The burden of head trauma in rural and remote North Queensland, Australia

Background: Head trauma is a leading cause of death and disability worldwide. Young males, Indigenous people, and rural/remote residents have been identified as high-risk populations for head trauma, however, Australian research is limited. Our aim was to define and describe the incidence, demographics, causes, prehospital interventions, and outcomes of head trauma patients transported by aeromedical services within North Queensland, Australia. We hypothesized that young, Indigenous males living remotely would be disproportionately affected by head trauma. Methods: We conducted a retrospective study of all head trauma patients transferred by air to or between Townsville, Cairns, Mount Isa and Mackay Hospitals between January 1, 2016 and December 31, 2018. Patients were identified from the Trauma Care in the Tropics data registry and followed for a median 30-months postinjury. Primary endpoints were patient and injury characteristics. Secondary outcome measures were hospital stay and mortality. Results: A total of 981 patients were included and 31.1 % were Indigenous. Sixty-seven percent of injuries occurred remotely and the median time from injury to hospital was 5.8-hours (range 67–3780 min). Eighty percent of severe head injuries occurred in males (p = 0.007). Indigenous and remote patients were more likely to sustain mild injuries. The most common mechanism of injury overall was vehicle accident (37.5 %), compared to assault in the Indigenous subgroup (46.6 %, p<0.001). The overall mortality rate was 4.9 %, with older age and lower initial Glasgow Coma Score significant predictors of in-hospital mortality. Prehospital intubation was associated with a 7-fold increased risk of mortality (p = 0.056), while patients that received tranexamic acid (TXA) were almost 5-times more likely to die. Conclusions: In North Queensland, young Indigenous males are at highest risk of traumatic head injuries. Vehicle accidents are an important preventable cause of head injury in the region. TXA administration is an important consideration for remote head trauma retrievals, in which time to emergency care is prolonged. Appropriate treatment and risk stratification strategies considering time to definitive care, severity of injury, and other prehospital patient factors require further investigation

Rickettsia felis in Ctenocephalides spp. Fleas, Brazil

In June 2000, suspected cases of Brazilian spotted fever (BSF) occurred in Coronel Fabriciano Municipality, Minas Gerais State, Brazil. Pooled fleas collected near two fatal cases contained rickettsial DNA. The nucleotide sequence alignment of the 391-bp segment of the 17-kDa protein gene showed that the products were identical to each other and to the R. felis 17-kDa gene, confirming circulation of R. felis in Brazil

Educational effectiveness of gynaecological teaching associates: a multi-centre randomised controlled trial

This trial was funded by The Medical College St Bartholo-mew’s Hospital Trust (reference number: 8368137)

Ergodicity and digital texts

Na passagem do texto físico para o texto digital ocorre uma quebra da linearidade da página impressa, que afecta a forma como a recepção se alia à produção através da performatividade característica das novas narrativas. A ruptura do limite material do texto, permitida pela hipertextualidade, obriga a uma construção de sentidos diferente, que assenta na exploração de um texto maior. A introdução do hipermedia vem depois ampliar e complexificar a ideia de hipertextualidade, ao fazer convergir linguagens diversas, num processo interactivo que se assemelha ao processo da própria criação. A partir de estímulos e aberturas do trabalho digital, os textos ergódicos constroem a imaterialidade da significação em espaços singularizados de materialidade algorítmica. Perante um texto destituído de corpo próprio ou único, pretende-se discutir a forma como a textualidade electrónica assiste a esta desmaterialização e a conduz, e como o discurso hipermedia se desloca entre linguagens e suportes multimédia diferentes.ABSTRACT: Whilst breaking the linearity of the printed page, the passage from the physical text to a digital one has blurred the limits between reception and production and has shaped different narrative performances. Hypertextuality has shattered the limits of the text and has simultaneously required the construction of meaning by exploring a major text. Eventually, hypermedia has amplified and complexified that hypertextuality by being able to converge diverse languages, in an interactive process that resembles the actual creation activity. In response to the nodes and stimuli of the digital work, ergodic texts coexist within a customized space of algorithmic materiality and signification immateriality. In this paper we want to discuss how the bodiless but crowded electronic textuality leads this dematerialization as the hypermedia discourse flickers among different languages and multimedia devices.info:eu-repo/semantics/publishedVersio

AIDS-defining illnesses among patients with HIV in Singapore, 1985 to 2001: results from the Singapore HIV Observational Cohort Study (SHOCS)

BACKGROUND: The objective was to describe the causes of initial and overall AIDS-defining disease episodes among HIV patients in Singapore. METHODS: A retrospective observational cohort study was performed of all adult patients seen at the national HIV referral center between 1985 and 2001. Data were extracted from the patients' records by ten trained healthcare workers. AIDS-defining conditions were established using predefined criteria. RESULTS: Among 1504 patients, 834 had experienced one or more AIDS-defining diseases. The most frequent causes of the initial AIDS-defining episode were Pneumocystis carinii pneumonia (35.7%), Mycobacterium tuberculosis (22.7%) and herpes simplex (7.4%). In total 1742 AIDS-defining episodes occurred. The most frequent causes were Pneumocystis carinii pneumonia (25.1%), Mycobacterium tuberculosis (16.2%) and cytomegalovirus retinitis (9.5%). CONCLUSIONS: The most frequent causes of AIDS-defining illnesses in Singapore are similar to those reported in the West, prior to the introduction of anti-retroviral therapy. Opportunistic infections remain the most frequent AIDS-defining illnesses