Critical thresholds of intracranial pressure and cerebral perfusion pressure related to age in paediatric head injury.

Background: The principal strategy for managing head injury is to reduce the frequency and severity of secondary brain insults from intracranial pressure (ICP) and cerebral perfusion pressure (CPP), and hence improve outcome. Precise critical threshold levels have not been determined in head injured children.

Objective: To create a novel pressure-time index (PTI) measuring both duration and amplitude of insult, and then employ it to determine critical insult thresholds of ICP and CPP in children.

'Must try harder?': a family empowerment intervention for acquired brain injury.

This paper describes an intervention aimed at empowering parents of child survivors of acquired brain injury (ABI) in their interaction with teachers and other professionals involved in their child's education. The particular characteristics of the late morbidity of child ABI led to the design of an intervention in the form of a video and informational booklet that is the property of the family. Early response to the intervention has been extremely positive, although formal evaluation has been unexpectedly challenging.

Kangaroo vs. porcine aortic valves: calcification potential after glutaraldehyde fixation.

The aim of this study was to evaluate and compare the calcification potential of kangaroo and porcine aortic valves after glutaraldehyde fixation at both low (0.6%) and high (2.0%) concentrations of glutaraldehyde in the rat subcutaneous model.

Epidemiology of traumatic brain injury in children receiving intensive care in the UK.

Aims: To describe the epidemiology of children with traumatic brain injury (TBI) admitted to paediatric intensive care units (PICUs) in the UK.

Methods: Prospective collection of clinical and demographic information from paediatric and adult intensive care units in the UK and Eire between February 2001 and August 2003.

Results: The UK prevalence rate for children (0-14 years) admitted to intensive care with TBI between February 2001 and August 2003 was 5.

Influence of burst TENS stimulation on collagen formation after Achilles tendon suture in man. A histological evaluation with Movat's pentachrome stain.

Retrograde or antidromic stimulation of the nociceptive C fibres is known to lead to the release of sensory neuropeptides, such as substance P (SP), by the peripheral endings of sensory unmyelinated C nerve fibres. These neuropeptides play a role in the healing of soft tissues. Burst TENS (Transcutaneous Electric Nerve Stimulation) is known to be most effective in influencing retrograde C fibre-evoked activity.

A case of infant botulism with a possible link to infant formula milk powder: evidence for the presence of more than one strain of Clostridium botulinum in clinical specimens and food.

Infant botulism was confirmed in a 5-month-old female by both isolation of Clostridium botulinum type B and by detection of type B botulinum neurotoxin in rectal washout and faeces. DNA fingerprinting of nine isolates from faeces yielded two different amplified-fragment length polymorphism (AFLP) patterns. C.

Characterisation of human knee meniscus cell phenotype.

Objective: Studies on the biology of the human meniscus cell are scarce. The objective of our studies was to assess survival/proliferation of human meniscus cells in different culture conditions and to characterize the extracellular matrix (ECM) produced by these cells in these artificial environments. The composition of this ECM offers a variable to define the distinct meniscus cell phenotype.

A statistical profile of road accidents during cross-flow turns.

In-depth studies of behavioral factors in road accidents using conventional methods are often inconclusive and costly. In a series of studies exploring alternative approaches, 200 cross-flow junction road accidents were sampled from the files of Nottinghamshire Constabulary, England, coded for computer analysis using a specially devised 'Traffic Related Action Analysis Language', and then examined using different computational and statistical techniques. For comparison, the same analyses were also carried out on 100 descriptions of safe turns, and 100 descriptions of hypothetical accidents provided by experienced drivers.

Presence of osteoclast-like multinucleated giant cells in the bone and nonostotic lesions of Langerhans cell histiocytosis.

Langerhans cell histiocytosis (LCH) is a disease that can involve one or multiple organ systems characterized by an accumulation of CD1a(+) Langerhans-like cells as well as several other myeloid cell types. The precise origin and role of one of these populations, the multinucleated giant cell (MGC), in this disease remains unknown. This work shows that in three different lesional tissues, bone, skin, and lymph node, the MGCs expressed the characteristic osteoclast markers, tartrate-resistant acid phosphatase and vitronectin receptor, as well as the enzymes cathepsin K and matrix metalloproteinase-9.

A tale of two hospitals: assessing cultural landscapes and compositions.

Clinical directorate service structures (CDs) have been widely implemented in acute settings in the belief that they will enhance efficiency and patient care by bringing teams together and involving clinicians in management. We argue that the achievement of such goals depends not only on changing its formalized structural arrangements but also the culture of the organisation concerned. We conducted comparative observational studies and questionnaire surveys of two large Australian teaching hospitals similar in size, role and CD structure.

Bovine glue (BioGlue) is catabolized by enzymatic reaction in the vascular dog model.

Purpose: The aim of the study is to explore the feasibility, patency, and histologic changes of a sutureless vascular anastomotic technique using biological glue as sole fixation method.

Description: Eight mongrel dogs (+/-15 kg) underwent direct reanastomosis of their transsected iliac arteries. Both ends were placed on a 5-mm balloon and the anastomosis was secured with biological glue (BioGlue, Cryolife, Kennesaw, GA).

Influence of control variables on mannequin temperature in a paediatric operating theatre.

Background: Core temperature drops in all children having general anaesthesia. Convection heating may be useful, but its effectiveness in the paediatric setting is not established. Additionally, its utility in many paediatric situations is limited by blanket design.

Influence of burst TENS stimulation on the healing of Achilles tendon suture in man.

Retrograde or antidromic stimulation of the nociceptive C fibres is known to lead to the release of sensory neuropeptides Substance P (SP) and Calcitonin Gene-Related Peptide (CGRP) by the peripheral endings of these ultra-thin nerve fibres. These neuropeptides have, among others, a vasodilatory effect, which explains why they play a role in the healing of soft tissues. Burst TENS (Transcutaneous Electric Nerve Stimulation) is known to be most effective in influencing C fibre-evoked activity.

Stability and compatibility of reconstituted ertapenem with commonly used i.v. infusion and coinfusion solutions.

Purpose: The stability of ertapenem sodium in various commonly used i.v. infusion solutions and its compatibility with coinfusion solutions was studied.

Evidence for involvement of a tumor suppressor gene on 1p in malignant peripheral nerve sheath tumors.

Malignant peripheral nerve sheath tumors (MPNST) are rare soft-tissue malignancies. The genetic basis of these tumors is still poorly understood. Cytogenetic analyses predominantly revealed complex karyotypes, precluding the identification of recurrent chromosomal changes.

Randomized controlled trials of continuing medical education: what makes them most effective?

Introduction: It is essential that professional standards of excellence are demonstrated in the continuing medical education (CME) curriculum and research.

Methods: This review examines 20 randomized controlled trial (RCT) studies in CME and their effect on physician performance and/or patient health care outcomes. A systematic evaluation of the 20 RCT articles was performed.

Noradrenergic agonists for acute traumatic brain injury.

Background: Although there have been considerable gains in understanding the cascade of events that lead to secondary injury after traumatic brain injury (TBI), efforts to translate this understanding into new therapeutic, so-called neuroprotective, approaches have so far proven disappointing. Animal models suggest an alternative strategy: agents enhancing monoaminergic transmission, particularly amphetamines, have been shown to promote motor recovery from focal brain injury and it has been suggested that this might represent a complementary means of therapeutic intervention in the later post-injury phase.

Objectives: To evaluate the evidence that amphetamines improve final outcome after traumatic brain injury.

A genome-wide strategy for the identification of essential genes in Staphylococcus aureus.

To address the need for new approaches to antibiotic drug development, we have identified a large number of essential genes for the bacterial pathogen, Staphylococcus aureus, using a rapid shotgun antisense RNA method. Staphylococcus aureus chromosomal DNA fragments were cloned into a xylose-inducible expression plasmid and transformed into S. aureus.

Recurrent focal epithelial hyperplasia due to HPV13 in an HIV-positive patient.

There are few reports on focal epithelial hyperplasia (FEH) in association with human immunodeficiency virus (HIV) infection; thus the relationship between them has not been completely clarified yet. We present a case of recurrent FEH in an HIV-positive man (the first described in Belgium), which, according to the PCR-DNA testing, was due to human papilloma virus type 13 (HPV13). To our knowledge, based on the accessible literature, this type of HPV has not been detected in any other documented study of FEH in HIV-positive patients before.

Routine intracranial pressure monitoring in acute coma.

Background: Studies in traumatic encephalopathy first led to the insight that the damage seen was not just due to direct consequences of the primary injury. A significant, and potentially preventable, contribution to the overall morbidity arose from secondary hypoxic-ischaemic damage. Brain swelling accompanied by raised intracranial pressure (ICP) resulted in inadequate cerebral perfusion with well-oxygenated blood.