bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human fascioliasis successfully treated with triclabendazole
Authors: Laird P. P. , Boray J. C. 
Published: March 2008

Abstract:Fascioliasis, caused by the common liver fluke Fusciolu hepatica, is an endemic infection in sheep and cattle in many parts of Australia. Infections in humans in Australia have been reported infrequently and the most appropriate therapy for human fascioliasis remains to be determined. This case report describes a patient with the infection unsuccessfully treated with multiple high doses of praziquantel, mebendazole or albendazole. The infection was successfully eliminated by the administration of triclabendazole in two single doses of 900 mg (12 mg/kg) two days apart. No side effects were observed after the treatment. Based on our experience and that recently reported in the literature, triclabendazole may be regarded as the drug of choice for the treatment of human fascioliasis. (Aust NZ J Med 1992; 22: 45–47.)
A comparison of Abrams and Raja pleural biopsy needles
Authors: O'Connor S. , Yung T. 
Published: March 2008

Abstract:The diagnostic yield of the recently developed Raja pleural biopsy needle was compared to that of the Abrams needle. Paired biopsies were obtained in 12 cases. In two cases the Raja yielded a diagnosis of malignancy when the Abrams was negative, and in two other cases (one TB and one leukaemia) the Raja provided more specific diagnostic material. There were no cases where the Abrams provided information not present in a Raja biopsy. In our hands, the Raja pleural biopsy needle gave a diagnostic yield superior to the Abrams needle.
Polymerase chain reaction in detection of CMV DNA in renal allograft recipients
Authors: Lee W. T. , Antoszewska H. , Powell K. F. , Collins J. , Doak P. B. , Williams L. C. , Munn S. , Verran D. , Croxson M. C. 
Published: March 2008

Abstract:This study investigates the w of polymerase chain reaction (PCR) in comparison with viral culture and serology for monitoring of cytomegalovirus (CMV) infection in 21 consecutive renal allograft recipients mated with a quadruple immunosuppression protocol. In addition, an attempt is made to explore the significance of quantitation of CMV signals obtained from peripheral blood leucocytes.CMV infection developed in 16 patients with seven of the patients having organ involve mat. All of these 16 patients bad a fourfold rise in antibody as well as positive identification of CMV DNA in peripheral blood leucocytes by PCR. Blood viral cultures were negative in two of these patients. All five patients who remained PCR negative also remained culture negative with no antibody change. PCR detected CMV infection on average 15 days and 20 days earlier than viral culture and serology respectively. All except one of the patients with CMV organ involvement had an initial peak of CMV DNA followed by prolonged carriage of detectable CMV. The majority of patients with fever only or asymptomatic CMV infection had a transient peak of CMV DNA.A high incidence of CMV disease with organ involvement occurred in seronegative recipients of kidneys from seropositive donors (3/5) and in seropositive recipients Of kidneys from seronegative donors (3/7). OKT3 was associated with a higher incidence of CMV organ involvement compared to Antilymphocytic globulin (3/5 v 4/16) but there was a higher incidence of CMV mismatched patients in the OKT3 created group.This study confirmed the high incidence of CMV infection in renal allograft recipients on an aggressive immunosuppression regimen. The detection of CMV DNA in peripheral blood leucocytes by PCR is a sensitive and specific marker of CMV infection. It enables an earlier diagnosis of CMV infection. The precise role for monitoring of CMV DNA levels is yet to be fully defined.
Coronary artery disease in Asians
Authors: Rajadurai J. , Arokiasamy J. , Pasamanickam K. , Shatar A. , Lin O. Mei 
Published: March 2008

Abstract:From available studies, there appears to be a racial preponderance of coronary artery disease (CAD) among Indians when compared to other ethnic groups. We found that this racial difference exists even in a young Asian population with premature atherosclerosis. In this small series, these racial differences could not be explained by the commonly known risk factors for coronary artery disease – smoking, hypertension, diabetes and hypercholesterolaemia, findings similar to those found in older patients elsewhere. Only fasting triglyceride levels were significantly higher among young Indians compared to non Indians (p <0.02) although the importance of this finding as a risk factor for CAD remains controversial. The majority of these young patients were treated medically and their one year survival was good.
A mucosal barrier of gastric surfactant identified in the human stomach
Authors: Hills B. A. 
Published: March 2008

Abstract:Using a special furation procedure avoiding glutaraldehyde, an oligolamellar lining has been demonstrated by electronmicroscopy on the luminal surface of the human stomach and, with more lamellations, on the epithelial surfaces of oxyntic ducts and parietal cells.These results indicate that, in the human stomach, there is indeed a gastric mucosal barrier consisting of a multi‐laminated structure of surface‐active phospholipid (SAPL). This gastric surfactant is probably produced in parietal cells and surface mucus cells in which lamellar bodies and some prominent multi‐focal lamellated agglomerates of SAPL were prevalent. These findings of a gastric mucosal barrier similar in structure and function to a very thin polyethylene liner are compatible with previous information about the hydrophobicity of the gastric mucosa, the clinical correlation of hydrophobicity with peptic ulceration and the action of barrier breakers (including Helicobacterpylorr). It is speculated that the administration of exogenous gastric surfactant in various forms may be effective for inexpensive long‐term maintenance of the ulcer patient treated acutely by more conventional means.
Biological markers of alcoholism
Authors: Whelan GREG 
Published: March 2008

Abstract:The roles of two categories of biological markers — those relating to alcohol consumption and those relating to the risk of developing alcohol related problems ‐ are reviewed. Platelet Mono‐amino oxidase levels are low in individuals with a strong inheritance of their drinking problem (Cloninger Type II alcoholics).Elevated gamma‐glutamyl transpeptidase (GGT) levels identify regular heavy drinkers with a sensitivity between 40–60%. Mean corpuscular volume (MCV) has a high specificity (95%) and is useful in detecting regular heavy drinkers in the ambulatory care population if other causes of an elevated MCV can be included.Currently there are no laboratory tests with adequate sensitivity to be used as screening tests for alcoholism. (Aust NZ J Med 1992; 22: 209–213.)
The role of dipyridamole in addition to low dose aspirin in the prevention of occlusion of coronary artery bypass grafts
Authors: Agnew T. M. , Brandt P. W. T. , French J. K. , Kerr A. R. , Neutze J. M. , Webber B. J. , Whitlock R. M. L. , Rutherford J. D. 
Published: March 2008

AbstractOne hundred and one subjects were randomised to receive either aspirin 100 mg or aspirin 100 mg + dipyridamole 300 mg daily before undergoing coronary bypass surgery. The drugs were commenced at least 36 hours before operation and patients were followed for one year. There were three perioperative deaths and 37 withdrawals, of which 14 were drug related (aspirin four, aspirin + dipyridamole ten). Cineangiocardiograms at nine weeks and one year showed vein graft patency rates of 93% and 87% for subjects treated with aspirin alone; and 90% and 89% in those who received aspirin + dipyridamole. During the follow‐up period 14% of 232 coronary lesions in the aspirin treated group advanced by more than two grades compared with 15% of 315 lesions in the aspirin + dipyridamole group.The study did not establish superiority of one regimen over another in terms of graft patency or progress of lesions in native vessels. However, low dose aspirin was better tolerated than combination therapy. (Aust NZ J Med 1992; 22: 665ndash;670.)
Medical care and case fatality from myocardial infarction and coronary death in Newcastle and Perth
Authors: Dobson A. J. , Jamrozik K. D. , Hobbs M. , Heller R. F. , Steele P. L. , Parsons R. , Thompson P. 
Published: March 2008

Abstract:Coronary mortality rates are significantly higher in Newcastle than Perth. In this paper we examine the extent to which this might be due to differences in medical treatment and case fatality.Population‐based disease registers were used to identify all cases of non‐fatal definite myocardial infarction (MI) and coronary death in people aged 25–64 years in the study populations between July 1988 and June 1990.Case fatality (at 28 days from onset of symptoms) was not significantly different between the centres. Thrombolytic therapy was used for one third of all hospitalised events in both centres. Other drugs of proven benefit were, however, used more often in Perth than in Newcastle. For example, during hospitalisation 74% of patients in Perth received β‐blockers compared with 41% in Newcastle (difference=33%, 95% confidence interval (CI): 28%, 37%) and 85% of patients in Perth compared with 72% in Newcastle received aspirin (difference313%, 95% CI: 9%, 17%). Median lengths of stay in a coronary care unit (CCU) and total hospital stay were one day shorter in Perth.As case fatality was similar, the differences in mortality rates can be attributed mainly to differences in attack rates. Greater use of cardio‐active drugs in Perth apparently did not result in improved short‐term outcome although potential long‐term benefits cannot be judged yet. (Aust NZ J Med 1993; 23: 12–18.)
Sheehan's syndrome: clinical profile, pituitary hormone responses and computed sellar tomography
Authors: Dash R. J. , Gupta V. , Suri S. 
Published: March 2008

Abstract:Twenty patients with the typical clinical presentation of Sheehan's syndrome were studied. All had a severe degree of hypopituitarism. The circulating mean basal levels of thyroid hormones, Cortisol and prolactin were significantly lower (p< 0.05 to <0.02) compared to those in 50 age matched controls. The provoked pituitary responses to combined pituitary stimulation in 13 patients were markedly lower (p <0.02 to <0.001) than those in ten age matched control subjects. Sellar computed tomography revealed an empty sella in all the patients; partial in five and complete in the remaining. A secondary empty sella is considered a characteristic finding in the classical form of Sheehan's syndrome. (Aust NZ J Med 1993; 23: 26–31.)
Cost effectiveness of radiofrequency catheter ablation in the treatment of symptomatic supraventricular tachyarrhythmias
Authors: Kertes P. J. , Kalman J. M. , Tonkin A. M. 
Published: March 2008

Abstract Background: The recent advent of radiofrequency (RF) catheter ablation as a curative therapy for supraventricular tachyarrhythmias has challenged the role of long term drug treatment, which is essentially a palliative therapy. To date, however, no data have been published on the cost‐effectiveness of RF ablation as compared with drug treatment in the Australian setting. Aims: The study aimed to compare actual and projected costs of these two treatment options in a consecutive group of patients having RF ablation as treatment for symptomatic tachyarrhythmias. Methods: The cost effectiveness of RF catheter ablation was assessed in 26 patients having RF ablation, using a hypothetical model of continued drug therapy in the same group of patients. A ‘cost saving’ criterion was used for cost effectiveness. Actual costs for the RF ablation and for continued drag therapy were based on data from medical records and from the answers to a detailed patient questionnaire. Analysis included costs of prior diagnostic electrophysiology (EP) study (17/26 patients), general anaesthesia (GA: 20/26 patients), post‐ablation echocardiography (10/26 patients), and late follow‐up EP study (7/26 patients). The in‐hospital stay for the RF ablation was two days in all cases, and no patient required implantation of a permanent pacemaker. The RF ablation procedure was successful in 23/26 patients (88.5%) with late recurrence of tachycardia in one patient. After a median follow‐up of nine months, 22/26 patients no longer require antiarrhythmic drug therapy. Results: The mean per patient cost of RF ablation was $4067 in the study group. This reduces to $2546 if prior EP study and GA are excluded. The mean per patient cost of continued medical therapy was $700 per year. Extrapolating over 20 years and allowing for an annual 5% inflation factor, RF ablation becomes cost saving in 5.5 years (3.8 years if prior EP and GA are excluded). Over 20 years, continued drag therapy would be four to five times more expensive than RF ablation in the patient study group. We consider RF ablation to be a cost‐effective alternative to long term drug therapy in patients with supraventricular tachyarrhythmias.
Radiofrequency catheter ablation for paroxysmal supraventricular tachycardia: a report of 135 procedures
Authors: Sathe S. , Vohra J. , Chan W. , Wong J. , Gerloff J , Riters A. , Hall R. , Hunt D. 
Published: March 2008

Abstract
Background:
Paroxysmal Supraventricular Tachycardia (PSVT) is a common condition which until recently has been treated with anti‐arrhythmic drugs or surgery. Radiofrequency (RF) catheter ablation is a new mode of treatment which provides a cure of this condition. Aims:To present our early experience of RF catheter ablation for PSVT.
Methods:
One hundred and thirty‐five procedures were performed in 117 patients. The diagnostic study and therapeutic catheter ablation were performed as a combined electrophysiological procedure in 74 patients (63%). In 58 patients (50%), PSVT was due to Atrio‐ventricular junctional (nodal) re‐entrant tachycardia (AVJRT). Twenty‐five of the 58 patients underwent a fast pathway ablation while 33 had ablation of their slow pathway. The mean number of radio‐frequency pulses delivered was ten for a mean duration of 25 seconds.Radiofrequency ablation of accessory pathways was attempted in 58 patients; pathways were left‐sided in 29 patients, postero‐septal in 21, midseptal in five, Mahaim connection in two, antero‐septal in one and right free wall in one patient. One patient with incessant automatic atrial tachycardia also underwent a successful RF ablation.
Results:
Using RF ablation cure of PSVT was achieved in 90% of patients. Cure of AVJRT was achieved in 95% (55/58) of patients using either fast or slow pathway ablation. Only one patient required permanent pacemaker implantation for Mobitz type I AV block following fast pathway ablation. The overall success rate for ablation of accessory pathways was 85%. There is an operator learning curve for this procedure suggested by the fact that the success rate for accessory pathway ablation at first attempt was 63% in the first 29 patients and 93% in the remaining 29. There was no significant morbidity or mortality during or after the procedure. In a mean follow‐up of nine months in the patients with successful ablation only two patients with AVJRT had a recurrence of documented PSVT. Both these patients had successful repeat RF ablation. Catheter ablation using radiofrequency energy is an effective and safe therapeutic option for patients with symptomatic PSVT. (Aust NZ J Med 1993; 23: 317–324.)
Lipid, lipoprotein and apolipoprotein distributions in an elderly New Zealand population
Authors: Lintott C. J. , Sainsbury R. , Hanger H. C. , Frampton C. , Scott R. S. 
Published: March 2008

Abstract:The aim of this study was to determine the lipid, lipoprotein and apolipoprotein distribution in an ambulant elderly New Zealand population, and to consider the association between these and other variables (including body mass index, diabetes mellitus, and smoking history) with the prevalence of manifest macrovascular disease in a cross‐section analysis.The population sample was randomly selected from the age/sex register of a large urban medical centre in Christchurch, New Zealand. A total of 369 subjects (participation rate 69%) aged 65 years and older were screened for manifest macrovascular disease, diabetes mellitus, smoking status, height and body weight. Levels of plasma total cholesterol, triglycerides, HDL cholesterol, apolipoproteins AI and B, glucose, glycated haemoglobin and fibrinogen were measured. Three way analysis of variance (ANOVA) was used to compare continuous variables across age/sex/macrovascular disease groups.Females had significantly higher levels of total and HDL cholesterol, apolipoproteins AI and B than males. Body mass index showed a significant decrease with increasing age.Macrovascular disease was manifest in 24% of males, and in 26% of females. No direct correlation was seen between any of the measured continuous variables and the presence of macrovascular disease, except for fibrinogen (P<0.05). No significant association was seen between macrovascular disease and smoking status, nor with a diagnosis of diabetes. In females, the frequency of macrovascular disease was significantly higher amongst those with low (<1.00 mmol/L) levels of HDL. (Aust NZ J Med 1993; 23: 162–167.)
Changing results of HLA‐identical sibling bone marrow transplantation in patients with haematological malignancy during the period 1981–1990
Authors: Atkinson K. , Marshall G. , Biggs J. C. , Wilson F. , Concannon A. J. , Young S. , Dodds A. J. , Ashby M. , Milliken S. , Morgan G. , Downs K. , Harkness J. 
Published: March 2008

Abstract:During the years 1981‐90 inclusive 227 patients with haematological malignancy received an HLA‐identical sibling first transplant at St Vincent's Hospital, Sydney. Recipients with acute leukaemia in first remission or chronic myeloid leukaemia in first chronic phase were analysed as good risk, and those beyond these stages, as poor risk patients. Good risk patients transplanted in the years 1986‐90 (n= 52) showed improved actuarial survival (74%) compared to those (n= 58) transplanted during 1981‐85 (37%, p= 0.01). There was a suggestion that leukaemia‐free survival was also improved in those transplanted during the later time period (62% versus 36%, p= 0.07). In contrast, poor risk patients transplanted during 1986‐90 (n=55) appeared to have worse leukaemia‐free survival (15%) compared to those transplanted during 1981‐85 (n= 62) (22%, p = 0.09). The incidence of acute graft‐versus‐host disease (GVHD) grades I‐IV in all patients was 94% in those transplanted during 1981‐85 (n=120) and 86% in those transplanted during 1986‐90 (n=107) (p= 0.002). The incidence of acute GVHD grades II‐IV was 37% during 1981‐83, 20% during 1984‐86, and 28% during 1987‐90 (p= 0.1). The decrease in incidence and severity of acute GVHD correlated with the introduction of the cyclosporin/short methotrexate regimen in our practice. The incidence of cytomegalovirus (CMV) pneumonitis was 18% in 1981‐85, and 11% in 1986‐90 (p= 0.09). In 1989 and 1990 no cases of CMV pneumonitis occurred. The decrease in incidence of CMV pneumonitis correlated with the introduction of prophylactic ganciclovir. The reduction of the transplant‐related complications acute GVHD and CMV pneumonitis has resulted in improved survival for good risk patients, but not for bad risk patients. (Aust NZ J Med 1993; 23: 181–186.)
A comparative study of radionuclide venography and contrast venography in the diagnosis of deep venous thrombosis
Authors: Kilpatrick T. K. , Lichtenstein M. , Andrews J. , Gibson R. N. , Neerhut P. , Hopper J. 
Published: March 2008

Abstract Background: The value of the radionuclide blood pool venogram in detecting deep venous thrombosis (DVT) has to date been inadequately evaluated. This is despite its lower complication rate than the gold standard of contrast X‐ray venography. Aims: To compare the relative accuracy and inter observer variability of radionuclide blood pool and X‐ray contrast venography as well as evaluate previous literature on radionuclide venography. Methods: Prospective comparison of radionuclide and contrast venography was performed in 39 patients. Sensitivity and specificity of radionuclide venography were compared to contrast venography and confidence intervals were measured using standard error calculations. A meta‐analysis of previous studies was also performed. Results: Significant inter observer variation in reports was present in both radionuclide (37%) and contrast (22%) venograms. Using consensus reports sensitivity of radionuclide venography was 87% compared to contrast venography and specificity was 83%. These results are similar to those obtained in previous studies. Furthermore, sensitivity in specificity in the proximal veins were 90% and 92% respectively which were superior to sensitivity and specificity in the distal veins where it was 74% and 90% respectively. Conclusion: The radionuclide venogram appears accurate in the proximal veins and in excluding but not diagnosing distal venous thrombosis. (Aust NZ J Med 1993; 23: 641–645.)
Cryptococcus neoformans in tropical northern Australia: predominantly variant gattii with good outcomes
Authors: Fisher D. , Burrow J. , Lo D. , Currie B. 
Published: March 2008

Abstract Background: Infection with Cryptococcus neoformans is common in the Northern Territory of Australia. Disease is life threatening and treatment is prolonged and often complicated by the need for surgery and difficulties with medical therapy. Aims: To document incidence, demography, risk factors, clinical features and outcomes of infection and to determine differences between gattii and neoformans varieties. Methods: Case records of all patients (n= 35) diagnosed with cryptococcal infection at the Royal Darwin Hospital between 1976 and 1992 were reviewed retrospectively. Current status of patients was ascertained. Variety identification of isolates was determined by growth in canavanine‐glycine‐bromthymol blue agar. Results: Of the 35 patients, 23 had meningitis, ten had pneumonia, one had a dermal infection and one had fungaemia with no obvious focus. Twelve (52%) meningitis cases and two (20%) pneumonia cases had no predisposing disease. Thirteen (57%) meningitis cases had concomitant pulmonary cryptococcosis. Twenty‐nine patients were Aboriginal and six were Caucasian, with a relative risk for Aboriginals compared with non‐Aboriginals of 20.6 (95% CI 8.6–49.5). Arnhem‐land was the commonest location of infection, with an annual incidence in Aboriginals of 0.14/1000. Fourteen (78%) of 18 isolates tested were C. neoformans var. gattii. Management was characterised by the frequent need for adjunctive surgery and prolonged or repeat courses of systemic antifungal therapy. Despite this, long‐term outcomes are encouraging with a mortality of 14% overall and 9% in meningitis patients. The river red gum (Eucalyptus camaldulensis) has a limited distribution in Arnhemland and ongoing studies are seeking alternative environmental sources of C. neoformans var. gattii. (Aust NZ J Med 1993; 23: 678–682.)