RESUMEN
The positions of Laurentia and other landmasses in the Precambrian supercontinent of Rodinia are controversial. Although geological and isotopic data support an East Antarctic fit with western Laurentia, alternative reconstructions favor the juxtaposition of Australia, Siberia, or South China. New geologic, age, and isotopic data provide a positive test of the juxtaposition with East Antarctica: Neodymium isotopes of Neoproterozoic rift-margin strata are similar; hafnium isotopes of approximately 1.4-billion-year-old Antarctic-margin detrital zircons match those in Laurentian granites of similar age; and a glacial clast of A-type granite has a uraniun-lead zircon age of approximately 1440 million years, an epsilon-hafnium initial value of +7, and an epsilon-neodymium initial value of +4. These tracers indicate the presence of granites in East Antarctica having the same age, geochemical properties, and isotopic signatures as the distinctive granites in Laurentia.
RESUMEN
OBJECTIVE: To perform a multicentre follow-up study to determine if previously identified markers of serious illness in early infancy were robust and statistically reliable. METHODS: Infants aged 1 week to 26 weeks presenting to the Emergency Departments of the Royal Children's Hospital and two Melbourne metropolitan hospitals were seen over a 12-month period. Eleven clinical markers as well as their temperature were documented by nursing staff and resident medical officers. Serious illness was defined if infants had a positive body fluid bacterial culture, a positive chest X-ray or if significant treatment was required in hospital. The predictive values, sensitivity and specificity for the individual and the best combination of clinical markers were determined. RESULTS: Assessments (3806) were performed with 312 infants being assessed as seriously ill (8.2%). The combination of either drowsiness on history or examination, pallor on history or examination, breathing difficulty (chest wall recession), temperature above 38 degrees C and a lump being present, identified 82.5% of all babies deemed subsequently to be seriously ill. The positive predictive value of an infant who was febrile, drowsy and pale on examination was 70.7% (previous study 74%). CONCLUSIONS: This study confirmed the high individual predictive value of arousal variables, pallor, and chest wall recession, especially when associated with fever, reaffirming their utility in the recognition of serious illness in infants under 6 months of age.
Asunto(s)
Biomarcadores/análisis , Enfermedades del Recién Nacido/diagnóstico , Anomalías Congénitas/diagnóstico , Anomalías Congénitas/terapia , Enfermedad Crítica , Enfermedades del Sistema Digestivo/diagnóstico , Enfermedades del Sistema Digestivo/terapia , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Enfermedades del Recién Nacido/terapia , Infecciones/diagnóstico , Infecciones/terapia , Masculino , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Virosis/diagnóstico , Virosis/terapiaRESUMEN
OBJECTIVE: To compare histoacryl blue tissue adhesive glue with suturing in the repair of simple paediatric lacerations. METHODOLOGY: Prospective, randomised controlled trial in tertiary paediatric emergency department. Children 4 years old or older with non-ragged lacerations <5 cm in length, <12-h-old and not involving eyelid or mucous membrane. A total of 163 patients were randomly allocated to either glue (83 cases) or sutures (80 controls) to repair their laceration. Primary outcome measures were cosmetic outcome at 3 and 12 months with secondary outcomes-length of time to perform procedure, and pain assessment of procedure by doctor, nurse, parent and child. RESULTS: Cases and controls were similar in age, wound length and width and body part involved, but more females received glue (P = 0.013). Time taken to repair the wound was faster in the glue group (median 0-2 mins vs. 6-10 min suture, P<0.001). Doctors (P = 0.02), nurses (P<0.01) and parents (P = 0.02) but not the children themselves (P = 0.24) rated glue repair as less distressing. Complications at 1 week (wound dehiscence, redness and discharge) were the same for both groups (P>0.2). Cosmetic outcome was the same for both groups at 3 (n = 65) and 12 (n = 65) months (P>0.7). CONCLUSION: Tissue adhesive glue is faster and probably less painful than suturing. Tissue adhesive glue has the same cosmetic result as suturing when used for the repair of simple lacerations in children.