bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for repeat attendance at hospital emergency departments among adults and children with asthma
Authors: Wakefield M. , Staugas R. , Ruffin R. , Campbell D. , Beilby J. , McCaul K. 
Published: March 2008

Abstract Background: Acute asthma attacks are frequent causes of attendance at hospital Emergency Departments (EDs) and a subgroup of these patients repeatedly present for such treatment. Aims: This study sought to characterise patients who were repeat attenders at EDs, to assist the targetting of appropriate future interventions aimed at reducing avoidable presentation. Methods: A cross‐sectional survey was undertaken of patients presenting with an asthma attack to the EDs of six teaching hospitals in Adelaide, South Australia between 14 May and 30 June 1994. Patients were interviewed within six weeks of their attendance about aspects of their asthma history, severity, medications, self‐management, attitudes and environment. Repeat attenders, defined as two or more visits over the course of the preceding year, were compared with those who reportedly attended on one occasion only, using logistic regression analyses. Results: Sixty‐two per cent of 272 patients aged under 15 years and 40% of 165 patients aged 15 years or more reported having attended two or more times over the course of the preceding year. Among adults, the variables independently associated with repeat attendance principally related to asthma severity. Among children, repeat attendance was associated with parental attitudinal variables relating to appraisal of their child's asthma severity, management of asthma attacks and parental worry. Conclusions: The factors underlying repeated presentations at EDs differ between adults and children and interventions to minimise avoidable presentation will require different emphasis for these patient subgroups.
High density lipoprotein (HDL) particle composition in patients with end stage renal failure (ESRF) on chronic dialysis
Authors: Lee P. , O'Neal D. , Murphy B. , Best J. 
Published: March 2008

Abstract Background: Hypertriglyceridaemia, low high density lipoprotein (HDL) cholesterol level and reduced LDL particle size are the major features of uraemic dyslipidaemia. They are also found in the Insulin Resistance Syndrome. Aim: To examine alterations in HDL composition in patients on chronic dialysis and their relationship with insulin resistance. Methods: HDL particle size was determined in 33 patients on chronic haemodialysis (HD), 27 on chronic ambulatory peritoneal dialysis (CAPD) and 32 control non‐diabetic subjects (C) without renal disease by non‐denaturing 3–30% polyacrylamide gradient gel electrophoresis. A weighted HDL particle size score was calculated taking into account both HDL particle size and percentage total HDL protein concentration of each HDL band of the individual. lipid and apolipoliprotein concentrations were determined in HDL2 and HDL3 particles obtained by sequential ultracentrifugation. In a subset of 24 control subjects and 22 subjects on HD, insulin sensitivity was also determined by an intravenous glucose tolerance test (IVGTT). Results: HDL particles were found to be more triglyceride enriched and apoAI depleted in subjects on HD even though plasma triglyceride level was highest in patients on CAPD. Five subpopulations of HDL particles were identified by gradient gel electrophoresis in all subjects combined. In the subgroup of subjects who underwent IVGTT, the weighted HDL particle size score correlated positively with HDL cholesterol level 0=0.6, p<0.0005), LDL particle size (r=0.47, p>0.001), and insulin sensitivity (r=0.48, p<0.001), and negatively with plasma triglyceride level (r=‐0.37, p<0.01). Conclusions: We conclude that even though HDL cholesterol is reduced to a similar level in subjects on both forms of dialysis for end stage renal failure, abnormalities of HDL composition are more marked in subjects on HD. Reduction in HDL particle size is linked with insulin resistance and accompanies reduction in LDL particle size and hypertriglyceridaemia.
The use of pamidronate in hypertrophic pulmonary osteoarthropathy (HPOA)
Authors: Speden D. , Nicklason F. , Francis H. , Ward J. 
Published: March 2008

Abstract Background: Hypertrophic pulmonary osteoarthropathy (HPOA) secondary to bronchogenic carcinoma can be associated with severe, disabling pain which is not always responsive to conventional treatment. Aim: To report on the use of pamidronate to control resistant pain in HPOA in three cases. Methods: A retrospective review of reported pain, chest X‐ray and radionuclide bone scans was made. Results: Pain relief was achieved in all three cases together with reduced radiolabel uptake in two cases. Conclusions: Pamidronate appears to be an effective therapy for HPOA. Further investigation is warranted.
Hyperprolactinaemia in males
Authors: Walsh J. P. , Pullan P. T. 
Published: March 2008

Abstract Background: The literature suggests that men with prolactinomas typically present with pressure effects of large pituitary tumours and/or the clinical features of hypogonadism. A definitive study of the clinical features of hyperprolactinaemia in males is, however, lacking. Aims: To identify the clinical, biochemical and radiological features of hyperprolactinaemia in males. Methods: Retrospective review of tlie case notes of 53 adult males with prolactinoma or idiopathic hyperprolactinaemia diagnosed 1980–1995. Results: The mean age of the patients was 41 years (range 19–75). The presenting symptom was endocrine in nature in 57% of patients (loss of libido/potency 47%, gynaecomastia 6%, galactorrhoea 2%, sparse beard growth 2%), pressure effects of pituitary tumour in 28% (headache 13%, visual loss 13%, diplopia 2%), while 15% of patients presented incidentally. On physical examination, galactorrhoea was present in 8% of patients, gynaecomastia in 23
Haemopoietic stem cell transplantation in Australia, 1992–95: a report from the Australian Bone Marrow Transplant Recipient Registry
Authors: Atkinson K. , Nivison‐Smith I. , Hawkins T. 
Published: March 2008

Abstract Background: Bone marrow and blood stem cell transplantation is increasingly utilised in Australia. The Australian Bone Marrow Transplant Recipient Registry was founded in 1991 to record this activity. Aim: To describe allogeneic and autologous bone marrow and blood stem cell transplantation in Australia during 1992‐95. Methods: Each bone marrow transplant programme in each State of Australia has been invited to contribute information to the Registry and all do. A single information sheet is compiled by the data manager in each programme when a marrow transplant is performed and mailed to the Registry office. An annual follow‐up sheet is then mailed from the Registry to the contributing centre at the anniversary of each individual transplant. Results: Australia‐wide, haemopoietic cell transplants have increased in number from 478 in 1992 to 681 in 1995. The number of hospitals contributing registrations to the Australian Bone Marrow Transplant Registry has increased from 20 in 1992 to 25 in 1995. The main reason for the increased number of transplants is an increase in the number of autologous blood stem cell transplants including an increase in the number of staged autologous blood stem cell transplants. The most common indication for a single autologous transplant in 1995 was non‐Hodgkin's lymphoma and for a staged autologous transplant was breast cancer. The commonest indication for an allogeneic family member transplant in 1995 was acute myeloid leukaemia and for an allogeneic unrelated donor transplant, acute lymphoblastic leukaemia. The three year actuarial overall survival for patients receiving a haemopoietic stem cell transplant between 1992 and 1994 was 54% with a median follow‐up time of 2.04 years. Recurrence of the underlying malignant disease was the main cause of death during both the first and second year post transplant after both allogeneic (13.3% and 8.3%) and autologous (22.1% and 11.8%) transplantation. Treatment‐related mortality was 13.1% after allogeneic transplantation and 3.3% after autologous transplantation.
Heart failure ‐ outlooks and strategies for treatment
Authors: Keogh Anne 
Published: March 2008

AbstractThe outlook in heart failure patients with a dilated cardiomyopathy has improved dramatically over the past ten years. The availability of many excellent drugs apart from angiotensin II converting enzyme inhibitors (ACEI) has contributed to this. The best current survival rates reported are, however, in association with deliberate optimisation of haemodynamic parameters and incorporation of functional testing to monitor disease progression. These practises could well be adopted more widely in Australia and New Zealand. Surgical options for heart failure continue to expand, but apart from heart transplantation, remain somewhat experimental.
Improving the results of coronary angioplasty
Authors: Aroney Con N. 
Published: March 2008

AbstractCoronary angioplasty has changed dramatically in the past three years with major reductions in suboptimal results and restenosis rates, and improvements in safety, efficacy and cost‐effectiveness. Intracoronary stent implantation with optimisation of strut expansion and the abandonment of anticoagulants after deployment, have led to less entry‐site complications, facilitated early hospital discharge, virtually abolished subacute stent thrombosis and resulted in a 50% reduction in target vessel revascularisation. Adjuvant medical treatment with anti‐platelet agents, including glycoprotein IIb/IIIa receptor inhibitors, improves the safety of angioplasty and may further reduce the restenosis rate. Selective use ofdebulking devices has extended the indications for angioplasty. High resolution fluoroscopy, quantitative coronary angiography and intracoronary ultrasound leading to improved diagnosis, equipment selection and treatment have contributed to better outcomes. Further clinical trials will compare angioplasty and stent implantation with coronary bypass surgery in patients with multivessel coronary disease, and may extend the indications for percutaneous transluminal coronary angioplasty (PTCA) to selected patients with three vessel disease.
Seroprevalence of Helicobacter pylori in a longitudinal study of New Zealanders at ages 11 and 21
Authors: Fawcett J. P. , Shaw J. P. , Brooke M. , Walker A. , Barbezat G. O. 
Published: March 2008

Abstract Background: Helicobacter pylori seroprevalence increases with age in adult life but spontaneous reversion may occur in childhood and adolescence. Aims: To determine the seroprevalence of H. pylori in a longitudinal study of New Zealanders at ages 11 and 21. Methods: Serum from members of the Dunedin Multidisciplinary Health and Development Study (DMHDS) at age 11 (n=561; 303 males, 258 females) and 21 (n=785; 413 males, 372 females) was tested for H. pylori antibodies. A large proportion of those tested at age 11 was retested at age 21 (n=465; 262 males, 203 females). Serological status was examined in terms of gender, socioeconomic status (SES) and self‐reported use of antibiotics. Results: The seroprevalence of H. pylori decreased by 38% from 6.6% (37/561) at age 11 to 4.1% (32/785) at age 21. Seroprevalence at age 11 was not associated with gender or SES. For those tested at both ages, the drop in seroprevalence from 6.7% to 4.1% was statistically significant (t=2.57, ρ<0.01, paired t‐test) and was much greater in females (71%) than males (12%). Of the 31 seropositive individuals at age 11, 17 (six males, 11 females) seroreverted and self‐reported antibiotic use in the year preceeding age 21 was more common in females (eight/11) than males (zero/six). Of die 434 seronegative individuals at age 11, only five (four males, one female) had seroconverted at age 21. Conclusions: Seroprevalence in the DMHDS declined from age 11 to 21 predominantly in females. The decline involved a greater rate of seroreversion and lower rate of seroconversion in females than males.
Australian encephalitis in the Northern Territory: clinical and epidemiological features, 1987–1996
Authors: Burrow J. N. C. , Whelan P. I. , Kilburn C. J. , Fisher D. A. , Currie B. J. , Smith D. W. 
Published: March 2008

Abstract Background: The last epidemic of Australian encephalitis occurred in 1974. Since then, cases have been reported from the Kimberley of Western Australia (WA). Aims: To describe the epidemiology and clinical features of Australian encephalitis in the Northern Territory (NT) of Australia. Methods: Review of cases of Australian encephalitis presenting to Royal Darwin Hospital from 1987–1996 and review of sentinel chicken surveillance for Australian encephalitis viruses. Results: Sixteen patients were identified; ten from the NT and six from WA. Cases occurred in the years 1987, 1988, 1991 and 1993. Infection was acquired throughout northern NT below latitude 20°S in the months March to July. All infections were due to Murray Valley encephalitis (MVE) virus. Eleven of the patients were children. Distinguishing features were spinal cord and brainstem involvement and the absence of seizures in adults. CT scanning was normal and EEG showed no focal activity. Five died (31%) and four (25%) have residual neurological disability. Sentinel chicken surveillance since 1992 shows yearly seroconversion to MVE virus throughout northern NT; human cases occurred simultaneously with chicken seroconversion in 1993. Conclusions: Australian encephalitis is endemic in the NT; the areas at risk are norm of Tennant Creek. Outbreaks are seasonal and occur every few years. Young children are most at risk. Mortality and morbidity are high. Prevention of disease is by avoidance of mosquito exposure and vector control measures.
Increased survival in patients diagnosed with Hodgkin's disease in Tasmania, 1972–1992
Authors: Strickland A. H. , Arthur G. E. , Matthews J. P. , Beresford J. A. , Lowenthal R. M. 
Published: March 2008

Abstract Background: It has been shown that in certain populations the prognosis of Hodgkin's disease (HD) has improved markedly since the late 1960s. This has not been formally demonstrated in an Australian population. Aims: To review all patients in Tasmania diagnosed with HD between 1972 and 1992, and to ascertain whether variation in survival is evident in this group over this period. Methods: Tasmanian patients with HD diagnosed from 1978 to 1992 were identified retrospectively from the Tasmanian Cancer Registry database. Identification of those diagnosed prior to 1978 was obtained from a previously published data set. To be valid for inclusion, subjects were required to have been diagnosed between January 1972 and December 1992, enabling a minimum four year follow up period. Survival was assessed by contacting patients' medical practitioners and by examining the most current electoral roll, medical records, and the register of births, deaths and marriages. Univariate and multivariate analyses were performed of the influence on prognosis of age, sex, histological subtype and epoch of diagnosis; information concerning stage of disease was not available. Results: During the period of this study 206 patients were newly diagnosed as having HD. Comparisons of cases diagnosed in the successive seven‐year epochs 1972–8, 1979–85 and 1986–92 revealed a significant increase in survival duration (ρ=0.023), with ten year survival rates of 46%, 55% and 73% respectively. In a multivariate analysis adjusting for age, sex and histology, each successive epoch was associated with an estimated 28% reduction in the death rate relative to the preceding epoch (ρ=0.022). Conclusions: There was a significant improvement in the survival duration of patients diagnosed with HD in Tasmania over the period 1972–92, which was possibly due to a combination of better diagnostic techniques and more effective treatments.
The effect of test duration on the sensitivity and specificity of ultra‐rapid urease test for the detection of Helicobacter pylori infection
Authors: Ho K. Y. , Kang J. Y. , Lim T. P. , Yeoh K. G. , Wee A. 
Published: March 2008

Abstract Background:‘Home made’ ultra‐rapid urease tests are used extensively in the Asia Pacific region. Data on the reliability of these ‘home made’ tests are limited. Aims: To evaluate the effect of test duration on the sensitivity and specificity of a self‐prepared biopsy urease test for the detection of Helicobacter pylori. Methods: Using histology as the ‘gold standard’, the effect of test duration on the sensitivity and specificity of a self prepared urease test for the detection of H.pylori was evaluated in 411 consecutive patients undergoing upper gastrointestinal endoscopy. Results: Histology was positive for H.pylori in 217 of the 411 patients (52.8%). Within 24 hours of retrieving the specimen, 189 (87.1%) of the histology positives and 174 (89.7%) of the histology negatives were correctly identified by the urease test. Of the H.pylori positives, 72.0%, 81.0%, 89.9% and 100% were detected by the urease test within one minute, five minutes, three hours and 24 hours respectively. Thus, sensitivities of the urease test at one minute, five minutes, three hours and 24 hours were 62.7%, 70.5%, 78.3% and 87.1% respectively. Corresponding figures for the specificity were 93.8%, 93.3%, 92.3% and 89.7% respectively. Using a receiver‐operating characteristic curve, an optimal combination of sensitivity and specificity was obtained when the urease test was read at 24 hours. Conclusions: While the biopsy urease test was positive in most cases within a minute, better results could be obtained if the test continued to be read over a 24 hour period.
Characteristics and prognosis of KI‐1 positive anaplastic large cell lymphoma in Asians
Authors: Lee S. C. , Kueh Y. K. , Lehnert M. , Chong S. M. , Tan Y. O. , Wong J. 
Published: March 2008

Abstract Background: Ki‐1 positive anaplastic large cell lymphoma is a rare type of non‐Hodgkin's lymphoma (NHL), and has not been extensively described in Asian patients. Aim: To evaluate the clinical characteristics, prognostic factors and treatment outcome of Ki‐1 positive lymphoma in an Asian community. Methods: A retrospective analysis of all patients with CD30 antigen positive anaplastic large cell lymphoma from 1987 to 1996 in a single institution. Results: Of 218 patients with NHL, ten (5%) were identified with Ki‐1 positive anaplastic large cell lymphoma. Eight were Chinese, two Indians. The male: female ratio was 1.5:1, and the median age was 32 years. Seven patients presented with B‐symptoms, and five had stage III/IV disease. The majority (seven of ten) was low‐or low‐intermediate risk according to the International Prognostic Index (IPI). Four out of five cases immunophenotyped showed a T‐cell origin. Five out of eight patients who received first‐line combination chemotherapy achieved a complete remission. Two relapsed, with one being re‐induced into a durable second remission. One patient with recurrent cutaneous lymphoma received solely radiotherapy and was disease‐free at 20+ years from diagnosis. At analysis, two patients had died, five were disease‐free at four, 27, 78, 89 months and 20 years respectively, and three were alive with disease. The IPI appears to have prognostic significance. Conclusion: Incidence and clinical characteristics in our Asian patients were similar to those described in Western populations. The IPI appears to have prognostic relevance. In approximately one‐third of patients, long term survival can be achieved with standard treatment.
Comorbidities and prediction of length of hospital stay
Authors: Roe C. J. , Dodich N. , Kulinskaya E. , Adam W. R. 
Published: March 2008

Abstract Background: Variability in length of stay (LOS) within Australian National Diagnosis Related Groups (AN‐DRGs) reflects clinical heterogeneity in age, severity of illness, complications and comorbidities. Aim: To develop a clinically based score which measures patient morbidity and which will better predict LOS compared to existing methods. Methods: ICD‐9‐CM codes of diseases and procedures were allocated to one of 23 body system categories to calculate the body burden of disease (BBD) score. Evaluation of BBD in predicting LOS was performed using multiple regression and analysis of variance with a data set of 34,079 cases from 75 AN‐DRGs from three Victorian hospitals. Results: Adding BBD and age improved prediction of LOS by 27.2% in AN‐DRG version 1.0 and by 17.5% in AN‐DRG version 3.1. When using average inlier LOS for AN‐DRG, BBD and age improved prediction of LOS by 44.6% and by 14.8% in AN‐DRG version 1.0 and version 3.1 respectively. Deaths were positively related to BBD. Conclusions: BBD is a simple quantitative measure of extent of disease that improves current methods in accounting for variability in LOS.
Safety of plasmapheresis in the treatment of neurological disease
Authors: Vucic S. , Davies L. 
Published: March 2008

Abstract Background: Plasmapheresis is used as a treatment modality in several neurological disorders. Adverse reactions relating to vascular access, replacement fluid and anticoagulant use have been reported. Aims: To establish the incidence of complications of therapeutic plasmapheresis in the treatment of neurological diseases. Methods: A retrospective study was performed, in which case records of patients undergoing plasmapheresis for neurological indications between 1 April 1992 and 1 September 1996 were reviewed for fatalities and adverse reactions related to vascular access, transmission of Hepatitis B or C or Human Immunodeficiency Virus (HIV), fluid imbalance, allergic or febrile reactions, haematological complications, machine failure and citrate toxicity. Results: In the study period, 1283 plasmapheresis procedures were performed on 73 patients with neurological disease. There were no fatalities, no cases of Hepatitis B or C or HIV transmission, no allergic or febrile reactions, thrombosis, bleeding diathesis or severe citrate toxicity. Infections related to venous access occurred in 0.5 per cent of procedures with septicaemia in 0.2 per cent of procedures (4.1% of patients). Less serious complications included hypotension in 1.2 per cent of procedures (11% of patients) and citrate toxicity manifesting as nausea, vomiting, cramping or paraesthesia in 1.2 per cent of procedures. Machine failure occurred in 0.2 per cent of procedures. Conclusions: Plasmapheresis is a safe procedure when performed for neurological indications by experienced personnel in a large pheresis unit. The most frequent adverse event is infection of the venous access site.