bluuebunny/crossref_metadata_2025 huggingface dataset:
Statistical Analysis of Data from the “Before‐After” Type of Experiments
Authors: Lee James
Published: March 2008

Summary: Statistical analysis of data from the “before‐after” type of experiments. J. Lee, Aust. N.Z. J. Med., 1978, 8, pp. 641–645.

There are many experiments in which the variable of interest is measured twice from each subject. Supposing a nutrition experiment were conducted to compare two diets on the mean gain in body weight. The body weight of each subject is recorded before the diets are given (initial weight, I) and then at the termination of the experiment (final weight, F). Comparison of mean weight gain is valid only if the distribution of initial weights were comparable between the two groups of subjects. Random allocation of subjects or matching (pairing) can be used at the design stage to enhance the comparability of the subjects in the two groups. However, random allocation does not ensure comparability, especially if the sample sizes were small. Matching does ensure comparability. But in many instances, matching may not be feasible for various logistic reasons. The likely situation is that the mean initial weights will not be comparable in the two groups being compared. Hence, some sort of statistical adjustment at the data‐analytic stage is called for. Statistical adjustment is usually done by either one of these methods: (1) Compare mean weight gain by the usual unpaired X‐test, where weight gain is computed by (F‐l) for each subject, (2) Use covariance adjustment (analysis of covari‐ance) of F using I as the covariate, (3) Compare mean relative (i.e. per cent) weight gain by the unpaired t‐test, where per cent weight gain is computed by 100(F‐1)/1 for each subject.
Surgical Division of an Accessory Atrioventricular Connection in the Posterior Septal Region Following Ventricular Fibrillation in the Wolff‐Parkinson‐White Syndrome*
Authors: Sadick IM. , Baird D. K. , Uther J. B.
Published: March 2008

Summary: Surgical division of an accessory atrioventricular connection in the posterior septal region following ventricular fibrillation in; the Wolff‐Parkinson‐White syndrome. N. Sadick,;D. K. Baird and J. B. Uther, Aust. N.Z. J. Med., 1978, 8, pp. 652–655.

A young man presented with atrial fibrillation and a rapid ventricular response which degenerated into ventricular fibrillation.

Electrophysiological study demonstrated an accessory atrioventricular connection in the posterior septal region. This was sectioned to prevent recurrence of his arrhythmia. Post‐operative electrophysiological study demonstrated that the surgical section was successful.
The Prognostic Value of the HV Interval in Patients with Acute Myocardial Infarction and Bundle Branch Block
Authors: Bailey B. P. , Hunt David , Vohra J. K. , Sloman J. G.
Published: March 2008

Summary: HV intervals were measured in 42 of 119 patients in the acute phase of myocardial infarction associated with bundle branch block (BBB). The mean HV intervals of patients with right, left and incomplete bilateral BBB were similar. The hospital and subsequent mortality of patients with prolonged HV intervals did not differ significantly from that of patients with normal HV intervals. The HV interval appeared to remain stable over the following months in most patients in whom it was re‐measured. We conclude that the HV interval cannot be used to select patients who might benefit from prophylactic long term pacing.
The Effect of Mucaine on Gastrin Release in Man
Authors: Taggart G. J. , Hansky J.
Published: March 2008

Summary: The effect of Mucaine and Aludrox on basal and food stimulated immunoreactive gastrin has been assessed in normal control subjects and patients with duodenal or gastric ulcer. No differences in gastrin responses were observed either in the basal period or after the protein meal with the two antacids. As previously described, release of gastrin was greatest in gastric ulcer patients but in contrast to previous results, normal subjects seemed to show a greater response than duodenal ulcer patients but this was not statistically significant. Thus the combination of a local anaesthetic oxethazaine with aluminium hydroxide gel does not lead to diminished gastrin re/ease and is not the prime mechanism of action of this agent.
Chronic Thromboembolic Pulmonary Hypertension Following Ventriculo‐Atrial Shunting
Authors: Fagan E. T. , Jennings G. L.
Published: March 2008

Summary: Multiple pulmonary emboli and pulmonary hypertension occurred in a 49‐year‐old man four years after insertion of a ventriculoatrial shunt. Although this complication is a common finding at post‐mortem in children with ventriculo‐atrial shunts the frequency with which it occurs in adults is unknown. Routine electrocardiography and lung scanning is necessary for early diagnosis and treatment as symptoms are often insidious and the prognosis in established thromboembolic pulmonary hypertension is poor.
Echocardiographic Diagnosis of Cor Triatriatum
Authors: Bett J. H. N. , Graff R. F. , Stafford E. G. , Dryburgh L.
Published: March 2008

Summary: M‐mode echocardiography displayed abnormal echoes in the left atrium and posterior to the mitral leaflets in a child with severe heart failure. Cor triatriatum was demonstrated by angiography and cured by surgical excision. Subsequent echo studies no longer showed the abnormal structure.
Some Uses of the Continuous Flow Blood Separator in the Myeloproliferative Syndrome
Authors: Bell R. , Sullivan J. R. , Hurley T. H. , D'Apice A. J. F. , Kincaid‐Smith Priscilla
Published: March 2008

Summary: A continuous flow blood separator was used for leucapheresis in two patients with chronic myeloid leukaemia, complicated by pregnancy and leukastasis respectively, and for thrombocytopheresis in a patient with megakaryocytic myelosis. The cases described, outline some of the clinical uses of this machine in the myeloproliferative syndrome.
Hospital Discharge Rates and Deaths from Asthma in the Hunter Health Region (NSW) 1971–72 to 1975–76
Authors: Hardes G. R. , Allomes J. , Leeder S. R.
Published: March 2008

Summary: During the five years 1971–72 to 1975–76 annual total discharges of patients with a primary diagnosis of asthma from public hospitals in the Hunter Health Region (NSW) fluctuated only slightly. The number of discharges did not reflect consistently the underlying population distribution. Significantly more discharges than expected occurred among people living in the drier inland areas of the Region.

Over the same period 65 residents of the Hunter Health Region were certified dead with asthma as the primary cause. In 29, death occurred at one of the Region's public hospitals but only eight were admitted as hospital inpatients primarily with asthma. Of the 65 asthma deaths, 36 (55.4%) occurred outside the Region's public hospitals.
Spinal Cord Tumours in the Elderly
Authors: Huang C. Y. , Matheson J.
Published: March 2008

Summary: Spinal cord tumours in patients over 65 years of age are mostly due to metastatic lesions when maximum deficit occurs within eight weeks. Benign tumours have a more chronic progressing course, are mostly in the thoracic region and, unlike younger patients, are overwhelmingly meningiomas. Although uncommon, benign spinal cord tumours should be recognised as a cause of gait deterioration in the elderly patient, as they respond well to surgery.
Cyclic Nucleotide Metabolism in Tumours
Authors: Hunt N. H. , Martin T. J.
Published: March 2008

Summary: Many hormones act by combining with cell surface receptors and stimulating adenylate cyclase activity. The cyclic AMP generated is the mediator of a number of cellular metabolic processes. Other processes may be influenced by changes in cyclic GMP levels. Although much evidence from cultured cells suggested that low cellular levels of cyclic AMP and high levels of cyclic GMP are a feature of rapid cell growth and of malignant transformation, review of the data reveals many inconsistencies. Thus in established tumours growing in vivo, for example, cyclic AMP levels appear to be unrelated to tumour growth rates. It seems that tumour cell cyclic AMP is more likely concerned with the regulation of tumour cell function than of growth.

This would have implications for therapy, in that drugs which influence cyclic nucleotide metabolism could influence tumour cell function. The control of cyclic nucleotide production in normal and tumour cells is discussed, together with the possible ways in which abnormalities of this may occur.
Prevalence, Pathogenesis and Treatment of Post‐menopausal Osteoporosis
Authors: Crilly R. , Horsman A. , Marshall D. H. , Nordin B. E. C.
Published: March 2008

Summary: About 11% of post‐menopausal women with wrist fractures have spinal osteoporosis with compressed vertebrae, and about 25% of post‐menopausal osteoporosis patients have had a wrist fracture. The estimated prevalence of post‐menopausal spinal osteoporosis is 4% of the female population at age 60 and about 8% at age 80. Osteoporotic patients have lower plasma oestrone and androstenedione levels, lower calcium absorption and higher urinary hydroxyproline than matched controls. Of six treatments tested in three different ways, the least successful were vitamin D2 and 1α‐OHD3 and the most successful were hormones with or without 1α.‐(OH)2D3 and calcium supplements. Calcium and vitamin D given in combination occupied an intermediate position.
Growth Failure, Somatomedin and Growth Hormone Levels in Juvenile Diabetes Mellitus—A Pilot Study
Authors: Nash H.
Published: March 2008

Summary: Growth hormone (hGH) responsiveness to exercise and Somatomedin C (SmC) activity were measured in ten children with insulin‐deficient diabetes mellitus.

Four of the ten children showed a significant degree of growth retardation. Normal SmC activity was found in association with elevated hGH levels.

The hypothesis that growth‐retarded diabetics have a failure of Sm production despite high hGH levels (analogous to malnutrition and Laron dwarfism) was not substantiated by this study. Chronic deficiency of insulin, itself a somatomedin, may play a major role in diabetic growth failure.
Osteomalacia Due to Unusual Causes Presenting in Adults
Authors: Melick R. A. , Larkins R. G. , Greenberg P. B. , Wark J. D.
Published: March 2008

Summary: Severe osteomalacia due to causes other than malabsorption and, where renal function was impaired, disproportionate to the degree of renal failure, is described in 15 adults. Only one was younger than 46 years, the median age being 59 years. The diagnosis was not made for months in most patients. After investigation, the patients were grouped as follows: nutritional three cases, “renal” six cases, hypophosphataemia three cases, neurofibromatosis and primary hyperparathyroidism one each. The last patient was poorly nourished and had taken anticonvulsants and analgesics. Most patients responded well to treatment with calciferol.

These cases indicate the need to be aware that osteomalacia may occur in previously healthy middle‐aged or elderly subjects.
Insulin Secretion in Non‐Obese (J‐type) Diabetics in Papua New Guinea
Authors: Martin F. I. R. , Simeanova L.
Published: March 2008

Summary: Nine of ten non‐obese non‐ketotic diabetics attending Port Moresby General Hospital had detectable C‐peptide in plasma. All had received insulin for at least two months at the time of study.

It is concluded that many non‐obese non‐ketotic young diabetics in Papua New Guinea retain pancreatic insulin secretion and so resemble the maturity onset diabetics of “Western” countries.
Drug Usage in a Western Australian Rural Community
Authors: Madsen B. W. , Murphy B. P. , Wearne K. L.
Published: March 2008

Summary: Drug usage in two agricultural shires, Kondinin and Kulin, was surveyed by questionnaire. Both prescription and over the counter (OTC) drugs were recorded together with age, sex, forced expiratory volume in one second (FEV1), systolic blood pressure (SBP) and body weight, and 1284 people, or 55·8% of the eligible population over six years of age, participated. Approximately 35%, 53% and 12% of people said they were taking no drugs, one to two drugs and three or more drugs respectively, a result very similar to that found in an earlier urban study (Traralgon). The interaction of all five factors on drug consumption was studied jointly by multivariate analysis; FEV1, SBP and weight were normalised using standard tables. Prescription drug usage was directly related to obesity, respiratory impairment and sex (P < 0 · 01) but not to age or SBP. People taking either OTC drugs or none at all differed only in sex, with females taking more than males (P< 0·01). There were no differences in the factors studied between prescription only and prescription plus OTC drug users.
Drug Compliance in Outpatients with Rheumatoid Arthritis
Authors: Lee P. , Tan L. J. P.
Published: March 2008

Summary: A study of drug compliance was carried out on 108 patients with rheumatoid arthritis. Thirty‐nine per cent were non‐compliant with their ant rheumatic medication, varying from occasional to complete failure to take the prescribed drugs. Compared with those taking their medication regularly, the non‐compliant patients had a significantly lower mean active joint count and average pain severity and a significantly higher proportion had not received an adequate explanation of their disease.

However, drug default does not appear to be a significant problem in management of rheumatoid arthritis, as over 90% of patients were taking their medications all or most of the time. Patients with this disease appear motivated to taking their medication regularly by the presence of chronic and often severe pain.
Coronary Heart Disease in Tribal Aborigines—The West Kimberley Survey
Authors: Bastian Paul
Published: March 2008

Summary: Two‐hundred‐and‐forty‐eight full‐blood tribal Aborigines from the West Kimberley region of Western Australia were surveyed for the prevalence of coronary heart disease, and compared with the known prevalence in whites in the country town of Busselton, WA. The prevalence was found to be greater among the Aborigines, with 7% of men, and 11% of women being found to have “probable” coronary heart disease. Seven per cent of the population had electrocardiographic changes characteristic of frank ischaemia. The major risk factors contributing to this high prevalence were hypertension, diabetes mellitus, and obesity. Thirty‐seven per cent of the Aborigines were hypertensive, and 17% had diabetes mellitus.
Pulmonary Alveolar—Septal Amyloidosis Associated with Pulmonary Tuberculosis and an Unusual Paraproteinaemia
Authors: Bye P. T. P. , Gianoutsos P. , Jelihovsky T. , Clancy R. L.
Published: March 2008

Summary: A patient is described who presented with mixed obstructive and restrictive lung disease, shown to be due to deposition of amyloid in an alveolar‐septal distribution. An association with a plasma cell dyscrasia and pulmonary tuberculosis is discussed, as is the need for early diagnosis and a trial of aggressive cytotoxic therapy in primary amyloidosis.
IgA Deficiency, Superior Mediastinal Tumour with Unusual Clinical Manifestations
Authors: Lee C. H. , Quin J. W. , Wong C. S. , Grace C. S. , Rozenberg M. C.
Published: March 2008

Summary: The clinical course of a 17‐year‐old man with selective IgA deficiency and anaplastic carcinoma in the superior mediastinum is described. High swinging fevers, neutrophil leucocytosis reaching 60 X 109/I, polyarthralgia and skin vasodilatation were unusual manifestations of the tumour. Marked tissue reactions in the neck and polyserositis occurred with a neutrophil granulocyte tissue reaction and progressed to fibrosis. Circulating immune complexes were present and IgE levels were grossly raised. It was not established whether the unusual clinical manifestations were due solely to the tumour or were an abnormal response of an IgA‐deficient host.

Review of the literature of malignancy in selective IgA deficiency casts doubt upon an increased incidence of neoplasm in this immune deficiency.
Thermometerphagophilia in Münchausen Syndrome
Authors: Aw T. C. , Yeo P. P. B. , Cheah J. S.
Published: March 2008

Summary: Münchausen syndrome is a medical curiosity. The presenting symptomatology is varied. An unusual presentation—Thermometerphagophilia (swallowing of thermometers), is reported.
Pneumococcal Disease and its Prevention with Polyvalent Pneumococcal Polysaccharide Vaccines—A Review
Authors: Douglas R. M. , Riley I. D.
Published: March 2008

Summary: Polyvalent pneumococcal polysaccharide vaccines have been shown to be safe, immunogenic and efficacious and are becoming available for use in patients at high risk of developing pneumococcal infections.

Precise estimates of the role of the pneumococcus in human respiratory disease are difficult to obtain, as this organism is also a frequent commensal of the upper respiratory tract; and as the optimal techniques for the identification and proof of its role are not widely used. Nevertheless, the pneumococcus remains the principal cause of adult pneumonia and paediatric otitis media, and is also an important cause of death from bacteremia and meningitis.

At present it seems likely that in Australia these vaccines will be most useful amongst people over the age of 50 years, those with chronic systemic disease, alcoholics, splenectomized individuals and disadvantaged groups such as Australian aborigines, all of whom are particularly susceptible to pneumo‐coccal bacteremia which has a considerable mortality rate. The possibility of preventing pneumococcal otitis media in childhood is still being evaluated. Studies of the role played by the various pneumococcal serotypes in Australian populations are urgently needed.
Emerging Patterns off Hepatitis B Chronic Liver Disease in Australia
Authors: McCaughan G. W. , Parsons C. , Gallagher N. D.
Published: March 2008

Summary: Emerging patterns of hepatitis B chronic liver disease in Australia. G. W. McCaughan, C. Parsons and N. D. Gallagher, Aust. N.Z. J. Med., 1979, 9, pp. 359–364.

Until now, the hepatitis B virus has been thought to play a minor role in the aetiology of chronic liver disease in Australia. This is a report of 21 patients with cirrhosis and/or primary hepatocellular carcinoma with hepatitis B antigenaemia. Primary hepatocellular carcinoma occurred in six patients, five of whom had underlying cirrhosis. The disease occurred mainly in non‐Australian born males, and was not often associated with a previous history of hepatitis. The death of 16 patients within 12 months of presentation is in contrast to previous concepts of the benign nature of hepatitis B associated cirrhosis.
Is Pancreatic Polypeptide Estimation of Value in Diagnosing Gastrinomas (Zollinger‐Ellison Syndrome)?
Authors: Byrnes D. J. , Marjason J. , Henderson L. , Gallagher N. , Fabricatorian D.
Published: March 2008

Summary: Is pancreatic polypeptide estimation of value in diagnosing gastrinomas (Zollinger‐Ellison syndrome)? D. J. Byrnes, J. Marjason, L. Henderson, N. Gallagher and D. Fabricatorian, Aust. N.Z. J. Med., 1979, 9, pp. 364–366.

Serum levels of pancreatic polypeptide (PP) were determined in 32 normal subjects, 18 patients with gastrinoma, 19 patients with pituitary adenoma and 11 patients with duodenal ulceration.

Mean serum levels of PP in patients with gastrinomas (67±31 pmol/ (SD)) were significantly (P < 0·01) higher than in the normal subjects (47 ± 15 pmol/). However, only five of 18 of the patients with gastrinomas had PP levels above the upper limit of normal and elevations of similar magnitude were observed in patients with other disease processes. It is therefore concluded that serum PP estimations are not of value in the diagnosis of gastrinomas.
Thyroid Hormone Response to Thyrotrophin Releasing Hormone Stimulation in Subjects from Endemic Goitre Regions of Sarawak, Malaysia
Authors: Maberly G. F. , Eastman C. J. , Corcoran J. M.
Published: March 2008

Summary: Thyroid hormone response to thyro‐trophin releasing hormone stimulation in subjects from endemic goitre regions of Sarawak, Malaysia. G. F. Maberly, C. J. Eastman and J. M. Corcoran, Aust. N.Z. J. Med., 1979, 9, pp. 385–390.

In iodine deficient subjects a common finding has been subnormal T4 levels, normal or slightly elevated T3 levels together with normal or elevated TSH levels. A comparative study of circulating thyroid hormone concentrations in 165 severely goitrous (prevalence of 99%) and 122 non‐goitrous control subjects from two regions in Sarawak, Malaysia confirmed serum levels consistent with these findings.

There has been some uncertainty whether these altered serum hormone concentrations found in endemic goitrous subjects arise primarily from thyroidal secretion or increased peripheral conversion of T4 to T3 or altered disposal of these hormones. A 20 mg dose of oral TRH was administered to ten goitrous and five non‐goitrous subjects and the serum thyroidal response measured over four hours. The mean maximal increment in TSH in the goitrous (43±2 mU) was almost double that of the non‐goitrous (23±2 mU/) subjects (P<0·02). Despite this the mean maximal increment in T4 in the goitrous (14·2±16·7 nmol/) was less than one quarter of the non‐goitrous group (94±32 nmol/; P <0·02). The mean maximal increment in T3, in the two groups, however, were similar (goitrous, 1·21±0·1 nmol/; non‐goitrous 1·32±0·7 nmol/). Serum thyroid hormone concentrations measured 24 hours following 10 IU parenterally administered bovine TSH to 14 goitrous and seven non‐goitrous subjects gave a similar pattern. TSH suppressed to low levels in both groups. The mean increment in T3 was almost identical in both groups (goitrous, 1·55±0·12 nmol/; non‐goitrous, 1·57±0·12 nmol/). The mean increment in T4 in the goitrous (14±2·10 nmol/) was less than one quarter of the non‐goitrous group (62±14 nmol/; P < 0·05). These findings support evidence, thus far mainly derived from animal studies, that the altered serum thyroid hormone concentrations seen in endemic goitre arise primarily from thyroidal secretion. It is further suggested that the pattern arises from the iodine deficient gland being unable to maintain a normal T4 secretion rather than an adaptation by the thyroid to maintain euthyroidism by increased T3 secretion.
Hodgkin's Disease Terminating in Acute Leukaemia: Report of Seven Cases
Authors: Wolf M. M. , Cooper I. A. , Ding J. C.
Published: March 2008

Summary: Hodgkin's disease terminating in acute leukaemia. M. M. Wolf, I. A. Cooper and J. C. Ding, Aust. N.Z. J. Med., 1979, 9, pp. 398–402.

Acute nonlymphocytic leukaemia developed in seven patients treated for Hodgkin's disease. All had received intensive radiotherapy and chemotherapy. One patient had clinical evidence of active Hodgkin's disease at the time of diagnosis of acute leukaemia, and of four other patients who had a post mortem examination another showed evidence of Hodgkin's disease. The median time from the first presentation with Hodgkin's disease to the development of acute leukaemia was 7·7 years. Chromosomal abnormalities were found in four patients. A preleukaemic phase was present in three patients. Survival following diagnosis of acute leukaemia was short (median four weeks) and only one patient achieved a complete remission. Although published data suggests that radiation exposure is an important aetiologic factor in the induction of acute leukaemia in patients with Hodgkin's disease, it appears likely that additional chemotherapy may have a significant potentiating effect.
Iron Deficiency Anaemia—A Prospective Study
Authors: Kerlin P. , Reiner R. , Daviesr M. , Sage R. E. , Grant A. Kerr
Published: March 2008

Summary: Iron deficiency anaemia‐a prospec; tivestudy. P. Kerlin, R. Reiner, M. Davies, R. E. Sage and A. Kerr Grant, Aust. N.Z. J. Med., 1979, 9, pp. 402–407.

A prospective study was performed over 15 months to determine the cause of iron deficiency in adult males and postmenopausal females attending a general hospital. The laboratory computer identified all subjects with a haemoglobin less than 10·6 g/dl and a mean corpuscular volume less than 86 fl. Patients becoming anaemic after trauma or recent surgery were excluded. The iron status of each patient was assessed by serum iron studies, serum ferritin or sternal marrow aspiration. Reduced red cell indices and blood film morphology were not diagnostic of iron deficiency. Of 215 patients assessed, about half (103) were found to be iron replete. This group had a variety of disorders—malignancy, chronic inflammation, chronic renal and non‐malignant haematological diseases. The other group of 104 patients satisfied criteria for iron deficiency, and 100 of these were investigated further. The cause of iron deficiency was found in all but three subjects. Inadequate dietary intake was a contributing factor in over half of the patients and 40 regularly took salicylates. Investigation defined a source of chronic gastrointestinal blood loss in most instances.
Bronchial Reactivity in Western Red Cedar Induced Asthma
Authors: Hamilton R. D. , Crockett A. J. , Ruffin R. E. , Alpers J. H.
Published: March 2008

Summary: Bronchial reactivity in western red cedar induced asthma. R. D. Hamilton, A. J. Crockett, R. E. Ruffin and J. H. Alpers, Aust. N.Z. J. Med., 1979, 9, pp. 417–419.

A patient with Western red cedar induced asthma is described. The diagnosis was confirmed by a bronchial challenge with Western red cedar saw dust and the subsequent prolonged bronchial reactivity changes were measured using histamine inhalation tests.
Radiation‐related Coronary Artery Disease in Hodgkin's Disease
Authors: Leong A. S. Y. , Forbes I. J. , Ruzic T.
Published: March 2008

Summary: Radiation‐related coronary artery disease in Hodgkin's disease. A. S. Y. Leong, I. J. Forbes and T. Ruzic, Aust. N.Z. J. Med., 1979, 9, pp. 423–425.

Coronary artery disease is a rare and only recently recognised complication of mediastinal irradiation. A 34‐year‐old man died suddenly eight years after mediastinal irradiation for Hodgkin's disease. Autopsy disclosed severe narrowing of all major extramural coronary arteries by atherosclerotic plaques whereas all other systemic and visceral arteries were virtually free of atheroma. Autopsy findings in the five reported cases of radiation‐related coronary artery disease are reviewed.
67Gallium Uptake in Psittacosis Infection
Authors: Andrews J. T. , Fraser J. R. E.
Published: March 2008

Summary: 67Gallium uptake in psittacosis infection. J. T. Andrews and J. R. E. Fraser, Aust. N.Z. J. Med., 1979, 9, p. 437–439.

67Gallium citrate isotope scanning was performed in a febrile patient with pneumonitis and hepatitis who was later shown to have psittacosis. Focal isotope uptake was detected in both lungs in the absence of radiological changes. There was no enhanced concentration in the liver where inflammatory cell infiltration was slight.
Serum Gastrin after 12 Months' Continuous Cimetidine Therapy for Duodenal Ulcer
Authors: Hansky J. , Stern A. I. , Korman M. G. , Waugh J.
Published: March 2008

Summary: Serum immunoreactive gastrin was measured in 14 patients with duodenal ulcer before and during a 12‐month course of cimetidine 400 mg bd. All patients were symptomatically well during the cimetidine therapy and both basal gastrin and that in response to a protein rich meal were assessed before, at six months and at 12 months during therapy. The basal and post‐prandial gastrin were significantly higher at six and 12 months on cimetidine than before cimetidine but the six and 12 month levels were similar. This study thus shows that the progressive increase in serum gastrin during six months of continuous cimetidine therapy does not occur beyond this time period.
Atrial Pacing in Ventricular Tachycardia and Supraventricular Tachycardia with Aberrant Intraventricular Conduction: Diagnostic and Therapeutic Implications*
Authors: Tonkin A. M. , Tornos P. , Heddle W. F.
Published: March 2008

Summary: The diagnostic and potential therapeutic value of rapid right atrial pacing in ventricular tachycardia and supraventricular tachycardia with aberrant intraventricular conduction, was examined. The effect of right atrial pacing at incremental rates beginning 10 bpm above the rate of the tachycardia was studied in five patients with ventricular tachycardia, and in four patients with supraventricular tachycardia with rate‐related bundle branch block aberration, the mechanism of tachycardia having been demonstrated at electrophysiology study. Atrial pacing resulted in persistent (four) or occasional (one) normalisation of the QRS complexes to that seen in sinus rhythm in those five patients with ventricular tachycardia. The intraventricular conduction pattern persisted with atrial pacing in those patients with supra‐ventricular tachycardia and aberrant intraventricular conduction. This confirms that atrial pacing is a useful and simple diagnostic test in wide QRS tachycardia, which does not require sophisticated electrophysiological facilities. In three of the patients with ventricular tachycardia, atrial pacing terminated the arrhythmia, suggesting potential therapeutic use of rapid atrial pacing in such patients.
Aldosterone Producing Adenoma: Fludrocortisone Suppression and Left Adrenal Vein Catheterisation in Definitive Diagnosis and Management
Authors: Gordon R. D. , Jackson R. V. , Strakosch C. R. , Tunny T. J. , Rutherford J. C. , McCosker J. , Moriarty W.
Published: March 2008

Summary: In 12 (eight female) consecutive patients with primary aldosteronism (1971–1978), aged 15 to 54 years, the diagnosis was unsuspected until hypokalaemia (mean 2.2 mmol/l) was revealed by routine biochemical testing. In nine patients, hypertension was severe (diastolic blood pressure > 120 mmHg, seven on treatment). A firm diagnosis of primary aldosteronism was based on sequential demonstration of (1) high urine potassium excretion with concurrent unexplained hypokalaemia, (2) inappropriately suppressed plasma renin activity after application of two potent stimuli to renin secretion, namely, salt‐free diet and upright posture, (3) inappropriately high aldosterone production demonstrated by measurement of 24‐hour urine aldosterone excretion after seven days of high salt diet and fludrocortisone acetate orally.

Left adrenal vein catheterisation, which is said to provide preoperative localisation of aldosterone producing adenoma to the right or left gland and to distinguish aldosterone producing adenoma from bilateral hyperplasia of the zona glomerulosa, was successful in ten of 12 patients. A left‐sided adenoma was correctly predicted in eight, a right‐sided adenoma in one and results consistent with bilateral hyperplasia were found in one patient. Right‐sided adenomas were present in the two patients in whom adrenal vein catheterisation was unsuccessful. After removal of the 11 adenomas, plasma potassium returned to normal and hypertension was cured in nine patients and markedly improved in two.

These results show that the combination of seven days of salt loading and fludrocortisone acetate to firmly establish the diagnosis, followed by adrenal venous catheterisation to lateralise the tumour, leads to a high cure rate in the treatment of aldosterone producing adenoma.
Burkitt's Lymphoma in Australia
Authors: Harvey L. , Woods R. L. , Fox R. M. , Tattersall M. H. N. , Lauer C.
Published: March 2008

Summary: Three patients with Burkitt's lymphoma have been seen at Royal Prince Alfred Hospital during the past 18 months. Following treatment, two patients are in complete clinical remission.
Nalidixic Acid and Lactic Acidosis
Authors: Phillips P. J. , Need A. G. , Thomas D. W. , Conyers R. A. J. , Edwards J. B. , Lehmann D.
Published: March 2008

Summary: Nalidixic acid may cause severe acidosis and we report a fatal case of lactic acidosis associated with nalidixic acid therapy. Studies in normal volunteers showed drug related impairment of lactate metabolism. We question whether the drug should be used in patients who may accumulate the drug or be predisposed to lactic acidosis.
Release of Secretin—Plasma Levels Reproduced by Exogenous Infusion
Authors: Byrnes D. J. , Marjason J. , Henderson L. , Lazarus L.
Published: March 2008

Summary: Infusion of 0.1 M HCI (0.5 mmol/kg/hr over 20 minutes) into the duodenum of each of seven normal subjects led to a significant rise (P<0.05) in mean plasma secretin levels from 3.0±2.2 (SE) to 15±4.0 pmol/l. Intravenous infusion of secretin at a rate of 6–6 pmol/kg/hr (0.08 clinical units/kg/hr) reproduced the peak plasma levels of secretin observed during duodenal acidification. However, there was no detectable (2.5 pmol/l) change in plasma secretin after oral protein or glucose.
Progressive Polyradiculoneuropathy: Treatment with Azathioprine
Authors: Walker G. L.
Published: March 2008

Summary: A case is presented of a 64‐year‐old male with chronic inflammatory polyradiculoneuropathy (CIP) relentlessly progressing (despite steroids) to virtually complete quadriplegia over seven months. Once commenced on Azathioprine he dramatically improved over a six week period.

The truly progressive form of CIP is rare. It is, however, immunologically similar to relapsing CIP and to the more common acute inflammatory polyradiculoneuropathy (AIP). Although the place of steroid therapy is still in doubt it would seem that cytotoxic immunosup‐pressives have something definite to offer in these conditions where there is progression beyond 4–5 weeks. In the largest series of CIP available (where the patients were untreated, or treated with steroids alone) the mortality rate was 11%, and the “complete recovery” rate only 5%. Although only isolated case reports are available, it would seem that if more aggressive immunosuppressive therapy was used more frequently, the prognosis might be considerably improved.
Heparin‐Associated Thrombocytopenia: Case Report and Prospective Study
Authors: Gallus A. S. , Goodall K. T. , Beswick W. , Chesterman C. N.
Published: March 2008

Summary:Heparin‐associated thrombocytopenia: Case report and prospective study. A. S. Gallus, K. T. Goodall, W. Beswick and C. N. Chesterman,Aust. N.Z. J. Med., 1980,10, pp. 25–31.

After observing a patient with heparin‐induced thrombocytopenia we prospectively recorded the incidence of thrombocytopenia associated with heparin treatment by measuring the platelet count every second day in 166 patients given therapeutic heparin for various thrombo‐embolic disorders, and 51 patients given low‐dose heparin prophylaxis. A platelet count below 100×10g/litre developed in nine patients (5.4%) during or soon after full‐dose heparin therapy, and in one patient given low‐dose heparin. Careful clinical review suggested that heparin was either the most likely cause or a contributing cause of thrombocytopenia in 51166 patients (3.0%) receiving therapeutic heparin and none of the patients who received prophylactic heparin. Associated laboratory studies suggest that heparin‐initiated platelet aggregation in vivo is a useful marker for heparin‐induced thrombocytopenia.
Renal Infection with Mycobacterium Chelonei
Authors: Becker G. J. , Walker R. G. , Dziukas L. J. , Harvey K. J. , Valentine R. , Kincaid‐Smith P.
Published: March 2008

Summary: Renal infection with mycobacterium chelonei. G. J. Becker, R. G. Walker, L. J. Dziukas, K. J. Harvey, R. Valentine and P. Kincaid‐Smith, Aust. N.Z. J. Med., 1980, 10, pp. 44–47.

A case of renal infection with Mycobacterium chelonei is described. The infection probably occurred via haematogenous spread from an infected arteriovenous shunt in a uraemic woman. Prolonged treatment with intravenous cefoxitin combined with oral erythromycin and rifampicin eradicated the organism from the urine. Although renal function stabilized for one year, gradual deterioration to end‐stage renal failure occurred.
Thrombotic Thrombocytopaenic Purpura and Anuria: Response to Plasma Exchange
Authors: Richmond J. M. , D'Apice A. J. F. , Whitworth J. A. , Kincaid‐Smith P.
Published: March 2008

Summary: Thrombotic thrombocytopaenic purpura and anuria: Response to plasma exchange.

J. M. Richmond, A. J. F. d'Apice, J. A. Whitworth and P. Kincaid‐Smith, Aust. N.Z. J. Med., 1980, 10, pp. 48–50.

This report discusses the treatment and recovery of a 29‐year‐old woman with thrombotic thrombocytopaenic purpura complicated by severe renal failure. The case is reported because of the rarity of recovery from anuric renal failure in this disease and the probable contribution of plasma exchange to this recover.
Dermal Necrosis Following Coumarin: Is It Immunologically Induced?
Authors: Hislop I. G. , Zilko P. J. , Petersen M. , Ahmed N.
Published: March 2008

Summary: Dermal necrosis following coumarin: Is it immunologically induced? I. G. Hislop, P. J. Zilko, M. Petersen and N. Ahmed, Aust. N.Z. J. Med., 1980, 10, pp. 51–53.

Two patients with dermal necrosis due to anticoagulation therapy with warfarin are reported. Both patients demonstrated some disturbance in immunological function. It appears possible that warfarin may act as a happen in the induction of hypersensitivity to the drug. It is recommended that future cases should be studied to determine whether there is a defect in immunoregulation, and whether circulating immune complexes are responsible for the typical skin lesions.
Immune Thrombocytopenia Induced by Cotrimoxazole
Authors: Barr A. L. , Whineray M.
Published: March 2008

Summary: Immune thrombocytopenia induced by cotrimoxazole. A. L. Barr and M. Whineray. Aust. N.Z. J. Med., 1980, 10, pp. 54–55.

Cotrimoxazole administration is occasionally associated with thrombocytopenia. Interference with folate metabolism has been postulated.2 The drug has also been postulated to induce an autoantibody by acting as a hapten3, but proof has not been forthcoming. A case is reported in which the serum has been shown to contain an anti‐platelet autoantibody requiring sulphamethoxazole or cotrimoxazole for activity.
Viral Hepatitis and the Drug Cult: A Brief Socioepidemiological Study in Sydney
Authors: Boughton C. R. , Hawkes R. A.
Published: March 2008

Summary: Viral hepatitis and the drug cult: A brief socio‐epidemiological study in Sydney. C. R. Boughton and R. A. Hawkes, Aust. N.Z. J. Med., 1980, 10, pp. 157–161.

Study of 141 individuals attending a Sydney drug referral centre revealed considerable psychosocial maladjustment in the group. Seventy‐five per cent showed serological evidence of hepatitis B virus infection, past or present, as compared with 73% of control subjects. Antibody to hepatitis B core antigen was found to be twice as frequent as a serological marker of HBV infection, as antibody to hepatitis B surface antigen

Prevalence rates of antibody to hepatitis A virus were similar in the drug and control groups

Hepatitis possibly due to hepatitis non A non B virus infection, was found in 74% of those with clinical and biochemical hepatitis at the time of the study
The Influence of Beta Blockers upon Plasma Cyclic AMP Levels*
Authors: England J. F.
Published: March 2008

Summary: The influence of beta blockers upon plasma cyclic AMP levels. J. F. England, Aust. N.Z. J. Med., 1980, 10, pp. 180–181.

Beta adrenoreceptor blocking drugs with high intrinsic sympathomimetic activity (pindolol and alprenolol) produced significant elevation of plasma cyclic AMP levels, when compared to propranolol. In hypertensive patients, despite these marked differences in plasma cyclic AMP levels, similar blood pressure control was achieved with these three beta blockers
Carcinoma of the Stomach—Prognostic Factors and Current Treatment
Authors: Hecker R. , Durbridge T.
Published: March 2008

Summary: Two‐hundred‐and‐six cases of gastric carcinoma were analysed for survival on the basis of their clinical, endoscopic and operative findings. An attempt has been made to identify prognostic factors and the role of endoscopy. It is concluded that too much radical surgery is being performed in patients who can be recognised preoperatively as having obviously advanced disease.
Utility Analysis of a Computer Stored Diagnosis Index and Other Medical Record Data
Authors: Proudfoot A. D. , Mackay I. R.
Published: March 2008

Summary: A computer‐based system for storing items of medical record data including a complete coded list of diagnoses was established in 1971 for all patients admitted to a research‐oriented medical ward. An analysis was made to assess the usefulness of such an electronically‐stored data base from the stand‐point of Unit activity, disease correlations, stability of diagnostic criteria, completeness of diagnosis lists and accuracy of coding. Over six years, 1972–77, there were 3569 admissions of which 1679 were first admissions. The most frequently made principal diagnoses were cerebrovascular accident (8%), myocardial infarction (5·4%), ischaemic heart disease (2·9%), rheumatoid arthritis (2%), duodenal ulcer (2%) and systemic lupus erythematosus (1·9%); the 33 most frequent principal diagnoses accounted for only 45% of all principal diagnoses made. The duration of stay (mean 16 days) was shown to depend on principal diagnosis but not significantly on age. Variability in annual incidence was significant for 24% of diagnoses; for some diagnoses this was readily explainable by extraneous causes, but for others it suggested an “instability” of criteria for that diagnosis. The probability of a minor diagnosis being “overlooked”, using Dupuytren's contracture as an example, was shown to be high (50%). The rate of miscoding a diagnosis was 5%. This study, despite its illustration of the “softness' of diagnosis making in routine hospital ward practice, illustrates the potential of processing hospital diagnosis data by computer.
When is Diabetes?—A New Look at Diagnostic Criteria for Diabetes Mellitus
Authors: Zimmet P.
Published: March 2008

Summary: While the diagnosis of diabetes mellitus is usually straightforward because of typical symptoms and signs along with an unequivocally high plasma glucose, there is still considerable controversy about diagnostic criteria for diabetes based on the oral glucose tolerance test (OGTT).

Recently there has been world‐wide recognition of the need for standardisation of these criteria. A new set of diagnostic criteria, based on prospective and cross‐sectional epidemiologic studies have now been recommended by a World Health Organisation Expert Committee on Diabetes.

The new criteria set out recommendations for normal subjects, those with impaired glucose tolerance (a borderline group), and diabetics. The use of these criteria should result in uniform reporting of the OGTT, as well as reducing to a minimum the mis‐diagnosis of diabetes.
Fibre‐optic Bronchoscopy in Small Cell Lung Cancer: Findings Pre and Post Chemotherapy
Authors: Bye P. T. P. , Harvey H. P. B. , Woolcock A. J. , Stewart M. E. B. , Kearney E. , Wills E. J. , Fox R. M.
Published: March 2008

Summary: The aim of our study was to evaluate the role of fibre‐optic bronchoscopy both in diagnosing patients with small cell lung cancer, and in assessing remission status following combination chemotherapy. Diagnostic bronchoscopic examination was performed in 40 patients and revealed that in all cases the lesion was located in the central bronchi. Following combination chemotherapy remission status in 18 patients was assessed by comparing the findings at repeat bronchoscopy with those of chest radiology. In ten patients there was no relationship between the findings at bronchoscopic examination and the chest radiograph (normal or abnormal). Adequate assessment of response of small cell lung cancer to therapy requires bronchoscopy in addition to chest radiology.
Tuberculosis of the Lower Lung Field
Authors: Naraqi S. , Voibun M.
Published: March 2008

Summary: Pulmonary tuberculosis in adults is typically localised in the apices of the lungs. Lower lung field tuberculosis, although uncommon, is a well recognised entity which still occurs in countries with low or high prevalence of tuberculosis. Six patients with lower lung field tuberculosis, seen at the University of Papua New Guinea hospital over a period of one year, are described in this report. All six were Melanesian with a mean age of 32 years. Five were female. Fever, productive cough, pleuritic chest pain and localised crepitant rales over the affected area of the lungs were the most common clinical findings. Duration of symptoms prior to hospitalisation ranged from two to 12 months (mean: eight months). Four patients had haemoptysis. Right lung was affected more often than the left. The diagnosis of tuberculosis was delayed in four patients owing to the atypical localisation of the pulmonary infiltrates and to the absence of acid fast bacilli in the first three sputum smears. Lower lung field tuberculosis occurs more commonly in young females, affects the right lung more often and is associated with haemoptysis, early cavitation and hilar lymphadenopathy. Atypical location of the infiltrate may result in mis‐diagnosis as lobar pneumonia, lung abscess or carcinoma of the lung.
Selective IgA Deficiency in Australian Blood Donors
Authors: Wells J. V. , McNally M. P. , King M. A.
Published: March 2008

Summary: Selective serum IgA deficiency (defined as a serum IgA level less than 50 mgll) was detected in 14 of 6, 191 Australian blood donors screened by double diffusion analysis of serum specimens in agarose. This prevalence rate of 0·23% (1 in 442) is the same as that found in blood donors in Sweden but is higher than rates found in blood donors in France (0·05%), Norway (0·08%), USA (0·15%), England (0·19%) and Finland (0·20%).

Antibodies to human IgA were detected in the serum of three of 11 blood donors with selective IgA deficiency (27%). There was no evidence in the present study of blood transfusion reactions from these anti‐IgA antibodies when they were transfused into recipients.
Effects of Cimetidine on the Healing of Benign Gastric Ulcers
Authors: Clarke A. C. , Lee S. P. , Tasman‐Jones C.
Published: March 2008

Summary: A prospective double‐blind trial was undertaken to determine whether treatment with cimetidine influenced the healing of gastric ulcers in New Zealand patients. Ulcer size and healing was assessed by endoscopic examination.

Of the 30 patients who completed the trial, 15 were given cimetidine and 15 placebo. At six weeks, 60% of the patients on cimetidine had healed their ulcers, whereas only 20% of those on the placebo had healed ulcers (P < 0·05). Fewer patients taking cimetidine required antacids for symptom control than those on placebo treatment (P < 0·05).

The study confirmed that cimetidine treatment accelerates the healing of gastric ulcers.
Possible Genetic Determinants in Epidemic Polyarthritis Caused by Ross River Virus Infection
Authors: Fraser J. R. E. , Tait B. , Aaskov J. G. , Cunningham A. L.
Published: March 2008

Summary HLA D locus‐related (DR) antigens and Gm phenotypes were determined in 30 patients with epidemic polyarthritis following Ross River virus (RRV) infection and contrasted with those in comparison series of 119 (DR) and 1220 (Gm) normal subjects. HLA DR7 (46·7% cf. 21·0%) and the heterozygous Gm phenotype a+ x+ b+ (33·3% cf. 15·3%) were significantly increased in the patients, with relative risks of 3·3 and 2·8 respectively. The occurrence of Gm a+ x+ b + was independent of DR7, and conferred a relative risk of 4·3 in DR7‐negative patients. Differences found in clinical features, specific lymphocyte proliferative responses and antibody litres did not reach significant levels. The association with DR7 was inversely related to age in residents of an area of moderate endemic risk, and to levels of natural cell‐mediated immunity (natural killer cell activity). These correlations point to possible mechanisms by which genetic traits might influence the occurrence or consequences of RRV infection.