PubMed Health⌕ Search

Biomedical subjects

James Hamill

Publications and source records attributed to James Hamill.

9 recordsLinked to original sources
PubMed2006

Tackling the burden of injury in Australasia: developing a binational trauma registry.

Existing trauma registries in Australia and New Zealand play an important role in monitoring the management of injured patients. Over the past decade, such monitoring has been translated into changes in clinical processes and practices. Monitoring and changes have been ad hoc, as there are currently no Australasian benchmarks for "optimal" injury management. A binational trauma registry is urgently needed to benchmark injury management to improve outcomes for injured patients.

Australia↗
PubMed2006

Laparoscopic gastric diverticulectomy in a 13-year-old girl.

Symptomatic gastric diverticula are rare, mainly occurring in patients between 20 and 60 years of age. In adults, laparoscopic resection seems to be an attractive alternative to conventional surgery, although some authors experienced problems in identifying the diverticulum intraoperatively. We present a case of a gastric diverticulum in a 13-year-old girl and emphasize the difficulties in establishing the diagnosis. Once other gastrointestinal disorders were excluded, a laparoscopy was performed and the diverticulum resected successfully with an endoscopic linear stapler device. This is the first report on laparoscopic resection of a gastric diverticulum in a child. More experience is mandatory to confirm the safety and long-term success of a minimal invasive technique for this pathologic entity in pediatric patients.

Abdominal Pain↗
PubMed2006

Serious injuries from dishwasher powder ingestions in small children.

AIMS: To describe patterns and severity of caustic injuries sustained from dishwasher powder ingestion and highlight need for national safety standards. METHODS: Retrospective chart review of admissions for caustic ingestion to Starship Children's Hospital from January 2003 to January 2005 and review of New Zealand National Poisons Centre data. RESULTS: Between January 2003 and January 2005, the National Poisons Centre recorded 610 dishwashing powder ingestions, with 88% of children less than 2 years old. Twenty-three children were admitted to Starship Children's Hospital following caustic ingestion, of whom 11 were identified as having ingested dishwasher powder (9 boys and 2 girls) and were aged 11 to 30 months (mean 17.5). Five children (45%) were admitted to the Paediatric Intensive Care Unit over 4 months (October 2004 to January 2005), requiring intubation for airway control. Two children needed tracheostomy. Three of the 11 children (27%) required repeated oesophageal dilatation, and two underwent gastrostomy formation. One brand of dishwasher detergent and container type was implicated in over half of the cases. CONCLUSIONS: Dishwasher detergents are highly corrosive substances that cause potentially life-threatening injuries and ongoing morbidity. The recent surge of incidents may be related to change in product constituents or non-compliance with New Zealand safety standards. Efforts to limit product alkalinity, legislative requirement of Child-Resistant Packaging and public education may reduce injuries from these common household substances.

Accidents, Home↗
PubMed2006

Training in paediatric trauma: the problem of safer societies.

BACKGROUND: Trauma remains the most common cause of child death worldwide but the incidence of major trauma is declining in many developed countries: this has implications for training. METHODS: A survey of paediatric surgeons and paediatric surgical trainees was undertaken to evaluate perceptions of the relative importance of various forms of trauma training. A questionnaire was e-mailed to Australasian paediatric surgeons and trainees to determine trauma courses they had undertaken, operative and non-operative paediatric trauma experience and attitudes towards trauma training. RESULTS: The overall response rate was 49% (40 of 83 consultants and 11 of 22 trainees). The Early Management of Severe Trauma course had been undertaken by 82% of consultants and all trainees. The Definitive Surgical Trauma Care course had been undertaken by 22% of consultants and one trainee. The number of trauma laparotomies carried out in the previous year was in the one to five range for 71% of responders. Greater emphasis was placed on the value of adult trauma experience by consultants who had a general surgical fellowship. CONCLUSION: In societies where major trauma in children is relatively rare (fortunately) and the opportunities for training are limited, it is important to ensure that advanced trainees in paediatric surgery gain sufficient skills from a variety of sources to enable them to treat competently the severely injured child with multiple injuries.

Adult↗
PubMed2006

Paediatric lap-belt injury: a 7 year experience.

OBJECTIVE: To highlight the injuries that result from lap-belt use and make recommendations for prevention, the recent experience of a regional paediatric trauma centre was reviewed. METHODS: Retrospective review of admissions to Starship Children's Hospital from 1996 to 2003, with significant injury following involvement in a motor vehicle crash, while wearing a lap-belt. Patients were identified from two prospectively collected databases and discharge coding data. RESULTS: In total, 19 patients were identified over the 7 year period. The morbidity sustained includes 15 patients with hollow viscus injury, 13 laparotomies, 7 spinal fractures, 2 paraplegia and 1 fatality. A total of 11 patients required laparotomy with a median delay of 24 h. Of patients in the present series, 58% were aged less than 8 years and thus were inappropriately restrained. CONCLUSIONS: Lap-belt use can result in a range of life-threatening injuries or permanent disability in the paediatric population. The incidence of serious lap-belt injury does not appear to be decreasing. Morbidity and mortality could be reduced by the use of three-point restraints, age appropriate restraints and booster seats.

Abdominal Injuries↗
PubMed2002

Iterative reconstruction methods for high-throughput PET tomographs.

A fast iterative method is described for processing clinical PET scans acquired in three dimensions, that is, with no inter-plane septa, using standard computers to replace dedicated processors used until the late 1990s. The method is based on sinogram resampling, Fourier rebinning, Monte Carlo scatter simulation and iterative reconstruction using the attenuation-weighted OSEM method and a projector based on a Gaussian pixel model. Resampling of measured sinogram values occurs before Fourier rebinning, to minimize parallax and geometric distortions due to the circular geometry, and also to reduce the size of the sinogram. We analyse the geometrical and statistical effects of resampling, showing that the lines of response are positioned correctly and that resampling is equivalent to about 4 mm of post-reconstruction filtering. We also present phantom and patient results. In this approach, multi-bed clinical oncology scans can be ready for diagnosis within minutes.

Algorithms↗
PubMedDate not supplied

Improved breast cytology results with near patient FNA diagnosis.

OBJECTIVE: To examine the impact of a cytopathologist using near patient fine needle aspiration diagnosis (NPFD) for breast diagnosis. STUDY DESIGN: The cytology results of all palpable solid breast lesions undergoing fine needle aspiration (FNA) during a two-year period were prospectively audited and categorized as definitely benign or malignant (definite), probably benign, indeterminate or suspicious (indefinite) or unsatisfactory. The final diagnosis (benign or malignant) was determined from a review of patients' charts and a survey of patients' family physicians. Aspirates were performed by surgical staffand reported either later (non-NPFD) or by NPFD. RESULTS: Of 720 FNAs, 230 were by NPFD and 490 by non-NPFD. NPFD was associated with a significantly greater proportion of definite reports (91.9% versus 82.4%). NPFD of discrete breast lumps was associated with higher specificity (89.1% versus 67.5%) and a lower unsatisfactory rate (9.4% versus 19.6%) than non-NPFD. NPFD did not improve the unsatisfactory rate of FNAs from diffuse breast thickenings. CONCLUSION: FNA by a dedicated specialist and immediate reporting should be an integral part of a breast diagnostic service.

Adult↗