bluuebunny/crossref_metadata_2025_split huggingface dataset:
HYPERCALCAEMIA IN ASSOCIATION WITH RENAL FAILURE: THE ROLE OF IMMOBILISATION
Authors: PRINCE R. L. , EISMAN J. A. , SIMPSON R. W. 
Published: August 2010

Abstract:Hypercalcaemia occurring after ten weeks of immobilisation was observed in four adult patients all of whom had had prior renal failure sufficient to require renal dialysis. In all patients parathyroid hormone levels were normal or low and in three plasma 1,25(OH)2D3 levels were low. These findings are consistent with immobilisation induced increases in bone calcium resorption. Renal excretion of calcium may have been impaired by renal dysfunction resulting in hypercalcaemia and suppression of plasma PTH and 1,25(OH)2D3 levels. Resolution of the hypercalcaemia was associated with remobilisation. Parathyroidectomy is inappropriate treatment.
LONG TERM MINOXIDIL THERAPY and RENAL FUNCTION, CARDIAC FUNCTION, HYPERTRICHOSIS and BLOOD PRESSURE
Authors: JACKSON R. V. , WILLIAMSON M. M. , SENEVIRATNE B. , GORDON R. D. 
Published: August 2010

Abstract:Twenty‐eight patients with severe, refractory hypertension were treated with minoxidil, in combination with a beta‐blocker and a diuretic, for periods ranging from 1.5 to 39 months.In 16 patients treated for more than a year (14 to 39 months, average 24) mean supine blood pressure fell from 209/115 mmHg to 163/87 mmHg at one year and 157/87 mmHg when last seen; mean standing blood pressure fell from 186/109 mmHg to 148/86 mmHg at one year and 147/88 mmHg when last seen. Minoxidil did not cause postural dizziness. Six patients with renal artery stenosis were treated for 1.5 to 11 months in preparation for renovascular surgery. Only one of 28 patients developed resistance to minoxidil (up to 80 mg daily) after an initial response.Nine of the 16 patients treated for more than a year had plasma creatinine levels in excess of 0.20 mmol/l before commencing minoxidil. In three of them, levels increased further during treatment. In the remaining 13 patients, mean creatinine levels after one year and when last seen were not higher than pre‐treatment levels.All patients experienced fluid retention and hypertrichosis after commencing minoxidil. These effects were always controllable but very large doses of frusemide and the use of depilatory creams were sometimes required. The average dose of frusemide was 240 mg daily. Treatment did not have to be ceased because of these side‐effects. Serial echocardiography revealed no evidence of pericardial effusion, and a significant reduction in estimated mean left ventricular mass in ten patients followed for at least one year.It is concluded that minoxidil is an effective agent in the long‐term treatment of severe, resistant hypertension not responding to more conventional therapy. Provided that fluid retention and hypertrichosis were anticipated and treated vigorously when they arose, its use was not associated with any other serious problems.
MONOCLONAL ANTIBODIES IN CLINICAL MEDICINE – A REVIEW
Authors: THURLOW P. J. , MckENZIE I. F. C. 
Published: August 2010

Abstract:Monoclonal antibodies are produced by the cell fusion method, whereby immune murine spleen cells are fused with a murine myeloma to produce large quantities of specific homogenous antibodies. These have obvious advantages over conventional antisera particularly for in vitro diagnostic procedures. The use of monoclonal antibodies to human T cells, leukaemias and solid tumours are reviewed. In these areas, monoclonal antibodies are now being used for the diagnosis of disease activity, for the monitoring of graft rejection, and for the in vivo treatment of leukaemia and graft rejection in man. Murine monoclonal antibodies–examples of genetic engineering–represent a new and early phase of the use of molecular biological techniques for the production of reagents of use in clinical medicine.
Trends in the home management of non‐fatal acute myocardial infarction in Perth, Western Australia between 1984 and 1993
Authors: Bel H. C. , Parsons R. W. , Jamrozik K. D. , Fritjes C. 
Published: August 2010

Abstract Background: Trends in the incidence of acute myocardial infarction (MI) that are based on admissions to hospital would be misleading if the proportion of non‐fatal infarctions treated at home changed over time. Aim: To estimate trends in the management at home of cases of non‐fatal AM1 in Perth between 1984 and 1993 in order to determine if the number of such cases has remained consistently small and can be neglected in studies of the incidence of AMI. Methods: In 1989, 251 general practitioners in Perth responded to a postal questionnaire asking about management of cases of AM1 at home in the preceding 12 months. In 1993, 288 general practitioners and 174 physicians responded to the same questionnaire. Results: We estimate that 1.5% of all patients less than 65 years of age diagnosed with non‐fatal AM1 were managed at home in 1989. The corresponding figure for 1993 was 4.1%. A previous study in Perth in 1984 found that 3.9% of cases of non‐fatal AM1 in patients less than 65 years of age were managed at home. Conclusion: The management at home of cases of non‐fatal AM1 in people of working age in Perth has remained at a negligible level from 1984 to 1993. Thus a register based on admissions to hospital for AM1 will accurately reflect trends in AM1 in people of working age.
Peripheral blood lymphocyte subset distribution and function in patients with Alzheimer's disease and other dementias
Authors: HU G.‐R , Walls R. S. , Creasey H. , McCusker E. , Broe G. A. 
Published: August 2010

Abstract Background: Until recently, new data on immune aspects of Alzheimer's disease (AD) have suggested that some facets of AD pathogenesis may be immune related. However, the effects of dementia itself on immune function have not been considered. Aim: To compare the distribution of peripheral blood lymphocyte subsets and their function in patients with AD and other dementias. Methods: Peripheral blood lymphocyte numbers, T cell subset distribution, proliferative responses to mitogens and suppressor cell assay were studied in a well characterised group of patients with AD, and compared to patients with other forms of dementia. Age and sex matched elderly controls were screened to exclude dementia, and young controls were medical, paramedical and laboratory staff. Analysis of variance (ANOVA) and student's t test were used for statistical analysis. Results: The CD8 + lymphocyte population was reduced in AD and in other forms of dementia, when compared with non‐demented elderly and young controls. Concanavalin A induced lymphocyte transformation was reduced in all dementia groups and in elderly compared with young controls. The changes in T cell numbers and function were not specific for Alzheimer's disease, but were found also in other forms of dementia.
Serum 25‐hydroxyvitamin D3 is related to physical activity and ethnicity but not obesity in a multicultural workforce
Authors: Scragg R. , Holdaway I. , Singh V. , Metcalf P. , Baker J. , Dryson E. 
Published: August 2010

Abstract Methods: Serum 25‐hydroxyvitamin D3, a marker of recent sun exposure and vitamin D status, was measured in 390 New Zealand residents (95 Pacific Islanders, 74 Maori and 221 others mostly of European descent), who were part of a larger cross‐sectional survey of a workforce (n= 5677) aged 40–64 years. Results: Serum 25‐hydroxyvitamin D3 levels were significantly lower in Pacific Islanders (mean (SE) = 56 (3) nmol/L; p= 0.0001) and Maoris (68 (3) nmol/L; p=0.036) compared with Europeans (75 (2) nmol/L) after adjusting for age, sex and time of year. Also adjusting for ethnic group, 25‐hydroxyvitamin D, was higher in people doing vigorous (aerobic) leisure physical activities (71 (2) nmol/L; p=0.0066) and moderate (non‐aerobic) activities (68 (3) nmol/L; p = 0.12) compared with those who were inactive (63 (2) nmol/L). However, 25‐hydroxyvitamin D3 was unrelated to body mass index, serum lipids, blood pressure or cigarette smoking. Background: Recent research suggests that body vitamin D levels are decreased in coronary heart disease and diabetes, but it is unclear which cardiovascular risk factors are related to vitamin D status. Aims: To examine the relation between vitamin D status and major cardiovascular risk factors. Conclusions: People with increased skin pigmentation, such as Polynesians, and people who are inactive, have decreased body levels of vitamin D; this might partly explain their increased risk of cardiovascular disease.
Adjuvant chemotherapy for non‐metastatic osteosarcorna of the extremities in two New Zealand cancer centres
Authors: Jameson M. B. , Evans B. D. , Gray D. H. , Forgeson G. V. , Allan S. G. , Humm G. , Thomson J. , Harvey V. J. , Thompson P. I. 
Published: August 2010

Abstract Background: Adjuvant chemotherapy significantly improves survival of patients with non‐metastatic osteosarcoma but most of the data come from trials conducted in major international cancer centres. Aim: To review the efficacy and toxicity of an adjuvant chemotherapy regimen used in two regional cancer centres in New Zealand. Methods: Retrospective review of patients treated for non‐metastatic high‐grade osteosarcoma of the extremities. The regimen (POMA) consists of high‐dose methotrexate 8 g/m2 and vincristine 1.5 mg/m2 (maximum 2 mg) on days 1 and 8 followed by folinic acid then doxorubicin 50 mg/m2 and cisplatin 100 mg/m2 on day 15. This cycle was repeated every 35 days. Following amputation patients received six cycles while in selected patients two cycles were planned prior to limb salvage surgery followed by a further four cycles. Actuarial survival was calculated using the Kaplan‐Meier method. Results: Twenty patients were treated with POMA between 1986 and 1993. Amputation was performed in 16 patients and limb‐salvage surgery in four. Sixteen patients (80%) remain alive with no evidence of disease at a median follow‐up of 40 months. Thirteen patients (65%) have been continuously disease‐free. Actuarial survival at five years is 70%. Seven patients relapsed, six in lungs, of whom four underwent pulmonary metastasectomy; three of these remain free of disease 31, 35 and 40 months later. There was no local relapse. The toxicity of POMA is significant but tolerable. Conclusion: The results obtained at two regional cancer centres in New Zealand using POMA compare favourably to those achieved in clinical trials performed at major international cancer centres.
Association between ulcerative colitis and multiple sclerosis
Authors: Pokorny C. S. , Beran R. G. , Pokorny M. J. 
Published: August 2010

AbstractAn association between inflammatory bowel disease (IBD) and multiple sclerosis (MS) has been described. The current study was undertaken to explore this association further. Personal records of patients with IBD and MS were reviewed. In addition, a search of medical records at a large tertiary teaching hospital in Sydney was carried out for the years 1996–2006. Four patients (three women and one man) with both ulcerative colitis and MS were identified. MS did not occur in any of our patients with Crohn’s disease. The association between ulcerative colitis and MS appears to be real and may help identify common factors involved in the cause of these two diseases. No association was found in this study between MS and Crohn’s disease, sparking consideration why such difference should occur. With the increasing use of biological therapies in IBD and their reported propensity to cause demyelination, recognition of an association is all the more important.
Are Australasian academic physicians an endangered species?
Authors: Wilson A. 
Published: August 2010

AbstractIt has been stated that academic medicine is in a worldwide crisis. Is this decline in hospital academic practice a predictable consequence of modern clinical practice with its emphasis on community and outpatient‐based services as well as a corporate health‐care ethos or does it relate to innate problems in the training process and career structure for academic clinicians? A better understanding of the barriers to involvement in academic practice, including the effect of gender, the role and effect of overseas training, expectation of further research degrees and issues pertaining to the Australian academic workplace will facilitate recruitment and retention of the next generation of academic clinicians. Physician‐scientists remain highly relevant as medical practice and education evolves in the 21st century. Hospital‐based academics carry out a critical role in the ongoing mentoring of trainees and junior colleagues, whose training is still largely hospital based in most specialty programmes. Academic clinicians are uniquely placed to translate the rapid advances in medical biology into the clinical sphere, by guiding and carrying out translational research as well as leading clinical studies. Academic physicians also play key leadership in relations with government and industry, in professional groups and medical colleges. Thus, there is a strong case to assess the problems facing recruitment and retention of physician‐scientists in academic practice and to develop workable solutions.
First Fracture Project: addressing the osteoporosis care gap
Authors: Vaile J. , Sullivan L. , Bennett C. , Bleasel J. 
Published: August 2010

AbstractPatients sustaining a low‐trauma fracture are at greater risk of subsequent fracture, but as a group are poorly managed. We report the development of our ‘First Fracture Project’, in which we attempt to assess all patients over 50 years of age with a low‐trauma fracture attending orthopaedic fracture clinics and treat osteopenia and osteoporosis. We found that the First Fracture Project has greatly increased our success in improving delivery of osteoporosis care to appropriate at‐risk patients.
One drug or two? Step‐down therapy after i.v. antibiotics for community‐acquired pneumonia
Authors: Harrington Z. , Barnes D. J. 
Published: August 2010

AbstractBackground:  The aim of the study was to describe the oral antibiotics prescribed as step‐down therapy for patients hospitalized for community‐acquired pneumonia (CAP).Methods:  A comparative audit of patient records in a Sydney teaching hospital, a district referral hospital and a regional hospital was carried out. Patients older than 15 years admitted between 1 July 2004 and 31 December 2004 with a diagnosis of CAP were identified by diagnostic code. The medical records were reviewed for patient demographics, the specialty of the attending physician, comorbidities, adverse drug events, relevant microbiological results and the antibiotic therapy prescribed for the treatment of pneumonia. Cases were randomly selected from all pneumonia admissions, with approximately equal numbers from urban and regional hospitals. One hundred and ninety‐six admissions for CAP (in 193 patients) were included in this review. Patients were predominantly cared for by respiratory physicians (62%) and geriatricians (14%). Eighty‐nine per cent of patients received dual antibiotic therapy on admission.Results:  For patients commenced on two antibiotics, 62% were prescribed two oral antibiotics after completing i.v. therapy, 27% were prescribed one oral agent and 11% were prescribed no step‐down therapy. Geographic location and the presence of a documented antibiotic allergy affected prescribing practice. Neither the specialty of the attending medical officer nor the identification of a likely pathogen affected prescribing practice.Conclusion:  Although most of the patients with CAP were initially prescribed two antibiotics, there was considerable variability in whether one, two or no oral agents were prescribed as step‐down therapy.
Ethics of organ donation and transplantation involving prisoners: the debate extends beyond our borders
Authors: Westall G. P. , Komesaroff P. , Gorton M. W. , Snell G. I. 
Published: August 2010

AbstractThe transplantation of solid organs raises many ethical considerations, many of which focus on the need to expand the donor pool, the limiting step in achieving ongoing growth in solid organ transplantation. A contentious source of organs, albeit not one practised in Australia or New Zealand, is the retrieval of donor organs from executed prisoners on death row. Although potentially increasing the organ donor pool, the acceptance of such organ donors raises significant ethical and legal concerns. These issues, although not appearing to affect directly and influence Australians, cannot be ignored given our position, both geographical and medical, in the wider Asia–Pacific region.
Wegener’s granulomatosis: epidemiological and clinical features in a South Australian study
Authors: Hissaria P. , Cai F. Z. J. , Ahern M. , Smith M. , Gillis D. , Roberts‐Thomson P. 
Published: August 2010

AbstractBackground:  The epidemiology of Wegener’s granulomatosis (WG) has shown a latitude‐dependent predisposition in Northern Hemisphere and in New Zealand. There are no studies describing epidemiology or long‐term follow up of WG reported from Australia. The aims of this study were to describe the epidemiological and clinical features of WG in South Australia (SA).Methods:  The 5‐year incidence of WG in SA over the period 2001–2005 was determined using the International Classification of Diseases classification (M313) of the discharge diagnosis using the Integrated South Australian Activity Collection. A retrospective case record analysis of 30 patients fulfilling the American College of Rheumatology criteria for WG and managed at two regional hospitals over a 20‐year period (1985–2004) was carried out.Results:  The 5‐year incidence of WG in SA was 56 per 106 (95% confidence interval 44.1–68.4 per 106). There were no regional or seasonal variations in disease occurrence. The demographic, clinical and serological features in the clinical study were similar to previously published studies. Significant treatment‐related morbidity was noted with 50% of patients having atherosclerotic vascular complications. The median survival was 12 years. There were two important periods with greater risk of dying – in the first 5 years and after 10 years.Conclusion:  The 5‐year incidence of WG in SA is higher than that in the same latitudinal region in New Zealand (∼34°S). Atherosclerotic vascular disease was a major long‐term morbidity. There is increased incidence of early mortality, warranting the need for earlier diagnosis and better therapies. Further studies from Southern Hemisphere are required for better epidemiological description of this disease.
Use of tunnelled active fixation leads allows reliable temporary pacing over prolonged periods
Authors: Orsbourn G. , Lever N. , Harding S. A. 
Published: August 2010

AbstractTemporary tunnelled pacing (TTP) is an alternative method of providing temporary pacing in which an active fixation permanent pacing lead is placed fluoroscopically through percutaneous venous access, tunnelled subcutaneously and connected to a resterilized external pulse generator. Our study shows that temporary tunnelled pacing is a safe and reliable method of achieving prolonged temporary pacing. We believe that temporary tunnelled pacing should be considered as an option in all patients who have an indication for prolonged temporary pacing.
Search engine as a diagnostic tool in difficult immunological and allergologic cases: is Google useful?
Authors: Lombardi C. , Griffiths E. , McLeod B. , Caviglia A. , Penagos M. 
Published: August 2010

AbstractBackground: Web search engines are an important tool in communication and diffusion of knowledge. Among these, Google appears to be the most popular one: in August 2008, it accounted for 87% of all web searches in the UK, compared with Yahoo‘s 3.3%. Google’s value as a diagnostic guide in general medicine was recently reported. The aim of this comparative cross‐sectional study was to evaluate whether searching Google with disease‐related terms was effective in the identification and diagnosis of complex immunological and allergic cases.Methods: Forty‐five case reports were randomly selected by an independent observer from peer‐reviewed medical journals. Clinical data were presented separately to three investigators, blinded to the final diagnoses. Investigator A was a Consultant with an expert knowledge in Internal Medicine and Allergy (IM&A) and basic computing skills. Investigator B was a Registrar in IM&A. Investigator C was a Research Nurse. Both Investigators B and C were familiar with computers and search engines. For every clinical case presented, each investigator independently carried out an Internet search using Google to provide a final diagnosis. Their results were then compared with the published diagnoses.Results: Correct diagnoses were provided in 30/45 (66%) cases, 39/45 (86%) cases, and in 29/45 (64%) cases by investigator A, B, and C, respectively. All of the three investigators achieved the correct diagnosis in 19 cases (42%), and all of them failed in two cases.Conclusion: This Google‐based search was useful to identify an appropriate diagnosis in complex immunological and allergic cases. Computing skills may help to get better results.
A numerical study of fatigue crack closure induced by plasticity
Authors: ANTUNES F. V. , BORREGO L. F. P. , COSTA J. D. , FERREIRA J. M. 
Published: August 2010

ABSTRACTCrack closure delays the intrinsic mechanisms responsible for crack growth, therefore, it must be considered in fatigue crack growth modelling. The objective of this work is to develop a numerical procedure to predict crack closure induced by plasticity. First the crack closure was experimentally measured on M(T) 6082‐T6 aluminium alloy specimens of 3 mm thickness. A pin microgauge was used with the compliance technique. Then different parameters of the numerical procedure were analysed, namely the finite element mesh and the crack propagation scheme. The size of crack‐tip elements has an important influence and it is recommended to be of the same order of cyclic plastic zone. Crack‐opening levels only 10% lower than experimental results were obtained considering kinematic hardening and two load cycles in each increment.
Probabilistic fatigue crack growth analysis of spot‐welded joints
Authors: NI K. , MAHADEVAN S. 
Published: August 2010

ABSTRACTThis paper presents a probabilistic fatigue crack growth life prediction methodology for spot‐welded joints under variable amplitude loading history. The loading is multi‐axial and is obtained from transient response analysis of a vehicle model using finite‐element analysis. A three‐dimensional (3D) finite element model of a simplified joint with four spot welds is developed, and the static stress analysis of this joint is performed. Then the fatigue crack inside the base material sheet is modelled as a surface crack. Probabilistic crack growth model is combined with the stress analysis result to develop a probabilistic fatigue crack growth life prediction methodology for spot welds. This new method is implemented with MSC/NASTRAN and MSC/FATIGUE and is useful for the reliability assessment of spot‐welded joints against fatigue crack growth.