bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recently characterised autoantibodies and their clinical significance
Authors: Sturgess A. 
Published: March 2008

Abstract:Multisystem autoimmune diseases such as systemic lupus uythcmatosus (SLE), primary Sjögrcn's syndrome (SS), sclcroderma and polymositis are characterised by the presence of antinuclear antibodies (ANAs). Immunoblotting and cDNA cloning studies reveal that the autoantigens of the multisystem autoimmune dixsucs are important proteins involved in nucleic acid metabolism, including tRNA charging, intron splicing, DNA uncoiling, and RNA polymuase co‐factors.Each spaific syndrome associates with a restricted variety of ANAs e.g. anti‐La with primary SS, anti‐Sm with SLE, and‐synthetase enzymes with myositis, and‐topoisomerase 1 (Scl 70) with scleroderma, and anti‐centromere with CREST. Precise characterisation of an ANA provides valuable diagnostic and prognostic information, and should be performed when an ANA is detected.
Lipoprotein(a) concentration in diabetes: relationship to proteinuria and diabetes control
Authors: Irish A. B. , Simons L. A. , Simons J. 
Published: March 2008

Abstract:Diabetic patients are at increased risk of cardiovascular disease, particularly when proteinuria is present. Lipoprotein(a)[Lp(a)] levels were assessed in 37 patients with insulin dependent (IDDM) and in 75 patients with non‐insulin dependent (NIDDM) diabetes who showed varying degrees of proteinuria and glycaemic control. Median Lp(a) in 112 diabetic patients was significantly greater than in 116 healthy controls (113 vs 48 mg/L; p <0.01). 86 of the patients had first morning urine albumin concentration < 30 mg/L (normoalbuminuria = NA), 16 patients 30–200 mg/L (microalbuminuria = MA) and ten patients < 200 mg/L (albuminuria = ALB). There was no significant difference in median Lp(a) concentration between the three groups (NA = 108, MA = 163, ALB = 98 mg/L; p > 0.5). No significant difference in median Lp(a) concentration was found between patients with IDDM, NIDDM treated with insulin, or NIDDM treated with oral agents and/or diet (120, 98, 115 mg/L respectively; p > 0.7). When the 86 NA patients were divided on the basis of median fructosamine concentration (357 umol/L), no significant difference was found in median Lp(a) levels between those grouped below or above this median (98 mg/L vs 118 mg/L; p < 0.5). Across all diabetics studied there was no significant correlation present between Lp(a) and urinary protein or glycaemic control. These cross‐sectional results suggest that median Lp(a) concentration is increased in both IDDM and NIDDM patients, but this increase is not related to the degree of proteinuria or short‐term glycaemic control.
The value of complement measurements in the assessment of lupus activity
Authors: Milis L. , Timmermans V. , Morris C. A. , Pussell B. A. , Charlesworth J. A. 
Published: March 2008

Abstract:The complement system was studied prospectively in 29 patients, predominantly renal (25), with systemic lupus erythematosus (SLE) to examine the value of complement assays in the distinction between active and inactive disease. Disease activity was evaluated primarily by clinical, biochemical and histological parameters which were obtained at the time of assessment. Fourteen patients had active disease, as assessed by clinical and laboratory criteria. Clq, C4, C4a, C2, C3, C3a, C5, total haemolytic activity (CH50) and complement inhibitors were measured in each patient. The ratios of C4a:C4 and C3a:C3 were also calculated.Values for all components except C5 were different between control subjects and active patients while only CH50 was different between inactive patients and controls. All parameters except C4a:C4 and C5 were different between active and inactive patients. There was a highly significant difference in the number of active patients with reduced levels of C2, C3 and C3a:C3 compared to inactive patients (i.e. p < 0.001) whereas lesser or no difference was observed for other parameters. The concentration of complement inhibitors was elevated in both groups.We conclude that, among readily available complement parameters, C2 and C3 provide the best assessment of disease activity in patients with SLE.
Symptomatic choroidal metastases in breast cancer
Authors: Doig R. G. , Olver I. N. , Jeal P. N. , Bishop J. F. 
Published: March 2008

Abstract:A series of 21 consecutive patients with carcinoma of the breast and symptomatic choroidal metastases was reviewed. All patients were symptomatic of choroidal metastases at presentation. Most patients had disease progression at other sites at the time of diagnosis. The incidence of cerebral metastases was not increased in this group compared to that in patients with metastatic breast cancer at other sites. Radiotherapy using a direct anterior field proved effective palliation for this disease site. Of the 32 eyes treated, serial visual acuity was documented in 23. Seventeen showed objective improvement and six showed stabilisation. The median duration of improvement was 11.5 months.
Prevalence of antibodies to hepatitis C virus in patients receiving renal replacement therapy, and in the staff caring for them
Authors: Blackmore T.K. , Stace N.H. , Maddocks P. , Hatfield P. 
Published: March 2008

Abstract:Two hundred and forty‐three patients receiving renal replacement therapy (RRT) and 20 renal unit staff were tested for antibodies to hepatitis C (HCV). Three patients (1.2%) were positive by the first generation test kit, the lowest rate in patients receiving RRT reported in the literature to date. These three, and eight other patients tested positive by the second generation kit, a prevalence rate of 4.5%. Anti‐HCV antibody positivity was associated with higher mean serum alanine aminotransferase (p= 0.0003) and aspartate aminotransferase (p= 0.018) levels. However, only one of the 11 anti‐HCV positive patients had liver transaminase levels more than twice the upper limit of the laboratory reference range. Anti‐HCV positivity was associated with a higher mean number of units of blood transfused (p= 0.035). None of 20 staff were anti‐HCV positive. Twenty‐five of 212 (11.7%) patients reported a history of liver disease; none of these were anti‐HCV positive. Hepatitis B surface antigen was detected in eight of 215 (3.7%) patients, of which three were e antigen positive. There was evidence of past hepatitis B infection in 53 of 215 (24.7%) patients, more frequently in Maoris (p= 0.001). Overall, significantly raised liver transaminases were present in three of 198 (1.5%) patients and in no staff. This unit has a remark‐ably low prevalence of antibodies to HCV, an observation supported by the low rate of abnormal serum liver enzymes.
Heparin‐induced thrombocytopenia
Authors: Chong B. H. 
Published: March 2008

Abstract:Thrombocytopenia is a common adverse effect of heparin therapy. Two types of heparinlinduced thrombocytopenia (HIT) are observed clinically ‐ an early onset mild thrombocytopenia (Type I) in which the patients remain asymptomatic and a delayed onset severe thrombocytopenia (Type II). Patients with Type II HIT have an increased risk of thrombotic complications which frequently cause crippling disability e.g. limb amputation or even death. Type I HIT, the commoner of the two types, is believed to be due to the platelet proaggregating effect of heparin itself but Type II HIT is generally agreed to be caused by an immune mechanism, in which heparin‐antibody complexes bind to platelets resulting in platelet activation, reduced platelet survival, thrombocytopenia and, in some cases, thrombosis. The diagnosis of HIT is made mainly on a clinical basis but in patients with suspected Type II HIT, laboratory test for the heparin‐dependent antibody using platelet aggregometry or the two‐point14C‐serotonin release method, allows confirmation of the diagnosis. In most Type I and all Type II patients, heparin should be stopped and warfarin commenced if there is a recent or new thrombosis requiring continuing anticoagulation. An alternative antithrombotic drug such as low molecular weight heparinoid (Org 10172) or dextran should be given at the same time until warfarin becomes therapeutic. The use of low molecular weight heparins (e.g. Fragmin) should be avoided unless it can be demonstrated that the HIT antibody does not cross‐react with these drugs. (Aust NZ J Med 1992; 22: 145–152.)
Immediate and long‐term results of percutaneous balloon aortic valvuloplasty: a report of 33 procedures
Authors: Sathe S. , Warren R. , Wong J. , Hunt D. 
Published: March 2008

AbstractThe purpose of this study was to evaluate the immediate and long‐term clinical and haemodynamic effects of Percutaneous Balloon Aortic Valvuloplasty (PBAV). Thirty‐three procedures were performed in 27 patients, 11 males and 16 females with a mean age of 72 years. The peak to peak systolic gradient across the aortic valve decreased by 52%, from 67 ± 24 mmHg to 31 ± 15 mmHg (p< 0.0001) and the aortic valve area increased by 35%, from 0.48 ±0.16 to 0.67 ± 0.21 cm2 (p <0.001) after PBAV. There were no procedural deaths. Minor complications occurred in seven patients. Eighty‐one per cent of patients (27 procedures) showed immediate symptomatic improvement, five remained symptomatic and one died in hospital before discharge. In a mean follow‐up of 17 ± 12 months (range six to 38 months), eight patients died due to congestive cardiac failure, six underwent repeat PBAV, three died due to noncardiac causes and three had recurrent symptoms controlled on medical therapy. Event free survival at 15 months was 43%.In conclusion PBAV produces a satisfactory immediate clinical and haemodynamic result, however, considering the high rate of symptom recurrence, this procedure has a beneficial role only in short‐term palliation of severely symptomatic patients who are unable to undergo aortic valve replacement. (Aust NZ J Med 1992; 22: 647ndash;651.)
Autoantibodies to neutrophil cytoplasmic (ANCA) and endothelial cell surface antigens (AECA) in chronic inflammatory bowel disease
Authors: Romas E. , D'Apice A. J. F. , Paspaliaris B. , Elliott P. R. 
Published: March 2008

AbstractSera from 103 patients with chronic inflammatory bowel disease (IBD) were tested prospectively for antibodies against neutrophil cytoplasmic antigens (anti‐neutrophil cytoplasm antibodies, ANCA) and endothelial cell surface antigens (anti‐endothelial cell antibodies, AECA) by indirect immunofluorescence (IIF) and assays based on whole fixed neutrophils, purified neutrophil enzyme substrates and human umbilical vein endothelial cells.Using IIF, ANCA were found in 26 IBD sera (25%) and in none of 51 controls. Twenty‐two positive sera (85%) were from patients with ulcerative colitis (UC). The pattern of distribution of immunofluorescence was always perinuclear (P‐ANCA). A majority of UC patients positive for these autoantibodies (68%) had active colitis, but none had evidence of vasculitis. Using a whole neutrophil ELISA, binding was demonstrable in 73% of UC sera compared to 27% of Crohn's (CD) sera and only 4% of controls. Unlike vasculitis sera, UC sera with P‐ANCA did not bind strongly to myeloperoxidase (MPO). Forty‐five per cent of IBD sera tested positive for IgG AECA in an endothelial cell ELISA, compared to seven of 51 (14%) controls. Binding correlated with both active and extensive colitis.A type of P‐ANCA, in most cases distinct from MPO‐specific P‐ANCA observed in vasculitis, is detected in a significant proportion of patients with UC, but rarely Crohn's colitis and therefore may be of differential diagnostic value. IgG AECA are also frequent in CIBD sera but are less disease specific than ANCA. (Aust NZ J Med 1992; 22: 652ndash;659.)
A comparison of peripheral blood stem cell mobilisation after chemotherapy with cyclophosphamide as a single agent in doses of 4 g/m2 or 7 g/m2 in patients with advanced cancer
Authors: Rowlings P. A. , Bayly J. L. , Rawling C. M. , Juttner C. A. , To L. B. 
Published: March 2008

AbstractWe used cyclophosphamide at a dose of 7 g/m2 in patients with advanced cancer and compared the efficacy of this treatment to generate peripheral blood stem cells (PBSC) with the previously reported regimen of cyclophosphamide 4 g/m2 in a similar group of patients. None of these patients received haemopoietic growth factors. Twenty‐two patients received 7 g/m2 and 37 received 4 g/m2. PBSC were collected by apheresis after the leukocyte count recovered to 1.0times109/L.The yield of colony forming unit‐granulocyte macrophage (CFU‐GM) was higher for the 7 g/m2 group with a median of 35 times 104/kg versus 15 times 104/kg body weight (BW) (p<l0.05) and higher mononuclear cell yield with medians of 4.2 times 108/kg compared with 3.1 times 10s/kg BW (p <0.001). The percentage of patients achieving the minimum safe level of > 15 times 104 CFU‐GM/kg BW was higher in the 7 g/m2 cyclophosphamide group (82%) than the 4 g/m2 cyclophosphamide group (51%). The duration of significant neutropaenia was a median of 11 compared with nine days (p <0.004) and all patients receiving 7 g/m2 required admission to hospital and intravenous antibiotic therapy compared with 44% in the 4 g/m2 group. There was one death during the period of neutropaenia after cyclophosphamide in each group. Nineteen per cent of patients required platelet transfusions after cyclophosphamide 7 g/m2 compared with 18% after 4 g/m2.We conclude that the 7 g/m2 cyclophosphamide gives a higher yield of haemopoietic progenitor cells than the 4 g/m2 but at increased clinical toxicity. (Aust NZ J Med 1992; 22: 660ndash;664.)
The structured interview as a tool for predicting premature withdrawal from medical school
Authors: Powis D. A. , Bristow T. , Waring T. C. , O'Connell D. L. 
Published: March 2008

AbstractA 1:1 matched case‐control study was carried out to assess whether comments written about a candidate during a semi‐structured interview can identify students likely to withdraw from a medical course better than global numerical scores. Fifty‐nine students who withdrew from the undergraduate medical course at the University of Newcastle prior to completion were matched for sex, year and mode of entry into the course, prior academic qualifications and age at entry, with 59 students who had not discontinued or been excluded from the course.No significant differences were found between the numerical scores allocated for personal attributes to students who later withdrew from the course and those who continued. However, students who withdrew had statistically significantly more negative comments made about them at interview with respect to their supportive and encouraging behaviour (p= 0.04) and their motivation to become doctors (p= 0.05). Although no other comparisons reached statistical significance, students who withdrew consistently received more negative comments and fewer positive comments than their continuing peers. A stepwise logistic regression procedure identified the number of negative comments made by interviewers about a candidate on their supportive and encouraging behaviour as the only statistically significant predictor of later withdrawal (odds ratio 1.65 95% confidence interval 1.01–2.70). (Aust NZ J Med 1992; 22: 692ndash;698.)
The Australian and New Zealand Cardiothoracic Organ Transplant Registry: first report 1984ndash;1992
Authors: Keogh A. M. , Kaan A. 
Published: March 2008

AbstractThis initial report of the Australian and New Zealand Cardiothoracic Organ Transplant Registry summarises the results of all cardiothoracic transplants performed between February 1984 and April 1992. A total of 549 first cardiothoracic transplant procedures and six cardiac retransplant operations were performed in five transplant units throughout Australia and New Zealand. There were 466 orthotopic cardiac transplants and one heterotopic transplant with overall survival 86% at one year and 80% at five years. Two of six patients who underwent cardiac retransplan‐tation are alive. Fifty‐three heart‐lung transplants were performed with 72% one year and 42% five year survival. Twenty‐nine single lung transplant procedures were undertaken, with actuarial survival 72% at 12 months. Factors influencing waiting period and post‐transplant survival for each type of procedure are detailed. The relative lack of donors compared with recipient demand has produced increased waiting times for every type of cardiothoracic organ transplant. (Aust NZ J Med 1992; 22: 712ndash;717.)
Yttrium synovectomy: a meta‐analysis of the literature
Authors: Jones G. 
Published: March 2008

Abstract
Background:
Yttrium synovectomy for chronic synovitis of the knee enjoys widespread usage in Australia with approximately 400 patients receiving yttrium‐90 in 1991. Despite abundant anecdotal evidence of its efficacy there is a paucity of controlled trials and those that have been done have produced conflicting results and have been of insufficient sample size.
Aims:
To critically and quantitatively evaluate the published English literature on comparative trials of yttrium‐90 therapy for chronic synovitis of the knee.
Methods:
The technique of meta‐analysis was utilised. The literature search was carried out using the MeSH terms of synovectomy and knee; and yttrium. This was augmented by referring to reviews, current textbooks and back‐references. Outcome measures varied between trials but could be grouped as treatment success. The Peto modification of Mantel and Haenszl was used for statistical pooling of data yielding a pooled odds ratio (OR).
Results:
The literature search revealed ten controlled trials of which two were excluded from further analysis. Yttrium was superior to placebo (OR 2.42, 95% CI 1.02–5.73) but this result should be interpreted with caution due to possible publication bias. Yttrium was not superior to triamcinolone (OR 1.89, 95% CI 0.81‐10.55) or other active modalities (OR 1.04, 95% CI 0.72‐1.52). Further research comparing yttrium with other modalities is necessary to properly determine its place in rheumatological practice. (Aust NZ J Med 1993; 23: 272–275.)
Clinical analysis of 125 patients with the lupus anticoagulant
Authors: Morgan M. , Chesterman C. N. , Downs K. , Biggs J. C. 
Published: March 2008

Abstract:A retrospective analysis of 125 consecutive lupus anticoagulant (LA) positive patients and 125 age, sex matched lupus anticoagulant negative controls is reported with the aims of defining further the clinical spectrum of disease, determining at‐risk subgroups and management strategies. There was no significant difference in the incidence or pattern of complications in those with systemic lupus erythematosus (SLE) and related disorders, and those without SLE. Venous thromboembolism, immune thrombocytopenia, foetal loss, depression and hypertension were statistically more common in the LA group than in the control group. In contrast to previous reports, children aged ten years or less with the LA developed significantly more complications than controls. Patients with the LA secondary to drugs also developed complications, a finding which is also at variance with previous reports. There was a significant difference in the outcome of arterial disease (p < 0.04) and venous thromboembolism (p< 0.001) when long term anticoagulation was part of the treatment regimen. (Aust NZ J Med 1993; 23: 151–156.)
Wegener's granulomatosis: clinical features and prognosis in 37 patients
Authors: Romas E. , Kennedy J. T. , Murphy B. F. , Niall J. F. , 'Apice A. J. F. 
Published: March 2008

Abstract:Thirty‐seven patients (21 female, 16 male) with Wegener's granulomatosis (WG)were reviewed. Patients were followed for a mean six years after diagnosis; 14 were followed for more than seven years. The clinical features were similar to those in previous studies. In this series, only 13 patients (35%) had renal disease at presentation and the cumulative incidence of renal involvement was 51%. Thirty‐one patients received treatment which included cyclophosphamide (CP). The case fatality rate of the six patients not treated with CP was 83% (five deaths). By contrast, all CP treated patients improved and 21 (68%) had complete remissions. Nine (29%) were in complete remission for a mean 4.9 years after discontinuing all treatment. Two were disease free for over ten years. The actuarial probability of survival for these patients was 97% at one year and 71% at ten years. Only three CP treated patients (10%) progressed to end‐stage renal disease. The case fatality rate was 26% (eight patients) and sepsis was the cause of death in five. Fourteen patients (45%) treated with CP had at least one relapse of vasculitis and seven (23%) had multiple (two or more) relapses. These data indicate that CP is effective in inducing remissions and prolonging survival in patients with WG; however, relapses are frequent. (Aust NZ J Med 1993; 23: 168–175.)
Kennedy's disease: genetic diagnosis of an inherited form of motor neuron disease
Authors: Choi W‐T. , MacLean H. E. , Chu S. , Warne G. L. , Zajac J. D. 
Published: March 2008

Abstract:Kennedy's disease (X‐linked spinal and bulbar muscular atrophy) is an inherited form of motor neuron disease that may be diagnosed genetically using the polymerase chain reaction (PCR). This form of motor neuron disease principally affects the proximal limb girdle muscles as well as those involved with deglutition and phonation. Onset is usually late, in the fourth to fifth decades of life, and progression is slow. Moderate gynecomastia and testicular atrophy are usually present, suggesting a defect in androgen receptor function. Being inherited in an X‐linked recessive manner, only males are affected, with females as the unaffected carriers.The genetic abnormality that causes Kennedy's disease is an enlargement of the androgen receptor (AR) gene, which is located on the proximal long arm of the X chromosome. In patients with this disease, a region in the gene containing repeated CAG triplet nucleotides is approximately twice the size of that found in normal people. Using PCR to amplify this region of the AR gene, this study confirms this genetic mutation in 12 males from eight different families. All these families live on the east coast of Australia. This mutation was not found in five patients with other forms of motor neuron disease. Twelve heterozygote females, the daughters of affected males and carrier females, have also been identified. In addition, there are 14 asymptomatic and as yet untested sons of carriers, ranging in age from less than one year to over 40 years of age. Each has a 50% chance of inheriting the abnormal gene from his mother and thus developing Kennedy's disease.This study shows that Kennedy's disease may be diagnosed genetically using whole blood, and discusses the ethics of prenatal and presymptomatic testing, particularly in males under 16. (Aust NZ J Med 1993; 23: 187–192.)