of surfactant replacement therapy at Johannesburg Hospital, November 1991 December 1992

Objective. To assess the impact of surfactant replacement therapy (SRl) on the outcome of hyaline membrane disease (HMD) and to assess the cost implications of a policy of selective administration of artificial surfactant. Design. The short-term outcome of 103 newborns ventilated for HMD (61 selected for SRT according to initial and/or ongoing oxygen requirements) was compared with that of a historical control group of 173 infants ventilated for HMD before the introduction of SRT. Main outcome measures. Mortality and morbidity of HMD including death, bronchopulmonary dysplasia, pneumothorax, pulmonary haemorrhage, patent ductus arteriosus and intraventricular haemorrhage. Results. There were significant demographic differences between the treatment and control groups (black patients 74% v. 28%, P < 0,0001; unbooked mothers 72% v. 15%, P < 0,0001) as well as evidence of more severe lung disease in the treatment group (pressor support 44% v. 27%, P < 0,005; and paralysis during ventilation 38% v. 25%, P < 0,005). Pneumothorax was reduced in the SRT group (7% v. 17%, P < 0,01). There were no significant differences between the two groups in the incidence of BPO or mortality. The use of SRT added to the total cost of treating a patient ventilated for HMD. Conclusion. The selective use of SRT had the effect of converting severe -disease into moderate disease rather than achieVing maximal benefit in all cases of HMD through routine use of the product. A policy of restricting use may result in cost savings where resources are limited.S Afr Med J 1995; 85; 646-649

Revision shoulder hemiarthroplasty and total shoulder arthroplasty a systematic review and meta-analysis.

The number of shoulder replacements performed each year continues to increase, and the need for revision replacements has grown accordingly. The outcome of a revision replacement may influence which primary implant is selected and the timing of primary surgery, particularly in younger patients. The aim of this study was to establish the expected improvement in shoulder function and implant survival following revision of a hemiarthroplasty and revision of an anatomical total shoulder arthroplasty (TSA). A systematic review and meta-analysis were performed of all studies reporting shoulder scores or implant survival following revision hemiarthroplasty or revision TSA. MEDLINE, EMBASE, CENTRAL, The Cochrane Database of Systematic Reviews and National Joint Registry reports were searched. 15 studies were included, reporting on 593 revision anatomical shoulder replacements. There was large variation in the magnitude of improvement in shoulder scores following revision surgery. Over 80% of revision replacements last 5 years and over 70% last 10 years. There was no significant difference in shoulder scores or implant survival according to the type of primary implant. The belief that revision of a shoulder hemiarthroplasty may lead to improved outcomes compared to revision of a TSA is not supported by the current literature

Limitations of augmentation index in the assessment of wave reflection in normotensive healthy individuals

Objectives Augmentation index (AIx) is widely used as a measure of wave reflection. We compared the relationship between AIx and age, height and sex with ‘gold standard’ measures of wave reflection derived from measurements of pressure and flow to establish how well AIx measures wave reflection. Materials and Methods Measurements of carotid pressure and flow velocity were made in the carotid artery of 65 healthy normotensive individuals (age 21–78 yr; 43 male) and pulse wave analysis, wave intensity analysis and wave separation was performed; waveforms were classified into type A, B or C. AIx, the time of the first shoulder (Ts), wave reflection index (WRI) and the ratio of backward to forward pressure (Pb/Pf) were calculated. Results AIx did not correlate with log WRI or Pb/Pf. When AIx was restricted to positive values AIx and log WRI were positively correlated (r = 0.33; p = 0.04). In contrast log WRI and Pb/Pf were closely correlated (r = 0.66; p<0.001). There was no correlation between the Ts and the timing of Pb or the reflected wave identified by wave intensity analysis. Wave intensity analysis showed that the morphology of type C waveforms (negative AIx) was principally due to a forward travelling (re-reflected) decompression wave in mid-systole. AIx correlated positively with age, inversely with height and was higher in women. In contrast log WRI and Pb/Pf showed negative associations with age, were unrelated to height and did not differ significantly by gender. Conclusions AIx has serious limitations as a measure of wave reflection. Negative AIx values derived from Type C waves should not be used as estimates of wave reflection magnitude

On-chip Terahertz Spectroscopy of Liquid Mixtures

We demonstrate 'through-substrate' sensing of fluids for application in the terahertz spectroscopy of biological materials. This technique employs planar Goubau lines with integrated photoconductive material, formed on a flexible, thin polyimide substrate, and bonded to a microfluidic channel. Few-picosecond pulses are used to probe liquid samples confined within the channel, over a total interaction length of 4 mm, overcoming water-absorption limitations of free-space terahertz transmission measurements

Accurate Parameter Extraction From Liquids Measured Using On-chip Terahertz Spectroscopy

We introduce a method for estimating the permittivity of liquid samples measured using integrated microfluidic/planar Goubau line terahertz waveguides, in which simulation results are incorporated with measurement data to enable accurate frequency-dependent analysis

On an Analytical Framework for Voids: Their abundances, density profiles and local mass functions

We present a general analytical procedure for computing the number density of voids with radius above a given value within the context of gravitational formation of the large scale structure of the universe out of Gaussian initial conditions. To this end we develop an accurate (under generally satisfied conditions) extension of unconditional mass function to constrained environments, which allowes us both to obtain the number density of collapsed objects of certain mass at any distance from the center of the void, and to derive the number density of voids defined by those collapsed objects. We have made detailed calculations for the spherically averaged mass density and halo number density profiles for individual voids. We also present a formal expression for the number density of voids defined by galaxies of a given type and luminosity. This expression contains the probability for a collapsed object of certain mass to host a galaxy of that type and luminosity as a function of the environmental density. We propose a procedure to infer this function, which may provide useful clues as to the galaxy formation process, from the observed void densities.Comment: 14 pages, 7 figures, MNRAS in pres

Detection of Ventricular Tachycardia Using Scanning Correlation Analysis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72896/1/j.1540-8159.1990.tb06919.x.pd