bluuebunny/crossref_metadata_2025_split huggingface dataset:
OBSTRUCTIVE AZOOSPERMIA AFTER A SECOND RENAL TRANSPLANT: AN AVOIDABLE CAUSE OF INFERTILITY
Authors: HANDELSMAN D. J. 
Published: March 2008

Abstract:A case of obstructive azoospermia and infertility after renal transplantation is presented. Vasec‐tomies were performed incidental to insertion of a renal allograft on each side and were not amenable to vasovasostomy owing to retraction of the proximal vasal stump. The desirability of spermatic cord preservation in younger men undergoing renal transplantation is discussed.
ENDOSCOPIC SPHINCTEROTOMY OF THE PAPILLA OF VATER: AN ANALYSIS OF 300 CASES
Authors: ROBERTS‐THOMSON I. C. 
Published: March 2008

Abstract:Endoscopic sphincterotomy was performed on 300 patients with biliary and/or pancreatic disease during the period 1978–1983. The most frequent indications were choledocholithiasis after cholecystectomy (59%), choledocholithiasis without cholecystectomy (17%) and presumed motility disorders of the sphincter of Oddi (15%). In choledocholithiasis, stones passed spontaneously or were extracted from the bile duct in 147 of 164 patients (90%) in whom the outcome was determined by cholangiography immediately after stone extraction or by a second retrograde cholangiogram. In presumed motility disorders, only 51% of patients have shown sustained improvement in symptoms. Complications were uncommon (5%) but included bleeding from the margins of the incision, pancreatitis, cholangitis and an entrapped Dormia basket; no patient died. Duodenal diverticula were more frequent (p<0.005) in patients with bile duct stones after cholecystectomy (28%) than in patients in whom retrograde cholangiography did not reveal stones (9%) but the presence of diverticula did not influence the outcome of the procedure. Endoscopic sphincterotomy is a safe and effective procedure of particular relevance to elderly patients with choledocholithiasis after cholecystectomy and to high‐risk patients with choledocholithiasis without cholecystectomy.
LEGIONELLA PNEUMOPHILA AND WATER TEMPERATURES IN AUSTRALIAN HOSPITALS
Authors: PEEL M. M. , HARKNESS J. L. , CALWELL J. M. , ROUCH G. J. , CHRISTOPHER P. J. 
Published: March 2008

Abstract: Thirty‐four samples of warm waters from 12 psychiatric centres in Victoria and New South Wales were examined for legionellae by guinea‐pig inoculation. Legionella pneumophila was isolated from 20 of the samples collected from ten of the establishments investigated. The detected prevalence proportion of L. pneumophila in waters of temperatures 36 to 43oC was 0.9 (18/20), whereas the prevalence in waters of temperatures 45 to 54.2oC was 0.14 (2/14). The two ‘positive’ waters within the latter range showed evidence of low numbers of L pneumophila. No significant antibody titres to relevant serogroups were detected in the 112 exposed residents tested from seven psychiatric hospitals in New South Wales.The findings show that the temperature range with the greatest prevalence of L. pneumophila in warm waters is 36 to 43oC. The presence of legionellae in these warm water‐distribution systems contrasts with their absence from the water‐distribution systems of Victorian hospitals in an earlier survey and underlines the value and simplicity of the usual Australian practice of maintaining hospital hot water temperatures at about 70oC in the control of L pneumophila.
WEGENER'S GRANULOMATOSIS: CLINICAL FEATURES AND OUTCOME IN SEVENTEEN PATIENTS
Authors: LITTLEJOHN G. O. , RYAN P. J. , HOLDSWORTH S. R. 
Published: March 2008

Abstract:Seventeen patients with Wegener's granulomatosis are reviewed. Eleven males and six females, with a mean age of 46.9± 4.5 years, were followed for 35.7 ± 9.0 months. Mean duration from time of onset of symptoms to diagnosis was 8.5 ±3.1 months. Constitutional symptoms (100%), lower respiratory tract involvement (93%), renal involvement (87%), and upper respiratory tract involvement (80%) were the most frequent clinical manifestations. Arthritis (60%), dermal vasculitis (60%), and inflammatory ocular disease (40%) were also common. Elevated ESR (94%), anemia (70%), and lymphopenia (77%) were frequent laboratory findings prior to treatment. Five patients had renal failure at presentation and two patients progressed from no renal involvement at presentation to renal failure at diagnosis, while five patients progressed from renal involvement without impairment at diagnosis to end‐stage renal failure. Seven patients died; six of these deaths were related to active Wegener's granulomatosis. The patients with a severe systemic vasculitis, and renal involvement had a poor outcome while predominant respiratory disease had a good prognosis.
GLUE SNIFFING NEUROPATHY
Authors: KING P. J. L. , MORRIS J. G. L. , POLLARD J. D. 
Published: March 2008

Abstract:Three young men are described in whom a severe, subacute, predominantly motor peripheral neuropathy resulted from the deliberate inhalation of glue vapour. Weakness began after several years of daily glue sniffing and was marked in proximal as well as distal muscles. Muscle wasting was prominent at the time of presentation. Deterioration continued for several weeks after glue sniffing ceased. Peripheral nerve conduction was markedly slow and there was extensive denervation in the muscles. Characteristic changes were seen on sural nerve biopsy. The habit of glue sniffing is now widespread amongst Australian adolescents and this factor should be considered when any young person presents with a peripheral neuropathy. (Aust NZ J Med 1985; 15: 293–299.)
CHRONIC RELAPSING MYALGIA (? POST VIRAL): CLINICAL, HISTOLOGICAL, AND BIOCHEMICAL STUDIES
Authors: BYRNE E. , TROUNCE I. , DENNETT X. 
Published: March 2008

Abstract:Two patients with persistent myalgia characterised by onset after an ill‐defined systemic illness, marked fluctuations in the severity of the symptoms, and normal neuromuscular examination with the exception of variable muscle tenderness on deep palpation, may have a forme fruste of myalgic encephalomyelitis. Differentiation from psychogenic muscle pain is important in management. Muscle histology revealed non‐specific Type II fibre atrophy. Mitochondrial respiration was assayed polarographically in intact organelles in vitro and revealed a mild depression of State 3 respiration rates with Site I and Site II substrates. (Aust NZ J Med 1985; 15: 305–308.)
THE INFLAMMATORY RESPONSE IN THE SYNOVIUM OF A PATIENT WITH ROSS RIVER ARBOVIRUS INFECTION
Authors: HAZELTON R. A. , HUGHES C. , AASKOV J. G. 
Published: March 2008

Abstract:Ross River virus has been incriminated in the etiology of many sporadic and epidemic cases of polyarthritis in Australia and the Pacific. Both synovium and synovial exudate fluid recovered from the knee of an epidemic polyarthritis patient showed a predominantly mononuclear leucocyte infiltrate. Infectious virus could not be recovered from the synovial exudate. Functional natural killer cells were detected in the synovial fluid. Their level of cytotoxic activity was similar to that detected in the peripheral circulation. (Aust NZ J Med 1985; 15: 336–339.)
SPINAL CORD COMPRESSION IN MULTIPLE MYELOMA: WHO GETS IT?
Authors: WOO E. , YU Y. L. , NG M. , HUANG C. Y. , TODD D. 
Published: March 2008

Abstract Of 97 Chinese patients with multiple myeloma seen over a 12‐year period, 23.7% were found to have cauda equina or spinal cord compression (SCC). Predictive features for SCC include paraprotein type, hemoglobin level, and the extent of bone lesion at initial hematological diagnosis. A discriminant function derived from this analysis can be used to predict the likelihood of SCC with 79% accuracy. It is postulated that when the cortex is more involved than the medulla in a vertebra, it will predispose to SCC while hemopoiesis is relatively preserved.Our patients presented late with advanced neurological deficit so that treatment was unsatisfactory. It is emphasised that early recognition of back pain and neurological symptoms is essential, as any delay would jeopardise the chance of neurological recovery. (Aust NZ J Med 1986; 16: 671–675.)
BALLOON DILATATION PULMONARY VALVULOPLASTY IN PULMONARY STENOSIS
Authors: McCREDlE R. M. , SWINBURN M. J. , LEE C. L. , WARNER G. 
Published: March 2008

Abstract Balloon valvuloplasty was used to treat congenital pulmonary valve stenosis in 13 patients, 11 with isolated pulmonary stenosis, one associated with complex univentricular heart and tricuspid atresia, and one associated with tetralogy of Fallot.A balloon catheter was introduced through the pulmonary valve over a guidewire positioned in the distal pulmonary artery and inflated for 15 seconds on two or three occasions to 3 to 5 atmospheres and rapidly deflated.Marked improvement in pressure gradients was achieved in eight of the 11 patients with isolated pulmonary valve stenosis and symptoms disappeared in the only patient in this group who was symptomatic. The two patients with complex congenital malformations improved clinically. The procedure was without complication and satisfactory results have been maintained from two to twelve months later.The procedure offers effective treatment. We believe that pulmonary balloon valvuloplasty should be the initial treatment for isolated severe and moderate pulmonary valve stenosis.
CONGENITAL LOBAR EMPHYSEMA REQUIRING SURGERY IN ADULT LIFE
Authors: Mcdonald C. F. , Pierce R. J. , Barter C. E. , Chou S. T. , Daniel F. J. 
Published: March 2008

AbstractWe report a case of congenital lobar emphysema requiring surgery in early adult life to relieve respiratory symptoms of fate onset. Regional lung function studies helped to predict the outcome of surgery which was successful in relieving symptoms. (Aust NZ J Med 1986; 16: 501–505.)
AUSTRALIAN HEMOPHILIAC RECIPIENTS OF VOLUNTARY DONOR BLOOD PRODUCTS LONGITUDINALLY EVALUATED FOR AIDS. A CLINICAL AND LABORATORY STUDY, 1983–1986
Authors: GARSIA R. J. , GATENBY P. A. , BASTEN A. , KENNY D. F. , GALLAGHER K. J. , RICKARD K. A. , GUST I. D. , MASKILL W. 
Published: March 2008

Abstract One hundred and sixty‐one Australian patients with hereditary bleeding disorders comprising hemophilia A (120), hemophilia B (18), von Willebrand's disease (16), and seven symptomatic female hemophilia A or B carriers were screened for clinical and serological evidence of exposure to HTLV‐IM/LAV/ARV/HIV infection. During the previous five years (1979–1984) they had been treated almost exclusively with blood products derived from Australian voluntary donors.The prevalence of HTLV‐III antibodies in 1985 was 45%, with the highest frequency being in those with severe hemophilia A (78%) and the lowest in patients with hemophilia B (6%). Antibody positivity correlated with a reduced absolute T helper (T4) cell numbers and/or an inverted T4:T8 ratio. Lymphadenopathy was detected in 23 subjects but only 13 had an abnormal T cell ratio. Comparison of seropositivity and T4:T8 ratios in 32 patients studied in 1983 and again in 1985 suggested that T4 cell deficiency reflected HTLV‐III exposure rather than being a predisposing factor for infection with the virus. Individual patients showed considerable fluctuation in T cell subsets over a 12 month period of follow‐up, but as a population there was a slight trend with time towards diminishing T4:T8 ratio only in the antibody positive hemophilia A patients of mild to moderate severity.Three (2%) of the 161 patients screened to date have developed confirmed AIDS with fatal outcome. Following the introduction of rigid exclusion criteria for donors and heat treatment of Australian lyophilised concentrates in late 1984, no antibody negative subjects have seroconverted. To date none of 15 regular sexual partners of antibody positive patients have been consistently seropositive and four clinically well, antibody negative babies have been born to antibody positive fathers.
SERUM IgG SUBCLASSES IN PATIENTS WITH AN INCREASED SUSCEPTIBILITY TO RESPIRATORY TRACT INFECTIONS
Authors: FRENCH M. A. H. , HARRISON G. 
Published: March 2008

Abstract Serum IgG subclass concentrations were assayed in 45 patients with chronic respiratory tract infections and 16 patients with recurrent acute respiratory tract infections. Eleven of these 61 patients, all but one with recurrent acute infections, were IgA‐deficient but the remainder had normal or high serum immunoglobulin concentrations.Only 4% of patients with chronic infections were lgG2‐deficient. The prevalence of lgG2 deficiency amongst patients with recurrent acute infections was greater (31%), but in most cases this appeared to be due to an association with IgA deficiency. Owing to the limits of assay sensitivity it was not possible to determine whether any patient was lgG4‐deficient, but the number of sera with undetectable lgG4 was greater in patients with recurrent acute infections than in controls (37.5%vs 10%, p<0.01), although such patients were mainly those with IgA and lgG2 deficiency. None of the patients had IgGl or lgG3 deficiency; in fact lgG3 concentrations were higher than those of controls in both groups of patients (ρ<0.001) and IgGl concentrations were higher than those of controls in patients with recurrent infections (ρ<0.01). Thus, unequivocal IgG subclass deficiency is uncommon in non‐lgA‐deficient patients, but those with lgG2 deficiency may have an immune defect requiring further investigation.
RESULTS OF A TECHNIQUE OF MITRAL VALVE REPAIR
Authors: BRADY P. W. , DEAL C. W. , ANGUS G. 
Published: March 2008

Abstract A particular technique for mitral repair of the posterior leaflet prolapse of the mitral valve has been used at Royal North Shore Hospital over a 15‐year period. The anatomical details, complications and results of repair, as well as mortality, are reviewed in a group of 49 patients.Surgery in this group was performed with three peri‐operative deaths. Three patients required re‐operation due to the failure of repair; one patient within one month of surgery and the others at 6.5 and 9 years. All patients improved symptomatically following mitral repair.This series demonstrates that the repair of posterior leaflet prolapse can be performed in all patient age groups with low mortality and morbidity rates. A low incidence of re‐operation for failure of repair and other complications related to valve surgery can be anticipated. (Aust NZ J Med 1987; 17: 491–494)
USEFULNESS OF ESTIMATING INDIVIDUAL PHARMACOKINETIC DATA FOR AMINOGLYCOSIDE THERAPY IN SERIOUSLY ILL PATIENTS
Authors: DENARO C. P. , RAVENSCROFT P. J. 
Published: March 2008

Abstract This study proposes the use of individual pharmacokinetic parameters to predict effective dosages of aminoglycosides for patients with serious infections. Parameters were calculated for 51 patients using a one‐compartment model. This model required a trough and three postinfusion aminoglycoside concentrations from each patient, as well as least squares linear regression. A total of 56 dosing regimens (37 gentamicin, 19 tobramycin) were predicted from these parameters and the efficacy of this approach was examined by comparing the predicted peak (8 mg/l) and trough (1.5 mg/l) concentrations with the observed peak and trough concentrations measured 24 h later. Aminoglycoside concentrations in serum were measured using a fluorescence polarisation immunoassay.Parameters varied widely, as the following ranges demonstrate: Volume of distribution 0.16–0.52 Ukg; clearance 0.04–0.17 I/kg/h; half‐life 1.l‐5.3 h. The doses predicted ranged from 3.2–16.9 mg/kg/day, with an average of 8.6 (standard deviation [SD] 3.4) mg/kg/day. The measured peak (mean 7.5; SD 1.6) and trough (mean 1.95; SD 0.57) concentrations closely approximated the predicted levels. The equations used underestimated trough concentrations mainly because of aminoglycoside accumulation. The changing pharmacokinetic parameters for each patient meant that regular drug assays were still required to fine‐tune the dosing regimen. Two patients (4%) developed significant nephrotoxicity. Ototoxicity was not assessed.We conclude that individual pharmacokinetic data for aminoglycoside therapy can be used effectively to predict dosages for desired concentrations in seriously ill patients. The dose required was on average 1.5–2 times the normal recommended dosage. (Aust NZ J Med 1987; 17: 526–531).
AUTOIMMUNE HEMOLYTIC ANEMIA: CURRENT CONCEPTS
Authors: GIBSON JOHN 
Published: March 2008

AbstractAutoimmune hemolytic anemia (AIHA) is one end of a spectrum of clinical and serological disorders resulting from an autoimmune attack against red cells. Although the etiology of this disorder is far from firmly established, the pathogenesis of red cell destruction by the effector mechanisms of the immune system is well characterised and correlates well with the clinical and serological features of this disorder. Direct antiglobulin test (DAGT) negative AIHA, production crises, AIHA in children and following alpha methyldopa therapy are subgroups of AIHA which have recently been described or more clearly defined and understood. The addition of high dose immunoglobulin and danazol as well as the potential use of more novel approaches to the traditional triad of corticosteroids, splenectomy and immunosuppressive agents has expanded and increased the flexibility of the therapeutic options in this disorder.
CARDIAC ARREST – A MANIFESTATION OF 5‐FLUOROURACIL CARDIOTOXICITY
Authors: MILLWARD M. J. , GANJU V. , BUCK M. 
Published: March 2008

AbstractWe report a case of cardiac arrest occurring during an infusion of 5‐fluorouracil where electrocardiograms suggested coronary artery spasm as the underlying event. Treatment with vasodilators and diltiazem, proved effective. This clinical presentation of 5‐fluorouracil cardiotoxicity has not previously been described.
THE EFFECT OF DIETS CONTAINING FISH AND FISH OILS ON DISEASE RISK FACTORS IN HUMANS
Authors: GIBSON R. A. 
Published: March 2008

AbstractFish and fish oils are rich in omega 3 polyunsaturated fatty acids which are capable of acting as both a source of active eicosanoids and as inhibitors of synthesis of eicosanoids from arachidonic acid by a variety of human cells. There is an extensive literature on the role of omega 3 polyunsaturates in ameliorating the risk factors associated with coronary heart disease, including both atherosclerotic and thrombotic factors. In addition, there is a limited number of studies which report the results of trials testing the effects of fish oils on other clinical conditions including diabetes, arthritis, migraine and psoriasis. There appears to be sufficient evidence to suggest that patients at risk from heart disease could benefit from low doses (1–6 g/day) of fish oil in conjunction with a prudent diet.
EOSINOPHILIC ENTERITIS – A RECENT NORTH QUEENSLAND EXPERIENCE
Authors: CROESE T. J. 
Published: March 2008

Abstract:Thirty‐three patients have been investigated in Townsville between 1983 and 1987 with eosinophilic enteritis. All were Caucasian and had been well prior to this illness. Twenty‐six had similar presentations with episodic and transient abdominal pain often with features of small bowel obstruction. Four patients presented with pain and diarrhoea, two with chronic diarrhoea and one with recurrent melena. All patients at some stage during their illness developed high peripheral blood eosinophil counts, mean value 2096/mm3. Nine patients had laparotomies. The disease typically involved a short segment of ileum or jejunum with thickening and induration. The histology of the four resected specimens demonstrated a transmural inflammation with edema and an intense eosinophilic infiltrate. A solitary adult hookworm was identified in one patient adherent to the mucosa of the resected bowel. Each of the 19 patients treated with antihelminthic drugs responded promptly. Recovery was accompanied by a return to normal peripheral blood eosinophil counts. This paper reports an unusual form of eosinophilic enteritis thought due to a parasitic infection. The diagnosis should be considered in patients from North Queensland presenting with abdominal pain and eosinophilia. Laparotomy should be delayed pending a trial of conservative therapy with mebendazole.
FIFTY YEARS OF MIGRAINE RESEARCH
Authors: Lance James W. 
Published: March 2008

SummaryThe prevalence of ice‐pick pains and ice‐cream headache in migrainous patients and their localisation to the habitual site of migraine headache, suggest that segments of the central pain pathways remain hyperexcitable between spontaneous attacks. Excessive afferent stimulation (flashing lights, noise, strong perfumes) or hypothalamic changes resulting from emotion, stress or the operation of some internal clock may set in motion brainstem mechanisms, including spontaneous unilateral or bilateral discharge of pain pathways.Studies in the experimental animal have shown that certain monoaminergic brainstem nuclei can influence the cerebral circulation unilaterally and that they and the trigeminal system can induce a reflex dilatation of the external carotid circulation. Descending pathways from the same brainstem nuclei cause the adrenal gland to secrete noradrenaline, which in turn can release serotonin from blood platelets. Free serotonin may become adsorbed to the arterial wall, thus increasing sensitivity to pain, augmenting afferent input and adding a pulsating quality to migrainous pain.Both neural and vascular components of migraine implicate monoamines, specifically noradrenaline and serotonin, as neurotransmitters and humoral agents. The recent pharmacological classification of serotonin (5HT) receptors indicates that agonists of a subset of the 5HT1 receptor and antagonists of 5HT2 receptors are most likely to be helpful in the treatment of migraine.
SOME URINARY TRACT DISEASE IN AUSTRALIAN ABORIGINAL INPATIENTS IN 1980
Authors: ASSUMPCAO C. 
Published: March 2008

AbstractFour hundred and ninety‐three patients were admitted to the Royal Darwin Hospital in 1980 with urinary tract disease. Aboriginals had an increased incidence (p < 0.005) of urinary tract infection and glomerulonephritis (p < 0.001) compared with non Aboriginals. Aboriginals with post‐streptococcal glomerulonephritis tended to grow Group A Beta hemolytic streptococci from their skins, non Aboriginals tended to grow it from their throats. Aboriginals had a lower incidence of urolithiasis (p<O.OOl). There was no difference in the incidence of benign prostatic hypertrophy between the two populations.
LACK OF CROSS SENSITIVITY BETWEEN CAPTOPRIL AND ENALAPRIL
Authors: JACKSON B. , MAHER D. , MATTHEWS P. G. , McGRATH B. P. , JOHNSTON C. I. 
Published: March 2008

AbstractOral inhibitors of angiotensin converting enzyme (ACE) now have an established place in the treatment of hypertension and heart failure. Captopril, the first of these agents, was initially used in high doses and was associated with adverse effects including proteinuria, skin rash and taste disturbance. We report 11 patients who developed side effects during captopril therapy (proteinuria two, rash four, taste disturbance four and taste disturbance with rash one) who were subsequently treated with enalapril, a second generation angiotensin converting enzyme inhibitor. Proteinuria did not recur in either patient, skin rash resolved in all five cases and taste disturbance resolved in four of five duringenalaprii therapy. We conclude that the side effects of proteinuria, skin rash and taste disturbance are consequences of captopril idiosyncrasy rather than inhibition of the angiotensin converting enzyme. The reported incidence of these side effects with the current recommended dosage of captopril is low.