bluuebunny/crossref_metadata_2025_split huggingface dataset:
Information sources accessed by parents following childhood poisoning
Authors: Rush Jennifer A , Reith David M 
Published: July 2003

AbstractObjective: To ascertain the sources of information accessed by parents/caregivers following an incident of child poison ingestion, prior to their presentation to an ED.Methods: A questionnaire based survey of the parents/caregivers of children presenting to the Mater Children's Hospital Emergency Department with poisoning from March to October 2001.Results: A total of 121 parents/caregivers were surveyed. In 117 cases (97%), information was sought prior to presentation. The Poisons Information Centre (PIC) was the initial source of information in 39 cases (32%), the ED in 25 cases (21%) and the family doctor (by telephone or consultation) in 21 cases (17%). Poisons Information Centres, emergency departments and family doctors were the sole sources of information for 18%, 15% and 12% of cases, respectively. For 46% of cases multiple sources of information were accessed, and overall, in 57 cases (47%) the Poisons Information Centre was accessed, the ED in 38 cases (31%) and the family doctor in 34 cases (28%).Conclusions: Poisons Information Centres are under‐utilized as the first point of contact after childhood poisoning but in nearly all cases of poison ingestion that presented to the ED, information was sought prior to presentation and in most cases this was from direct contact with a health professional.
The status of the Glasgow Coma Scale
Authors: Gabbe Belinda J , Cameron Peter A , Finch Caroline F 
Published: July 2003

AbstractThe Glasgow Coma Scale (GCS) was first introduced in the 1970s to provide a simple and reliable method of recording and monitoring change in the level of consciousness of head injured patients. Since its introduction, the GCS has been widely utilized in the trauma community and its use expanded beyond the original intentions of the score. In the context of traumatic injury, this paper discusses the use of the GCS as a predictor of outcome, the limitations of the GCS, the reliability of the GCS and potential alternatives through a critical review of the literature. The relevance to Australian trauma populations is also addressed.
Emergency management of eclampsia and severe pre‐eclampsia
Authors: Lew Martin , Klonis Evangelos 
Published: July 2003

AbstractEclampsia and severe pre‐eclampsia are rare, but potentially life‐threatening conditions that emergency physicians must be able to diagnose and treat promptly, because initial presentations to the ED are real possibilities. The treatment of the major complications of this disorder, hypertension and seizures, have been the focus of much research. Magnesium sulphate is now the first line agent for acute treatment and prophylaxis of seizures in eclampsia and pre‐eclampsia. Severe pre‐eclampsia should be treated with magnesium to prevent progression to eclampsia. Severe hypertension requires treatment with an intravenous antihypertensive agent familiar to the clinician. No single antihypertensive has been proven to be better than another, although in Australia, hydralazine is probably the initial intravenous agent of choice. Routine use of invasive haemodynamic monitoring and volume expansion is not recommended and consultation with obstetric colleagues is essential.
Giving a voice to the community: A qualitative study of consumer expectations for the emergency department
Authors: Stuart Peter John , Parker Steven , Rogers Mark 
Published: July 2003

AbstractObjective: To identify consumer expectations with respect to the ED.Methods: Semi‐structured focus groups comprising representatives from a wide range of community groups. Data was analysed using a qualitative analytical approach.Results: The major themes of the groups were communication, triage, waiting area, cultural issues and carers. Consumers expressed the need to be informed about how the ED functions, particularly with regard to the triage process, patient assessment and admissions procedure. Privacy at the triage desk, comfort and safety of the waiting area, provision of facilities for children, cultural awareness of staff, access interpreter services and recognition of the needs of carers were identified as key issues.Conclusion: The recognition of consumer needs provides the opportunity for the ED to develop strategies to match patient needs to service delivery.
Presumed Angel's trumpet (Brugmansia) poisoning: Clinical effects and epidemiology
Authors: Isbister Geoffrey K , Oakley Patrick , Dawson Andrew H , Whyte Ian M 
Published: July 2003

AbstractObjective: To investigate the pattern and epidemiology of anticholinergic plant poisoning, and to characterize its time course and clinical features.Methods: We reviewed all anticholinergic plant poisonings using a prospective database of all poisonings admitted to a major toxicology unit in Australia. All patients that presented with anticholinergic plant poisoning between July 1990 and June 2000 were included. Patient demographics, details of poisoning, diagnostic clinical features, adverse effects (seizures, arrhythmias, hypotension, accidental injury), and treatments required were obtained. Important diagnostic features were analysed and compared to previous studies.Results: Thirty‐three patients were presumed to have ingested Brugmansia spp. (Angel's trumpet) based on their description of the plant; median age 18 years (interquartile range 16–20); 82% males. Thirty‐one ingested a brewed tea or parts of the plant (flower). Thirty‐one used it recreationally. Common clinical features were: mydriasis (100%), mean duration 29 h (SD 13) and delirium (88%) with a mean duration of 18 h (SD 12). Tachycardia only occurred in 11 of the 33 patients (33%). In 24 patients where the time of ingestion was certain, 7 of 8 (88%) patients presenting within 5 h had tachycardia and only 5 out of 16 (31%) presenting after 5 h had tachycardia. There were no deaths, seizures or arrhythmias (excepting tachycardia). One patient had hypotension and two sustained accidental traumatic injuries. Nineteen patients required sedation, mainly with benzodiazepines. Physostigmine was used diagnostically in eight cases.Conclusions: Anticholinergic plant abuse is sporadic in nature. Most cases were moderate in severity, requiring sedation only, and severe toxicity was rare. Mydriasis and delirium were the commonest features, the later having important implications for management.
Comparison of two needle types for intraosseus access in an animal model
Authors: Boyd Russell J , Schutz Jackie , Stuart Peter 
Published: July 2003

AbstractObjectives: This study was designed to investigate the success rate, time for insertion and perceived difficulty in gaining intraosseus access in a porcine‐derived animal model. The model was selected to have bone characteristics similar to human adult bone. Prehospital care personnel used two varieties of commercially available intraosseus needles, Cook Paediatric Intraosseus Insertion Needles and Cook Osteo‐site needles.Methods: Sixteen ambulance paramedic trainees were trained to use both of two intraosseus needle types. They were timed from start of insertion attempt to successful insertion and asked to score perceived difficulty of intraosseus needle insertion using a modified Likert scale.Results: Sixteen of 16 (100%) of the insertions with the Cook Osteo‐site needle were successful. Eleven of 16 (69%) insertions with the Cook Paediatric Intraosseus Insertion needle were successful. There was a statistically significant difference between the two groups (P = 0.033). The Cook Osteo‐site needle was perceived to be significantly easier to use than the Cook Paediatric Intraosseus Insertion needle (P = 0.0085) and there was a non‐significant trend to shorter insertion times for the Cook Osteo‐site needle.Conclusions: Use of intraosseus needles to gain access in an animal model is possible. The use of the Cook Osteo‐site needle is associated with excellent success rates for insertion and appears easier to use than the Cook Paediatric Intraosseus Insertion needle. Further work to evaluate the use of the intraosseus access device in the prehospital care situation is required.
Retrospective analysis of 74 cases of seminoma treated with radiotherapy
Authors: GÜDEN METIN , GÖKTAŞ SERDAR , SÜMER FAHRI , ULUTİN CÜNEYT , PAK YÜCEL 
Published: July 2003

AbstractBackground:  Standard post‐orchiectomy radiotherapy (RT) is accepted as a standard management option for stage I seminoma.Methods:  Retrospective evaluation of 74 patients with stage I seminoma was performed according to the Royal Marsden staging system. All of the patients underwent RT in the Radiation Oncology Department of Gülhane Military Medical Academy between 1974 and 1995. The median age of patients was 27 years (range, 20–56). Radiotherapy was applied to all of the patients after orchiectomy for adjuvant purposes. Sixty‐nine patients underwent RT while five patients who had recurrence received chemotherapy following radiotherapy.Results:  After a mean follow‐up period of 54 months, the 5‐year overall survival rate was 98.61%, which complied with the literature. The disease‐free survival rate was 90.54%. According to the World Health Organization toxicity scale, acute enteritis was 9.4% for grade I and 5.4% for grade II, while nausea/vomiting was 36.4% for grade I and 5.4% for grade II.Conclusion:  To avoid acute toxicity related to RT, prognostic risk factors should be well‐known and patients with low risk factors should be monitored carefully after orchiectomy. RT should be directed to the para‐aortic ± ipsilateral pelvic lymph nodes in high risk patients. Although post‐orchiectomy RT is a traditional management option for clinical stage I seminoma, the results of RT should be well‐known to compare it with other treatment options (e.g. RPLND, adjuvant chemotherapy and surveillance).
Further investigation of the epitope recognized by the new monoclonal antibody 2C9
Authors: KATO KEITARO , YOSHIKAWA KAZUHIRO , TAKI TOMOHIRO , SHITARA KENYA , NAKAMURA KAZUYASU , HIROTA MAIKO , HANAI NOBUO , NAKAMURA KOGENTA , KOKUBO HIROTO , MITSUI KENJI , YAMADA YOSHIAKI , HONDA NOBUAKI , UEDA RYUZO , SAGA SHINSUKE , FUKATSU HIDETOSHI 
Published: July 2003

AbstractObjective:  We established a new monoclonal antibody (2C9) that reacted with prostate tissue. The immunohistochemical reactivity of this antibody is similar to anti‐prostate‐specific membrane antigen (PSMA). Herein, we report the antigenic determinant of 2C9 antibody.Methods:  The reactivity of the antibody was characterized by immunohistochemical staining and the antigen target was characterized by amino acid sequencing after immuno‐affinity purification from an LNCaP cell lysate and cloning of a cDNA using a mammalian expression cDNA cloning system.Results:  The amino acid and nucleotide sequences for the antigen molecule recognized with 2C9 monoclonal antibody demonstrated identity with PSMA.Conclusion:  The target molecule of the 2C9 monoclonal antibody is PSMA, pointing to future diagnostic and therapeutic applications.
Urolithiasis in Okinawa, Japan: A relatively high prevalence of uric acid stones
Authors: HOSSAIN RAYHAN ZUBAIR , OGAWA YOSHIHIDE , HOKAMA SANEHIRO , MOROZUMI MAKOTO , HATANO TADASHI 
Published: July 2003

AbstractAim:  The aim of the present study was to investigate the composition of urinary tract stones in patients from Okinawa, the most southern island group of Japan.Methods:  The study was conducted by 12 hospitals in Okinawa. A total of 1816 urinary tract calculi were obtained from 1816 patients (1323 males; 493 females). The patients had a mean age of 53 ± 15.3 years (mean ± SD). The calculi were examined to determine their chemical composition. Stone samples were analyzed by computed infrared spectrophotometer.Results:  Pure stones comprised 58.4% of the total, with calcium oxalate stones accounting for 40% (21% monohydrate [whewellite]; 6.6% dihydrate [weddellite]; and 12.4% combined monohydrate and dihydrate stones), uric acid/urate stones for 9.6%, calcium phosphate stones for 5.1%, and struvite stones for 3.7%. The other 41.6% of the stones consisted of calcium oxalate mixed with other components. The male‐to‐female ratio was 2.7 : 1.Conclusion:  In our series, calcium oxalate stones accounted for 81.6% of the urinary tract calculi, while uric acid/urate stones accounted for 15.8%. Uric acid stones, predominantly the anhydrous and/or dihydrate forms, showed a relatively high prevalence. Calcium oxalate stones, predominantly in the form of whewellite, showed a high prevalence among pure calculi; while the predominant combinations among mixed calculi were weddellite + calcium phosphate and whewellite + uric acid/urate.
Determinants of quality of life of bladder cancer survivors five years after treatment in France
Authors: MATSUDA TOMOHIRO , APTEL ISABELLE , EXBRAYAT CATHERINE , GROSCLAUDE PASCALE 
Published: July 2003

AbstractObjectives:  The aim of the population‐based study presented here was to evaluate quality of life (QOL) among bladder cancer survivors at least five years after diagnosis, ascertain the long term effects of treatments, and investigate important pathological and sociodemographic factors influencing the QOL of such survivors.Methods:  A Functional Assessment of Cancer Therapy (FACT) questionnaire with a bladder‐specific option (FACT‐Bl), was sent by mail to patients randomly selected from the database of the Isère and Tarn cancer registries in France. Ninety‐five valid completed questionnaires were returned by 78 males and 17 females, with a median age of 72 years (range, 33–90). The pathological information contained in the completed questionnaires was examined.Results:  Of the 95 patients (76 with a superficial tumor, 17 with an invasive tumor), 20 had undergone total cystectomy. Total cystectomy clearly deteriorates the autonomy of survivors (ECOG‐PSR), as well as their scores on the bladder cancer‐specific sub‐scale in sexuality‐related questions. Survivors claimed impotency and loss of sexual interest after the cystectomy. In contrast, neither the type of treatment nor the time from the most recent major treatment were score‐modifying factors. Negative psychological effects of treatments in the long‐term were not observed. Rather, patients’ QOL was affected by their autonomy in daily life and by old age. In addition, familial situation had a critical impact on emotional and Familial/Social Well‐being.Conclusion:  The present study showed the long‐term negative effect of total cystectomy on survivors. Survivor autonomy and other sociodemographic backgrounds were also determinants of their QOL. The maintenance of good health, sexual function and active family relationships should be promoted so that patients can lead full lives after treatment.
Morbidity of laparoscopic radical prostatectomy: Summary of early multi‐institutional experience in Japan
Authors: ARAI YOICHI , EGAWA SHIN , TERACHI TOSHIRO , SUZUKI KAZUO , GOTOH MOMOKAZU , KAWAKITA MUTSUSHI , TANAKA MASATOSHI , TERADA NAOKI , BABA SHIRO , OKUMURA KAZUHIRO , HAYAMI SHINSUKE , ONO YOSHINARI , MATSUDA TADASHI , NAITO SEIJI 
Published: July 2003

AbstractAim:  Laparoscopic radical prostatectomy is being evaluated throughout the world. The aim of the present study is to report early multi‐institutional experience of the procedure in Japan.Methods:  A total of 148 men who were diagnosed with clinically localized prostate cancer underwent laparoscopic radical prostatectomy at seven different institutions in Japan. Early complications (within 30 days postoperatively) and postoperative convalescence were reviewed retrospectively. The median age of patients was 68.0 years (range, 51–80).Results:  The median operative time was 403 minutes (range, 167–925; average, 427). Blood loss ranged from 50 to 5000 mL (median, 540; average, 856). A total of 66 complications were reported in 55 patients (37.2%). Intraoperative complications were noted in 25 of 148 patients (16.9%): 10 rectal injuries (6.8%); five bladder injuries (3.4%); five cases of subcutaneous emphysema (3.4%); two intestinal injuries (1.4%); one major vessel injury (0.7%); one ureteral injury (0.7%); and one obturator nerve injury (0.7%). Overall, 16 of 148 patients (10.8%) required open conversion or postoperative open surgical repair. The most common postoperative complications were anastomotic leakage (6.8%), wound‐related complications (4.7%) and perineal pain (4.7%). The bladder catheter was removed on day 7 or earlier in 73 cases (49.3%). The median time to ambulation was 1 day (mean 1.4, range 1–5). Oral intake was started on postoperative day 1 in 67 patients (45.2%) and on postoperative day 2 in 65 (43.9%).Conclusion:  Although laparoscopic radical prostatectomy is technically demanding, reduced blood loss and shorter convalescence periods can be expected from the procedure. Surgeons should be aware of the disturbingly high morbidity rate related to early experience. By mastering laparoscopic skills and sharing knowledge, surgeons could reduce the impact of the learning curve required to complete this procedure competently.
Device to promote pelvic floor muscle training for stress incontinence
Authors: SUGAYA KIMIO , OWAN TOMOKO , HATANO TADASHI , NISHIJIMA SAORI , MIYAZATO MINORU , MUKOUYAMA HIDEKI , SHIROMA KAZUO , SOEJIMA KYOKO , MASAKI ZENJIRO , OGAWA YOSHIHIDE 
Published: July 2003

AbstractAim:  Many patients with stress urinary incontinence do not have enough motivation to continue pelvic floor muscle training (PFMT) by themselves. Therefore, a device was created to support PFMT, and its effect was examined.Methods:  Forty‐six women with stress urinary incontinence were assigned to a control group or a device group in order of presentation. A pamphlet on PFMT was given to control patients, while the same pamphlet plus the device and instructions on its use were given to patients in the device group. The device had a chime that was set to sound three times a day when exercise sessions were scheduled. PFMT consisted of fast and slow pelvic floor muscle contraction exercises that were performed for 2 min and followed a rhythm set by the device.Results:  After 8 weeks, 20 patients from the control group and 21 patients from the device group could be evaluated. In the control group, only the quality of life (QOL) index improved significantly. In the device group, however, the daily number of incontinence episodes, the number of pads used daily, the QOL index, and the pad weight in the pad test improved significantly. Patients in the device group said that they felt obligated to perform PFMT when the chime sounded. Forty‐eight percent of patients from the device group were satisfied with the outcome of PFMT, while only 15% were satisfied in the control group.Conclusion:  This device may be useful to support the management of stress urinary incontinence.
Ionotropic glutamate receptors in isolated horizontal cells of the rabbit retina
Authors: Blanco Román , De La Villa Pedro 
Published: July 2003

AbstractWith the use of the whole‐cell voltage‐clamp technique, we have recorded the currents induced by ionotropic glutamate receptor agonists on isolated axonless horizontal cells (HC) of rabbit retina. Bath application of the non‐N‐methyl‐d‐aspartate receptor agonists: kainate (KA), α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid (AMPA) and l‐glutamate (GLU) produced an increase in the conductance for non‐selective cations. All the isolated horizontal cells responded to GLU, AMPA and KA. Responses elicited by GLU and AMPA but not KA exhibited a concentration‐dependent desensitization. Application of N‐methyl‐d‐aspartate (NMDA) evoked no responses. The rank order affinities of the agonists as estimated from EC50 values were AMPA > GLU > KA. Whereas KA had the lowest affinity of the agonists tested, it produced the largest currents. Hill coefficients of the concentration–response data were near 1 for AMPA, and 2 for KA and GLU. Coapplication of AMPA with cyclothiazide (CTZ) blocks AMPA receptor desensitization, and enhanced its effects on conductance. However, CTZ did not change the KA ‐induced conductances. In all cells tested, 6,7‐dinitroquinoxaline (DNQX) completely and reversibly blocked the effects of KA and AMPA. The KA‐ and AMPA‐induced currents were also completely blocked by 1‐(4‐aminophenyl)‐4‐methyl‐7,8‐methylenedioxy‐5H‐2,3‐benzodiazepine (GYKI 52466), a selective AMPA receptor antagonist. These results indicate that the responses to glutamate agonists in HC were mediated almost exclusively by AMPA receptors. Our study indicates that AMPA receptors play a fundamental role in mediating the synaptic input into rabbit horizontal cells.
Threshold Measurements:
Authors: IRNICH WERNER 
Published: July 2003

The following rules for professionally measuring thresholds are derived and discussed: RULE 1: Thresholds should be expressed as voltage averaged over pulse duration to get reproducible and comparable results! RULE 2: Pacing threshold measurements with exponentially decaying pulses should not be extended beyond 1.4 ms as that portion of the pulse below rheobase does not contribute to the stimulation effect! RULE 3: Threshold measurements are best carried out with fixed pulse duration and variable voltage! RULE 4: If threshold measurements are carried out in discrete steps, the steps should be chosen such that the relative step size is as equal as possible! RULE 5: Accuracy of threshold measurements is highly increased if the arithmetically averaged value of the last effective and the first ineffective pulse is defined as threshold! RULE 6: To determine strength‐duration‐curves, a linear regression of the quantity versus pulse duration should be calculated which yields simply the numerical values of the chronaxie and rheobase! RULE 7: To reach representative strength‐duration‐curves, measurements with at least four pairs of values must be carried out! RULE 8: Measuring defibrillation thresholds, the relative voltage step size should be chosen equally to have equal accuracy for all steps. RULE 9: If the result of a defibrillation threshold investigation does not reach significance, a too large voltage step size could be an explanation! RULE 10: Comparing intraindividually the threshold of two different defibrillation systems or parameter settings, the threshold ratios should be formed and averaged! Obeying these rules guaranties professional threshold measurements expressed as “rheobase” and “chronaxie” even with devices with discrete steps in parameter programming. (PACE 2003; 26:1738–1746)
Metabotropic glutamate type 1α receptor localizes in low‐density caveolin‐rich plasma membrane fractions
Authors: Burgueño Javier , Enrich Carlos , Canela Enric I. , Mallol Josefa , Lluis Carmen , Franco Rafael , Ciruela Francisco 
Published: July 2003

AbstractRecent evidence suggest that many G protein‐coupled receptors (GPCR) and signalling molecules localize in microdomains of the plasma membrane. In this study, flotation gradient analysis in the absence of detergents demonstrated the presence of the metabotropic glutamate receptor type 1α (mGlu1α) in low‐density caveolin‐enriched membrane fractions (CEMF) in permanently transfected BHK cells. BHK‐1α cells exhibit a similar pattern of staining for caveolin‐1 and caveolin‐2, and these two proteins show a high degree of co‐localization with mGlu1α receptor as demonstrated by immunogold and confocal laser microscopy. The presence of mGlu1α in CEMF was also demonstrated by co‐immunoprecipitation of mGlu1α receptor using antibodies against caveolin proteins. Activation of the mGlu1α receptor by agonist increased extracellular signal‐regulated kinases phosphorylation in CEMF and not in high‐density membrane fractions (HDMF), suggesting that mGlu1α receptor‐mediated signal transduction could occur in caveolae‐like domains. Overall, these results clearly show a molecular and functional association of mGlu1α receptor with caveolins.