bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kava toxicity
Authors: Chanwai L Giles 
Published: March 2003

AbstractKava is a psychoactive drink widely used among people of the South Pacific nations. It is a non‐narcotic, non‐alcoholic, non‐addictive beverage. Kava is extracted from the pepper plant, Piper methysticum. The roots are used to prepare a beverage that is consumed for social and ceremonial purposes. A case illustrating the effects of acute kava intoxication upon heavy chronic consumption is presented with a discussion of the pharmacology, clinical manifestation and treatment of kava toxicity, followed by discussion of the health impact on society.
Noxious gas exposure in the outback: Two cases of hydrogen sulfide toxicity
Authors: Gunn Barry , Wong Robert 
Published: March 2003

AbstractTwo cases of toxicity from industrial exposure to hydrogen sulfide are presented. Both patients had neurological effects with loss of consciousness and amnesia along with respiratory symptoms and signs. Both were treated with hyperbaric oxygen therapy in addition to standard resuscitative techniques with rapid improvement. Sodium nitrite and hyperbaric oxygen therapy are suggested specific treatments. The literature and the two case reports support the use of hyperbaric oxygen therapy in the treatment of acute hydrogen sulfide toxicity. Hyperbaric oxygen therapy has also been reported to have a role in the prevention of both short‐ and long‐term neurological toxicity.
Survey of major chronic iIlnesses and hospital admissions via the emergency department in a randomized older population in Randwick, Australia
Authors: Chan Daniel KY , Chong Robert , Basilikas Jim , Mathie Merryn , Hung Wai Tak 
Published: March 2003

AbstractObjective: To find out if patients with chronic illnesses living in the community are at risk of unplanned hospital admissions through emergency departments; what types of chronic illnesses may be putative risk factors; and if an increase in the number of chronic illnesses may be associated with increased risk.Methods: The survey included the completion of a standardized questionnaire for medical illnesses in a random sample of older people dwelling in the community and analysis of admission records to our hospital. The principal diagnoses for admissions were recorded. The risk factors for admissions were analysed.Results: Five hundred and twenty‐six (239 men and 287 women) people aged 55 years and over were interviewed. Musculoskeletal disorders, hypertension, gastrointestinal disorders and ischaemic heart disease were the most frequently reported of the chronic illnesses surveyed. A total number of 70 people from the survey group with a total of 115 admissions through emergency departments were recorded. Using logistic regression model, hypertension, ischaemic heart disease and age were found to be risk factors for emergency admissions amongst this group of community‐dwelling residents. The ratios were 2.03 (95% confidence interval (CI): 1.2–3.44), 2.02 (95% CI: 1.16–3.49) and 1.05 (95% CI: 1.02–1.09), respectively. Furthermore, multiple (three or more) chronic illnesses were found to be a strong predictor of hospital admission via emergency department (chi‐square = 16.647, DF = 1, P‐value < 0.001).Conclusion: We conclude that there was significant association between multiple chronic diseases and emergency admissions for older people. Of these, hypertension and ischaemic heart disease were found to be significant predictors. Age per se was found to be of borderline significance.
Optic neuropathy resulting from indirect trauma
Authors: Ginifer Corinne , Scharapow David 
Published: March 2003

AbstractMinor blunt injury to the head and face may result in optic nerve contusion with secondary optic atrophy. The resulting visual loss is devastating for the individual. We report an uncommon but important complication that may result from an apparently trivial injury. Early identification and initiation of appropriate management may restore the individual's vision. Emergency physicians are often the first to see patients at risk of this complication yet there is little discussion of this injury in the emergency medicine literature.
Lack of agreement in classification of the severity of acute asthma between emergency physician assessment and classification using the National Asthma Council Australia guidelines (1998)
Authors: Powell Colin VE , Kelly Anne‐Maree , Kerr Debra 
Published: March 2003

AbstractAims: To determine the level of agreement in classification of the severity of acute asthma at presentation to the emergency department, between emergency physician global assessment and severity classification according to the National Asthma Council Guidelines, Australia 1998 (NACG).Methods: Prospective observational study in emergency departments throughout Australia, participating in the Asthma Snapshot 2000 project. Patients between the ages of one and 60 years presenting to participating emergency departments with acute asthma between 21 August and 3 September 2000 were included. Data collected were emergency physician global assessment of asthma severity and severity classification according to the National Asthma Council Guidelines and disposition.Results: Five hundred and five subjects had completed data for emergency physician assessment of severity and for calculation of severity classification according to the National Asthma Council Guidelines. Weighted kappa for agreement in classification was 0.48 (95% confidence interval: 0.40, 0.56). Emergency physicians assess asthma as less severe compared to the National Asthma Council Guidelines assessment.Conclusions: Agreement between physician assessment of severity of acute asthma and severity classification according to National Asthma Council Guidelines is only moderate. This may have implications in treatment and disposition. This also suggests that emergency physicians may be using other methods to classify acute asthma than the National Asthma Council Guidelines classification.
Clinical outcome of patients with initial diagnosis of acute self‐limiting colitis of unknown aetiology
Authors: Lam Tzit Yuen David , Choi Tat Fai , Lam Ching Wah , Kwok Samuel Po Yin 
Published: March 2003

Objective: To investigate the clinical course and outcome of patients whose initial histological features were compatible with acute self‐limiting colitis (ASLC) of unknown aetiology. Materials and Methods: We performed a computer search of our pathology registry for non‐specific inflammation of the colon and rectum for the years 1997–98. The histology reports and clinical notes were reviewed in detail. Results: Thirty‐three suitable patients were identified (17 males) with a median age of 48 years (22–87 years). The commonest presenting symptoms were rectal bleeding and diarrhoea. The passage of mucus and abdominal pain were also commonly found symptoms. Physical examination was usually normal, although abdominal tenderness was occasionally elicited. Systemic upset was unusual. Three patients had complications at presentation: severe bleeding (n = 1), intestinal obstruction (probably unrelated, n = 1), sigmoid colon cancer (probably unrelated, n = 1). Of 30 patients who were observed only, 10 patients’ symptoms resolved and 8 patients improved symptomatically, one worsened and one had not returned for reassessment. Ten subsequently needed medical treatment. Together with the other 3, a total of 13 patients received medication at some stage in their disease and 3 patients eventually required long‐term therapy. Two patients developed ulcerative colitis after 7.5 and 12 years, respectively. Conclusion: Patients with initial histological features of ASLC usually follow a self‐limiting clinical course and an initial period of observation is justified. Progression to a more protracted disease course occurs in one‐third and the diagnosis of ASLC should be revised. Salicylates and steroids are useful in refractory cases. Less than 6% progressed to chronic inflammatory bowel disease.
Haemorrhoidectomy using harmonic scalpel: An initial report
Authors: Chung () Chi‐Chiu , Ha () Joe Ping‐Yiu , Tai () Yuk‐Ping , Tsang () Wilson Wen‐Chieng , Li () Michael Ka‐Wah 
Published: March 2003

Objective: The objective of this study was to evaluate the surgical outcomes of haemorrhoidectomy using harmonic scalpel. Method: From June to August 1999, 12 patients suffering from third degree piles were admitted for harmonic scalpel haemorrhoidectomy. The whole operation was performed entirely with the harmonic scalpel with the power set at level 3. The pedicles were coagulated with the harmonic scalpel rather than transfixed. Postoperatively, pethidine injection was given intramuscularly on demand for pain control. The postoperative pain score (0–10) from the first to the fifth postoperative day was assessed. Patients were followed up at 4, 8 and 12 weeks, and complications were recorded. Results: Twelve patients with a median age of 48 years were studied. The median operation time was 15 min (range: 12–20), with a median blood loss of 15 mL (range: 2–25). The median postoperative stay was 2 days (range: 2–4). The median pain score was maximal at postoperative day one (score: 3). The pain score rapidly dropped over the next 2 days, and became zero by postoperative day 4. Only two patients required pethidine injections on the first postoperative day. Conclusion: Preliminary evidence suggests harmonic scalpel haemorrhoidectomy is safe and expedious; it is associated with less pain compared with conventional scissors dissection, and is a good alternative to diathermy excision.
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Mesh plug hernioplasty of superior lumbar hernia
Authors: Lau Hung , Lee Francis 
Published: March 2003

Superior lumbar hernia is a rare clinical entity. Techniques for the repair of lumbar hernia have evolved in the past few decades. The case of a 77‐year‐old woman presenting with a reducible left lumbar swelling for 3 months is reported. Repair of the hernia using a mesh plug technique was performed. The cone‐shaped prolene mesh plug maintained the inversion of the hernia and occluded the hernial defect, thereby conferring a mechanical advantage. The application of mesh plug hernioplasty for the repair of a superior lumbar hernia was simple and effective. Chinese Abstract imageimage
Always expect the unexpected in appendicectomy
Authors: Chan Tony Kam‐Tong , Lam David Tzit‐Yuen , Lam Steve Ching‐Wah , Kwok Samuel Po‐Yin 
Published: March 2003

A 59‐year‐old Chinese man who presented with signs and symptoms of acute appendicitis is described. The patient received an appendicectomy, and the histology report of the appendix revealed villous adenoma with margin involved. Postoperatively, he developed a colocutaneous fistula and ended up having a right hemicolectomy and fistulectomy. The literature on villous adenoma and other tumours of the appendix is reviewed, and their surgical treatment is discussed. Chinese Abstract imageimage
Successful laparoscopic‐assisted treatment of ileal endometriosis with intestinal obstruction
Authors: Tsumura Hiroaki , Kagawa Tetsuya , Ichikawa Toru , Nishihara Masahiro 
Published: March 2003

A patient in whom the laparoscopic procedure for intestinal endometriosis with small bowel obstruction was effective is reported. A 35‐year‐old woman who had complained of a stomach ache during menstruation had been followed up for 1 year at another hospital. She presented at Hiroshima Funairi Hospital with upper abdominal pain, and was admitted with suspected small bowel obstruction as a result of plain abdominal X‐ray showing abnormal intestine gas. Laparoscopic observation revealed marked adhesion and stenosis of the distal ileum, which were responsible for the obstruction. Mini‐laparotomy was selected and ilectomy and anastomosis were performed under laparoscopic‐assisted procedure. Histologically, endometriosis was confirmed and resection of the involved segment yielded excellent results, and the patient was discharged. This was an extremely rare case of intestinal obstructive involvement by endometriosis and we briefly discuss here the effectiveness of laparoscopic‐assisted operation. Chinese Abstract imageimage
Age and symptoms as a triage method for per‐rectal bleeding
Authors: Lam David Tzit‐Yuen , Choy Catherine Lai‐Yin , Lam Steve Ching‐Wa , Kwok Samuel Po‐Yin 
Published: March 2003

Objective:Per‐rectal bleeding is a common reason of surgical referral. The average waiting time in a busy clinic could be months, which should preferably be shortened for potentially serious cases. With little information on referral letters, other methods for triage have to be searched for. Age and symptoms as triage methods were evaluated.Methods:Data from patients attending the United Christian Hospital specialist clinic for per‐rectal bleeding were collected prospectively. The association between age and the prevalence of colorectal neoplasia was analysed. The most suitable cut‐off age was determined by a receiving operating characteristic (ROC) curve. For symptoms, a questionnaire to check for high‐risk features of per‐rectal bleeding was designed. Non‐medically trained volunteers were instructed to interview each patient before the surgical consultation. A positive result for the questionnaire is the presence of high‐risk features. The surgeons were unaware of the questionnaires’ findings. The results were compared with the final diagnosis. Positive diagnoses were defined as either malignancy or significant polyps. The sensitivity and specificity of age and the questionnaire were computed.Results:A total of 194 patients were interviewed. Twenty patients declined colonoscopy and were excluded, leaving 174 for analysis. The ROC curve showed 60 years to be the most suitable age for triage. The sensitivity and specificity of age (≥ 60 years old) was 73.1% and 62.8%, respectively. The sensitivity and specificity of the questionnaire was 65.4% and 55.4%, respectively. The positive predictive value of age was 25.7%, which was increased to 33.6% with a positive questionnaire result. The negative predictive value of 93.0% by age alone was increased to 95.5% with a negative questionnaire result.Conclusion:Age is a very effective triage criterion. Using 60 years of age as a cut‐off point screens out low‐risk patients effectively. A preconsultation‐structured interview designed to identify high‐risk symptoms has little additional triage benefit. Chinese Abstract imageimageimageimageimage
Factors affecting awareness and knowledge of glaucoma among patients presenting to an urban emergency department
Authors: Landers John A , Goldberg Ivan , Graham Stuart L 
Published: March 2003

Abstract Background: Until advanced, glaucoma is asymptomatic. For early diagnosis to occur, patients may need to be aware of it and seek assessment regularly. People who have risk factors for glaucoma may have a greater awareness of the disease. Methods: Patients presenting to an urban hospital emergency department were surveyed with a brief questionnaire to assess their knowledge of glaucoma. Data was collected about their gender, age, family history of glaucoma and presence of systemic hypertension, diabetes, Raynaud’s phenomenon, migraines and myopia. Results: Women (Odds ratio 2.3; 95% CI
1.4−3.7; P < 0.01), people
who were 40 years or older (Odds ratio 2.2; 95% CI
1.1−4.4; P < 0.05) and
those who were aware of a family history of glaucoma (Odds ratio
15.7; CI 5.5−45.3; P < 0.01) knew significantly more about the disease than others. People with other risk factors did not demonstrate significantly greater knowledge despite 89% of all participants having had a previous eye examination. Conclusion: This information may be useful to predict which patients may know about glaucoma when they present for an eye examination and who should be targeted in public health campaigns.
Understanding local community preferences for wetland quality
Authors: Morrison Mark 
Published: March 2003

Summary The results of a local community survey designed to estimate the value of improved wetland quality in the Macquarie Marshes are presented. The present survey parallels an earlier survey conducted in Sydney for the same purpose. The survey involves the use of a technique known as ‘choice modelling’, which was developed in the marketing literature but is now widely used in environmental economics. This technique allows for the estimation of the monetary value people place on improved wetland quality, as well as enabling estimation of the proportion of the community that would support a particular wetland management option. It was found that while the local community has different priorities for wetland improvement, overall per household willingness to pay for improved wetland quality was greater in the Macquarie Marshes community than for households in Sydney. The options that received the greatest and least local community support are described.Key words choice modelling, non‐market valuation, wetlands.
Laser‐induced chorioretinal venous anastomosis for non‐ischaemic hemi‐central vein occlusion
Authors: Eckstein Michael , McAllister Ian 
Published: March 2003

ABSTRACT Purpose: To assess the effectiveness and complications of laser‐induced chorioretinal venous anastomosis performed on eyes with non‐ischaemic hemi‐central retinal vein occlusions (hemi‐CRVO). Methods: Fourteen eyes with a hemi‐CRVO which reduced the visual acuity to 6/24 or less were treated with argon laser photocoagulation in an attempt to create a chorioretinal venous anastomosis between a retinal vein and the choroidal circulation. Results: Laser anastomoses were successfully created in six eyes (43%) and required a mean of 1.8 attempts in each eye. Of the eyes that developed an anastomosis, four had significant visual improvement. The distal retinal venous segment closed off in five eyes and these had prophylactic segmental argon pan‐retinal photocoagulation performed. Two eyes had localized fibrovascular proliferation. No permanent vision‐threatening complications were observed in any of the 14 eyes over the follow‐up period. Conclusions: Successful anastomosis between the retinal and choroidal circulation in eyes with hemi‐vein occlusions may reduce macular oedema and improve vision. Complications of the technique are significant and a randomized clinical trial is due to commence which may clarify the suitability of this treatment.
Corynebacterium pseudodiphtheriticum keratitis and conjunctivitis: a case report
Authors: Li Amy , Lal Shishir 
Published: March 2003

ABSTRACTA case of keratitis and conjunctivitis in an 86‐year‐old man caused by Corynebacterium pseudodiphtheriticum is reported. Corynebacteria are uncommon causes of ocular surface infections. However, the presence of corneal and conjunctival epithelial defects in an immunocompromised patient can result in severe infection by a commensal organism such as C. pseudodiphtheriticum. The significance of a positive culture in these settings should not be overlooked.
Bilateral inferior insertion of lateral rectus muscles associated with schizencephaly
Authors: Wine Steven B , Saad Nick , Vella Meaghan E 
Published: March 2003

ABSTRACTA 5‐year‐old boy with a large V‐pattern exotropia is described. He has a background of congenital left hemiparesis associated with schizencephaly. At the time of surgery the lateral recti were found to be abnormally inferiorly positioned. Accordingly, both lateral rectus muscles were recessed 6.5 mm and supraplaced. A V‐pattern exotropia persisted postoperatively with clinical overaction of the inferior obliques. To our knowledge this is the first known case of extraocular muscle abnormalities associated with schizencephaly.
Staphylococcus aureus causes acute inflammatory episodes in the cornea during contact lens wear
Authors: Wu Pzj , Thakur A , Stapleton F , Willcox Mdp 
Published: March 2003

ABSTRACTThe aim of this investigation was to determine the ability of Staphylococcus aureus to cause keratitis during contact lens wear in the rabbit. Rabbits were fitted with hydrogel lenses and wore them on an extended wear schedule for 7 weeks. At the end of each week of wear, one drop of S. aureus was added to the eyes, and the eyes were monitored using slit lamp bio‐microscopy, with subsequent microbial and histological studies of the cornea. In the presence of S. aureus, keratitis occurred after 3 weeks of lens wear, a condition that was characterized by diffuse infiltration of the peripheral cornea and limbal redness. In the absence of bacteria, there was no infiltration until week 6. Contact lens wear also prolonged the retention of bacteria in the eye. Extended contact lens wear and S. aureus caused non‐ulcerative keratitis in a rabbit model, and disturbances in the ability of the eye to remove bacteria.
Employing following eye movements to discriminate normal from glaucoma subjects
Authors: Severt Wl , Maddess T , Ibbotson Mr 
Published: March 2003

ABSTRACTWe recorded optokinetic nystagmus (OKN) to see if slow phase velocity, duration or other measures were affected by glaucoma. Drifting grating patterns that either weakly or strongly evoked the spatial frequency doubling illusion were employed. Analysis of 68 variables characterizing the OKN revealed that small subsets of these variables were good at discriminating normal from primary open angle glaucoma subjects. The variables were related to the regularity of following eye movements. Models including the best five variables selected in two different ways classified about 90% of subjects correctly. Impaired accuracy of eye movements suggests that glaucoma changes the signal to noise ratio available to the brain. The gross changes observed permit the use of electro‐oculography or other simple methods in the clinic.
Age‐specific prevalence and causes of bilateral and unilateral visual impairment in older Australians: the Blue Mountains Eye Study
Authors: Wang Jie Jin , Foran Suriya , Mitchell Paul 
Published: March 2003

ABSTRACT Purpose: To report age‐specific prevalence and causes of bilateral and unilateral visual impairment in a representative older Australian population. Methods: Participants in the Blue Mountains Eye Study (n = 3654) underwent a detailed eye examination. Any visual impairment was defined as best‐corrected visual acuity (VA) of 6/12 or worse, moderate impairment as VA 6/24–6/60 and severe impairment as VA worse than 6/60 (the Australian definition for legal blindness). Bilateral visual impairment was defined from the better eye and unilateral impairment from the worse eye. Proportional causes for visual loss were determined by the examining ophthalmologist. Results: Prevalence of bilateral and unilateral visual impairment was strongly age related. Corresponding bilateral and unilateral visual impairment prevalence rates were, respectively, 0.6% and 3.6% for persons aged 49–59 years, 1.1% and 8.2% for ages 60–69, 5.4% and 20.1% for ages 70–79, and 26.3% and 52.2% for persons aged 80+ years. Overwhelmingly, age‐related maculopathy (ARM) was the predominant cause of bilateral blindness (13/17) and of moderate to severe bilateral visual impairment in persons aged 70+ years. However, cataract was the most frequent cause of mild bilateral visual impairment among persons aged 60+ years. Amblyopia was the most frequent cause of mild or worse unilateral visual impairment in persons aged 49–59 years. Cataract was the most common cause of mild unilateral visual impairment in people aged 60+ years, while ARM and cataract were jointly the most frequent causes of moderate to severe unilateral visual impairment in people aged 70+ years. Conclusions: These findings indicate that around half of visually impaired persons aged 60 years or over had cataract, a cause amenable to treatment.