan 5 mg/kg per day. Untreated GH and a group of normotensive Wistar (N) rats served as control groups.3. At 12 weeks of age, intra‐arterial (i.a.) blood pressure was measured by femoral cannulation and rats were then perfused (at the SBP of the animal) with Tyrode's solution containing heparin and papaverine followed by 2.5% glutaraldehyde in Tyrode's solution; MRA and basilar arteries were embedded in Technovit. Serial sections were cut and Giemsa stained and stereological methods used to obtain media width, lumen diameter, medial cross‐sectional area (CSA) and the ratio of media width to lumen diameter. Hearts were weighed to determine left ventricular (LV) mass.4. Fluvastatin had no effect on blood pressure or LV mass, whereas valsartan given alone or with fluvastatin significantly reduced both parameters.5. In MRA, fluvastatin reduced medial CSA, increased lumen size and, therefore, probably decreased vascular resistance. The media/lumen ratio was reduced to a level below that seen with the combination treatment and to below that of the N group.6. In the basilar artery, fluvastatin and valsartan showed similar outward remodelling of the lumen and reduction in the media/lumen ratio. The combination treatment group showed, in addition, a reduction in medial CSA and an even lower ratio than the GH group on fluvastatin or valsartan alone or the N group.7. Although fluvastatin has no effect on blood pressure, it does cause significant remodelling of MRA and the basilar artery. These beneficial structural changes in a peripheral resistance artery bed and in an artery involved in regulating resistance in the brain are worthy of further study.
Nitric oxide inhibits renal cytochrome P450‐dependent epoxygenases in the rat
Authors: Oyekan Adebayo 
Published: March 2003

Summary1. Nitric oxide (NO), or peroxynitrite, is known to inhibit haemoproteins, including cytochrome P450 mono‐oxygenases. The present study explores the functional correlates of the inhibition by NO of renal epoxygenase on the vascular responses to arachidonic acid (AA) in the perfused kidney.2. Control kidneys produce measurable amounts of epoxyeicosatrienoic acids (epoxides), which were increased from 0.6 ± 0.2 to 1.8 ± 0.9 ng/min (P < 0.05) following the addition of AA 5 µg. Sodium nitroprusside (SNP; 100 µmol/L), an NO donor, blunted the basal and AA‐stimulated efflux of epoxides.3. Sodium nitroprusside at 10 and 100 µmol/L inhibited renal microsomal conversion of [14C]‐AA to epoxides and its hydration products dihydroxyeicosatrienoic acid (diols). Microsomes harvested from rats 3 h after treatment with Escherichia coli endotoxin (lipopolysaccharide; LPS) also inhibited renal epoxygenase activity (81 ± 8%; P < 0.05).4. In the phenylephrine‐preconstricted and indomethacin (2.8 µmol/L)‐treated kidney, AA at 5, 10 and 25 µg elicited vasodilation that was blunted by miconazole (2 µmol/L), 80 mmol/L KCl, tetraethylammonium (10 mmol/L), a K+ channel blocker, or SNP (100 µmol/L).5. Vasodilation induced by AA, but not 5,6‐epoxide, was reduced in rats treated with LPS, an effect that was abolished by Nω‐nitro‐l‐arginine (100 mg/kg in drinking water for 10 days).6. These data suggest that NO inhibits renal epoxygenase activity and inhibits epoxide‐mediated AA‐induced vasodilation in the rat kidney.
Membrane‐bound and releasable nucleotidase activities: Differences in canine mesenteric artery and vein
Authors: Bobalova Janette , Mutafova‐Yambolieva Violeta N 
Published: March 2003

Summary1. At least two enzymatic activities are proposed to degrade the extracellular ATP: (i) ubiquitously expressed membrane‐bound enzymes (ecto‐nucleotidases); and (ii) soluble (releasable) nucleotidases that are released during stimulation of sympathetic nerves and break down neuronal ATP. No quantitative data have placed the magnitude of these nucleotidase activities into a physiological perspective of neurovascular control.2. We studied comparatively the membrane‐bound and releasable nucleotidase activities in canine isolated inferior mesenteric arteries and veins using 1,N6‐etheno(ε)‐nucleotides (i.e. ε‐ATP, ε‐ADP, ε‐AMP and ε‐adenosine) as exogenous substrates. The enzymatic activities were estimated by measuring the disappearance of the ε‐substrate and appearance of ε‐products by means of HPLC–fluorescence detection during either stimulation of sympathetic perivascular nerves (releasable activity) or in the absence of nerve stimulation (ecto‐nucleotidase activity).3. Incubation of vascular segments with 50 nmol/L ε‐ATP for 60 min resulted in a decrease of the ε‐ATP substrate by 63.5 ± 4.6 and 91.2 ± 6.2% in the artery and vein, respectively. In contrast, the decrease of the ε‐ATP during electrical field stimulation (EFS; 16 Hz, 0.3 msec, 2 min) was 39.8 ± 4.2% in the artery and 13.1 ± 7.3% in the vein. Therefore, the mesenteric arteries demonstrate a greater releasable ATPase activity and a weaker ecto‐ATPase activity than mesenteric veins.4. The degradation of ε‐ADP and ε‐AMP was similar in both blood vessels under either experimental protocol. The ε‐adenosine was not significantly degraded in the absence or presence of EFS.5. These data implicate a differential removal of extracellular ATP as a potential mechanism of serving resistance and capacitance in the splanchnic circulation.
Specification and differentiation processes of secondary mesenchyme‐derived cells in embryos of the sea urchin Hemicentrotus pulcherrimus
Authors: Tokuoka Miki , Setoguchi Chihiro , Kominami Tetsuya 
Published: March 2003

Four types of mesoderm cells (pigment cells, blastocoelar cells, coelomic pouch cells and circumesophageal muscle cells) are derived from secondary mesenchyme cells (SMC) in sea urchin embryos. To gain information on the specification and differentiation processes of SMC‐derived cells, we studied the exact number and division cycles of each type of cell in Hemicentrotus pulcherrimus. Numbers of blastocoelar cells, coelomic pouch cells and circumesophageal muscle fibers were 18.0 ± 2.0 (36 h post‐fertilization (h.p.f.)), 23.0 ± 2.5 (36 h.p.f.) and 9.5 ± 1.3 (60 h.p.f.), respectively, whereas the number of pigment cells ranged from 40 to 60. From the diameters of blastocoelar cells and coelomic pouch cells, the numbers of division cycles were elucidated; these two types of cells had undertaken 11 rounds of cell division by the prism stage, somewhat earlier than pigment cells. To determine the relationship among the four types of cells, we tried to alter the number of pigment cells with chemical treatment and found that CH3COONa increased pigment cells without affecting embryo morphology. Interestingly, the number of blastocoelar cells became smaller in CH3COONa‐treated embryos. In contrast, blastocoelar cells were markedly increased with NiCl2 treatment, whereas the number of pigment cells was markedly decreased. The number of coelomic pouch cells and circumesophageal muscle fibers was not affected with these treatments, indicating that coelomic pouch and muscle cells are specified independently of, or at much later stages, than pigment and blastocoelar cells.
Second species in the Australian ant genus Peronomyrmex Viehmeyer (Hymenoptera: Formicidae)
Authors: Shattuck Steven O , Hinkley Simon 
Published: March 2003

AbstractA second species of the rare Australian ant genus Peronomyrmex is described

from Victoria. This new species, P. bartoni, represents only the third time

the genus has been collected, the previous records being the holotype of P. overbecki Viehmeyer from north‐eastern New South Wales and a collection, subsequently lost, from northern Queensland.
Use of an emergency sedation protocol to assist intubation in helicopter patient retrieval in Victoria
Authors: Sams James , Kelly Anne‐Maree 
Published: March 2003

Abstract Objectives: To review emergency sedation intubation as practised in the Melbourne‐based ambulance helicopter. Specifically, to describe patient profiles, drug dosage, difficulties encountered, success rate and patient outcomes. Methods: Retrospective review of all helicopter primary and secondary retrieval patients, who received application of the emergency sedation intubation protocol using morphine and diazepam during a 3 year period (January 1995 to December 1997). Data were collected from an audit of patient care records completed by flight paramedics and from hospital records. Results: Emergency sedation intubation was performed on 128 patients: 103 adults and 25 children. The median dose of drugs required for emergency sedation intubation by adult patients was 20 mg morphine and 20 mg diazepam. The overall success rate for emergency sedation intubation was 94.5%, with 73.6% of these being successful intubations at the first attempt. On intubation, 54.1% of patients were fully relaxed, while a gag reflex was still present in 45.9% of patients during or just after emergency sedation intubation. Twenty‐two per cent of patients had a change in blood pressure of more than 20 mmHg. The maximum rise in blood pressure was 60 mmHg and the maximum fall was 80 mmHg. Conclusions: Flight paramedics achieved a high success rate for intubation with the morphine/ diazepam emergency sedation intubation protocol. However, there was still a significant percentage of patients for whom more than one attempt was required to achieve emergency sedation intubation and, in almost half the patients, gag reflexes remained present either during or immediately after intubation. Additionally, some patients experienced blood pressure changes following intubation that may have potential adverse consequences in terms of compromised cerebral perfusion or rises in intracranial pressure. Consideration should be given to revision of the protocol to allow the use of neuromuscular blocking agents and alternative airway management techniques, such as cricothyroidotomy, for specified circumstances in the aeromedical environment.
Air embolism in chest trauma
Authors: Holdgate Anna , Arendts Glenn 
Published: March 2003

AbstractAir embolism is a recognized complication of penetrating chest trauma. A case of fatal air embolism is presented and the pathophysiology of both venous and arterial air embolism is described. Air embolism can be precipitated by positive intrathoracic pressure in the presence of open vascular injury and can present as unexpected cardiovascular collapse following intubation and positive pressure ventilation. Strategies for preventing air embolism include minimum airway pressures during ventilation, single lung ventilation via a double lumen tube and maintenance of adequate pulmonary venous pressure with intravenous fluids. Established air embolism is managed by patient positioning to direct air bubbles away from vital organs, aspiration of intravascular air, minimizing air bubble size and repairing the underlying injury.
Access to care: What should we be measuring?
Authors: Kennedy Marcus P 
Published: March 2003

AbstractSome of the key measures on which emergency departments are judged concern access to care. In Australasia, the most common current measure of access is the percentage of patients who are seen within a specified time for each category of the national triage scale. Access measures regarding availability of in‐patient beds is less uniform, but tends to be related to the number of patients who spend longer than a specified time in the emergency department. There are, however, measurables that are demonstrative of departmental process rather than being simple waiting time quantiles. These include mean and median elapsed times, together with standard deviations and coefficient of variation for each of the indicators. These measures better describe the central tendency and spread of performance, both of which are fundamentally important to any measure of the quality of process. This paper discusses the use of these broader and more descriptive indicators of process.
Validation study of injury surveillance data collected through Queensland hospital emergency departments
Authors: Hockey Richard , Horth Adrian , Pitt W Robert 
Published: March 2003

Abstract Objective: The objective of this study was to assess and validate the EDIS (Emergency Department Information System) as a means of acquiring Level 2 injury surveillance data as defined by the National Data Standards for Injury Surveillance in public hospital emergency departments in Queensland. Methods: This validation was based on interviews with patients presenting to selected emergency departments in Queensland for treatment of an injury which was then compared to data obtained from emergency department staff completing the routine medical record for these patients using EDIS. To assess the level of coding variability and set baseline levels of agreement the data were separately coded by three experienced coders and the level of agreement evaluated. At the time of the validation emergency department staff were also asked to complete a questionnaire relating to their attitudes towards EDIS and to injury surveillance. Results: A total of 572 cases of injury were collected during the period of the validation of which 509 (89.0%) corresponded to an injury recorded in EDIS. Demographic details collected in the emergency department data were coded correctly in almost all cases. The exception was Indigenous status where the emergency department systems recorded only 38% of the Indigenous cases correctly. Injury data fields were better than 85% complete for two sites but only 65% complete for the third. Coding agreement between Emergency Department Information System and the validation study for items relating to the injury event varied from 95% for Intent to 50% for Activity when injured. The interrater agreement analysis revealed that the highest agreement between the coders was for intent (94–96%) while the lowest was for main injury factor (63–78%). The results of the emergency department staff satisfaction survey showed a high acceptance of EDIS and injury surveillance in general. Conclusions: This analysis demonstrates that injury surveillance is a viable proposition for most emergency departments using computerized patient management systems designed with injury surveillance in mind. Emergency department‐based injury surveillance provides a pro‐active mechanism for monitoring injuries in specific areas of known concern, identifies previously unrecognized injury events and risk factors and permits the evaluation of preventive strategies.
Intravenous lignocaine as pretreatment for intubation of patients with acute severe head injury
Authors: Monaghan Mark 
Published: March 2003

AbstractIntravenous lignocaine at a dose of 1.5–2.0 mg/kg is frequently included in intubation protocols for patients with acute severe head injury. This literature review attempts to provide an evidence base for this. A Medline search and review of all relevant articles post‐1966 was undertaken. There is evidence that lignocaine has a beneficial effect on intracranial and intraocular pressures. Neuroprotection is demonstrated in some animal models. There is, however, no evidence that lignocaine improves outcome. This article recommends using lignocaine in pre‐intubation for patients where a rise in intraocular pressure is a concern (e.g. penetrating eye injury), but cannot, on evidence alone, justify its inclusion in head injury protocols.
The CDC Pacific emergency health initiative: A pilot study of emergency preparedness in Oceania
Authors: Keim Mark E , Rhyne Gary J 
Published: March 2003

AbstractObjective:Environmental emergencies and disasters are becoming more frequent in developing nations. Between 1992 and 1996, disasters affected an annual average of 4.5 million Oceania residents. Unfortunately, public health planners in the region and responders throughout the world have little evidence on which to base measures of emergency preparedness. Indicators of preparedness must be identified, implemented and evaluated before the effectiveness of emergency planning interventions can be measured accurately. The aim of this study was to perform an objective evaluation of emergency preparedness among five nations in Oceania.Methods:A standardized retrospective review of national‐level public health and institutional‐level hospital emergency operations plans from a convenience sample of five Pacific nations or territories was performed. In addition, in‐country interviews, observation of operations and review of documentation were conducted. The rates of affirmative responses to 957 yes/no queries in the questionnaire were tabulated according to major emergency operational planning concepts and categories of emergency support functions.Results:The study revealed remarkably low levels of emergency planning and preparedness among health and medical sectors of five Pacific islands.Conclusion:These data suggest a very low level of host national capacity for development of preparedness. Further investigation is necessary to define this need throughout this region of Oceania.See Commentary, page 143.
Reliability of modern microwave ovens to safely heat intravenous fluids for resuscitation
Authors: Delaney Anthony 
Published: March 2003

AbstractObjective:To determine if intravenous fluid heated in modern microwave ovens is warmed to a consistently safe temperature, as has been advocated in a number of texts and journals.Methods:Five, 1L bags of normal saline in Viaflex (Baxter Healthcare, Old Toongabie, NSW, Australia) containers were heated for 2 min on high setting in 16 different microwave ovens. The output power ranged from 650 to 1000 W. All microwave ovens were equipped with electronic timers and turntables. Initial and final temperatures were recorded with a TestoTerm 1100 electronic thermometer (Dade Behring, Lane Cove, NSW, Australia), accessing the centre of the fluid via the injection port. The average and standard deviation for each measurement was determined for each microwave oven.Results:In nine out of the 16 microwaves (56%) tested, the fluid had reached an average final temperature greater than 42°C and thus was greater than the recommended maximum temperature for the heating of intravenous fluids. All microwave ovens with an output power of greater than 900 W overheated the fluids. However 13/16 microwaves (81%) had a temperature range less than 3°C, thus if correctly calibrated could be appropriate for heating intravenous fluid for resuscitation.Conclusions:The increased output power of modern microwave ovens can lead to overheating of resuscitation fluids, if the simple algorithm currently recommended is followed, leading to potentially serious complications. Microwave heating of intravenous fluid could be a safe, simple, cheap and effective means of heating intravenous fluids for resuscitation, but care needs to be taken to calibrate individual machines to ensure a safe temperature is reached.
Prevertebral haematoma after thrombolysis: An unusual cause of airway obstruction
Authors: Semmonds Alison K , Doherty Steven 
Published: March 2003

AbstractA case report of prevertebral haematoma causing airway obstruction following thrombolytic therapy for acute myocardial infarction is presented. The management options for airway obstruction, after thrombolytic therapy, are discussed.
Small emergency departments: Does size matter?
Authors: Smith Brendon 
Published: March 2003

AbstractAn emergency department provides care for a full spectrum of undifferentiated disorders and its size may influence how well it can do so. Outcomes research in emergency medicine is limited, although outcomes in severe trauma and acute coronary syndromes have been shown to be influenced by available facilities and expertise. A department can be too small to provide the full spectrum of emergency care, as has been documented with General Practice Casualty Units. Some research suggests that a critical mass is required to ensure acceptable outcomes. Small departments may operate in a hierarchical system, led by teaching hospitals setting practice standards. However, these may be opinion as much as evidence based and not broadly applicable as a universal practice standard. Small departments can be overwhelmed by trauma and other major cases or when the teaching hospital is unable to accept emergency patients or transfers because they are operating at capacity. Further outcomes research and audit of individual hospitals is required to determine a minimum optimum size for emergency departments. See Commentary, page 12.
Sustained‐release bupropion overdose: A new entity for Australian emergency departments
Authors: Paoloni Richard , Szekely Ilona 
Published: March 2003

AbstractBupropion hydrochloride (Zyban, Glaxo Wellcome Australia, Melbourne, Vic., Australia) was released in Australia in November 2000 as adjunctive therapy to assist with smoking cessation, having previously been used as an antidepressant in the US since 1989. The toxicity profile of bupropion hydrochloride in overdose differs considerably from other antidepressants, with prominent neurological manifestations and little cardiovascular toxicity. A case of bupropion overdose demonstrating the typical toxic syndrome is presented, together with a review of the literature and a discussion of the magnitude of the demand for bupropion and of the potential differences in presentation of overdoses in Australia.
Efficacy of ciprofloxacin in urinary tract infections and risk factors for ciprofloxacin‐resistant infections
Authors: Daniel Tai‐Yam Lee , Velayudhan Venu , Samuel Po‐Yin Kwok 
Published: March 2003

Objectives: The study was undertaken to assess the safety and efficacy of sequential intravenous and oral ciprofloxacin in the treatment of moderate‐to‐severe urinary tract infections (UTI), and to identify risk factors for acquiring UTI caused by ciprofloxacin‐resistant organisms. Materials and Methods: Using a prospective, open, single‐centre study design, hospitalized patients with a clinical diagnosis of moderately severe UTI were enrolled. After a minimum of 3 days of intravenous ciprofloxacin, patients were switched to oral therapy. Assessment for response and analysis of risk factors were performed at the end of therapy. Results: Between December 1996 and November 1997, a total of 66 patients met the criteria for efficacy evaluation. Among the 55 patients with ciprofloxacin‐sensitive organisms, 51 patients (93%) were cured. Persisting infection was noted in three patients (5%) and one patient (2%) was re‐infected with a ciprofloxacin‐resistant organism. Of the organisms isolated, 14 (19%) were resistant to ciprofloxacin. The presence of prostatic obstruction (odds ratio 6.02, 95% confidence interval (CI) 1.28–28.30, P = 0.02) and recurrent UTI (odds ratio 8.63, 95% CI 1.81–41.17, P = 0.007) were independently associated with infections caused by ciprofloxacin‐resistant organisms. Adverse events were reported in 5 patients (8%) but no premature discontinuation or mortality was documented. Conclusion: Sequential therapy with oral therapy after initial parenteral ciprofloxacin is safe and effective in the management of moderate‐to‐severe UTI in appropriately selected patients.