bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extranodal Ki‐1 lymphoma in a renal transplant patient
Authors: Ng K. , Trotter J. , Metcalf C. , Thatcher G. , Marshall E. 
Published: March 2008

Abstract:The Ki‐1 (CD 30) antigen has been identified as a marker of a subset of large cell anaplastic non‐Hodgkin's lymphoma that may have a more favourable prognosis. We describe an immunosuppressed renal transplant patient who developed primary extranodal large cell anaplastic Ki‐1 lymphoma of T‐cell phenotype confined to the sigmoid colon. The patient was treated with local resection of the sigmoid colon and reduction of immunosuppression and at two year follow‐up remains free of recurrence. It is recognised that long term immunosuppression in post transplant patients increases the risk of certain malignancies. Localised gut lymphoma may be amenable to local resection as a curative procedure. (Aust NZ J Med 1992; 22: 51–53.)
Monoclonal large granular lymphocyte proliferation in SLE with HTLV‐I seroreactivity
Authors: Marlton P. , Taylor K. , Elliott S. , McCormack J. 
Published: March 2008

Abstract:A 60‐year‐old part Aboriginal woman was observed to develop severe neutropenia and a large granular lymphocyte (LGL) proliferation five years after the diagnosis of systemic lupus erythematosus (SLE). Monoclonality of the CD3 +, CD4 ‐, CD8 + LGL population was confirmed using the novel approach of X‐linked restriction fragment length polymorphism (RFLP) analysis. Indeterminate HTLV‐I serology was present. The patient responded to steroid therapy. LGL proliferation in the setting of SLE and the use of X‐linked RFLP analysis to define LGL clonality have not previously been reported. (Aust NZ J Med 1992; 22: 54–55.)
Trabecular spacing in post‐menspausal Australian women with and without vertebral fractures
Authors: Moore R. J. , Durbridge T. C. , McNcil P. J. , Parkinson I. H. , Need A. G. , Vernon‐Roberts B. 
Published: March 2008

Abstract:Histomorphometric measurements were made from iliac crest biopsies of 32 women with vertebral fractures and 37 women without fracture. All were post‐menopausal Australian women who had presented with back pain to a hospital out‐patient endocrinology clinic Bone from the fracture cases was characterised by loss of individual trabccular elements, with the remaining trabeculac being spaced further apart than those in the non‐fracture women (p <0.0001). This resulted in a significant decrease in trabecular bone volume (p <0.01). In addition osteoid surface was reduced (p <0.01). Dynamic parameters of bone turnover were not significantly different between the two groups. These data should be useful for the assessment of iliac bone histomorphometry in Australian post‐menopausal women suspected of having osteoporosis. (Aust NZ J Med 1992; 22: 269–273.)
Health service utilisation in the public and private sector by patients with diabetes rnellitus aged less than 40 years
Authors: Griffiths R. , Moses R. 
Published: March 2008

Abstract:This paper uses the Illawarra 0–39 years diabetes register to provide a data base of health suvice utilisation in tbc public and private sectors. Eligible patients from the register were divided into a ‘stable group’ comprising children and adults who had had diabetes for more than one year prior to review and a ‘newly diagnosed’ group who were followed for one year after diagnosis. The records of inpatient and selected autpatbt services at public hospitals as well as visits to general practitioners, paediatricians and physicians were considered. Less than balf of all ‘newly diagnosed’ patients were admitted to hospital faf stabilisation and none required readmission in the 12 month review period. Less than one fifth of all ‘stable’ patients were admitted to hospital during the year. General practitioners were the most frequently used health used health resource being attended by 31/38(82%) ‘stable children’, 122/133 (92%) ‘stable adults’ and 25/25 (100%) ‘newly diagnosed patients’. Public hospital Accident and Emergency Services were the least used health facility being frequented by only 9/38 (24%), 23/133 (17%) and 7/25 (28%) rrspecrivtly. (AWR NZ J Med 1992; 22:274–277.)
Semi‐quantitative determination of microalbuminuri by urinary dipstick
Authors: Gilbert R. E. , Akdeniz A. , Jerums G. 
Published: March 2008

Abstract:Microalbuminuria predicts subsequent clinical nephropathy and mortality in diabetic patients. This study was undertaken to determine the usefulness of a new immunochemical urinary dipstick test (Micral‐Test, Boehringer Mannheim, GmbH Mannheim, Germany) in identifying urinary albumin concentrations within the microalbuminuric range (urinary albumin concentration 20–200 mg/L). Twenty‐four hour urine specimens were collected from 298 consecutive diabetic outpatients. Micral‐Test was performed by two laboratory scientists blinded to each other's results and those of radioimmunoassay (RIA) and immunoturbidimetry on the same specimen. When compared with RIA, Micral‐Test had an overall sensitivity of 92.2%, specificity of 92.3% and positive predictive value of 86.4%. However, at the threshold value of 20 mg/l Micral‐Test showed false positive results in 37.8% of samples when compared with RIA. Similar results were obtained when Micral‐Test was compared with immunoturbidimetry. We conclude that Micral‐Test is a useful screening method for the detection of microalbuminuria. We suggest that positive tests be confirmed by a timed urine collection using established methodology and that patients whose Micral‐Test is negative be subjected to annual retesting.
The prevalence of asthma in Victorian adults
Authors: Abramson M. , Kutin J. , Bowes G. 
Published: March 2008

Abstract:To determine the prevalence of asthma in Victorian adults, we carried out a cross‐sectional postal survey utilising a new screening questionnaire which gathered data on self reported respiratory symptoms, whether asthma had been diagnosed and, if so, how it had been treated. Questionnaires were returned by 2198 (72%) of 3095 adults selected randomly from the Victorian electoral roll, an adequate response rate. The reported prevalences of individual asthmatic symptoms in the last 12 months ranged from 8% for nocturnal wheeze to 22% for current wheeze. Thirteen per cent of respondents had ever had asthma, 7% had experienced an attack within the last 12 months and 6% were currently taking medication.The high prevalence of asthma revealed by our study has major implications for the planning of health services.
Effect of the revised CDC case definition of AIDS on the number of AIDS cases in the Sydney AIDS Prospective Study
Authors: Tindall B. , Sharkey T. , Kaldor J. , Cooper D. A. 
Published: March 2008

Abstract:We sought to evaluate the potential impact of a proposed revision in the case definition of acquired immunodeficiency syndrome (AIDS) (from a clinical case definition to one also including subjects with HIV infection who have an absolute number of peripheral CD4 + cells of less than 200 times 106/L) among 512 HIV‐seropositive homosexual/bisexual who were reviewed between 1984 and 1991. According to the current case definition, 151 (30%) of 512 at‐risk subjects developed AIDS between 1984 and August 1, 1991. Of the 361 at‐risk subjects who were not classified as AIDS by the current definition, 47 (13%; 95% CI 9 – 17%) were classified as AIDS according to the revised definition. The median time to development of AIDS according to the revised definition was 288 weeks and that according to the current definition was 338 weeks. Data on clinical status were available for 34 of the new cases at the time of their diagnosis according to the proposed case definition: 16 (47%) of these were asymptomatic, 10 (29%) had persistent generalised lymphadenopathy and eight had minor infectious diseases. Of the 151 cases diagnosed according to the current definition, 78 (52%) had an antecedent CD4 + cell count that met the criteria for AIDS under the revised definition a median of 59 weeks before their diagnosis according to the current definition. These data indicate an appreciable increase in the number of cases of AIDS in this cohort when the revised case definition was applied. These findings have important implications for the surveillance, and for the clinical monitoring and treatment, of patients with HIV disease in Australia.
Failure of intensive chemotherapy in poor prognosis non‐Hodgkin's lymphoma
Authors: Matthews J. R. D. , Cooper I. A. , Matthews J. P. , Ding J. CHONG 
Published: March 2008

Abstract:In an attempt to improve response and survival rates in patients with non‐Hodgkin's lymphoma, a relatively intense six drug regimen MATCOP was developed comprising four‐weekly cycles of methotrexate (100mg/m2, IVY day 8), Adriamycin (30mg/m2, IVY days 1,2), teniposide (75 mg/rn2, IV, day 1), cyclophophamide (300 mg/m2, po, days one to five), Oncovin (1.4 mg/m2, IV: maximum 2 mg, days 8,15) and prednisolone (100 mg, po, days one to five). A randomised trial was conducted comparing MATCOP with the standard CHOP regimen, comprising three‐weekly cycles of cyclophosphamide (750 mg/m2, IV, day 1), Adriamycin (50 mg/m2, IV, day 1), Oncovin (1.4 mg/m2 IV: maximum 2 mg, day 1) and prednisolone (100 mg, PO, days two to six). Eighty patients with large cell lymphoma, diffuse mixed small cleaved and large cell lymphoma or diffuse small cleaved cell lymphoma were randomised, 47 to MATCOP and 33 to CHOP. MATCOP patients experienced increased granulocytopenia, thrombocytopenia (p 0.0001), mucositis (p= 0.002) and infections (p= 0.01) compared to CHOP patients. Complete response rates were similar: 66% for MATCOP patients and 61% for CHOP patients. There were no apparent differences in the time to relapse for patients achieving CR, the time to treatment failure or the overall survival time. Thus despite an increase in toxicity, the more intense regimen MATCOP failed to confer any therapeutic benefit compared with the standard CHOP regimen.Survival was not influenced but toxicity was increased by dose intensification. (Aust NZ J Med 1992; 22: 123–128.)
Streptokinase morbidity — more common than previously recognised
Authors: Siebert W. J. , Ayres R. W. , Bulling M. T. , Thomas C. M. , Minson R. B. , Aylward P. E. 
Published: March 2008

Abstract:Streptokinase is the thrombolytic agent most commonly used for the treatment of acute myocardial infarction. We report eight patients who developed late uncommon adverse reactions to streptokinase probably due to immune complex disease. The clinical manifestations included vasculitic rashes, abnormal renal and liver function tests and a syndrome resembling adult respiratory distress syndrome, Major adverse events with streptokinase such as stroke, bleeding and othet allergic reactions, have been previously documented but the morbidity related to delayed reactions has not been widely recognised. These reactions produced significant morbidity resulting in prolonged hospital stay and may need to be considered in the decision to use streptokinase. (Aust NZ J Med 1992; 22: 129–133.)
Fulminant hepatic failure in a young mother
Authors: Gane E. J. , Zwi L. J. , Lane M. R. 
Published: March 2008

Abstract:We report the case of a mother who developed hlminant hepatic failure with hypoglycaemia, coagulopathy, Grade III hepatic encephalopathy, two days after the delivery of her fourth child. She had complained of pruritus for the final two weeks of pregnancy. She received supportive medical management within a critical care unit, and the hepatic failure resolved completely within 48 hours. Liver biopsy confirmed the diagnosis of acute fatty liver of pregnancy. This case is unusual in that this patient deteriorated markedly following delivery, at a time when spontaneous recovery is normally expected. (Aust NZ J Med 1992; 22: 142–143.)
Pharmacological treatment of alcoholism
Authors: Monteiro MARISTELA G. 
Published: March 2008

Abstract:This paper presents an overview on pharmacologic treatment of alcoholism. A wide range of drugs have been tested over the years, some showing a reduction of alcohol drinking in alcoholics. However, at present, there is little evidence that phnrmacotherapy is effective in the rehabilitation of alcoholics. Although research in this area still has several methodological problems and much needs to be done, a greater understanding of the neuropharmacoiogy and neurobiology of alcohol use and abuse will certainly open new avenues for investigation and drug development. Patient‐treatment matching and the combination of two or more modalities of intervention may also help increase overall effectiveness of alcohol treatment. (Aust NZ J Med 1992; 22: 220–223.)
New approaches to the management of poor prognosis non‐seminomatous germ cell tumours
Authors: Grigg A. , McKendrick J. , Fox R. 
Published: March 2008

AbstractWhile most patients with disseminated non‐seminomatous germ cell tumours (NSGCT) are cured by treatment with cisplatinum‐based chemotherapy, a subset die from refractory or relapsing disease. Poor prognostic factors at diagnosis include bulky disease, visceral involvement, high serum marker levels and an inadequate rate of fall in these markers in response to treatment.There are a number of approaches to poorer risk patients. One is to use conventional induction chemotherapy followed by second‐line salvage regimens in those who fail induction. Results with this approach have been disappointing. A second approach is to use more intensive induction regimens, in some cases with growth factor support; whether these are superior to standard treatment has yet to be established by randomised studies. A third approach, based on the chemotherapy‐dose responsiveness of NSGCT, consists of the administration of very high dose chemotherapy followed by haematological rescue with autologous marrow to patients failing initial therapy. Review of autograft studies suggest that durable remissions can be obtained in most patients with responsive disease, but not if the disease is chemotherapy‐refractory. A new approach may be elective early autografting in patients identified at diagnosis to have very poor prognosis disease. (Aust NZ J Med 1992; 22: 679ndash;684.)
Culture‐positive tuberculosis at St Vincent's Hospital, Melbourne, 1962–1989
Authors: Hurley J. C. , Uren E. M. , Andrew J. H. , Burdon J. 
Published: March 2008

AbstractThe disease types and demography of patients with culture confirmed tuberculosis (TB) diagnosed at St Vincent's Hospital, Melbourne between the years 1962 to 1989 were reviewed. Four hundred and eighty‐two patients with culture‐positive TB were identified whose origins were as follows: Australia 194; Northern Europe 38; The Mediterranean 98; Asia 60 and other or unknown 92. Patients whose country of birth was in Asia or the Mediterranean area accounted for 57% of patients in the 1980s; they presented at a younger age, with a higher proportion of extrapulmonary disease and a more equal sex distribution than did Australian born patients. The main types of extrapulmonary disease also differed for the various ethnic groups. The overall proportion of patients with an isolate resistant to at least one of the anti‐TB drugs was 10.0% but in the Asian born was 21.7%. This survey, the longest series of bacteriologically confirmed cases of TB reported from a single institution in Australasia, has identified several changes in how TB is presenting for diagnosis. (Aust NZ J Med 1993; 23: 7–11.)
Continuous hepatic artery infusion of 5‐fluorouracil for metastatic colorectal cancer localised to the liver
Authors: Boyle F. M. , Smith R. C. , Levi J. A. 
Published: March 2008

Abstract:Continuous regional delivery of chemotherapeutic agents offers the prospect of maximising dose intensity at the site of localised disease, while minimising systemic toxicity. This prospective phase II study evaluates the efficacy and toxicity of hepatic arterial infusion of 5‐Fluorouracil (5‐FU) via an implantable Infusaid™ pump in previously untreated patients with localised but unresectable hepatic metastases from colorectal cancer. In 25 patients the response rate was 56% and median survival was 15 months, comparable to previous reports utilising fluorodeoxy‐uridine (FUDR). Twenty per cent of patients (all responders) survived longer than three years. Systemic toxicity was trivial, and the practice of reducing the intensity of therapy when nausea or a rise in alkaline phosphatase occurred avoided the previously described local toxicity of biliary sclerosis seen frequently with FUDR. In selected patients, particularly those with more limited disease, this form of therapy is effective and well tolerated and warrants further evaluation as an alternative to FUDR. (Aust NZ J Med 1993; 23: 32–34.)
Intravenous aminophylline confers no benefit in acute asthma treated with intravenous steroids and inhaled bronchodilators
Authors: Coleridge J. , Epstein J. , Cameron P. , Teichtahl H. 
Published: March 2008

Abstract Background: The role of intravenous aminophylline in acute asthma is unclear despite meta‐analysis of many studies comparing aminophylline with other bronchodilator therapies. Aims: The aim of this study is to determine whether continuous aminophylline infusion confers any benefit in acute severe asthmatics treated with intravenous steroids and inhaled bronchodilators. Methods: The study was randomised, double‐blind and placebo‐controlled. All patients received nebulised salbutamol (1 mL of 0.5%) and ipratropium bromide (1 mL of 0.025%) with glycol diluent (1 mL) at 0, two, four, six, eight and 12 hours, and six‐hourly thereafter. In addition all patients were given intravenous hydrocortisone 250 mg six‐hourly and oxygen to maintain normoxia. Aminophylline infusions were adjusted to maintain therapeutic levels. Peak expiratory flow rate (PEFR) was measured before and after nebulised bronchodilator on a two‐hourly basis in the Emergency Department (ED) and six‐hourly on the inpatient wards. Results: Thirty‐one patients were clinically sufficiently improved within 12 hours to be discharged home from the ED. The remaining 28 patients were admitted to the inpatient ward for a total trial duration of 48 hours.No significant difference was found between the placebo and treatment groups for measurements of PEFR, or for the duration of stay of the patients in hospital. The power of the study was 80% for a 25% to 33% difference at a 5% level of significance. Presentation values of PEFR and arterial blood gases did not predict which patients would require inpatient admission and which could be safely discharged home from the ED.
Treating hypercholesterolaemia with HMG CoA reductase inhibitors: a direct comparison of simvastatin and pravastatin
Authors: Lintott C. J. , Sutherland W. H. F. , Scott R. S. , Bremer J. 
Published: March 2008

Abstract Background: Simvastatin and pravastatin are both competitive inhibitors of the rate limiting enzyme for cholesterol biosynthesis (HMG CoA) reductase, but data from individual clinical trials suggest significant differences in potency for cholesterol reduction between the two drugs. Aim: To assess any differences in efficacy and safety between simvastatin and pravastatin in a direct, comparative study. Methods: A double‐blind, double‐dummy, randomised study design was used, involving 48 patients with primary hypercholesterolaemia. Following a 6 week placebo baseline period, patients were randomly allocated to treatment with either simvastatin or pravastatin, commencing at a dose of 10 mg daily. The dose levels were titrated up to the recommended maximum effective dose of 40 mg daily at 6 weekly intervals if LDL cholesterol levels remained 3.4 mmol/L. After 18 weeks of therapy, all patients were transferred to simvastatin therapy for a further 6 weeks, continuing at their week 18 dose level. Patients complied with a standard lipid lowering diet (containing < 30% of energy as total fat) throughout the study period. Results: Over the 18 week direct comparison of the two drugs, there was a significant difference (p< 0.001) in response between simvastatin and pravastatin for reduction in levels of total cholesterol (32%vs21% respectively), LDL cholesterol (38%vs27%) and apolipoprotein B levels (34%vs23%). No significant difference in drug effect was seen for the small reduction in levels of apolipoprotein AI (5%vs6% respectively), nor for the increased levels of apolipoprotein All (14%vsll%) and HDL cholesterol (1 l%vs7%). Lp(a) levels remained unchanged.When pravastatin was replaced with simvastatin for the final 6 weeks of the study in the 23 patients initially randomised to pravastatin, there were further reductions (p < 0.01) in total and LDL cholesterol, and apolipoprotein B.These results establish the advantage of simvastatin over pravastatin in terms of efficacy, for the treatment of primary hypercholesterolaemia.
Book Reviews
Authors: Baume Peter 
Published: March 2008

Book reviewed in this article:ABORIGINAL HEALTH AND HISTORY (Power and Prejudice in Remote Australia)By E. Hunter.HEALING THE SCHISM (Epidemiology, Medicine and the Public's Health)By K. L. White.COELIAC DISEASE Edited by M. N. Marsh.AUSTRALIA'S HEALTH 1992 By the Australian Institute of Health & Welfare.
Effect of lovastatin on serum lipid profile in the treatment of dyslipoproteinaemia in uraemic patients on continuous ambulatory peritoneal dialysis
Authors: Li Philip K. T. , Leung C. B. , Mak T. W. L. , Lui S‐ F‐ , Chiu K. , Lam C. W. K. , Mak G. Y. K. , Lai K. N. 
Published: March 2008

Abstract
Background:
Dyslipoproteinaemia is an important risk factor for cardiovascular disease in uraemic patients on continuous ambulatory peritoneal dialysis (CAPD). Lovastatin is an HMG Coenzyme A reductase inhibitor which is useful in treating non‐uraemic patients with hypercholesterolaemia.
Aims:
We conducted a single blind cross‐over study versus placebo in 10 CAPD patients to examine the effect of lovastatin (20–40 mg) on the serum lipid profile and its safety in uraemic patients.
Methods:
Treatment phases were of eight weeks' duration. Each four weeks' measurements were made of serum total cholesterol (TC), triglyceride (TG), HDL‐cholesterol (HDL‐C), LDL‐cholesterol (LDL‐C), VLDL‐cholesterol (VLDL‐C), Apolipoprotein Al & B (Apo Al & Apo B) and Lipoprotein (a). After eight weeks, lovastatin significantly reduced TC by 29% from 6.7 ± 0.3 (mean±S.E.M.) to 4.8±0.1 mmol/L, LDL‐C by 41% from 4.6±0.3 to 2.7±0.1 mmol/L and Apo B by 32% from 116±7 to 78±3 mg/dl (p<0.01). HDL‐C increased by 8% froml.2±0.1 to 1.3 ±0.2 mmol/L after eight weeks' therapy (p<0.05). TG decreased by 18% from 1.9 ±0.4 to 1.6 ±0.3 mmol/L (p< 0.05). There was no significant difference in changes of other lipid profiles between placebo and drug. No adverse effects of the drug were noted during treatment and the liver function and muscle enzymes were not significantly altered by either drug therapy or placebo.
Results:
Lovastatin appears to be a safe and useful drug in effectively treating dyslipoproteinaemia in CAPD patients. (Aust NZ J Med 1993; 23: 252–257.)
Decreased uptake of L‐cystine by duodenal brush border membrane vesicles from patients with cystinuria
Authors: Furlong T. J. , Stiel D. 
Published: March 2008

Abstract
Background:
The pathophysiology of cystinuria remains unclear. Decreased absorption of L‐cystine across brush border membranes of small intestinal and renal proximal tubular epithelial cells is likely but has not been directly demonstrated.
Aims:
To compare the rates of L‐cystine transport by isolated duodenal brush border membranes of normal individuals and patients with cystinuria.
Methods:
Distal duodenal biopsies were taken from normal individuals and patients with cystinuria. Brush border membrane vesicles (BBMV) were prepared using magnesium aggregation and differential centrifugation and the rates of L‐cystine transport into the vesicles measured using a rapid filtration technique.
Results:
Rates of L‐cystine transport by BBMV from patients with cystinuria were reduced at 5 minute (p = 0.003) and 30 minute (/> = 0.053). Time points, indicating that L‐cystine absorption across brush border membranes is abnormal in cystinuria. (Aust NZ J Med 1993; 23: 258–263.)