bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXERCISE TESTING IN THE EVALUATION OF DIFFUSE INTERSTITIAL LUNG DISEASE
Authors: ANDERSON S. D. , BYE P. T. P. 
Published: March 2008

Abstract:The cardio‐pulmonary response to incremental and steady‐state bicycte exercise was measured in a group of 22 patients with diffuse interstitial lung disease (DILD). In most patients the lung volumes were less than 80% of their predicted normal value. In 19 patients the uptake of carbon monoxide was less than 60% of the value predicted for the observed lung volume.Maximum working capacity (wmax) was reduced in 20 patients. Eight patients stopped exercising before they achieved their predicted maximum heart rate. In all patients ventilation (VE) was increased in relation to oxygen consumption. The increase in VE resulted from an increased frequency of breathing.Exercise induced a decrease in arterial oxygen tension in 11 patients. When 60% oxygen was inspired during exercise the endurance time at 80% Wmax increased from 8.0 ± 5.5 to 13.9 ± 8.7 min. The increase in endurance time related to the extent of desaturation during exercise with air breathing. Oxygen breathing did not improve Wmax.We conclude that exercise testing in patients with DILD is useful for determining the severity of disease and provides additional information in relation to gas exchange.
PYOGENIC LIVER ABSCESS—A NEGLECTED DIAGNOSIS
Authors: SANDFORD N. L. , BRADBEAR R. A. , POWELL L. W. 
Published: March 2008

Abstract:Twenty‐five patients with pyogenic liver abscess admitted to the Royal Brisbane Hospital between 1970 and 1982 have been reviewed. The mortality rate was 32%; however, all patients who were diagnosed before death survived. In seven patients there was a history of biliary obstruction or biliary surgery of whom six died. The mean age of the patients who died was significantly higher than those surviving and it is suggested that this resulted from overdiagnosis of malignancy in the elderly, some hesitancy in investigating older patients, and a tendency to attribute multiple space‐filling defects to metastatic tumour. If liver biopsy or even exploratory laparotomy have failed to confirm the diagnosis of hepatic abscess the clinician should not discard the possibility. It is concluded that the continuing high mortality from liver abscess is in large part due to lack of clinical awareness and failure in diagnosis rather than to inadequate therapy.
ZINC CONTENT OF RED AND WHITE BLOOD CELLS IN ABORIGINAL CHILDREN
Authors: CHEEK D. B. , HAY H. J. , LATTANZIO L. , NESS D. , LUDWIGSEN N. , SPARGO R. 
Published: March 2008

Abstract:Studies were carried out on erythrocyte, granulocyte and lymphocyte zinc content of aboriginal children at the La Grange settlement in the north‐west area of the Kimberley. Forty‐eight children, 34 boys and 14 girls between 6 and 13 years were studied. Only the boys were investigated for white blood cell (WBC) zinc. Twenty‐five Caucasian children volunteered to give blood for control studies. Two approaches were made concerning zinc analyses, atomic absorption spectroscopy and proton induced x‐ray emission.It was found that lymphocyte, granulocyte and erythrocyte zinc content were significantly reduced in aboriginal boys aged 6 to 13 years. Since the turnover of white blood cells is relatively fast, it follows that the zinc content of these cells may be a true index of current zinc status confirming previous observations.
ANTICOAGULANTS AND CEREBRAL VENOUS THROMBOSIS
Authors: HALPERN J. P. , MORRIS J. G. L. , DRISCOLL G. L. 
Published: March 2008

Abstract:Three patients with cerebral venous thrombosis are described. The management of this rare condition is discussed and a case is made for using anticoagulant therapy provided the diagnosis is established before cerebral infarction or hemorrhage have occurred.
ARTICULAR CHONDROCALCINOSIS IN A HOSPITAL POPULATION: AN AUSTRALIAN EXPERIENCE
Authors: GORDON T. P. , SMITH M. , EBERT B. , McCREDIE M. , BROOKS P. M. 
Published: March 2008

Abstract:A group of hospital patients aged 55 years or over (53 men, 74 women) were screened for articular chondrocalcinosis (ACC) with high‐resolution radiographs of knees, wrists, hands and pelvis. Two men (4%) aged 79 and 86 years had ACC involving knees, wrists and symphysis pubis. Both had clinical joint disease and radiological osteoarthritis (OA). Eighteen women (24%) had ACC with sites affected including the knees (89%), wrists (39%) and symphysis pubis (44%). Metabolic screening did not reveal any predisposing factors in patients with ACC. Symptoms and signs of joint disease were not significantly more common in women with ACC compared to those without ACC, and 44% of those with knee calcification were clinically asymptomatic and had no evidence of OA radiologically. However, the presence of knee ACC significantly increased the risk for OA in the same knee by a factor of three‐to‐four while knee calcification was associated with the more severe grades of radiographic OA.
IRON OVERLOAD ASSOCIATED WITH CONGENITAL PYRUVATE KINASE DEFICIENCY AND HIGH DOSE ASCORBIC ACID INGESTION
Authors: ROWBOTHAM B. , ROESER H. P. 
Published: March 2008

Abstract:Iron overload is an uncommon complication of untransfused chronic hemolytic anemias. This paper describes only the fourth reported case of erythrocyte pyruvate kinase deficiency and iron overload. Important aspects of this case are the presence of the HLA genotype commonly associated with genetic (idiopathic) hemochromatosis and a history of ingestion of large doses of ascorbic acid. Their roles in the development of iron loading and toxicity are discussed.A beneficial response to treatment with desferrioxamine was observed before significant iron removal. A mechanism for this action of desferrioxamine is proposed.
CENTRAL NERVOUS SYSTEM ECHOVIRUS INFECTION IN BRUTON'S X–LINKED HYPOGAMMAGLOBULINEMIA
Authors: R. L. PRENTICE S , A. G. DALGLEISH N , GATENYB P. A. , LOBLAY R. H. , WADE S. , KAPPAGODA N. , BASTEN A. 
Published: March 2008

AbstractA patient with Bruton's X–linked hypogammaglobulinemia, who developed the typical syndrome associated with systemic echovirus 3 infection whilst on routine intramuscular gammaglobulin replacement therapy, is described. Following regular infusions of specific antibody–containing plasma from his spouse, he has shown sustained clinical improvement over a period of two years, and is, therefore, one of the very rare cases with this syndrome to survive for more than a few months,
LONG‐TERM BROMOCRIPTINE THERAPY MAY RESTORE THE INHIBITORY CONTROL OF PROLACTIN RELEASE IN SOME PATIENTS WITH PATHOLOGICAL HYPERPROLACTINEMIA
Authors: HO K. Y. , SMYTHE G. A. , COMPTON P. J. , LAZARUS L. 
Published: March 2008

Abstract:While bromocriptine is effective in controlling hyperprolactinemia, it is not known if bromocriptine therapy can restore the abnormal regulation of prolactin (PRL) release found in patients with pathological hyperprolactinemia. We report 15 hyperprolactinemic patients treated for a mean duration of 5.5 ± 0.6 years (mean ± SE) in whom stimulation tests to assess PRL control mechanisms [thyrotropin releasing hormone (TRH) and metoclopramide] were performed before and at least one month after withdrawal of bromocriptine therapy. The basal PRL level after withdrawal of bromocriptine therapy was significantly lower (p< 0.001) than that before therapy. All patients had blunted PRL stimulatory responses to TRH and metoclopramide (%D́16.0±5.6%) before treatment. After withdrawal of bromocriptine, PRL responses to stimulatory tests were significantly improved in seven patients (termed ‘responders’, %D́ 376 ±55%) but remained unchanged in eight patients (termed ‘non‐responders’, %D́ 9.2 ± 3.0%). Basal PRL levels were significantly lower (p<0.01) in responders (290 ±35 mlU/l) than in non‐responders (10360 ± 6790 mlU/l). Four of the responders have maintained normoprolactinemia and normal stimulated PRL responses for 15 months to three years following cessation of bromocriptine therapy and appear to be in remission. Favourable factors amongst the responders were the female sex, absence of a macroadenoma, and a pre‐treatment PRL level below 3000 mlU/l. PRL stimulation tests performed before therapy could not predict which patients would respond. No relationship was found between duration of therapy, or age at presentation, and improvement after bromocriptine. Our data demonstrate that the inhibitory control of PRL release can be restored in some patients with pathological hyperprolactinemia and suggest that the underlying hypothalamic‐pituitary defect responsible for the pathogenesis of pathological hyperprolactinemia may be corrected by bromocriptine therapy.
EVALUATION OF DOMICILIARY TREATMENT WITH TERBUTALINE BY WET NEBULISATION IN PATIENTS WITH CHRONIC BRONCHITIS AND EMPHYSEMA
Authors: SILINS R. A. , MARLIN G. E. 
Published: March 2008

Abstract:Domiciliary treatment with terbutaline by wet nebulisation (5 mg, four times daily) was compared with placebo in a double‐blind study over four consecutive periods, each of seven days duration, in eight patients with severe airflow limitation due to chronic bronchitis and emphysema. Lung function tests performed at the conclusion of each treatment period showed small but significant improvements in FEVT before and after 500 μg of terbutaline by metered dose inhaler (MDI), with reductions in functional residual capacity and residual volume for terbutaline compared with placebo. Morning and evening peak expiratory flow rate recordings were greater and there was a significant reduction in the use of terbutaline by MDI during the terbutaline treatment. Three patients were unable to complete the placebo treatment because of excessive symptoms. Analysing all individual results, only one patient appeared not to benefit from nebulised terbutaline, while the preference rating for the other seven patients was significantly in favour of terbutaline.
OPTIC NERVE INVOLVEMENT IN GRAVES‘ OPHTHALMOPATHY: A CASE REPORT AND REVIEW
Authors: DUNNE J. W. , EDIS R. H. 
Published: March 2008

Abstract:Optic neuropathy in Graves' disease is an uncommon, but potentially treatable cause of disabling visual loss. Optic nerve damage is probably secondary to compression by swollen extraocular muscles at the apex of the orbit. The visual loss is usually bilateral and insidiously progressive, although accelerated visual loss, fluctuations in vision, and features mimicking orbital cellulitis may occur. Ocular congestive symptoms and proptosis have no direct relationship to the severity of visual loss. Early diagnosis is facilitated by orbital CT scanning. Oral corticosteroids and radiotherapy, alone or in combination, are the primary modalities of medical treatment. Surgical decompression of the orbit can be used where medical approaches have failed
PREGNANCY AFTER RENAL TRANSPLANTATION
Authors: O'DONNELL D. , SEVITZ H. , SEGGIE J. L. , MEYERS A. M. , BOTHA J. R. , MYBURGH J. A. 
Published: March 2008

Abstract:During the 13 year period 1971 to 1984 there were 38 pregnancies in 21 renal transplant patients at the Johannesburg Hospital. Twenty‐two ended with live births and included two sets of twins; there were nine spontaneous abortions, six therapeutic abortions, and one stillbirth. Maternal complications were mild in the majority but five patients suffered deterioration in renal function, two undergoing transplant nephrectomy as a result of this. There were seven neonatal deaths, including both sets of twins; death was due to prematurity in six and congenital malformation (diaphragmatic hernia) in one. A further infant had congenital pyloric stenosis which was corrected surgically.Pregnancies were analysed according to whether or not their outcome was successful. Those with a successful outcome had less exposure to warfarin during pregnancy (p = 0.0025) and showed a tendency towards lower immunosuppressive doses of prednisone and azathioprine although these did not reach significance.Although these results indicate an unhappy prognosis for both the mother and fetus, two redeeming features are to be noted. Pregnancy outcome improved markedly in the latter years, possibly owing to non‐exposure to warfarin, less immunosuppression, and improvement in neonatal care, and four of the five mothers who suffered deterioration in renal function were notoriously unco‐operative in their medical care.Pregnancy can only be recommended in the transplanted patient who has stable renal function, is compliant in taking of medications, and whose graft is of such age that the immunosuppressive drug dose is minimal. Warfarin should be avoided. (Aust NZ J Med 1985; 15: 320–325.)
CHLAMYDIAL ENDOCARDITIS
Authors: DIMMITT S. B. , PEARMAN J. W. , WOOLLARD K. V. 
Published: March 2008

Abstract:Echocardiography diagnosis of a case of endocarditis, subsequently proven to be due to a chlamydial organism, is described. Early echocardiographic diagnosis guided initial medical management and directed urgent surgical intervention when the patient deteriorated. Reported cases of chlamydial endocarditis are reviewed. (Aust NZ J Med 1985; 15: 340–342.)
TAKAYASU'S DISEASE ASSOCIATED WITH GENERALISED AMYLOIDOSIS
Authors: GRAHAM A. N. , DELAHUNT B. , RENOUF J. J. , AUSTAD W. I. 
Published: March 2008

Abstract:A case of Takayasu's disease in a young Caucasian female is described. The major complications which developed over the ten year course of the disease include nephrotic syndrome, severe refractory hypertension, aortic valve regurgitation associated with aneurysmal dilatation of the ascending aorta, and recurrent congestive heart failure. Amyloid deposits have been demonstrated in the aorta, atrial appendage, aortic valve, and renal cortex.The association of amyloidosis and Takayasu's disease is discussed. (Aust NZ J Med 1985; 15: 343–345.)
CURRENT CONCEPTS IN THE ETIOPATHOGENESIS AND TREATMENT OF SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)
Authors: MANOLIOS N. , SCHRIEBER L. 
Published: March 2008

Abstract Systemic lupus erythematosus is an autoimmune disorder that occurs spontaneously in humans and mice. Genetic factors play an important role in the predisposition to and expression of disease. Environmental factors augment the expression of illness and in the absence of normal control mechanisms may provide the stimulus to autoimmunity. Sex hormones modulate the immune response and tend to modify disease expression. Disordered immune regulation may be due to a primary or secondary abnormality in cellular, cytokine, and/or humoral function.Therapy for SLE is directed towards suppression of exaggerated immunological and inflammatory activity. This review will re‐evaluate current therapy and describe newer approaches including the use of pharmacological, hormonal, immunological, dietary, and physical modalities. (Aust NZ J Med 1986; 16: 729–743.)
THE IMPACT OF LEUKEMIA STATUS AT THE TIME OF HLA‐IDENTICAL SIBLING MARROW TRANSPLANTATION ON SUBSEQUENT COMPLICATION RATE AND SURVIVAL OF ADULTS WITH ACUTE LEUKEMIA
Authors: Atkinson K. , Biggs J. C. , Concannon A. , Dodos A. , Raphael H. , Ashby M. , Mapley D. , Andrews K. 
Published: March 2008

AbstractBetween March 1981 and March 1985, 76 patients with acute leukemia were treated with cyclophosphamide (120 mg/kg), 12 or 14 Gy total body irradiation, and an HLA‐identical sibling marrow transplant. Forty‐seven patients had acute non‐lymphoblastic leukemia (ANLL) and 29 had acute lymphoblastic leukemia (ALL). Forty‐one were transplanted during first remission and 28 during or after first relapse of their disease. An additional six patients were transplanted because their leukemia was refractory to conventional cytotoxic chemotherapy, and one was transplanted as initial therapy. Actuarial 42 month survival for those transplanted during first remission was 47% and for those transplanted in first relapse or later it was 22% (p = 0.02). There was no difference in either group between those with ANLL and those with ALL. Two of the six patients with refractory leukemia are alive more than 22 and more than 15 months after the transplant. The incidence of acute graft‐versus‐host disease and interstitial pneumonitis was 90% and 39%, respectively, for the first remission group, and 96% and 37% for those transplanted in first relapse or later. There was no significant difference in transplant‐related mortality between the two groups (29% and 43%, respectively). The leukemia recurrence rate, however, was 13% for those transplanted in first remission and 67% for those transplanted in first relapse or later (p = 0.0003). Thus, the major factor determining the incidence of leukemia recurrence and survival after transplant was the status of the leukemia at the time of transplantation. These findings indicate that adults with acute leukemia who have an HLA‐identical sibling should be transplanted in first remission, and that transplant‐related mortality must be reduced urgently. (Aust NZ J Med 1986; 16: 462–469.)
PREVALENCE OF HEMOCHROMATOSIS IN A RANDOM SAMPLE OF ASYMPTOMATIC MEN*
Authors: Elliott R. , Lin B. P. C. , Dent O. F. , Tait A. , Smith C. I. 
Published: March 2008

AbstractThe prevalence of hemochromatosis was studied in 343 randomly selected male World War II veterans aged 58 years and older. Those men with a serum ferritin level of greater than 700 μg/l or a transferrin saturation of greater than 55% underwent liver biopsy. Hepatic iron concentration was assessed histochemically and by atomic absorption spectrophotometry. Histology was assessed blindly by one histopathologist. Of 21 veterans biopsied, four men had hemochromatosis, confirmed by venesection response, and the remaining biopsies all showed some histological abnormality. All four men with hemochromatosis had a transferrin saturation of greater than 55% while only three of the four had a serum ferritin level over 700 μg/l. The prevalence of hemochromatosis detected in this sample was 1.2%, which is higher than that suggested by overseas studies.
ENHANCED PREDICTION OF MAJOR CARDIAC EVENTS AFTER MYOCARDIAL INFARCTION USING EXERCISE RADIONUCLIDE VENTRICULOGRAPHY
Authors: KUCHAR D. L. , FREUND J. , YEATES M. , SAMMEL N. 
Published: March 2008

Abstract Exercise radionuclide ventriculography (RVG) was performed 7–12 days after acute myocardial infarction (Ml) in 153 patients to assess its value in identifying those at risk of serious recurrent cardiac events. In addition to electrocardiogram (ECG) features of the exercise test, clinical and hemodynamic features were also considered: the exercise test was abnormal if there was a fall in blood pressure of 10 mmHg or more, development of angina, or inability to complete three minutes of exercise. RVG was used to measure left ventricular ejection fraction and to assess wall motion at rest and at peak exercise. After a median follow‐up of 14 months, there were 18 cardiac events: six deaths and 12 patients with recurrent Ml. In addition, 18 patients underwent coronary artery bypass surgery; the decision to perform surgery was predicted by ST segment depression or a fall in blood pressure during exercise (p<0.005).The sensitivity of the exercise test for identifying patients with a cardiac event increased progressively as additional parameters were considered in a cumulative fashion; hence, ST depression identified 28% of patients with events, whereas addition of clinical and hemodynamic parameters increased this to 61%. The addition of RVG increased the sensitivity further to 88%, but with a specificity of 50%. Although exercise‐induced ST depression of up to 1 mm did not predict outcome significantly, a positive exercise RVG did predict cardiac events: 17% of patients with a positive test had an event, compared with 6% of those with a normal study (p<0.05).Exercise testing, using conventional ECG criteria alone, is an insensitive method of identifying patients at risk of recurrent Ml or death when performed within two weeks of Ml. The addition of clinical and hemodynamic variables, and the use of RVG, improves the prognostic value of exercise testing.
CHIASMAL APOPLEXY DUE TO INTRACHIASMATIC VASCULAR MALFORMATION RUPTURE
Authors: KHANGURE M. S. , HANKEY G. J. 
Published: March 2008

Abstract Hemorrhage from an intrinsic vascular malformation of the optic chiasm (chiasmal apoplexy) is an uncommon cause of sudden visual loss with chiasmal visual field defects.This paper describes one case of sudden visual loss with an anterior chiasmal visual field defect due to rupture of an intrachiasmatic venous angioma and contrasts it with the clinical presentation of a case of hemorrhage from an intrachiasmatic arteriovenous malformation causing severe headache and a less apoplectic onset of visual symptoms.The variable clinical presentation and the accuracy of high resolution post‐contrast cranial CT scan in the diagnosis of intrachiasmal hemorrhage is highlighted.
EXTRAPULMONARY TUBERCULOSIS A CONTINUING PROBLEM IN AUSTRALIA
Authors: DWYER DOMINIC E. , MacLEOD COLIN , COLLIGNON PETER J. , SORRELL TANIA C. 
Published: March 2008

Abstract Extrapulmonary tuberculosis (TB) remains a major health problem in Australia, with 24.3% of all new tuberculosis notifications in 1984 of extrapulmonary origin. We have reviewed our recent experience to assess the epidemiology and clinical features that may allow the earlier recognition and treatment of patients at risk for this disease. From 1980–1985, 51 cases of extrapulmonary TB were identified at Westmead Hospital. Thirty‐eight patients were born outside Australia, mainly in South‐East Asia and Europe. The commonest sites of disease were the lymph nodes, genitourinary tract, pleura and bone. Tuberculous lymphadenitis occurred predominantly in South‐East Asians, whilst genitourinary tract disease was confined to Caucasians.A history of previous exposure to tuberculosis was obtained in 45% of patients. Fever, sweats and weight loss were noted in less than half of the cases. Changes consistent with old pulmonary disease were found on routine chest X‐ray in 34% of cases. Laboratory confirmation of TB was made in 88% of cases, with typical histopathology in 90% and isolation of Mycobacterium tuberculosis in 69% of specimens submitted for analysis. Drug resistance was confined to isolates from South‐East Asian patients. (Aust NZ J Med 1987; 17: 507–511).
ORBITAL MYOSITIS: A STUDY OF SIX CASES
Authors: HANKEY G. J. , EDIS R. H. , SILBERT P. L. , NICOLL A. M. 
Published: March 2008

Abstract Orbital myositis implies orbital inflammation confined to one or more of the extraocular muscles. Orbital computerised tomography (CT) demonstrates irregular extraocular muscle enlargement which extends anteriorly to involve the tendon (muscle insertion).Six cases of presumed orbital myositis are reported, in each of whom the diagnosis was suspected clinically and confirmed by the orbital CT scan appearances. The mean age of the patients was 33 years (range 8–45 years). All presented with painful ophthalmoplegia and the majority manifested proptosis (five cases), conjunctival congestion (five cases) and periorbital and eyelid edema (two cases). Systemic corticosteroid therapy was used in two patients initially and also in another patient who relapsed, with rapid and dramatic responses. Extraocular muscle biopsy was performed in one case, disclosing features of non‐specific muscle inflammation and no evidence of vasculitis.It is considered that orbital myositis is a discrete, identifiable subgroup within the spectrum of the nonspecific idiopathic orbital inflammatory syndromes; termed previously orbital ‘pseudotumours’. Although the clinical features are frequently suggestive, they are nonspecific, and non‐invasive investigations such as orbital ultra‐sonography and CT scanning are required for precise anatomical tissue localisation and diagnosis. The role of ocular muscle biopsy is probably limited to atypical cases, or those unresponsive to steroid therapy, particularly to exclude neoplasia.Orbital myositis may be acute, subacute or recurrent. The acute form responds well to high doses of oral corticosteroids tapered gradually, but it may recur or become chronic. The subacute form of the disease responds less well.