bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL SIGNIFICANCE OF MEASUREMENT OF RESTING ENERGY EXPENDITURE IN CHILDHOOD
Authors: Amagai Teruyoshi , Mouri Takeshi , Kirii Kyoko , Hori Tetsuo , Kaneko Michio , Ohkawa Haruo 
Published: March 2003

Summary1. Biliary atresia (BA), as a common disease in Japan, and cystic fibrosis (CF), as an extremely uncommon disease in Japan, were selected to assess the clinical significance of measurement of energy expenditure (EE).2. Energy expenditure was significantly higher in children with BA than in normal children.3. Measurement of EE in BA lead to clues to resolving its mechanism by novel assessment of interleukin‐6 and leptin.4. Energy expenditure in children with CF is also higher, but this has been addressed by nutritional intervention with additional calories.5. Individualization of EE measurement is necessary in the analysis of pathological mechanisms and nutritional management of patients with both common and uncommon diseases.
Accuracy of flow and sensors of indirect calorimetry for neonates and infants: Using mass spectrometry and a pneumotachogram
Authors: Amagai Teruyoshi , Mouri Takeshi , Ohkawa Haruo , Nishi Isao 
Published: March 2003

Summary1. The accuracy of measurements of flow rate and concentrations of O2 and CO2 in expiratory gas by indirect calorimetry (IC) using paediatric and adult circuits were assessed by mass spectrometry and a pneumotachogram, which have been proven as the most reliable instruments for these purposes.2. In the paediatric circuit, all measurements were demonstrated to be reliable: error rates for flow rate, O2 concentration and CO2 concentration were +3.13, +2.66 and −6.63%, respectively. All were within the 10%, which is acceptable as a biological error.3. However, in the adult circuit of IC, all measurements were reliable except for measurements of CO2 concentration: error rates for flow rate, O2 concentration and CO2 concentration were +2.82, +1.64 and +11.42%, respectively.4. A fluctuation phenomenon of expiratory gas concentration was observed only in IC. Mass spectrometry did not show this phenomenon. This phenomenon seems to be derived from the IC machine itself.
Adelphocorisella Miyamoto and Yasunaga newly recorded from Australia, with the description of a new species (Heteroptera: Miridae: Mirinae)
Authors: Malipatil MB , Chérot F 
Published: March 2003

Abstract Adelphocorisella australis sp. n. is described from north Queensland. This, the first representative of the genus known from Australia, is compared with the two previously described species, both from Japan.
Which triage category patients die in hospital after being admitted through emergency departments? A study in one teaching hospital
Authors: Dent Andrew , Rofe Geoff , Sansom Guy 
Published: March 2003

Abstract Objectives: To quantify the number of deaths per triage category (scale 1–5, Australian National Triage Scale) occurring after admission to hospital via an emergency department and to examine the causes of death in each category. Setting: St Vincent's Hospital, Melbourne (Victoria, Australia) is an acute adult tertiary referral hospital. Methods: Electronic collection of all hospital admissions and their subsequent destination for the calendar year 1997, with chart and/or postmortem review to determine the cause of death. Results: The percentage of deaths per triage group decreased with urgency. Numerically, the largest group of all admissions and admissions followed by deaths consist of patients presenting in category 4 (semi‐urgent). Conclusions: Triage categories may be a useful tool for prioritizing acute patients, but patients in low triage categories often have fatal illnesses. Performance measurements and workload assessments for emergency departments may need to involve category 4 patients to take account of this factor.
Slow‐release potassium overdose: Is there a role for magnesium?
Authors: Davey Michael , Kuhn Marie 
Published: March 2003

AbstractSlow‐release potassium overdose is rare and often fatal. Recommended treatment is derived from that of other, more common, causes of hyperkalaemia and from the general principles of overdose management. We present a patient who survived after a massive slow‐release potassium (Slow‐K®) ingestion resulting in a peak potassium concentration of 12 mmol/L, the highest yet reported. A review of previously reported cases of potassium overdose and a summary of recommended therapies for the treatment of hyperkalaemia are presented. Laboratory and current clinical evidence support the addition of magnesium to standard therapy for potassium overdose, particularly where there is concern about increasing doses of calcium; this suggestion requires further clinical research.
Penetrating and blunt cardiac trauma: Diagnosis and management
Authors: Sava Jack , Demetriades Demetrios 
Published: March 2003

AbstractCardiac trauma is often lethal in the field, but the majority of patients may be salvaged if they survive transport. Management of penetrating injury depends on rapid diagnosis of haemopericardium and prompt surgical repair. Identification of blunt injury is a diagnostic challenge, but most patients do well with appropriate monitoring and prompt recognition of complications. A review of diagnosis and management of penetrating and blunt cardiac injury is presented with extensive references.
Successful treatment of presumed death‐adder neurotoxicity using anticholinesterases
Authors: Little Mark , Pereira Peter 
Published: March 2003

AbstractWe present the first reported case in Australia of anticholinesterases being used successfully in conjunction with antivenom to treat neurotoxicity following death‐adder envenomation. A 49‐year‐old man was bitten by his pet death adder. He developed significant neurotoxicity due to delayed presentation and suboptimal first aid. Following one ampoule of polyvalent antivenom which produced an allergic reaction, administration of neostigmine and atropine facilitated aeromedical evacuation without the need for mechanical ventilation. After three ampoules of monovalent death‐adder antivenom at the receiving hospital, antivenom supplies were exhausted. Further neostigmine and atropine resulted in complete resolution of paralysis, allowing discharge. Anticholinesterases may reduce the dose of antivenom required to treat death‐adder envenomation. They may also be of use in cases of allergic reactions to antivenom, and in reducing the need for endotracheal intubation.
Drug‐ and poison‐related deaths in Victoria during 1997
Authors: Bystrzycki Adam , Coleridge John 
Published: March 2003

Abstract Objective: To audit deaths due to prescription or illicit drugs, alcohols or poisons (hereafter referred to as ‘drugs’) occurring in Victoria in 1997 and to examine the classes of drug causing death. Method: Retrospective review of all deaths reported to the Victorian State Coroner in 1997 in which toxicological investigation was undertaken and drugs were determined to have caused death. Deaths due to heroin and carbon monoxide were separately audited by the Victorian Institute of Forensic Pathology and are excluded from this paper. Results: One hundred and seventy‐three people died with an average age of 41 years. The most frequent cause of death was combined drug overdose (64 cases, 37%). Ethanol was the commonest single drug causing death (32 cases, 18%), followed by prescribed opiates (18 cases, 10%) and tricyclic antidepressants (15 cases, 9%). Four teenagers died while inhaling butane or propane. In 14 cases (8%), toxic levels of selective serotonin and noradrenaline re‐uptake inhibitor antidepressants were found in combination with drugs known to produce fatal drug interactions. Conclusions: Drug overdose remains a common cause of death. Prescribed opiates and ethanol are most frequently associated with death, followed by the older and more dangerous antidepressant medications. The newer selective serotonin and noradrenaline re‐uptake inhibitors may not be as safe as was initially proposed.
Non‐medical technicians reduce emergency department waiting times
Authors: Grouse Andrew , Bishop Rod 
Published: March 2003

AbstractObjective:To observe the impact of trained non‐medical technicians on emergency department waiting times. The technicians were to perform minor procedures that had previously been performed by medical staff.Methods:A prospective cohort study with two matched groups of patients. One group comprised patients who presented to the emergency department on days when the technicians worked (working group) and the other comprised patients who presented when the technicians did not work (control group). The waiting times for patients in each group were compared.Results:The median waiting time was 10 min shorter in the working group than the control group (P < 0.0001). This reduction was confined to triage categories 3 and 4. The number of patients who left without being seen was reduced from 8.2% in the control group to 5.3% in the working group (P < 0.00001).Conclusion:When added to the normal staff complement, non‐medical technicians reduce patient waiting times in the emergency department.
Spontaneous pneumomediastinum, pneumothorax and ecstasy abuse
Authors: Mazur Stefan , Hitchcock Thomas 
Published: March 2003

AbstractA case report is presented of a patient with bilateral pneumothoraces and spontaneous pneumomediastinum associated with ecstasy use. Pneumothorax and spontaneous pneumomediastinum should be considered in an ecstasy user who complains of chest pain, neck pain or shortness of breath.
Are methods used to estimate weight in children accurate?
Authors: Black Karen , Barnett Peter , Wolfe Rory , Young Simon 
Published: March 2003

AbstractObjective: The exact weight of a child undergoing resuscitation is usually not known. Several methods to estimate a child’s weight have been proposed. We evaluated six of these methods to determine their accuracy and clinical usefulness across a range of weights and ages.Method: Children attending a tertiary paediatric emergency department on 30 non‐consecutive days were weighed, a length or height was obtained and an estimation of body habitus (slim, average or heavy) made by a single investigator, Karen Black (KB). All children less than 145 cm were also measured using the Broselow tape. Six methods of weight estimation were employed and the calculated weight compared to the true weight. The weight estimation methods evaluated were the advanced paediatric life support (APLS) method, Broselow tape, devised weight estimation method (DWEM), Oakley table, Traub–Johnson and the Traub–Kichen methods.Results: Four hundred and ninety‐five children were included in the study. Children were evenly distributed among the weight groups of less than 10 kg, 10–25 kg, 25–40 kg and over 40 kg. The methods with the best overall performance were the devised weight estimation method and Broselow tape although the latter has a length limitation of 145 cm. The other methods performed well in the middle two weight groups but poorly outside these groups.Conclusions: The most accurate methods of weight estimation in children are the Broselow tape and the devised weight estimation method . We recommend the use of either of these methods in emergency situations where direct weighing is not possible.
High‐pressure water injection injury: Emergency presentation and management
Authors: Subramaniam Rathan M , Clearwater Gary M 
Published: March 2003

AbstractPresentations of high‐pressure water blaster injuries to the emergency department are varied. Though these injuries are sometimes described as a ‘benign variant’ of high‐pressure injection injuries, external appearances can be deceptive. These injuries can produce an unexpected pattern of severe internal injury and infectious complications. Such injuries are surgical emergencies and must be evaluated quickly and thoroughly in the emergency department. We review the current literature of these injuries and present the first reported case involving a forearm injury.
Is a negative dipstick urinalysis good enough to exclude urinary tract infection in paediatric emergency department patients?
Authors: Doley Andrew , Nelligan Melissa 
Published: March 2003

AbstractBackground: Urinary tract infection is a common cause of serious bacterial infection in young children. The non‐specific presentation has implications for misdiagnosis and the potential for long‐term complications.Aims: To determine if a negative dipstick urinalysis is adequate to exclude urinary tract infection in children aged 0–10 years. Data was subdivided into two age groups: 0–2 years and 2–10 years.Methods: Retrospective case note review over an 8‐month period. Cases included required a printed urinalysis recorded from the Clinitek 50 (Bayer) machine and a printed microscopy and culture result. We defined a negative urinalysis as being negative for all of blood, protein, leucocytes and nitrites. A total of 375 cases were included for statistical calculation.Results: Three hundred and seventy‐five cases gave a prevalence of 10.7% with a sensitivity of 92.5%, specificity of 39.4% and a negative predictive value of 97.8%. In the 0–2‐year‐old group, we demonstrated a prevalence of 15%, a sensitivity of 87.5%, specificity of 39.7% and a negative predictive value of 94.7%. This compares to the older group (2–10 years) with a prevalence of 7.0%, a sensitivity of 100%, specificity of 39.7% and a negative predictive value of 100%.Conclusions: Prevalence of urinary tract infection varied with age with a higher prevalence in the 0–2 years age group. The lower negative predictive value and the higher clinical importance in this age group means that dipstick urinalysis is inadequate to exclude urinary tract infection. Conversely, we believe that children in the 2–10 years age group can adequately have urinary tract infection excluded with a negative dipstick urinalysis.
Technique for safe placement of reusable trocars during endoscopic extraperitoneal inguinal hernioplasty
Authors: Lau Hung , Lee Francis , Patil Nivritti Gajanan , Yuen Wai‐Key 
Published: March 2003

Endoscopic extraperitoneal inguinal hernioplasty has become an established technique for the repair of inguinal hernias. To reduce the cost of the procedure, reusable metallic trocars are substituted for disposable trocar ports. However, the use of metallic trocars is often associated with pericannula air leak and uncontrolled sliding movements. The insertion of the primary subumbilical trocar by open dissection technique has been widely accepted but percutaneous placement of secondary trocars with sharp obturators, even under direct endoscopic vision, is still potentially hazardous in the confined extraperitoneal space. We have, therefore, modified our method of placement of secondary trocars with finger dissection and railroad techniques. Making the trocar snug with a purse‐string suture over the fascial opening can substantially reduce peri‐cannula air leak, diminish the sliding movement of the cannula and facilitate closure of the wound. To avoid the risk of visceral and major vascular injuries, all endoscopic instruments are blunt‐tipped. Open dissection combined with finger dissection and railroad techniques enables the safe placement of trocars for endoscopic extraperitoneal inguinal hernioplasty.
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NON‐SURGICAL TREATMENT OF CHRONIC SUBDURAL HAEMATOMA—ROLE OF STEROID
Authors: Sun David T.F. , Boet Ronald , Poon W.S. 
Published: March 2003

Aim:Response to surgery has been very satisfactory and this is generally considered the treatment of choice for chronic subdural haematoma (CSDH). In this study, however, we would like to identify the group of patients who can be managed with steroid (dexamethasone) successfully without surgery.Method:From a series of 121 cases of CSDH being managed in our hospital during the period from January 1998 to December 1999, we studied the 24 patients who are intended to be treated initially with steroid alone. Clinical features and outcomes were compared with the other 97 patients.Results:There were 70 men and 51 women, 37–91 years old being treated in our hospital with CSDH. Twenty‐four of them were initially planned to be treated with steroid alone (varied from 4 to 21 days). Of these, five (20%) presented with focal weakness while seven patients (30%) were confused on admission. The maximum thickness of the CSDH varied from 5 mm to 30 mm. Only one of them (4%) required drainage later, which was done 1.5 months after the presentation. Two of them (8%) were severely disabled while all the others (92%) had favourable outcomes. No mortality was noted in this group of patients. No significant complication from steroid was seen. Fourteen other patients were not given steroid and not planned for surgery initially. One of them died (7%) while two of them (14%) required later drainage and the other one defaulted follow up. Eighty‐four patients underwent surgical drainage. Thirteen of them were not given steroid and two of them (15%) required redrainage. The remaining 71 patients underwent surgical drainage in addition to steroid administration. The width of the subdural haematoma varied from 10 mm to 40 mm. Four of them (6%) required repeated drainage. Two mortality cases with sepsis and liver failure respectively were noted in this group and one other death was due to intracerebral haemorrhage 1 month after the procedure (mortality = 4%). Two (3%) were severely disabled. All the others (93%) had favourable outcome.Conclusion:We believe that, with careful case selection, CSDH can be safely managed conservatively with steroids initially. Surgical drainage can be reserved for those showing features of rapid increase in intracranial pressure or comatose patients. This regimen will help to avoid unnecessary surgical risks particularly for those elderly and unfit patients.
Prediction of common bile duct stones and cholangitis in acute biliary pancreatitis
Authors: Wong Simon Kin‐Hung , Lam Yuk‐Hoi , McKay Colin John , Lee Danny Wai‐Hung , Sung Joseph Jao‐Yiu , Chung Sydney Sheung‐Chee 
Published: March 2003

Objective:To define factors in predicting common bile duct (CBD) stones and cholangitis in patients with acute biliary pancreatitis.Method:Retrospective analysis of patients with acute biliary pancreatitis who received early (< 72 h) endoscopic retrograde cholangiopancreatography (ERCP). Data on their clinical presentation, severity of attacks, liver function on admission, ERCP findings and bile culture results were analysed.Results:Sixty‐four patients admitted with acute biliary pancreatitis were referred for early ERCP. Common bile duct stones were found in 33 patients (52%). Only five (8%) patients presented with symptoms suggestive of coexisting acute cholangitis (fever, abdominal pain and jaundice). Bile cultures were positive in 12 of 18 specimens (67%), and nine of these (75%) were associated with choledocholithiasis. Variables were entered into a logistic regression analysis and a high bilirubin level on admission was the only significant factor in predicting ductal stones.Conclusion:In the locality of Hong Kong the incidence of choledocholithiasis is high in acute biliary pancreatitis and only a high bilirubin level can predict CBD stones. Although many patients have infected bile, overt cholangitis is relatively uncommon. Chinese Abstract imageimageimageimageimage
Perception of native grassland in southeastern Australia
Authors: Williams Kathryn , Cary John 
Published: March 2003

SummaryNative grasslands are considered to be one of Australia’s most threatened ecosystems, yet relatively little is known about human preferences and attitudes that contribute to continued degradation of these landscapes. In a study conducted in southeastern Australia, landholders were asked to assess the agricultural, ecological and aesthetic value of native grasslands and other rural landscapes depicted in colour photographs. The results confirm low preference for treeless landscapes. Landholders’ preferences for native grassland on their own property appeared most closely related to the perceived agricultural and aesthetic value of the grassland scene. This paper discusses the implication of these findings for programmes seeking to protect native grasslands on private properties.Key wordsenvironmental attitudes, native grasslands, perception.
Reversal of floppy eyelid syndrome with treatment of obstructive sleep apnoea
Authors: McNab Alan A 
Published: March 2003

ABSTRACT Purpose: To describe the beneficial effects of treatment of obstructive sleep apnoea on the symptoms and signs of floppy eyelid syndrome. Method: A case of sleep apnoea with associated floppy eyelid syndrome is reported. Results: A 32‐year‐old man presented with left floppy eyelid syndrome and a known diagnosis of obstructive sleep apnoea. He underwent treatment for 4 years with continuous positive airways pressure by mask during sleep and the symptoms and signs of his floppy eyelid syndrome disappeared. Conclusion: Treatment of obstructive sleep apnoea may reverse the changes of floppy eyelid syndrome.
Low molecular weight analysis of tears using matrix assisted laser desorption ionization‐time of flight mass spectrometry
Authors: Mulvenna Irene , Stapleton Fiona , Hains Peter G , Cengiz Arzu , Tan Maxine , Walsh Bradley , Holden Brien 
Published: March 2003

ABSTRACTMany low molecular weight substances in human tears, including protein and lipid species, have yet to be characterized. Some of these uncharacterized substances may well be important in the pathogenesis of ocular surface disease or in ocular discomfort. The aim of this study was to build a biochemical profile of low molecular weight species in tears, and to determine its repeatability. A total of 80 tear samples were collected from 11 subjects. Tear samples were dialysed to remove salts, added to a matrix of α‐cyano‐4‐ hydroxycinnamic acid, and analysed using matrix‐assisted laser desorption ionization‐time of flight (MALDI‐TOF) mass spectrometry. Species were separated based on their mass to charge ratio (m : z). The repeatability of the appearance of the different species was analysed using logistic regression and diurnal and day‐to‐day repeatability were ascertained. Peptides were identified in the range of 848–3897 Da. Of these, 39 peptides were found to be present in more than 10 / 80 samples. There was no diurnal variation in the peptides. All species were found to occur repeatably, with the exception of peptide 1653 Da. This study has demonstrated that the majority of low molecular weight species in tears are repeatably present and do not exhibit diurnal variation. Further study aims to characterize these species and to identify changes in tear profiles between subject groups.
A comparison of short wavelength automated perimetry with frequency doubling perimetry for the early detection of visual field loss in ocular hypertension
Authors: Landers John , Goldberg Ivan , Graham Stuart 
Published: March 2003

ABSTRACT Background: Achromatic automated perimetry (AAP) is limited in its ability to detect very early visual field loss in ocular hypertensive patients. Tests targeting axons that are selectively damaged, or have low redundancy, may detect visual field losses before they are seen on AAP. It has been claimed that short wavelength automated perimetry (SWAP) and frequency doubling perimetry (FDP) are two tests that provide early detection. Methods: Patients (n = 62) were selected on the basis that they had raised intraocular pressure but normal visual fields detected by AAP. A SWAP and an FDP was performed on each of the patients and the results compared. Fields were scored as either normal or abnormal based on criteria used in previous studies. Results: On comparing FDP with SWAP as the ‘gold standard’, a sensitivity of 88.9% and a specificity of 96.2% was found, showing a high concordance between the two tests. Conclusion: These results suggest that as SWAP may be predictive of AAP visual field loss, FDP may be similarly predictive.