Management of childhood and adolescent asthma

No Abstract

Vertical axis wind turbine generator case study : costs and losses associated with variable torque and variable speed strategies

This case study investigates the generator of a large offshore Vertical Axis Wind Turbine (VAWT). In particular this case study focuses on the effect of the inherent cyclic torque loading of the VAWT on the generator in terms of the costs and losses experienced. A spectrum of torque control strategies were created based on the ratio q of the allowed electrical torque variation to the mechanical torque variation. Equations relating the copper and iron losses of the generator to this q factor were established and investigated for a test turbine. In addition the relationship between the allowed variation in electrical torque and the cost of the active materials of the generator was explored

Cluster Grid based Response-time analysis module for the PIPE Tool.

Generalized Stochastic Petri Nets (GSPNs) are a widely used high-level formalism used for modelling discrete-event systems. The Platform Independent Petri net Editor (PIPE) is an open source software project that allows creation, analysis and simulation of Petri Nets. This tool paper presents a PIPE module for response-time analysis of a Petri net’s underlying Continuous Time Markov Chain (CTMC). Jobs are submitted via a web interface, from within PIPE or from a browser. The parallel computations are run using Grid Engine on a cluster hosted at Imperial College London. 1

Surgical treatment for 'brain compartment syndrome' in children with severe head injury

OBJECTIVES: Traumatic brain injury accounts for a high percentage of deaths in children. Raised intracranial pressure (ICP) due to brain swelling within the closed compartment of the skull leads to death or severe neurological disability if not effectively treated. We report our experience with 12 children who presented with cerebral herniation due to traumatic brain swelling in whom decompressive craniectomy was used as an emergency. DESIGN: Prospective, observational. SETTING: Red Cross Children's Hospital. SUBJECTS: Children with severe traumatic brain injury and cerebral swelling. OUTCOME MEASURES: Computed tomography (CT) scanning, ICP control, clinical outcome. RESULTS: Despite the very poor clinical condition of these children preoperatively, aggressive management of the raised pressure resulted in unexpectedly good outcomes. CONCLUSION: Aggressive surgical measures to decrease ICP in the emergency situation can be of considerable benefit; the key concepts are selection of appropriate patients and early intervention

Exploration of the network spun by website users

Using data stretching over more than 5 years for the website http://gallery.future-i.com/ this paper investigates basic properties of the popularity of pictures and the way users navigate through the website. We find that the rank frequency plot of the downloaded pictures follows a Zipf law. The download rate of individual popular pictures over time resembles that seen of infection rates of diseases. The graph created by successive downloads of pictures shows a power law that does not change over different time periods. We discuss how our findings can be modelled and how they are of importance to website performance

Surgical treatment for 'brain compartment syndrome' in children with severe head injury

No Abstract. South African Medical Journal Vol. 96(9) (Part 2) 2006: 969-97

Resuscitation in major burns: The problem of fluid creep

We have noticed an alarming tendency for burn patients to be over-resuscitated, and we believe that protocols should be reviewed in light of our own and international experience. We recently managed an 8-year-old boy with 52% fullthickness burns, who developed abdominal and limb compartment syndromes during the period of resuscitation. The fluid volumes infused above those calculated were 1.6 and 4.7 litres on days 1 and 2 respectively to maintain haemodynamic stability and urine output above 2 ml/kg/h. Within 48 hours of the injury, he developed poor peripheral perfusion and a distended abdomen; the intravesical pressure was 32 mmHg and the abdominal perfusion pressure 23 mmHg. Abdominal decompression and three limb fasciotomies were performed, but small-bowel and lower limb muscle necrosis had developed. The patient deteriorated rapidly despite inotropic support and died

Imaging findings in a patient with eosinophilic pneumonia (Lvffler's syndrome)

Löffler’s syndrome was initially described as a disorder characterised by transient pulmonary infiltrates accompanied by peripheral blood eosinophilia in asymptomatic or mildly ill patients. Abnormal chest radiographic findings are said to occur in 95% of patients but there are no descriptions of CT findings. There are many causes of this syndrome, but in developing countries the most common presentation remains secondary to the migratory larvae of common intestinal helminths. We present the clinical and radiological features of a boy with clearly defined Löffler's syndrome due to larval migration

Paediatric nonbronchoscopic bronchoalveolar lavage: Overview and recommendations for clinical practice

NB-BAL is an effective procedure for the diagnosis of pulmonary disease processes in ventilated infants and children. This procedure is, however, not without risks to both patients and staff. Numerous complications of NB-BAL exist, with hypoxia being the most common. As a result, care should be taken in performing NB-BAL on haemodynamically unstable patients; patients with coagulation defects; and patients with cardiac or brain abnormalities. This paper presents an overview of paediatric nonbronchoscopic bronchoalveolar lavage (NB-BAL) including: the rationale for NB-BAL; the complications associated with the procedure; indications and contraindications. It also recommends an evidence-based clinical guideline for performing the procedure in the paediatric intensive care unit. By following the NB-BAL guidelines presented in this paper, one can ensure that an effective specimen is obtained from the lower respiratory tract, whilst minimising the risk to the patient