Twelve tips to revitalise problem-based learning.

The role of the problem-based learning (PBL) facilitator has seen different interpretations ever since PBL first gained widespread use. What has remained unchanged is the challenge for facilitators to use their knowledge and expertise sparingly and to use their interpersonal skills to improve group dynamics. Medical undergraduates attending PBL sessions have also changed in their skill sets, expectations and the use of technology.

Primary acute dengue and the deletion in chemokine receptor 5 (CCR5Δ32).

Dengue virus is a significant arboviral pathogen that is continuing to spread due to human travel and invasion of the mosquito vectors into new regions. Chemokine receptor 5 (CCR5) has a truncated 32 base pair deletion form (CCR5Δ32), which has been associated with resistance to HIV but increased severity in some flaviviral diseases. If CCR5Δ32 is associated with dengue, European carriers of this mutation may be at increased risk.

Negative-pressure pulmonary edema after routine septorhinoplasty: discussion of pathophysiology, treatment, and prevention.

Objective: To provide rhinologic surgeons with an understanding of acute negative-pressure pulmonary edema (NPPE) and its treatment.

Design: Case report and literature review of all published adult cases of NPPE. Patient factors, anesthetic variables, and outcomes are assessed.

Melioidosis, northeastern Brazil.

Melioidosis was first recognized in northeastern Brazil in 2003. Confirmation of additional cases from the 2003 cluster in Ceará, more recent cases in other districts, environmental isolation of Burkholderia pseudomallei, molecular confirmation and typing results, and positive serosurveillance specimens indicate that melioidosis is more widespread in northeastern Brazil than previously thought.

Chikungunya infection--an emerging disease in Malaysia.

Many countries neighboring Malaysia have reported human infections by chikungunya virus, a mosquito-borne togavirus belonging to the genus Alphavirus. However, although there is serological evidence of its presence in Malaysia, chikungunya virus has not been known to be associated with clinical illness in the country. An outbreak of chikungunya virus occurred in Klang, Malaysia, between December 1998 and February 1999.

Subarachnoid hemorrhage presenting as post-dural puncture headache: a case report.

A case of subarachnoid hemorrhage following spinal anesthesia for prostate radioactive seed implantation is reported. The implications of the differential diagnosis of post-dural puncture headache are discussed.

Milrinone is superior to epinephrine as treatment of myocardial depression due to ropivacaine in pigs.

Purpose: To determine whether milrinone is more effective than epinephrine in the resuscitation of ropivacaine induced cardiotoxicity in pigs.

Methods: Arterial, pulmonary, and LVdP/dt catheters were placed in 12 anesthetized, intubated and mechanically ventilated pigs. They received ropivacaine iv to cardiovascular toxicity: 50% decrease in LVdP/dt, cardiac output and mean arterial pressure (MAP).

Arrhythmogenic potential of dopexamine hydrochloride during halothane anaesthesia in dogs.

Dopexamine hydrochloride (Dopacard) is the novel synthetic catecholamine designed for use in the acute management of a low cardiac output status. In addition to dopaminergic receptor stimulation, dopexamine hydrochloride is a potent beta 2 adrenoceptor agonist with negligible direct beta 1 and no alpha adrenergic effect. The objective of this study was to compare the arrhythmogenic effects of dopexamine hydrochloride and dopamine in dogs anaesthetized with halothane (1.

Role of adenosine in the diagnosis and treatment of postoperative supraventricular tachyarrhythmias.

Adenosine (Adenocard) has a potent but very transient negative dromotropic effect on atrioventricular (A-V) nodal conduction. By slowing A-V nodal conduction, adenosine may interrupt a re-entry pathway causing paroxysmal supraventricular tachycardia or facilitate the diagnosis of other supraventricular tachycardia (SVT) by exposing the underlying atrial activity. We report 15 postoperative cases in which adenosine was used to clarify the diagnosis of postoperative SVT, and allowed the appropriate postoperative care.

A comparison of esmolol and labetalol for the treatment of perioperative hypertension in geriatric ambulatory surgical patients.

This is an open randomized study comparing the efficacy and safety of i.v. esmolol and labetalol in the treatment of perioperative hypertension in ambulatory surgery.

Esmolol prevents and suppresses arrhythmias during halothane anaesthesia in dogs.

The antiarrhythmic effect of esmolol, a selective beta 1 adrenoreceptor blocker, was evaluated in the presence of epinephrine induced arrhythmias in dogs (n = 6). The arrhythmogenic dose of epinephrine (ADE) during 1.2 MAC halothane in dogs was increased from 3.

Comparison of propofol and thiamylal for induction and maintenance of anaesthesia for outpatient surgery.

In an open, randomized study we have compared the safety and efficacy of propofol with thiamylal for induction and maintenance of anaesthesia supplemented by nitrous oxide in elective termination of pregnancy. Induction of anaesthesia was achieved with either propofol 2.5 mg kg-1 or thiamylal 4.

Prevalence of antibody to Legionella pneumophila in aborigines and non-aborigines in Western Australia.

Three hundred and sixty-two sera were examined by the Legionella pneumophila indirect fluorescent antibody test, with serogroups 1 to 6 as antigens. Three age- and sex-matched population groups were tested: 200 non-aborigines from Perth; 100 aborigines from the Kimberley region; and 62 aborigines from Jiggalong Mission in the Pilbara region. Each population group was composed of 50% male and 50% female subjects, all within the age range of 20 to 40 years.

Strongyloidiasis is endemic in another Australian population group: Indochinese immigrants.

The prevalence of antibodies against Strongyloides in the serum of newly-arrived Indochinese immigrants was determined. Sera that had been stored in the State Health Laboratories, Perth, were stratified according to age and sex, then samples were selected at random. Two hundred and ninety sera that had been obtained from persons between the ages of one and 69 years were examined by an indirect fluorescent antibody test.