bluuebunny/crossref_metadata_2025_split huggingface dataset:
Near-patient testing of blood glucose using the Bayer Rapidlab 860 analyser in a regional neonatal unit
Authors: Peet Andrew C , Kennedy David M , Hocking Michael D , Ewer Andrew K 
Published: October 2002

Background: We evaluated the use of the glucose biosensor on the Bayer Rapidlab 860 (BR 860) blood gas analyser for neonates and compared it with two laboratory-based methods for measuring blood glucose using the Yellow Springs Instruments 2300 STAT PLUS (YSI) analyser and the Vitros 750 XRC (Vitros) analyser. Methods: Arterial, capillary and venous blood samples were taken from 50 neonates, and blood glucose was measured using all three instruments. Blood pH, PO2, haematocrit and plasma albumin data were also recorded. The effect of varying the degree of haemolysis and the haematocrit was examined using cord blood samples prepared in vitro. Results: Day-to-day imprecision of the BR 860 was 4·90% at a mean glucose concentration of 2·55 mmol/L ( n=60), compared with 3·03% at 2·33 mmol/L ( n=34) for the YSI and 2·64% at 3·52 mmol/L for the Vitros ( n=59). Using Deming regression, the BR 860 results correlated well with results produced on both the YSI ( r=0·962, n=47, P<0·001) and Vitros ( r=0·980, n=46, P<0·001) analysers. Bland-Altman difference plots showed that the BR 860 had a mean of the differences of 0·30 mmol/L compared with the YSI and 0·09 mmol/L compared with the Vitros. The Bland-Altman standard deviation of the differences was 0·46 mmol/L when the BR 860 was compared with the YSI and 0·31 mmol/L when the BR 860 was compared with the Vitros. No significant correlation was found between the BR 860 glucose measurements and haematocrit, degree of sample haemolysis, plasma albumin, blood pH or PO2. Conclusions: The BR 860 analyser provides neonatal blood glucose measurements in the clinical setting of a neonatal unit that compare well with results obtained using laboratory-based methods.
Rapid measurement of insulin using the Abbott IMx: application to the management of insulinoma
Authors: Albright Suzanne V , McCart J Andrea , Libutti Steven K , Bartlett David L , Alexander H Richard , Sampson Maureen L , Ruddel Mark E , Remaley Alan T 
Published: October 2002

Background: Patients with multiple endocrine neoplasia (type 1) often present with multiple pancreatic endocrine tumours, such as insulinomas. A major difficulty in the surgical treatment of such patients is identifying which tumours are functionally active and therefore need to be resected for a cure. The objective of this study was to develop a rapid insulin assay that could be used intraoperatively for identifying insulinomas from pancreatic aspirates. Methods: By reducing the incubation time and by increasing the sample volume, a rapid insulin assay was developed on the IMx analyser. This was used to measure insulin from tissue aspirates collected from suspected insulinomas under ultrasound guidance. Results: The rapid insulin assay ( y) could be performed in 14 min and showed a good correlation with the standard IMx ( x) insulin assay ( y=0·808 x+0·04; r2=0·986). Using the rapid insulin assay on pancreatic tissue aspirates, insulinomas could be readily distinguished from normal pancreatic tissue or from non-functional adenomas based on a marked increase in insulin content. Conclusion: In summary, a new rapid assay for insulin is described that compares favourably to the standard IMx insulin assay and can potentially be used intraoperatively on pancreatic aspirates for identifying functionally active insulinomas.
Continuous glucose monitoring and haemoglobin A1c
Authors: Sharp Patrick , Rainbow Sandra 
Published: October 2002

Background: Measurement of HbA1c is the standard test for assessment of glycaemic control in diabetic subjects. Using new glucose sensing technology we re-evaluated the significance of HbA1c in terms of the aspects of the blood profile it measures in patients with diabetes. Methods: In a group of 27 patients with type 1 diabetes, interstitial fluid glucose concentrations were monitored for a mean of 2·6 days using the Continuous Glucose Monitoring SystemTM (MiniMed Inc, CA, USA). Results were correlated with an HbA1c measurement taken at the time of sensor insertion. Results: Results were available in 25 subjects, two datasets being lost due to patient error. There was a correlation between mean sensor glucose value, and the HbA1c value ( r=0·59, P=0·002). The correlation with standard deviation of the readings was weaker (r=0·3, P=0·15). No other descriptor of the sensor glucose concentration correlated with HbA1c. Conclusion: The mean interstitial glucose concentration recorded with the Continuous Glucose Monitoring System correlates with HbA1c level recorded at the time, but with no other marker of glucose control in diabetic subjects. These results have implications for the interpretation of HbA1c concentrations in type 1 diabetes.
Discrepancy between visual and spectrophotometric assessment of sample haemolysis
Authors: Hawkins Robert 
Published: October 2002

Background: This study assessed the agreement between visual grading of sample haemolysis with automated haemolysis index (H index) measurement on the Roche 917 clinical chemistry analyser. Methods: The H indices of 800 serum potassium samples and 800 EDTA plasma troponin I samples were compared with routine visual grading of sample haemolysis by technologists. Photographs of mild (haemoglobin 1 g/L), moderate (2·5 g/L) and severe (5 g/L) haemolysis were available for reference. Results: For serum samples, the weighted kappa coefficient was 0·42 with an 8·0% haemolysis rate determined by visual inspection and 3·4% by H index. For EDTA-plasma samples, the weighted kappa coefficient was 0·35 with a 4·5% haemolysis rate determined by visual inspection and 7·9% by H index. Conclusion: Visual assessment of sample haemolysis is unreliable and can give variable results depending on sample type. Laboratories should consider investigating sample haemolysis using automated haemolysis index measurement as an alternative to visual grading whenever it is available.
Limitations of Pneumovax® as a detection antigen in the measurement of serotype-specific antibodies by enzyme-linked immunosorbent assay
Authors: Huo ZM , Miles J , Riches PG , Harris T 
Published: October 2002

Background: Measurement of antibody responses to polysaccharide antigens is regarded as an important assessment of an individual's ability to respond to carbohydrate antigens. The currently used assays for the measurement of pneumococcal-specific antibody use the multi-serotype vaccine Pneumovax® as the detection antigen. Methods: An equal potency enzyme-linked immunosorbent assay (ELISA) system was used to compare the measurement of serotype-specific antibody with the multi-serotype assay. Results: Our results show that the concentration of specific antibody to Pneumovax is not related to the concentration of antibody to the individual serotypes. Neither is any correlation found between the antibody concentrations to any of the three single serotypes investigated, to the mixture of the three serotypes or to Pneumovax. Conclusion: We conclude that the measurement of the concentration of the specific antibody to the mixed serotypes present in Pneumovax has serious limitations when used to evaluate the protection acquired from Pneumovax immunization against any specific serotype.
Cavernous haemangioma of the internal auditory canal
Authors: Shaida A. M. , McFerran D. J. , da Cruz M. , Hardy D. G. , Moffat D. A. 
Published: October 2002

Cavernous haemangiomas are rare lesions of the cerebello-pontine angle that can mimic the more commonly occurring vestibular schwannoma. A case report involving a patient with a cavernous haemangioma of the internal auditory canal (IAC) highlights this as a diagnostic possibility for lesions of the IAC by comparing and contrasting the clinical and radiological findings with the more commonly occurring vestibular nerve and facial schwannomas.Symptoms such as hearing loss and facial paralysis that are disproportionate to the size of the lesion or fluctuate with hormonal changes such as those seen in pregnancy are suggestive of haemangioma. Radiological imaging demonstrating a lesion enchancing with gadolinium and containing areas of calcification is also suggestive of haemangioma. It is important to consider the possible diagnosis of haemangioma as early recognition of this entity may improve the chances of preserving the functional integrity of the facial nerve.
Malignant odontogenic myxoma of the maxilla: case with cytogenetic confirmation
Authors: Pahl Stefan , Henn Wolfram , Binger Thomas , Stein Ute , Remberger Klaus 
Published: October 2002

An odontogenic myxoma of the maxilla with an aggressive clinical course is presented. The tumour arose in a 53-year-old patient, recurred two times after extended maxillectomy and ultimately caused the patient’s death by uncontrollable local disease with infiltration of the cranial cavity.Microscopically, the tumour showed histological features of a low grade malignant myxosarcoma with cellular areas, enhanced mitotic activity and nuclear pleomorphism. Cytogenetic analysis revealed an unexpectedly aberrant hypertetraploid chromosome complement, that was considered as incompatible with the usual karyotypic patterns of benign tumours.
Computed tomography evidence of dental restoration as aetiological factor for maxillary sinusitis
Authors: Connor S. E. J. , Chavda S. V. , Pahor A. L. 
Published: October 2002

Maxillary sinusitis due to dental causes is usually secondary to periodontal disease or periapical infection and is commonly associated with mucosal thickening of the floor of the maxillary antrum. Computed tomography (CT) is currently the modality of choice for evaluating the extent of disease and any predisposing factors in patients with symptoms of chronic maxillary sinusitis, but it is unable to diagnose dental disease reliably. The presence of restorative dentistry is, however, easily seen at CT and is associated with both periapical and periodontal disease. We aimed to determine whether its presence at CT may predispose to maxillary sinusitis, and in particular to focal mucosal thickening of the sinus floor characteristic of dental origin.Three hundred and thirty maxillary sinus CT images in 165 patients were reviewed for the presence of restorative dentistry in the adjacent teeth, focal maxillary sinus floor mucosal thickening, any maxillary sinus disease (including complete opacification, air fluid levels, diffuse mucosal thickening, focal mucosal thickening) and evidence of a rhinogenic aetiology (osteomeatal complex pathology, mucosal thickening in other sinuses).One hundred and ninety two sinuses adjacent to restorative dentistry and 178 sinuses not adjacent to restorative dentistry were analysed. Focal floor thickening both with, and without, evidence of a rhinogenic aetiology, was significantly more common adjacent to restorative dentistry. Maxillary sinus disease overall was no more common adjacent to restorative dentistry.This work demonstrated that the presence of restorative dentistry predisposes to focal mucosal thickening in the floor of the maxillary sinus and its presence should prompt clinical and radiographical assessment to exclude dental disease as a source of chronic maxillary sinusitis.
Role of a home care team in paediatric day-case tonsillectomy
Authors: Shah C. , Shahab R. , Robb P. , Roy D. 
Published: October 2002

The feasibility of paediatric day-case tonsillectomy (PDCT) depends on its safety and acceptance by parents and patients. The purpose of our retrospective study of paediatric day-case tonsillectomy was to review the role of the home care team (HCT) in improving the safety and acceptance of the procedure.Between January 1997 and June 1999, 352 consecutive children underwent day-case tonsillectomy. The notes and HCT assessment sheets were reviewed for telephone calls made by HCT or by parents, home visit by HCT, types of complication and their outcome.The primary haemorrhage rate was 0.6 per cent. The effective day-case rate was 97 per cent. The unplanned admission rate was three per cent. The HCT visited about 25 per cent of patients at home. We conclude that paediatric day-case tonsillectomy is associated with high morbidity and considerable parental anxiety that can be dealt with by timely reassurance, support and advice by a dedicated HCT.
Combined ‘trache-stent’: a useful option in the treatment of a complex case of subglottic stenosis
Authors: Morris D. P. , Malik T. , Rothera M. P. 
Published: October 2002

The authors describe the adaptation of a Montgomery T-tube laryngo-tracheal stent to incorporate an uncuffed fenestrated Shiley tracheostomy tube in the management of a complex case of subglottic stenosis. The combined ‘ trache-stent’ provided a secure, unobstructed airway and optimal phonation. The presence of a removable inner tube facilitated cleaning and reduced patient anxiety regarding the perceived risks of stent obstruction with dried secretions.The combined ‘ trache-stent’ was upsized at four weeks with minimal evidence of local granulation formation. The device was removed entirely six weeks later after direct laryngoscopy reconfirmed the above findings. Almost two years later the patient retains a good voice and airway using a simple fenestrated tracheostomy tube and speaking valve. The subglottic area is stable and the patient has returned to full-time employment.
Long-term results of laser-assisted uvulopalatoplasty for snoring
Authors: Sharp H. R. , Mitchell D. B. 
Published: October 2002

We present the ongoing results of the series of 53 consecutive patients who underwent laser-assisted uvulopalatoplasty (LAUP) for snoring at the Kent and Canterbury Hospital. Twenty-nine patients (55 per cent) were completely satisfied with their surgery 18 to 24 months following LAUP when previously questioned via telephone questionnaire.We have followed up the 29 patients with a previously successful result at between 70 and 79 months following surgery. They underwent an average of 1.6 procedures. Twelve patients (22 per cent) continue to be completely satisfied at this late stage, and a further 12 (22 per cent) have some ongoing improvement in their snoring. Only three patients have indicated that a previously successful result has failed since the previous survey.The failure rate of LAUP in the treatment of snoring is seen predominantly in the first two years following surgery, but some long-term subjective recurrence of snoring does occur.
Fever and acquired torticollis in hospitalized children
Authors: Mezue W. C. , Taha Z. M. , Bashir E. M. 
Published: October 2002

Acute torticollis due to non-traumatic atlanto-axial subluxation (AAS) is often seen in children presenting with inflammatory conditions of the upper respiratory tract and the neck. Grisel’s syndrome is the eponym given to this condition. These patients may present earlier in the disease process without evident subluxation. Thus, early recognition of the condition with prompt commencement of appropriate conservative treatment could halt the progression into Grisel’s syndrome. The purpose of this study is to address the importance of early recognition of inflammatory torticollis that can be treated successfully by conservative methods.A retrospective review was made of the case files and radiological investigations of 13 children with fever and torticollis who were treated in the neurosurgery unit of Hamad General Hospital in Qatar, over a two-year period from July 1996 to July 1998. The children were aged between three and 12 years with a male to female ratio of 3:1. All patients arrived at the hospital within 48 hours of onset of torticollis and almost all had manifestations of upper respiratory tract or head and neck infections. Radiological examination by cervical spine X-rays, computerized tomography (CT) or magnetic resonance images (MRI) revealed that only three cases out of 13 had AAS. All patients underwent conservative treatment that included rest, neck collar, simple analgesics and antibiotics, where appropriate. A muscle relaxant was used in nine cases and Halter traction was applied to the three with AAS. All patients responded well to treatment and none required surgical intervention for AAS.We conclude that the majority of children presenting acutely with inflammatory torticollis have rotational deformity only without AAS. Progression to the latter, i.e. Grisel’s syndrome, may be aborted should the diagnosis be made early and conservative treatment initiated in time. On the other hand, delay in diagnosis would deprive these children an opportunity of receiving effective conservative treatment.
Day to day use and service-related issues with the bone-anchored hearing aid: the Entific Medical Systems questionnaire
Authors: Dutt Sunil N. , McDermott Ann-Louise , Jelbert Anwen , Reid Andrew P. , Proops David W. 
Published: October 2002

Over a 12-year period, the Birmingham implantation otology unit has implanted more than 300 patients with bone-anchored hearing aids (BAHA).The Entific Medical Systems questionnaire was administered to these patients to evaluate the day to day use of the BAHA, professional needs, after-care, wear and tear concerns and service related issues. Data analysis revealed that most patients used their BAHA for more than eight hours a day (90 per cent of BAHA users) and every day of the week (93 per cent of BAHA users). A high degree of satisfaction was expressed as regards sound amplification, listening to radio or television news, listening to music, speech perception in quiet conditions, during conversation with one person in noisy surroundings and conversation with family at home. Some degree of difficulty was expressed with the use of the BAHA during conversation with two or more people in noisy surroundings. A slow process of perceptual acclimatization was noticed with the majority of the patients. The majority of patients were pleased with the service as regards care of the wound, BAHA nursing clinics, device repairs and other service-related issues.
Serum lipid levels associated with increased risk for cardiovascular disease is associated with highly active antiretroviral therapy (HAART) in HIV-1 infection
Authors: Koppel Kristina , Bratt Göran , Eriksson Mats , Sandström Eric 
Published: October 2002

The long-term effects of fat metabolism, storage and utilization in HIV-1 infected patients on highly active antiretroviral therapy (HAART) including a protease inhibitor are profound and cause increasing concern. The main importance of these lipid/metabolic disorders lies in their assumed contribution to an increased risk of coronary heart disease (CHD). In the general population increased levels of lipoprotein(a) [Lp(a)] constitute an independent risk factor for CHD by itself as well as in combination with increased levels of cholesterol and low density lipoprotein (LDL)-cholesterol, respectively. Two hundred and fifty-six patients with 27 ± 7 months HAART and 84 treatment-naive HIV-1 positive patients were screened for cardiovascular risk factors. The subjective perception of fat wasting and/or accumulation in different sites of the body, which was possible to evaluate in 235 patients on HAART and 73 treatment-naive patients, the levels of plasma triglycerides (TG), cholesterol, LDL and high-density lipoproteins (HDL)-cholesterol, LDL/HDL ratio and Lp(a) were measured. Of the patients on HAART, 42% (98/235) reported abnormal fat distribution as compared with 4% (3/73) of the treatment-naive patients (P < 0.0001). The levels of TG, cholesterol and LDL-cholesterol, but not HDL-cholesterol or Lp(a) were higher (P < 0.0001) in the HAART group as compared with the naive group. Very high Lp(a) levels (>700 mg/l) were more common among HAART patients as compared with naive, 14% (36/256) vs 2% (2/83); P = 0.0022. The Lp(a) levels correlated to the levels of LDL-cholesterol, but not to total cholesterol, HDL-cholesterol or TG, and did not differ between patients with and without subjective perception of abnormal fat distribution. A significant number of the HAART patients had very high levels of Lp(a) and various combinations of increased lipid values associated with considerably increased risk for CHD. The elevation of Lp(a) did not relate to any other clinical or laboratory parameter than to LDL-cholesterol.
Historical Disclosure of Rape by Women Attending Genitourinary Medicine Clinics
Authors: Horn C K , Scott G R , Bain S S R 
Published: October 2002

In a previous internal audit of women attending the department of genitourinary medicine following rape, we noted that data from diagnostic coding seemed to underestimate the problem and that anecdotally, a number of women had been seen with concerns relating to historical assault. We therefore decided to record attendance following rape prospectively. Between 1 June 1996 and 31 May 1997 staff at the Department of Genitourinary Medicine (GUM) at the Royal Infirmary of Edinburgh completed a data collection form for every female patient aged > 15 years who attended the clinic and spontaneously disclosed a history of rape, either recent or historical. Seventy-five women attending GUM disclosed a history of rape. Sixty-six per cent were aged <25 years. Thirty women presented more than 12 months after the incidence, of whom 50% presented to the health adviser requesting HIV antibody testing. The incidence of sexually transmitted infections was low and in no case could be specifically attributed to the rape. None of the 38 HIV antibody tests performed were positive. A number of women present to GUM a long time after an incident of rape, most commonly due to concerns about HIV. They may have endured a great deal of mental anguish before summoning up the courage to seek help. This can have a substantial effect on workload, especially for health advisers.
Management of Reproductive Tract Infections in Rural Bangladesh
Authors: Ahmed Mohsin U , Mirza Tanjina , Khanum Parveen A , Khan Mehrab A , Ahmed Shameem , Khan Mobarak H 
Published: October 2002

This study was undertaken to identify existing reproductive tract infection (RTI) treatment practices of the government family planning (FP) paramedics in rural Bangladesh. It also assessed the knowledge and perceptions of the clients about RTIs as well as the service-seeking behaviour of the clients and their husbands. Data on paramedic treatment practices were collected by observing paramedic–client interactions at the family welfare centres (FWCs) and satellite clinics (SCs). One hundred clients seeking RTI treatment were observed. The same clients were interviewed at departure from the health-care facility to assess their knowledge and perceptions about RTIs as well as service-seeking behaviour of the clients and their husbands. Twenty-four village practitioners were also interviewed to assess their knowledge on the subject. Results of the study showed that in the treatment of RTI, paramedics of government FP services commonly: (i) did not do a physical examination, (ii) used a substandard dosage of drugs, and (iii) made no attempt to notify or treat male partners. Thirty-one of the 97 clients reported that their husbands had some kind of genital problem. It was revealed from the study that as an alternative to the government FP services, the clients and their husbands often seek RTI treatment from the village practitioners though the village practitioners’ knowledge concerning RTI is poor. Based on the findings of this study, it is recommended that the knowledge and skills of the paramedics and village practitioners for RTI treatment be strengthened. Prevention of RTI through awareness campaigns is essential for the control of RTIs, and especially of STDs.