Temporal trends and clinical characteristics of spontaneous intracerebral haemorrhage in the Waikato region of New Zealand: a hospital-based analysis.

AIMS: To determine the incidence, and any change in incidence, of spontaneous intracerebral haemorrhage (ICH) detected in the hospitals of the Waikato region of New Zealand (NZ) between 1999 and 2008. To analyse clinical and patient parameters, and to correlate these with outcome. METHODS: A retrospective analysis was performed on patients presenting to Waikato and Thames Hospitals with ICH during the study period. Radiology reports, blood tests and the electronic clinical record were reviewed for each patient. RESULTS: 653 episodes of ICH were identified. The average annual incidence per 100,000 per year was 17.4 (16.1-18.7, 95% confidence interval). This increased from an average of 14.4 (13.7-15.1) between 1999-2001 to 21.4 (20.6-22.2) between 2006-2008 (rate ratio 1.49, p<0.0001). 249 (38.1%) patients died within 30 days of their sentinel bleed. The presence of intraventricular extension of bleed on neuroimaging (Odds Ratio (OR) 6.18, p<0.001), warfarin use (OR 1.11, p=0.76), warfarin use and intraventricular extension of bleed (OR 23.8, p=0.014), lobar location of bleed (OR 1.88, p=0.001) and age (OR 1.16 for every 10-year increase in age, p=0.02) increased the likelihood of death within 30 days. CONCLUSION: Observed ICH has increased in incidence in our hospitals over the past 10 years. Increasing availability of neuroimaging, increasing numbers of elderly, and increasing warfarin associated ICH were likely contributors to this observed increase. Radiological evidence of extension of intraventricular bleed, warfarin use, lobar location of bleed, and increasing age correlated with poorer survival. This data will be available for comparison with future studies to assess trends in incidence, patient characteristics and outcome in ICH.

Urban rickettsiosis in the Waikato region of New Zealand.

Murine typhus is the only endemic rickettsia that has been shown to cause human disease in New Zealand (NZ). We present a case report of a rickettsial infection in the Waikato region which was not typical for murine typhus. We outline the features which made this case unusual, and discuss the diagnostic uncertainty in assessing rickettsial disease. Rickettsial infection should be suspected in all patients presenting with an undifferentiated febrile illness in NZ, even if they do not fit the typical clinical and epidemiological picture of murine typhus.

Convergent flash localization near saccades without equivalent "compression" of perceived separation.

Visual space is sometimes said to be "compressed" before saccadic eye movements. The most central evidence for this hypothesis is a converging pattern of localization errors on single flashes presented close to saccade time under certain conditions. An intuitive version of the compression hypothesis predicts that the reported distance between simultaneous, spatially separated presaccadic flashes should contract in the same way as their individual locations. In our experiment we tested this prediction by having subjects perform one of two tasks on stimuli made up of two bars simultaneously flashed near saccade time: either localizing one of the bars or judging the separation between the two. Localization judgments showed the previously observed converging pattern over the 50-100 ms before saccades. Contractions in perceived separation between the two bars were not accurately predicted by this pattern: they occurred mainly during saccades and were much weaker than convergence in localization. Different forms of spatial information about flashed stimuli can be differentially modulated before, during, and after saccades. Structural alterations in the perceptual field around saccades may explain these different effects, but alternative hypotheses based on decision making under uncertainty and on the influence of other perisaccadic mechanisms are also consistent with this and other evidence.

How does the nature of the steric stabilizer affect the pickering emulsifier performance of lightly cross-linked, acid-swellable poly(2-vinylpyridine) latexes?

A near-monodisperse styrene-functionalized poly[2-(dimethylamino)ethyl methacrylate] (PDMA) macromonomer was evaluated as a reactive steric stabilizer for the preparation of poly(2-vinylpyridine (P2VP) latexes via emulsion polymerization. The solution pH was shown to be a critical parameter for successful syntheses: stable latexes with minimal coagulum were only obtained at (or above) neutral pH. The presence of the grafted PDMA stabilizer in a near-monodisperse P2VP latex of 280 nm diameter was indicated by FT-IR spectroscopy and quantified at 6.0 wt % using 1H NMR spectroscopy. XPS studies confirmed that this stabilizer was located at the latex surface, as expected. Combined DLS and electrophoretic data indicated that these PDMA-P2VP particles exist in three states depending on the solution pH: swollen cationic microgels were obtained below pH 4.1, nonsolvated latex particles with a cationic stabilizer layer were obtained at intermediate pH, and flocculated latex particles with neutral PDMA stabilizer chains were obtained at around pH 8.5. Finally, this PDMA-P2VP latex was shown to be a superior Pickering emulsifier for stabilizing water-in-1-undecanol emulsions than either a poly(ethylene glycol)-stabilized P2VP latex or a charge-stabilized P2VP latex. This serves to illustrate the important role played by the steric stabilizer in determining particle wettability.

Rat-bite fever: a cautionary tale.

We present the first ever report of streptobacillary rat-bite fever in New Zealand. The patient was a young man who was admitted with systemic sepsis. He presented with a high fever, hypotension, and tender axillary lymphadenopathy. He had been bitten by a rat a week earlier. Blood cultures grew Streptobacillus moniliformis, thus confirming the diagnosis. The literature on rat-bite fever is also reviewed.

Portal venous thrombophlebitis in a case of perforated appendicitis: lessons from a case.

Portal and mesenteric pyelephlebitis is a rarely recognised condition associated with a high morbidity. It usually develops secondary to infection in the drainage area of the portal venous system. We report a case of perforated acute appendicitis complicated by superior mesenteric venous pyelephlebitis and thrombocytopaenia. Appendicectomy and treatment with broad-spectrum antibiotics, anticoagulation, and platelets led to a full recovery. Follow-up imaging revealed complete resolution of the thrombosis. The literature is reviewed and the operative and non-operative approaches for the management of mesenteric and portal venous thrombosis are discussed.

Efficient synthesis of sterically stabilized pH-responsive microgels of controllable particle diameter by emulsion polymerization.

Emulsion polymerization of 2-vinylpyridine (2VP) in the presence of divinylbenzene (DVB) cross-linker, a cationic surfactant, and a hydrophilic macromonomer, monomethoxy-capped poly(ethylene glycol) methacrylate (PEGMA), at around neutral pH and 60 degrees C afforded near-monodisperse, sterically stabilized latexes at approximately 10% solids. Judicious selection of the synthesis parameters enabled the mean latex diameter to be varied over an unusually wide range for one-shot batch syntheses. Scanning electron microscopy studies confirmed near-monodisperse spherical morphologies, with mean weight-average particle diameters ranging from 370 to 970 nm depending on the initiator, polymeric stabilizer, and surfactant concentrations. Particle sizing studies were also conducted using disk centrifuge photosedimentometry and dynamic light scattering and gave similar data. These lightly cross-linked latexes acquired cationic microgel character at low pH, as expected. The critical pH for this latex-to-microgel transition was around pH 4.1 at 1.0 wt % DVB, which is significantly lower than the pKa of 4.92 estimated for linear P2VP homopolymer by acid titration. 1H NMR and aqueous electrophoresis studies indicated that substantial swelling occurred at low pH due to protonation of the 2VP groups, while dynamic light scattering (DLS) studies indicated volumetric swelling ratios of up to 3 orders of magnitude, depending on the initial latex diameter. Systematic variation of the degree of cross-linking led to a monotonic decrease in the pKa values of the P2VP latexes (as judged by acid titration) and also the critical swelling pH (as judged by visual inspection). This was attributed to the increasingly branched nature of the P2VP chains in their swollen microgel form. Preliminary studies of the kinetics of acid-induced swelling were also conducted using the pH jump method in conjunction with a stopped-flow apparatus. These P2VP latexes swell significantly faster than P2VP latexes described in the literature and the characteristic time scales observed in the present study are much closer to those predicted by the Tanaka equation.

From our perspective: consumer researchers speak abut their experience in a community mental health research project.

People who have experienced the mental health system were hired and trained as researchers in a community mental health research project. Throughout the course of the project, these consumer researchers reflected on what they learned about their research experience. This article is a window into this learning process and offers an opportunity to see research through the eyes of consumer researchers. We begin by giving an overview of the research project and introducing the research team. Then the consumer researchers in our project share their experiences and insights about involving mental health consumers in research projects. We hope that ourproject's experiences will help other projects that involve consumers in ways that are empowering for the consumer and beneficial to the research.