bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic non‐A, non‐B hepatitis: lack of correlation between biochemical and morphological activity, and effects of immunosuppressive therapy on disease progression
Authors: Schoeman M. N. , Craig P. I. , Liddle C. , Bate R. G. , Bilous M. , Farrell G. C. , Grierson J. 
Published: March 2008

AbstractA study was made of 52 patients considered to probably have chronic non‐A, non‐B hepatitis who were seen during an eight‐year period at Westmead Hospital, Sydney. The patients were followed for a median of 28 months to assess the natural history of the disease and, in a small number of patients, the effect of immunosuppressive therapy on disease progression was examined. In 94% of cases, infection appeared to have been acquired by a parenteral route; the remainder were sporadic infections. Fifty‐six per cent of the patients had mild constitutional symptoms and the remainder were asymptomatic. Similarly, 54% of patients had no signs of chronic liver disease and none exhibited signs of hepatic decompensation. Liver biopsies were performed in 42 patients; chronic active hepatitis with or without cirrhosis was present in 90%. However, neither the presence of symptoms nor the degree of biochemical abnormality were predictive of disease severity as determined histologically. Among eight patients treated with corticosteroids (with or without azathioprine), six underwent follow‐up liver biopsy. Quantitative analysis of inflammatory and fibrotic changes indicated significant (p < 0.01) progression of histological severity during a median 33 months (range 7–98 months) between biopsies with cirrhosis developing in four instances. In contrast, among the seven untreated patients rebiopsied after a median of 16.0 months (range 11–37 months) there was no overall change in histological severity and only one patient developed cirrhosis. It is concluded that histological assessment is required in all patients suspected of having chronic non‐A, non‐B hepatitis as other means of assessment are unreliable. At present, immunosuppressive therapy cannot be recommended for patients with this form of chronic viral hepatitis; as well as being unhelpful, such treatment may accelerate disease progression.
The ‘shrinking lungs syndrome’—an infrequently recognised feature of systemic lupus erythematosus
Authors: Stevens W. M. R. , Burdon J. G. W. , Clemens L. E. , Webb J. 
Published: March 2008

AbstractTwo cases of the ‘Shrinking Lungs Syndrome’ in patients with systemic lupus erythematosus are described to highlight an infrequently recognised feature of this condition. Respiratory muscle weakness, improved by steroid therapy, was demonstrated in each patient and considered to be the mechanismunderlying the respiratory symptoms.
Non‐obstructive apical hypertrophic cardiomyopathy—Emergence of clinical features within three years in a Chinese
Authors: Woo K. S. , Ho David T. W. 
Published: March 2008

AbstractA Chinese engineer presented with non‐specific palpitation, atypical chest pain and normal electrocardiogram both at rest and during exercise, was documented to develop electrocardiographic evidence of left ventricular hypertrophy and abnormal isotopic cardiac scintigraphy during stress test within a period of three years. His echocardiogram remained unremarkable. Cardiac catheterisation and cineventriculogram confirmed the presence of apical hypertrophic cardiomyopathy, without any outflow tract obstruction or coronary artery disease. This case, together with 14 others detected recently in Hong Kong, will arouse the existence of this form of hypertrophic cardiomyopathy in the Chinese. The emergence of all diagnostic features in this patient within a short time will support an aetiological hypothesis that apical hypertrophic cardiomyopathy can be acquired in patients with genetic predisposition.
Seasonal, regional and secular variations of cardiovascular and cerebrovascular mortality in New Zealand
Authors: Douglas A. S. , Russell D. , Allan T. M. 
Published: March 2008

AbstractNumbers of deaths from coronary heart disease (CHD) and cerebrovascular disease (CVD) were available for five years (1980–84) in the North and South Islands of New Zealand; estimated death rates were determined, and age correction made.There was a major seasonal variation by month in coronary and cerebrovascular deaths in both sexes and both islands, with a zenith in June/July/August (winter) and a nadir in December/January/February (summer).There was a less obvious, and less complete, linear trend, with declining secular (annual) mortality over the five years. This was more obvious in North Island but not proven in South Island.After standardising for age, coronary mortality rates (but not cerebrovascular mortality rates), were significantly higher in South Island than in North Island. Mortality from both CHD and CVD was significantly higher in males than in females.
Geographical distribution of cancers of the kidney and urinary tract and analgesic nephropathy in Australia and New Zealand
Authors: McCredie M. , Coates M. S. , Ford J. M. , Disney A. P. S. , Auld J. J. , Stewart J. H. 
Published: March 2008

AbstractAge‐standardised incidence rates for cancers of the renal parenchyma, renal pelvis and bladder and for end‐stage renal failure due to analgesic nephropathy for the years 1982–83 were compared between the Australian states and New Zealand, and within New South Wales (NSW), to determine whether these rates paralleled the previous prevalence of consumption of phenacetin‐containing analgesics. Whereas little variation was seen within Australasia in respect of the incidence of cancer of the renal parenchyma and bladder, both cancer of the renal pelvis and end‐stage renal failure due to analgesic nephropathy had higher incidence rates amongst women in NSW and Queensland than in the other states or New Zealand. Within NSW, the average annual incidence rates during 1973–82 for renal pelvic cancer in the Hunter region of 1.3 (m) and 1.6 (f) per 100,000 were the highest in the state. These high incidence rates coincided with areas known to have had a high prevalence of consumption of compound analgesics containing phenacetin. In an international comparison with populations which had published incidence rates for each of the periods 1973–77 and 1978–82, the rate for cancer of the renal pelvis in women was highest in both time periods in NSW and had increased absolutely at a faster rate.
Pneumothorax: treatment by small‐lumen catheter aspiration
Authors: Markos J. , McGonigle P , Phillips M. J. 
Published: March 2008

AbstractTo assess the efficacy of simple aspiration as a treatment for pneumothorax, 40 consecutive pneumothoraces (28 spontaneous, 12 iatrogenic, all estimated at 20% collapse on visual inspection of the chest X‐ray) in 38 symptomatic patients were treated initially by small‐lumen catheter (SLC) aspiration. SLC aspiration avoided the need for large‐lumen intercostal catheter (LIC) underwater drainage in 28 cases (70%) ‐ 20 of 28 spontaneous and eight of 12 iatrogenic pneumothoraces. Outcome was not predicted by clinical variables or pneumothorax size, whereas an initial aspirate volume of 4 L (n = 33) was predicable of success in 28 cases (85%). Minor local subcutaneous emphysema and vasovagal reactions were encountered infrequently but with similar frequency to LIC drainage. No episodes of re‐expansion pulmonary oedema occurred. The results confirm previous reports of the efficacy of simple aspiration as a treatment for spontaneous or iatrogenic pneumothorax. Initial treatment by SLC aspiration is recommended for all but life‐threatening presentations of pneumothorax. Although not encountered in this study, the potential risk of re‐expansion pulmonary oedema suggests that patients should be observed closely for four hours after aspiration.
The Dubbo study: an Australian prospective community study of the health of elderly
Authors: Simons L. A. , McCallum J. , Simons J. , Powell I. , Ruys J. , Heller R. , Lerba C. 
Published: March 2008

AbstractThe proportion of Australian population over 60 years has risen progressively over the last 40 years and this growth is projected to continue. Major health problems of the elderly include coronary heart disease, cerebro‐vascular disease, osteoporosis and fracture. The risk factors for coronary heart disease and stroke in middle‐aged subjects have been extensively documented in prospective studies in Australia and elsewhere, and include lipid disorders, hypertension, cigarette smoking, diabetes and family history. Few prospective studies have been targeted exclusively on the elderly and information available with respect to vascular risk factors is fragmentary and contradictory. This is the background to a new prospective study of the health of elderly Australians now under way in Dubbo, NSW. The goals of the Dubbo Study are to identify predictors of mortality, hospitalisation and placement in long‐term care, while specific aims are the study of risk factors for chronic diseases and disability. This report describes the study rationale, reasons for selecting Dubbo as the study site, methods and measures, participation rates and demography. The target population included all non‐institutionalised subjects 60 years and over, domiciled in Dubbo, and is comprised of 1693 males and 2167 females. The attendance rate for an extensive medical and sociological baseline assessment over a 13 months' period was 73% for both sexes. The prospective study is now in place and within three to five years will be generating definitive information in the elderly.
Cot deaths in Canterbury (NZ): lack of association with respiratory virus patterns
Authors: Ford R. P. K. , McCormick H. E. , Jennings L. C. 
Published: March 2008

AbstractThis study was done to see whether any association between SIDS and respiratory viruses might be more obvious in Canterbury where the cot death rate is so high (about seven per thousand live births). The numbers of common respiratory virus identifications for the eight year period July 1981 to June 1989 were analysed for associations with cot death. The identifications were from inpatients at the Christchurch Public Hospital and other community sources in Canterbury. Weak associations were found with respiratory syncytial virus (r = 0.3), influenza A (r = 0.3) and influenza B (r = 0.2). However, the associations are overwhelmed by the effect of the month of the year. A high rate of respiratory virus infection cannot be invoked as the explanation for our high SIDS rate.
Torsade de Pointes associated with perhexiline maleate therapy
Authors: Kerr G. D. , Ingham G. 
Published: March 2008

AbstractMultiform ventricular tachycardia (torsade de pointes) is a recognised proarrhythmic effect of drugs which prolong the QT interval. A case is now described for the first time where torsade de pointes occurred with the administration of the anti‐anginal agent perhexiline maleate.
Prevalence of lupus anticoagulant and anticardiolipin antibodies in a healthy population
Authors: Shi W. , Krilis S. A. , Chong B. H. , Gordon S. , Chesterman C. N. 
Published: March 2008

AbstractThis study was designed to explore the incidence of lupus anticoagulant (LA) and anticardiolipin antibodies (ACA) and their relationship to each other in a healthy population of 499 blood donors. Plasma samples were tested for LA activity and IgG, IgM and polyvalent ACA. Prolongation of the kaolin clotting time of a mixture of 80% normal plasma and 20% test plasma compared to the normal (dKCT) was used to detect LA activity.A normal distribution of dKCT was found with the mean 3.5 seconds ±SD 10.6 seconds. Forty subjects (8%) were greater than 10% of the normal control; among these, 18 (3.6%) were outside the 95% confidence limits. The median age (29.3) and sex (M = 12, F = 28) of the 40 subjects with prolonged KCT were significantly different (ρ < 0.001) from the group as a whole, younger females predominating.The frequency distribution of IgG, IgM and polyvalent ACA was skewed and the majority did not have detectable levels. ACA concentration falling within 95% of the population group were regarded as normal. Applying this definition, abnormal IgG ACA was greater than 4.33 U/ml, IgM ACA greater than 3.55 U/ml and polyvalent ACA greater than 4.55 U/ml with a prevalence of 4.6%, 4.6% and 5.6% respectively. Of the subjects with positive ACA of any class there was no significant association with either age or sex or the presence of LA. Only three plasma samples had both activities. Neither ACA nor LA were associated with antinuclear antibodies (ANA) or rheumatoid factor (Rh factor). Thus, in a healthy population LA is found predominantly in younger females and neither LA or ACA appear to identify subjects with other autoimmune parameters such as ANA or Rh factor or, for that matter, each other.
Anti‐neutrophil cytoplasm antibodies (ANCA)
Authors: Savige J. A. , Davies D. J. 
Published: March 2008

AbstractCirculating antibodies directed against cytoplasmic constituents of granulocytes and monocytes (anti‐neutrophil cytoplasm antibodies, ANCA) are found in about 80% of active cases of Wegener's granulomatosis and microscopic polyarteritis. Antibodies are detected by indirect immunofluorescence on normal peripheral blood leucocytes, or by ELISA or radio‐immunoassay using a neutrophil cytoplasm extract. There are 2 patterns of staining seen on indirect immuno‐fluorescent examination of leucocytes and a number of different molecules recognised on Western blots. In Wegener's granulomatosis diffusely granular cytoplasmic staining (cANCA) is associated with a 29KD molecule that has recently been identified as neutrophil proteinase 3. A finely granular pattern may also be seen in microscopic polyarteritis. A perinuclear pattern (pANCA) is present in some other cases of segmental necrotising glomerulonephritis and occasionally in rheumatoid arthritis but almost never in Wegener's granulomatosis. This pattern is often associated with the presence of anti‐myeloperoxidase and anti‐elastase antibodies. Levels of anti‐neutrophil cytoplasm antibodies usually reflect disease activity but a pathogenetic role for these antibodies in the development of small vessel vasculitides is, as yet, unproven.
Cardiovascular reflexes from cardiac sensory receptors
Authors: Ludbrook J. 
Published: March 2008

Abstract The mammalian heart, especially its left ventricle, is densely innervated by sensory nerves. One set of these travels to the brainstem in the vagus nerves; the other to the spinal cord in sympathetic nerves. Excitation of vagal cardiac afferents, especially unmyelinated afferents from the left ventricle, cause a reflex bradycardia and fall in blood pressure and, under some conditions, a massive release of AVP. The sympathetic afferents convey the sensation of cardiac pain, but innocuous stimuli may cause a reflex tachycardia and rise in blood pressure.Both sympathetic and vagal cardiac afferents can be excited by mechanical distension of the heart (mechanoreceptors), and by a variety of foreign and endogenous chemical substances (chemosensitive receptors). It is not yet clear whether the effective natural stimulus to these receptors is mechanical, or through the chemical products of myocardial metabolism. Neither is it clear whether information from the heart exerts a minute‐to‐minute regulatory effect on the circulation, or whether it has a purely defensive role in the face of extreme disturbances of cardiac function.Cardiogenic reflexes are also thought to be the cause of haemodynamic and humoral disturbances that occur in clinical conditions such as myocardial ischaemia or infarction, left ventricular outflow obstruction, and acute reduction in central blood volume as well as during coronary angiography.
Long‐term nasal CPAP does not ameliorate obstructive sleep apnoea
Authors: Rolfe Isobel , Olson L. G. , Saunders N. A. 
Published: March 2008

AbstractFifty‐seven patients with obstructive sleep apnoea (OSA) were treated for at least six months with nasal continuous positive airway pressure (CPAP). At follow‐up, sleep studies were performed in which CPAP was not used for the first half of the night. We compared the severity of OSA at follow‐up without CPAP to the severity of OSA during the patient's initial diagnostic study. Apnoea and hypopnoea index (AHI) fell from 41.4 ± 7.5 (mean ±95% CI) to 34.8 ± 7.9 (p= 0.06 by Wilcoxon test) and minimum oxygen saturation rose from 71.6 ± 3.2 to 78.5 ± 2.6 (p<0.001). Some of this change may have been due to reduced REM sleep in the follow‐up study (10.5±2.1% Total Sleep Time vs 7.4±2.4% TST, p<0.05). Long‐term nasal CPAP was not associated with any reduction of obesity (BMI before CPAP 31.9 ± 1.0, after CPAP 31.7 ± 1.0 (p= 0.39). Systolic arterial pressure fell (before CPAP 143.0 ±4.5 mmHg, after CPAP 136.3 ± 4.6, p < 0.05) but diastolic pressure did not (before CPAP 88.5 ± 3.0 mmHg, after CPAP 85.6 ±2.9 mmHg, p = 0.11). We concluded that the effect of CPAP treatment for six or more months was a small fall in AHI and a small rise in minimum Sa02, but that this would be of marginal clinical significance, and may be artefactual. (Aust NZ J Med 1991; 21: 235–238.)
Reproducibility of synovial fluid examination for crystals
Authors: McGill N. W. , York H. F. 
Published: March 2008

Abstract A quality assurance survey of synovial fluid examination for crystals was performed at six teaching hospitals. Aliquots of 12 different fluids (three with no crystals, one with betamethasone crystals, four with calcium pyrophosphate dihydrate (CPPD) crystals and four with monosodium urate monohydrate [urate] crystals) were examined by all six laboratories. Four laboratories performed well (10 or more correct out of 12) but two did poorly (50% or less correct). False positive crystal identification occurred in eight of 72 samples, but all false positive reports were from two laboratories. CPPD and urate crystals were missed in seven of 24 (29%) and five of 24 (21%) samples respectively.The standard of synovial fluid examination for crystals in Sydney teaching hospitals is not uniform and in some cases appears unsatisfactory.
The use of a low molecular weight heparinoid (Org 10172) for extracorporeal procedures in patients with heparin dependent thrombocytopenia and thrombosis
Authors: Rowlings P. A. , Mansberg R. , Rozenberg M. C. , Evans S. , Murray B. 
Published: March 2008

Abstract:We report two cases of heparin induced thrombocytopenia (HIT), in patients who required anticoagulation for extracorporeal procedures (haemodialysis and cardiopulmonary bypass) one associated with recurrent thrombosis of the artificial circuits. Resolution of thrombocytopenia and successful anticoagulation were achieved using a low molecular weight heparinoid (LMWH) Org 10172. Anticoagulation was monitored using estimations of plasma anti‐factor Xa activity.These cases demonstrate that LMWH provides safe and effective anticoagulation in patients in whom unfractionated heparin has caused HIT.
First and second complete remissions in a HIV positive patient following remission induction therapy for acute non‐lymphoblastic leukaemia
Authors: Mansberg R. , Rowlings P. A. , Yip M‐Y , Rozenberg M. C. 
Published: March 2008

Abstract:A small number of patients positive for the human immunodeficiency virus (HIV) have been reported as developing acute non‐lymphoblastic leukaemia (ANLL) and none has achieved remission despite attempts at treatment.We report on a 34‐year‐old HIV positive heterosexual intravenous drug user who presented with ANLL (FAB classification M5, Monoblastic) and entered remission following one cycle of cytosine arabinoside and daunorubicin according to the 7‐3 protocol of the Australian Leukaemia Study Group (ALSG). This was followed by consolidation of 5‐2 as per ALSG and one cycle of maintenance with low dose cytosine arabinoside. Ten months after remission, he relapsed but achieved a second remission with the ALSG 7‐3‐7 protocol (7‐3 plus etoposide) followed by consolidation with 5‐2‐5. He remained HIV positive but showed little progression towards the acquired immunodeficiency syndrome despite the intense immunosuppression. The duration of his second remission was five months. The patient died of septicaemia during the third attempt at remission induction 18 months after diagnosis.We conclude that HIV seropositivity is not an absolute contraindication to aggressive chemotherapy in those patients who develop ANLL.
Standardised initial warfarin treatment: evaluation of initial treatment response and maintenance dose prediction by randomised trial, and risk factors for an excessive warfarin response
Authors: Doecke C. J. , Cosh D. G. , Gallus A. S. 
Published: March 2008

Abstract:We report a comparison of warfarin treatment outcomes in 172 inpatients in two general hospitals randomly assigned to commence warfarin therapy by one of two methods; the first where warfarin dosage was determined using a flexible dose induction protocol, and the other where dosage was prescribed empirically by resident medical staff.The mean INR for each treatment day, the mean time to reach a therapeutic level of INR, the mean maintenance dose and the mean time to reach maintenance dose were not significantly different between the protocol and empirical treatment groups. Although the mean observations of warfarin effect were similar between the two groups, there were more patients with excessive warfarin effect (INR > 4.0) during empirical treatment. In addition, age and identified complicating factors such as interfering drugs, heart failure or alcohol abuse were significant predictors of excessive warfarin effect, regardless of treatment group. The protocol dose administered on day 4 of treatment, which has been used as a determinant of maintenance dose, predicted maintenance dose to within lmg in 57/83 patients (69%, 95% confidence interval: 59–79%).We conclude that as a method for safely and effectively initiating warfarin therapy, this protocol at least matches the empirical prescribing skills of medical staff in a teaching hospital.
Pulmonary infiltrates and eosinophilia associated with sulphasalazine administration
Authors: Panayiotou B.N. 
Published: March 2008

Abstract:A case of blood eosinophilia with pulmonary infiltrates associated with sulphasalazine therapy in a patient with ulcerative colitis is described. These manifestations resolved when sulphasalazine was ceased and recurred with rechallenge. The failure of recurrence after treatment with mesalazine (5‐aminosalicylic acid in a sustained release preparation) suggests that sulphapyridine is the component responsible for this reaction.