bluuebunny/crossref_metadata_2025 huggingface dataset:
Growth of Australian Aboriginal Children Related to Social Circumstances
Authors: Cockington R. A.
Published: March 2008

Summary: Growth of Australian Aboriginal children related to social circumstances, R. A. Cockington, Aust. N.Z. J. Med., 1980, 10, pp. 199–208.

Surveys were conducted of the growth of Aboriginal children in three South Australian communities of differing social circumstances. Significant differences were found between the three groups' growth parameters, with better growth paralleling improvement in living conditions. Normal growth occurred in Aboriginal children who came from similar environments to Caucasian children and comparison with the latter group revealed no significant differences in growth, The relationship held when studied over time
Radiation Pneumonia Complicating Adjuvant Cytotoxic Chemotherapy
Authors: Manoharan A. , Schonell M.
Published: March 2008

Summary: Radiation pneumonia complicating adjuvant cytotoxic chemotherapy. A. Manoharan and M. Schonell, Aust. N.Z. J. Med., 1980, 10, pp. 218–220.

A patient with Hodgkin's disease developed acute radiation pneumonia four months after completion of mantle radiotherapy and during cyclical adjuvant chemotherapy, Respiratory function tests were useful in the diagnosis of the interstitial abnormality and in monitoring response to prednisone. Serial respiratory function tests in patients receiving bimodal therapy may facilitate early diagnosis of this potentially serious complication.
Failure of Oral Versus Parenteral Corticosteroids in a Case of Acute Inflammatory Polyradiculoneuropathy (GuiIlain‐Barré Syndrome)
Authors: Brumback R. A.
Published: March 2008

Summary: Failure of oral versus parenteral corticosteroids in a case of acute inflammatory polyradiculoneuropathy (Guillain‐Barré syndrome). R. A. Brumback, Aust. N.Z. J. Med., 1980. 10, pp. 224–226.

A case of acute inflammatory polyradiculoneuropathy (IPN, Guillain‐Barré syndrome) not responding to oral corticosteroids but showing marked improvement on parenteral corticosteroids is reported. Oral prednisone 60 mg/day was begun on hospital admission and increased after one week to 100 mg/day; however, the patient's respiratory function, demonstrated by forced vital capacity, continued to deteriorate. lmprovement was noted when the patient was switched to intravenous methyl‐prednisolone 100 mglday. Further attempts to use oral corticosteroids (including oral methyl‐prednisolone 96 mg/day) resulted in deterioration of the patient's function
MyocardiaI Infarction, PapiIIary MuscIe Dysfunction and Mitral Valvular incompetence in Systemic Lupus Erythaematosus
Authors: Bignold L. P. , Bailey I. K. , Kronenberg H.
Published: March 2008

Summary: Myocardial infarction, papillary muscle dysfunction and mitral valvular incompetence in systemic lupus erthaematosus. L. P. Bignold, I. K. Bailey and H. Kronenberg, Aust. N.Z. J. Med., 1980, 10, pp. 236–239.

A fatal case of systemic lupus erythaematosus complicated by myocardial infarction, papillary muscle dysfunction and mitral incompetence seven months before death is reported. Necropsy examination of the heart revealed that the infarct was due to multiple occlusive thrombi in epicardial branches of the corresponding coronary artery. No evidence of atherosclerosis or previous coronary arteritis was present
Hirsutism: Pathogenesis and Treatment
Authors: Casey J. H.
Published: March 2008

Summary: Hirsutism: pathogenesis and treatment. J. H. Casey, Aust. N.Z. J. Med., 1980, 10, pp 240–245.

When hirsutism is recognised as an endocrinopathy, a rational approach to treatment can be devised. In simple hirsutism, the ovaries are the most likely source of excess androgen production: and demonstrate a wide range of pathology. The adrenal cortex is sometimes of prime importance but is more frequently a contributor of androgen precursors. Long term hormonal suppressive treatment will successfully control hirsutism in the majority. Anti‐androgens constitute a potential treatment for future years: physical methods of depilation remain as useful adjuncts to medical therapy
Acute Gastric Ulceration—A Prospective Study of Incidence and Results of Management
Authors: Hunt P. S. , Korman M. G. , Hansky J. , Schmidt G. T. , Hillman H. S.
Published: March 2008

Summary: During a prospective six year study from 1972–1978 there were 894 admissions to a haematemesis and melaena unit. In 162 admissions bleeding was due to acute gastric ulceration, an incidence of 18%. The group comprised 157 patients, five patients being admitted on two occasions. There were 12 deaths (7%), seven after surgery and five in conservatively treated patients. A significant fall in incidence of admissions was noted in the final two year period of study. The reason for this is unknown as no other cause of haematemesis and melaena showed a similar fall in incidence. In addition over this two year period patients with acute ulceration followed a more benign course and required surgery less often.
Computerised Clinical Data Base System—Australia
Authors: Klestov A. C. , Kerr G. , Webb J.
Published: March 2008

Summary: In search for a practical solution to analyse a large quantity of medical information, rheumatic disease data base system (RDDS) is described. Details of data configuration, data entry and retrieval are discussed in some detail. The system incorporates a range of commonly used statistical tests and provisions for more advanced data analysis are made. Additional facilities include provisions for a variety of printed reports, back up facilities and a word processor. The ease of system operation and flexibility are emphasised. Technical support requirements are minimal even when new applications are being developed. The system is fully operational at present and can be implemented on a number of computer systems.
Diffuse Fasciitis with Eosinophilia
Authors: Barraclough D. , Begg M. W.
Published: March 2008

Summary: In 1974 Shulman1 described two patients who had a scleroderma‐like thickening of the skin in association with eosinophilia. Biopsies revealed striking thickening of the fascia between the subcutaneous tissue and muscle, with intense infiltration of plasma cells and lymphocytes. There was no evidence of myositis or of the visceral manifestations of systemic sclerosis.

Reports of similar patients2–15 have since appeared; we report a further patient thought to have this condition.
Leucocyte Adherence Inhibition Test for the Detection of Cell‐mediated Immunity to Malignant Melanoma*
Authors: Winter M. , Nelson D. S. , Milton G. W.
Published: March 2008

Summary: A tube leucocyte adherence test was used to detect reactivity of melanoma patients to extracts of melanoma tissue. Breast cancer extracts were used as a control. Of 31 melanoma patients 22 gave a positive reaction (non‐adherence index > 25%) to melanoma extracts whereas only three of 24 normal subjects did so. Fifteen of 16 patients with Stage 1 melanoma reacted but only seven of 15 patients with Stage 2 or Stage 3 disease did so. None of seven patients with breast cancer reacted to melanoma extract, but four of them reacted to breast cancer extract. None of four patients with benign breast disease reacted to either extract. It is concluded that leucocyte adherence inhibition is potentially useful in investigations of tumour‐specific immune reactivity to melanoma and of melanoma antigens.
Effects of Quinidine and Disopyramide on Serum Digoxin Concentrations
Authors: Manolas E. G. , Hunt D. , Sloman G.
Published: March 2008

Summary: Although quinidine and digoxin are frequently given together, it has only recently become apparent that serum digoxin concentration may rise during quinidine treatment. A prospective study was performed to compare the effects of quinidine and disopyramide in patients receiving maintenance digoxin therapy. During quinidine administration serum digoxin concentration rose by more than 50% in seven of nine patients (the mean concentration rising from 1·43 ± 0·20 to 2·61 ± 0·43 nmol/I, P < 0·005). During the disopyramide treatment a small rise in serum digoxin was noted (mean 1·3 ± 0·16 to 1·5 ± 0·19 nmol/I, P < 0·05). We suggest that digoxin doses should be reduced immediately prior to commencing quinidine therapy in patients already receiving adequate maintenance digoxin, and patients should be followed carefully for evidence of digoxin toxicity. Disopyramide appears a suitable alternative anti‐arrhythmic drug to quinidine in patients on maintenance digoxin.
Isolation of Group EF‐4 Bacteria in Australia
Authors: Peel M. M. , Holmes B.
Published: March 2008

Summary: A bacterial strain isolated from dog‐bite wound was identified as belonging to a group which is so far unnamed but which has been tentatively designated Group EF‐4 by workers at the Center for Disease Control, Atlanta, USA. Although this appears to be the first reported isolation in Australia of a strain belonging to this group, it is possible that strains of Group EF‐4 are not infrequently recovered from dog‐bite wounds but, when they are, they may either not be identified or be dismissed as skin contaminants. Characteristics are presented for differentiating Group EF‐4 from Pasteurella multocida, the bacterium typically associated with animal bite wounds in humans.
Myeloproliferative and Lymphoproliferative Disorders in the Same Patient
Authors: Hand H. , Chan W. , Vincent P. C.
Published: March 2008

Summary A 67‐year‐old man developed a Philadelphia‐negative myeloproliferative disorder which initially manifested as marked thrombocytosis, followed two years later by marked leucocytosis. He subsequently developed an IgG Λ plasma cell dyscrasia together with a monoclonal proliferation of circulating lymphocytes with IgMk surface immunoglobulin. The lymphoid neoplasm was associated with a rapidly progressive and fatal course.
Immunological Function in Glomerulonephritis*
Authors: Carney G. , Walls R. S. , George C. R. P. , Payne J. E. , Newland R. C. , Lawrence J. R.
Published: March 2008

Summary: Aspects of humoral and cellular immunity and of the complement system were examined in 44 patients with glomerulonephritis, and in control subjects. A number of patients with glomerulonephritis were shown to have evidence of altered immunity which may reflect underlying mechanisms of glomerular injury. Mesangial IgA glomerulonephritis was associated with elevation of serum IgA levels (P < 0.001), and focal sclerosing glomerulonephritis with raised serum IgM (P < 0.001). Serum IgG levels were abnormal in 15 patients with glomerulonephritis. The haemagglutinating antibody response to tetanus toxoid was reduced in patients compared with controls. Levels of serum complement components were increased, with some exceptions, and C‐reactive protein levels were also significantly raised (P < 0.001), findings consistent with an ongoing inflammatory process. No impairment in response to recall antigens or sensitisation to dinitrochlorobenzene was found, but phytohaemagglutinin induced lymphocyte transformation was reduced in some forms of the disease.
Appraisal of Factors Influencing the Normal Sinus Node Recovery Time*
Authors: Tonkin A. M. , Tornos P. , Rapp H. , Heddle W. F. , Helfgott A.
Published: March 2008

Summary: The normal period of depression of sinoatrial node automaticity (sinus node recovery time, SNRT) following one minute of overdrive right atrial pacing was evaluated in 34 subjects, aged 27–83 years. Specific attention was paid to the influence of the patient's heart rate, atrial pacing rate (100 and 130 bpm) and site, and of vagal and sympathetic effects, as assessed by observations following the administration of atropine, 0 03 mg/kg, and propranolol, 0.15 mg/kg.

Normal SNRT was 1046±17 ms at 100 bpm and 980±19 ms at 130 bpm. Linear regression analysis showed that at pacing rates of both 100 and 130 bpm, both before and after autonomic block, a highly significant relation existed between SNRT and the stable P‐P interval observed after cessation of pacing. These regression equations were used to develop a correction factor for cycle length in assessing SNRT (corrected SNRT = SNRT—0·86 X cycle length, where 0.86 was the slope of the regression equation). The mean corrected SNRT was 314±10 ms and 290±8 ms at 100 and 130 bpm, respectively. Vagal influences increased SNRT and were of greater magnitude than the decrease in SNRT due to sympathetic effects. Corrected SNRT was significantly longer following left atrial than following right atrial pacing, but in those eight patients studied, was not significantly different following right atrial or right ventricular stimulation.
Echocardiographic Assessment of Cardiac Chamber Size and Left Ventricular Function in Aerobically Trained Athletes
Authors: Blair N. L. , Youker J. E. , McDonald I. G. , Telford R. , Jelinek V. M.
Published: March 2008

Summary: We compared the echocardiographic assessment of left ventricular function in 20 aerobically trained male athletes (VO2 max 61 ml/kg/min) with 20 control subjects of similar age and size (VO2 max 37 ml/kg/min). On average, the left ventricle was larger in athletes and the extent of myocardial contraction (fractional shortening) was reduced. In nine athletes, fractional shortening was less than our laboratory lower limit of normal (26%) and in four athletes the left ventricle was enlarged and fractional shortening was reduced. However, the peak rate of circumferential shortening was not reduced in athletes. We concluded that athletes have normal myocardial contractility but some have a reduced extent of myocardial contraction which could be mistaken for the effects of myocardial disease.
Secretin Stimulated Pancreatic Polypeptide: A Test for Chronic Pancreatitis
Authors: Stern A. I. , Hansky J.
Published: March 2008

Abstract: The level of serum pancreatic polypeptide (PP) in response to intravenous Boots secretin has been measured by radioimmunoassay in 50 patients with documented chronic pancreatitis and 33 controls with no evidence of pancreatitis. Both groups showed significant increases in serum PP but patients with chronic pancreatitis had a significantly smaller response than controls. An abnormal PP response to Boots secretin has been defined as a peaklbasal ratio of less than five. Using this criterion, 90% of patients with chronic pancreatitis had a ratio of less than 5. whereas 91% of controls had a ratio of 5 or greater. There was a 92% correlation between a normal or abnormal pancreatic bicarbonate concentration and a normal or abnormal peakl basal PP ratio in response to Boots secretin. These results suggest that the serum PP response to Boots secretin may provide a simple, inexpensive and noninvasive method of accurately diagnosing chronic pancreatitis.
The Treatment of Metastatic Breast Cancer with Aminoglutethimide
Authors: Kaye S. B. , Woods R. L. , Fox R. M. , Tattersall M. H. N.
Published: March 2008

Abstract: Thirty‐eight patients with advanced breast cancer, resistant to prior endocrine therapy and in most cases prior chemotherapy, were treated with aminoglutethimide, 250 mg qds. Seven of 30 evaluable patients (23%) responded. Six have subsequently relapsed with a mean duration of response of 17 weeks, while one continues to respond after 50 weeks of therapy. Six additional patients (20%) had stable disease during aminoglutethimide therapy (mean duration of 16 weeks). Three of the seven responders had shown a partial response, two had stable disease and two had progressive disease on prior endocrine therapy (including tamoxifen); six of the seven patients responding to aminoglutethimide had received prior combination chemotherapy, to which ail had responded.

Aminoglutethimide was generally well tolerated, although three patients withdrew from treatment within the first two weeks because of intolerable drowsiness. Aminoglutethimide offers a useful alternative to surgical adrenalectomy for women with advanced breast cancer responsive to previous endocrine and cytotoxic chemotherapy.
Nitrofurantoin Neuropathy
Authors: Yiannikas C. , Pollard J. D. , McLeod J. G.
Published: March 2008

Abstract: Four cases of severe peripheral neuropathy directly attributable to nitrofurantoin are reported. The neuropathy was not dose‐related and not necessarily associated with abnormal renal function. Recovery was slow, and neither severity nor recovery was related to the total dose of the drug. The pathological changes seen on light microscopy and electron microscopy were those of acute, severe axonal degeneration. It is emphasised that nitrofurantoin is a neurotoxic drug and should not be prescribed to the elderly nor to anyone with impairment of renal function.
Pregnancy Associated Plasma Protein‐A: Interaction with Heparin in Crossed Affinity lmmunoelectrophoresis
Authors: Sinosich M. J. , Teisner B. , Davey M. , Grudzinskas J. G.
Published: March 2008

Abstract: A specific interaction between pregnancy associated plasma protein‐A (PAPP‐A) arid heparin has been demonstrated using heparin affinity crossed immuno electrophoresis applied to late pregnancy serum. The presence of heparin in the first dimensional gel accelerated the anodic migration of six serum proteins with β electrophoretic mobility and one protein in the α mobile region. Two of the six β mobile proteins were identified as anti‐thrombin III and β lipoprotein, the α mobile protein being PAPP‐A. The migration distance of other proteins originating in the placenta (pregnancy specific β1 glycoprotein), fetus (alpha‐fetoprotein). leucocytes (pregnancy zone protein), or maternal liver (α1 antitrypsin α2macroglobulin) was not altered. The interaction of PAPP‐A with heparin was therefore independent of Molecular size, charge, and site of origin indicating a specific high affinity interaction between PAPP‐A and heparin. These results indicate that PAPP‐A may be involved locally with the coagulation system in the maintenance of placental circulation.
Clinical Improvement and Hormonal Changes in Severe Cardiac Failure after Captopril Treatment
Authors: McGrath B. P. , Denham I. M. , Johnston C. I.
Published: March 2008

Abstract: The effects of oral captopril, an angiotensin converting enzyme inhibitor, on cardiac function and on the renin‐angiotensinaldosterone system were examined in nine male patients with severe congestive cardiac failure (New York Heart Association Class III or IV). All had been refractory to conventional therapy with bed rest and high dose frusemide and seven had failed to respond adequately to vasodilator therapy.

One hour after the first dose of captopril (25 mg p.o.) there were significant falls in mean blood pressure (98±5 to 78±8 mmHg, P < 0.01), heart rate (88±5 to 79±4 beats/min, P < 0.01) and plasma angiotensin II (77±38 to 16±5pg/ml, P < 0.01); plasma renin concentration, initially very high (9.0±2.5 ng/ml/hour), increased further (11.9±2.7 ng/ml/hour).

These changes were observed to persist during the first week of treatment. Urinary aldosterone excretion fell from 65±29 to 30±11 nmol/day on day 1 and further to 17±8 nmol/day after one week (P< 0.01). This was accompanied by both a natriuresis and a fall in potassium excretion. Creatinine clearance did not change. Rapid clinical improvement occurred in all but one patient who had severe aortic stenosis. Body weight fell (71.7±4.5 to 68.8±4.3 kg, P< 0.05), diuretic drugs were able to be reduced and, in the five patients in sinus rhythm, cardiac ejection fraction increased (13±2 to 17±2%, P<0.05) after one week's treatment. Three patients continued on longterm treatment have returned to work.

Low dose oral captopril therapy blocks angiotensin converting enzyme, suppresses secondary hyperaldosteronism, prevents hypokalaemia and produces sustained improvement in cardiac performance in patients with severe refractory congestive cardiac failure. Orally‐active inhibitors of angiotensin converting enzyme, of which captopril is the forerunner, appear to offer considerable therapeutic advantages in the treatment of cardiac failure.
The Current Status of the Vitamin D Metabolites
Authors: Larkins R. G.
Published: March 2008

Abstract: Research over the last fifteen years has led to the identification of several metabolites of vitamin D, elucidation of their mechanism of action, clarification of the pathogenesis of several metabolic bone diseases, and development of new diagnostic tests and more effective and safe treatment. 1, 25(OH)2D, the most active metabolite, can be regarded as a highly potent steroid hormone, with its formation from its precursors tightly coupled to physiological need by a variety of ionic and hormonal regulating mechanisms.
Alcohol‐related Behaviour Patterns
Authors: Hammond S. B.
Published: March 2008

Abstract: Alcohol‐related behaviour patterns.

When one tentatively accepts the evidence for possible genetic components in alcoholism and starts to speculate about the behavioural processes involved one faces the gap between alcoholism and alcohol related behaviour. There are four main ways of defining alcohol related behaviour, and each of these implies its own genetic themes. It is proposed to discuss these four approaches and then to turn for clarification to some longitudinal evidence on behavioural patterns related to alcohol consumption.
Lack of Metabolic Bone Disease in Patients with Fracture of the Femoral Neck*
Authors: Evans R. A. , Ashwell J. R. , Dunstan C. R.
Published: March 2008

Abstract: To examine the widely held belief that osteoporosis and osfeomalacia are pathogenetic factors in femoral neck fracture, we compared such patients with vertebral fracture patients and controls. Cortical bone was measured in hand X‐rays and cancellous bone in iliac crest biopsies, which were also used to assess osteoid, tetracycline and resorbing surface. The vertebral fracture patients were found to have a reduction of 53% and 41% in cancellous and cortical bone respectively compared to the controls, while in the much older femoral fracture patients the reductions were 19% and 16%. Three femoral fracture patients had mild osteomalacia from identifiable causes; a further one had fluorosis of bone and one had metastatic carcinoma; with the exception of these the osteoid covered surface of bone was less than in vertebral fracture patients and controls. We conclude that pathologic osteoporosis and osleomaiacia are not major factors in the pathogenesis of femoral neck fractures, though the normal age related reduction in bone mass may contribute. There may be another age related factor weakening the femoral neck. It was also noted that when assessed by a sensitive histochemical technique for osteoclast identification, bone resorption was not increased in either of the fracture groups.
The Lundh Test: A Review of its Clinical Use in the Diagnosis of Pancreatic Disease
Authors: Waller S. L. , Smithies A. , Kapp F. , Loyaza M. , Noguera E. C. A. , Philippakos D. , Stacherg H. G.
Published: March 2008

Abstract: The clinical value of the Lundh test in the diagnosis of pancreatic disorders was reviewed retrospectively for 139 patients with proven pancreatic disease (15 acute and 72 chronic pancreatitis, 51 carcinoma of the pancreas and one partial pancreatectomy). There was a good separation between patients with pancreatic disease and those with other gastrointestinal disorders who presented with similar symptoms. The test was most helpful in patients with chronic pancreatitis (diagnostic rate 89%, mean tryptic activity (MTA) < 7 U), more particularly in those presenting with jaundice or steatorrhoea (100%) than pain (86%), but less successful (diagnostic rate 68%) in carcinoma of the pancreas (steatorrhoea 100%; jaundice 64%; pain 55%). Complete absence of bile from duodenal juice in jaundiced patients usually indicated pancreatic or hepatobiliary carcinoma. An abnormal but not diagnostic MTA (7 to < 10 U) was seen in 7% of patients with chronic pancreatitis, 13% with carcinoma of the pancreas and 11% with non‐pancreatic disorders and suggested the need for further pancreatic investigation. Cytological examination of duodenal juice increased the usefulness of the test. Although malignant cells were rarely seen, characteristic (degenerate) cells were found in 22 of 44 (50%) patients with, but only five of 85 (6%) without pancreatic disease, even when the MTA was normal. The Lundh test can be conveniently combined with a jejunal biopsy at the same intubation for the investigation of diarrhoea or steatorrhoea.
Zinc, Copper and Environmental Factors in the Aboriginal Peoples of the North West*
Authors: Cheek D. B. , Smith R. M. , Spargo R. M. , Francis N.
Published: March 2008

Abstract:Three‐hundred Aboriginal people five to 70 yr have been studied at three missions in the north west of Australia—Beagle Bay, Lombadina and One Arm Point. The prevalence of hypozincaemia and hyper‐cupraemia (a departure of more than 2 S.D. from the expected normal) has been assessed. Plasma iron concentration was determined. Half of the individuals had hypozincaemia and for some age groups the prevalence was greater (almost 100% for 15 to 20–year‐old females at Lombadina). Hypercupraemia was prevalent and ranged from 70 to 100% for most age groups. Hypoferraemia was detected frequently. By the use of anthropometric methods the children were found to be growth retarded and to have reduced weight for height.

These people are known to be infected with intestinal parasites which cause bleeding into the bowel or malabsorption which can cause losses of zinc or failure of absorption. They prefer unleavened bread which contains phytic acid which inhibits zinc absorption. The soil is zinc deficient and the climate conducive to large losses of zinc in sweat. Geophagia is practised and pica is found to occur in children. Preliminary evidence of elevated copper status is available.

We speculate that growth failure may be related to zinc deficiency or copper toxicity.
Dexamethasone and Osteonecrosis
Authors: Black K. A. , Khangure M. S. , Owen E. T.
Published: March 2008

Abstract: Four cases are reported in whom osteonecrosis followed after Dexamethasone was administered in high dosage for a short time to mduce cerebral and spinal cord oedema. Although corticosteroids have been implicated in the development of osteonecrosis, the delay from corticosteroid administration to the development of symptoms (9–30 months), with further delay in radiographic changes (9–36 months) may result in diagnostic confusion.
Phenytoin Induced Granulomatous Hepatitis
Authors: Cook I. F. , Shilkin K. B. , Reed W. D.
Published: March 2008

Abstract: Granulomatous hepatitis was found in a patient who developed a severe hypersensitivity reaction to phenytoin prescribed for the treatment of partial complex seizures. This pattern of liver reaction is not generally included amongst lesions of the liver reported to be induced by phenytoin.
Anuric Renal Failure Due to Encasement of the Ureters by Lymphoma—Ureteric Obstruction Without Dilatation
Authors: Chong B. H. , Trew P. , Meng L. , Pitney W. R.
Published: March 2008

Abstract: A case of anuric renal failure due to encasement of the ureters by tumour is described in a patient with advanced non‐Hodgkin's lymphoma. In this patient as well as in two previously reported cases, the IVP showed delayed pyelogram and increasingly dense nephrogram on delayed films with little or no dilatation of the collecting systems. These radiographic features in a patient with extensive intra‐abdominal tumour should strongly suggest the possibility of this unusual form of obstructive uropatby. Correct diagnosis in these cases may enable the administration of effective palliative treatment for the renal failure.
A COMPARISON OF PLASMA METHYLPREDNISOLONE CONCENTRATIONS FOLLOWING INTRA‐ARTICULAR INJECTION IN PATIENTS WITH RHEUMATOID ARTHRITIS and OSTEOARTHRITIS
Authors: BERTOUCH J. V. , SALLUSTIO B. C. , MEFFIN P. J. , BROOKS P. M.
Published: March 2008

Plasma concentrations of methylprednisolone following intra‐articular injection were measured in rheumatoid arthritis and osteoarthritis patients. While substantial plasma concentrations were seen in both groups of patients there was no significant difference in the rate or extent of absorption of methylprednisolone from osteoarthritic or rheumatoid knees. This study suggests that it is the dissolution rate of the steroid formulation rather than the characteristics of the synovial membrane which determine rate and extent of systemic absorption of methylprednisolone after intra‐articular injection.
THE INFLUENCE OF SMOKING ON THE HEALING OF DUODENAL ULCER TREATED WITH OXMETIDINE OR CIMETIDINE
Authors: HETZEL D. J. , KORMAN M. G. , HANSKY J. , SHEARMAN D. J. , EAVES E. R. , SCHMIDT G. T. , HECKER R. , FITCH R. J.
Published: March 2008

The influence of smoking on duodenal ulcer healing was examined during a double blind study of 83 patients randomly allocated to oxmetidine or cimetidine treatment. Smoking habits were recorded but patients were not advised to change these. Smokers and nonsmokers were similar clinically and did not differ in compliance with medication.

Both H2‐receptor antagonists were equally effective and after four weeks of treatment ulcers were healed in 76% of patients. Ulcer healing occurred significantly less frequently in smokers (69%) than nonsmokers (89%). Smokers with healed ulcers consumed fewer cigarettes per day (mean ± SE: 15.8±1.4) than those whose ulcers did not heal (22.2±2.7). When smokers were grouped according to daily cigarette consumption, a direct relationship was found between increasing cigarette consumption and decreasing frequency of ulcer healing. No reduction in ulcer healing was apparent in patients who smoked nine cigarettes a day, or less. (Aust NZ J Med 1983; 13:687‐590.)
RAPID INTUBATION OF THE ILEO‐COLONIC REGION OF MAN*
Authors: KERLIN P. , TUCKER R. , PHILLIPS S. F.
Published: March 2008

The relative inaccessibility of the ileo‐cecal region of man has restricted study of, and limited the information available on, normal functions of this region. Intubation of the distal bowel from above may be slow, even in the presence of normal patterns of motility in the stomach and small intestine. This report documents that addition of a small balloon at the “lead‐point” of the tube alters motor patterns and allows rapid transit to the colon.
OUTBREAK OF CO‐TRIMOXAZOLE‐ and GENTAMICIN‐RESISTANT KLEBSIELLA AEROGENES BACTEREMIA IN NEUTROPENIC PATIENTS RECEIVING ORAL CO‐TRIMOXAZOLE PROPHYLAXIS
Authors: LEAHY M. F. , HUMBLE M. W.
Published: March 2008

Over a five‐day period, three neutropenic patients developed bacteremia with an identical strain of Klebsiella aerogenes (serotype K16) resistant to co‐trimoxazole and gentamicin. All three patients had received prophylaxis with oral co‐trimoxazole before the onset of bacteremia. This report outlines some of the problems associated with co‐trimoxazole prophylaxis. (Aust NZ J Med 1983; 13: 636–638.)
TEMPORAL ARTERITIS PRESENTING AS A SYMMETRICAL PERIPHERAL POLYARTHRITIS
Authors: SMITH M. D. , BROOKS P. M.
Published: March 2008

:An 83 year old female presenting with a symmetrical peripheral polyarthritis resembling rheumatoid arthritis, subsequently developed biopsy‐proven temporal arteritis. This case report draws attention to this uncommon presentation of temporal arteritis and briefly reviews common presenting features of this condition. (Aust NZ J Med 1983; 13: 639–640.)
THE STABILITY OF GLYCERYL TRINITRATE TABLETS DURING PATIENT USE
Authors: MARTY J. , SHAW J. , HUNT D.
Published: March 2008

Abstract: The stability of glyceryl trinitrate (GTN) tablets stored in ways commonly used by patients was investigated to enable pharmacists and physicians to give better advice about tablet storage. Analysis of 43 samples of tablets collected from hospital patients showed that the GTN content of these samples differed significantly from that of fresh tablets. Tablets kept in the manufacturer's bottle contained significantly more GTN than those transferred to other airtight vials (p<0.05) or pill boxes (p< 0.005). The content of GTN was also significantly lower in tablets stored in pill boxes compared with other vials (p<0.01). Similar trends were found when tablets were stored in glass or plastic vials, pill boxes or were left exposed to air in the laboratory. These results emphasize that the best way to store GTN tablets is in the manufacturer's container. However, since many patients find that this bottle is awkward and inconvenient, a suitable alternative would be to carry a few tablets in a small airtight container (preferably glass). The unused tablets should be discarded every two weeks and nothing else should be added to the container. The use of pill boxes should be strongly discouraged.
THE CHANGING PREVALENCE AND PATTERN OF ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE IN HONG KONG – (1968–1978)
Authors: WOO K. S. , KONG S. M. , WAI K. H.
Published: March 2008

Abstract: The occurrence and pattern of rheumatic fever and rheumatic heart disease in Hong Kong in the years 1968 to 1978 were surveyed. The incidence of rheumatic fever in hospitals had decreased by four‐fifths in the past 10 years. Rheumatic fever nowadays still predominantly affects children and younger adults, but middle‐aged patients may also be affected. There are a slight female dominance (1.3 to 1) and a relative predominance of patients from urban areas. A less severe form of manifestation in adult patients is encountered nowadays. Carditis was the dominant feature in 1968, but joint involvement was more common in recent years. Rheumatic nodules, chorea or erythema marginatum remained uncommon throughout the years. Only 49% of cases satisfied the revised Jones criteria (1965). In comparison, chronic rheumatic heart disease still remained prevalent, with a slower trend of decreasing prevalence. It accounted for (36 to 50%) of total cardiac admissions. The mitral valve was involved in (82.7 to 91.7%), aortic valve in (15.5 to 36.3%), while involvement of tricuspid or pulmonary valve was relatively uncommon. The socio‐economic implication of this changing trend was analysed, and the problem encountered in diagnosing rheumatic fever discussed.
HYPERTROPHIC PULMONARY OSTEOARTHROPATHY: RESPONSE TO CHEMOTHERAPY WITHOUT DOCUMENTED TUMOUR RESPONSE
Authors: DALGLEISH A. G.
Published: March 2008

Abstract: A case is reported of severe hypertrophic pulmonary osteoarthropathy associated with bronchogenic carcinoma which successfully responded to chemotherapy, despite the fact there was no objective response in the primary lesion. Previous treatment and responses are briefly reviewed. The method or methods by which chemotherapy may alleviate HPOA in the absence of response to the primary lesion are discussed. The marked discrepancy between progression of the HPOA and progression of the clubbing is noted. The fact that HPOA is potentially treatable despite the prognosis of the primary is emphasised.
CLINICAL FEATURES OF MITOCHONDRIAL MYOPATHY
Authors: BYRNE E. , BLUMBERGS P. C. , HALLPIKE J. F. , MUKHERJEE T. M.
Published: March 2008

Five patients with mitochondrial myopathy are discussed. Two presented with progressive external ophthalmoplegia (CPEO), one with CPEO and retinitis pigmentosa, and two with Kearns‐Sayre syndrome. Ragged red fibres and intra‐mitochondrial para‐crystalline inclusions were found in each case. The clinical heterogeneity of the mitochondrial myopathy syndrome in the presence of identical pathological changes in skeletal muscle is emphasised.
LIFE EVENTS AND MYOCARDIAL INFARCTION
Authors: MAGNI G. , CORFINI A. , BERTO F. , RIZZARDO R. , BOMBARDELLI S. , MIRAGLIA G.
Published: March 2008

Life events reported to have occurred twelve months before the onset of the illness were compared in 55 in‐patients who had a first episode of myocardial infarction and 55 control in‐patients matched for age, sex, marital status and social class and afflicted with acute abdomen, trauma and multiple trauma.

The Paykel interview for Recent Life Events was used.

Myocardial infarction patients reported significantly more previous events than the control group (p<0.001) with more undesirable (p<0.01) and uncontrolled (p<0.01) events. Moreover, myocardial infarction patients had significantly more events (p<0.01) which had an “objective negative impact” (rated as being traumatic).

These findings are consistent with the view that certain recent life events have a positive association with the onset of a first episode of myocardial infarction.
POST TRAUMATIC RENAL HYPERTENSION
Authors: ABRAMSON M. , GEE D. , JACKSON B. , JOHNSTON C. I.
Published: March 2008

Two cases of hypertension following renal trauma are reported. In both cases, blood pressure was controlled with captopril, an angiotensin converting enzyme inhibitor. Mechanisms of hypertension following renal trauma are reviewed and the place of medical or surgical management discussed.
PATHOGENESIS OF ALCOHOLIC PANCREATITIS
Authors: WILSON J. S. , PIROLA R. C.
Published: March 2008

The pathogenesis of alcoholic pancreatitis continues to be a puzzle. Of the many theories as to how alcohol might cause pancreatic damage, none satisfactorily explains why only a minority of alcoholics develop clinical pancreatitis. Hypertriglyceridemia and inherited factors could be important antecedents in some individuals, and high fat and protein diets may favour the development of the disease. Disturbances of the sphincter of Oddi have been postulated, but there are experimental and theoretical objections to the view that alcoholic pancreatitis generally results from sphincter dysfunction (obstruction‐hypersecretion, biliary‐pancreatic reflux and duodeno‐pancreatic reflux). Biochemical studies of the effect of alcohol on pancreatic tissue have so far been relatively unrewarding. The most widely held view is that alcohol causes the deposition of protein in peripheral ducts leading to obstruction, inflammation and degeneration. However, it remains to be shown that these deposits are the cause rather than a result of pancreatic inflammation. Research might be facilitated by the development of a suitable animal model of the disease.
ANALGESIC NEPHROPATHY ASSOCIATED WITH PARACETAMOL
Authors: SEGASOTHY M. , TONG B. KONG CHlEW , KAMAL A. , MURAD Z. , SULEIMAN A. B.
Published: March 2008

Seven cases of analgesic nephropathy due to excessive ingestion of paracetamol are reported. None of these patients had been taking any other analgesic. All had radiological features of papillary necrosis. With the increasing use of paracetamol as a mild analgesic it is necessary to be aware of the possibility that paracetamol may induce analgesic nephropathy.
CHANGES IN PLASMA CATECHOLAMINE LEVELS DURING HEMODIALYSIS
Authors: FREWIN D. B. , BARTHOLOMEUSZ F. D. L. , CUMMINGS M. F. , CLARKSON A. R. , BARRY L. A. , FURBER B. , LORENZO C. DE , JONSSON J. R. , TAYLOR W. B.
Published: March 2008

The plasma concentrations of dopamine (DA), adrenaline (AD) and noradrenaline (NA) were measured during 29 routine hemodialysis (HD) treatments on 13 patients to determine whether any changes occurred in the concentrations of these substances during HD. All of the 13 patients studied demonstrated a fall in mean arterial pressure (MAP) when HD was commenced. Decreased concentrations of all three catecholamines were also demonstrated after the first hour of dialysis. Plasma AD rose after two hours, but NA and DA were still significantly lower than pre‐dialysis values at the end of HD. Study of 12 further patients during the first hour of HD confirmed that the NA level had fallen significantly by the fifteenth minute of HD, while the DA and AD levels took somewhat longer to fall. Both NA and DA were present in the dialysate in substantial amounts. Although the fall in MAP which accompanies HD is probably multifactorial, the loss of plasma catecholamines during HD may possibly contribute to the hemodynamic changes.
REACTIVE ARTHRITIS
Authors: EDMONDS J.
Published: March 2008

Although sometimes used to refer to any sterile arthritis occurring in association with infection, the term ‘reactive arthritis’ is better reserved for arthritis following sexually acquired nonspecific urethritis or enteric infections with organisms such as Shigella, Salmonella, Yersinia and Campylobacter, because these arthropathies are unified by a number of shared clinical characteristics and an association with HLA B27. This review suggests that these arthropathies may also share a common pathogenic pathway, triggered by an ‘arthritogenic factor’ common to the diverse microbes which cause the disease and modified by genetic factors other than HLA B27. Although uncommon, reactive arthritis is important because it could provide the key to understanding the other seronegative arthropathies and mechanisms basic to chronic inflammatory synovitis. (Aust NZ J Med 1984; 14: 81–88.)
VEGETARIAN DIET, BLOOD PRESSURE AND CARDIOVASCULAR RISK
Authors: ROUSE I. L. , BEILIN L. J. , ARMSTRONG B. K. , VANDONGEN R.
Published: March 2008

This paper reviews the association between a vegetarian diet and a number of risk factors for cardiovascular disease investigated in a series of epidemiological and experimental studies. Ninety‐eight Seventh‐day Adventist “vegetarians” were similar to 113 Mormon omnivores for strength of religious affiliation, consumption of alcohol, tea and coffee and use of tobacco, but were significantly less obese and had significantly lower blood pressures adjusted for age, height and weight. A random sample of forty‐seven Adventist vegetarians had significantly lower home blood pressures, serum cholesterol levels and blood pressure responses to a cold‐pressor test than Mormon omnivores carefully matched for age, sex and Quetelet's index.

In a controlled dietary intervention study mean systolic and diastolic blood pressures and serum cholesterol fell significantly during feeding with a vegetarian diet — an effect unrelated to changes in other lifestyle factors.

Dietary analysis indicated that a vegetarian diet provided more polyunsaturated fat, fibre, vitamin C, vitamin E, magnesium, calcium and potassium and significantly less total fat, saturated fat and cholesterol than an omnivore diet. There was no evidence for a difference between vegetarians and omnivores in levels of catecholamines, plasma renin activity, angiotensin 11, cortisol or serum and urinary prostanoids.
THE ROLE OF SODIUM AND POTASSIUM IN THE CONTROL OF BLOOD PRESSURE
Authors: MORGAN T. , MYERS J. , TEOW B. HO
Published: March 2008

When sodium intake was increased from 70–200 mmol/day in normotensive volunteers, their blood pressure rose by 6/4 mmHg. In most people over 50 years, blood pressure rose and it also rose in about 15% of younger people, Those who had a rise in blood pressure had a creatinine clearance lower than others when on a reduced sodium intake. In the sodium sensitive group creatinine clearance rose when sodium intake was increased. In the people with a rise in blood pressure there was a fall in plasma volume.

Increased sodium intake altered a number of factors that control sodium transport across cell membranes. The changes are complex but suggest that genetically inherited and environmentally caused defects are necessary to allow hypertension to be expressed.

Reduction of sodium intake reduced blood pressure in people with mild hypertension. Potassium interacted with sodium to reduce the rise in blood pressure caused by sodium.

Sodium intake and blood pressure are linked by many mechanisms. If the intake is excessive for that individual or if there are defective control mechanisms, hypertension will result.
USE OF AN INTRAVENOUS SODIUM LOAD IN SCREENING FOR PRIMARY HYPERALDOSTERONISM
Authors: STOKES G. S. , MONAGHAN J. C. , MENNIE B. A.
Published: March 2008

A sodium loading test was performed in 35 patients presenting with hypertension and hypokalemia. In 14 of these patients, intravenous administration of 0.9% saline (2 I in 4 h) on two consecutive days caused urinary aldosterone excretion to fall to values within the range for normal volunteers. The other 21 patients, in whom urinary aldosterone excretion did not decline following two days of saline loading, or in whom pronounced hypokalemia after the first day of loading precluded further saline infusion, were designated as having primary aldosteronism. Seventeen of this group underwent surgery and discrete adrenal adenomas were found in 16. When serum potassium concentration, plasma renin activity or the relationships of serum potassium to concurrent urinary potassium excretion or of urinary aldosterone excretion to plasma renin activity were used as alternative diagnostic criteria for primary aldosteronism, overlapping of the two groups occurred. It is concluded that measurement of urinary aldosterone excretion after intravenous sodium loading is a useful test in the identification of primary aldosteronism due to aldosterone‐producing adenoma. In this series the saline loading test was more specific in diagnosis than criteria based on serum and urinary potassium, plasma renin activity or unsuppressed aldosterone excretion.
SEVERE THORACIC SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: McDONALD C. F. , BARTER C. E. , FRASER K. J. , HANAN J. A.
Published: March 2008

The effects of corticosteroid administration to eight patients with severe thoracic systemic lupus erythematosus (SLE) were assessed in a prospective study over a mean period of 26 months by serial measurements of respiratory function, ESR, and a clinical score. Initial assessment of respiratory function showed severe restrictive ventilatory defects and impairment of carbon monoxide uptake not wholly attributable to the small lung volumes. ESR and clinical score showed high correlation coefficients with FEV1 in all patients, with VC and TLC in seven patients, and with TLCO in four patients, indicating that changes of respiratory function were reflecting the activity of the disease. This study shows that in patients with severe thoracic SLE it is valid to use serial measurements of respiratory function to assess the response to treatment and that pronounced and sustained improvement of respiratory function can be expected.
VASCULITIS AND GLOMERULONEPHRITIS: A SUBGROUP WITH AN ANTINEUTROPHIL CYTOPLASMIC ANTIBODY
Authors: HALL J. B. , WADHAM B. McN. , WOOD C. J. , ASHTON V. , ADAM W. R.
Published: March 2008

Four subjects whose plasma produced positive staining of neutrophil cytoplasm, on testing for antinuclear factor, have been found over eight years (and over 10 000 antinuclear factor studies). All four had evidence of diffuse systemic disease with polyarthralgia and lung involvement. Three of four (at least) had evidence of renal involvement and two of four skin biopsy evidence of vasculitis. Defining such a subgroup may help in defining etiology(s) and treatment regimes in diffuse vasculitic disease.
PARENTS WHO PHYSICALLY ABUSE THEIR CHILDREN
Authors: OATES R. K.
Published: March 2008

Increased knowledge of child abuse has made what was once an infrequently diagnosed condition become recognised as a major pediatric and social problem. While there is no typical profile of an abusive parent, characteristics that have been found more frequently include a history of having been deprived and possibly abused in the parent's own childhood, low self‐esteem in the mother and increased ill‐health in the immediate family members. Personality testing shows that the parents relate poorly to their children and to other people and that they have immature and impetuous personalities. Predictive studies show that abuse is commoner in families where the above characteristics are found, where family supports are minimal and where there are complications in the pregnancy, birth and in the neonatal period. However it should be recognised that the majority of families with these characteristics do not abuse their children. There is evidence that supportive measures provided to families who have known risk factors for abuse can reduce the incidence of this problem.