bluuebunny/crossref_metadata_2025_split huggingface dataset:
DAY CASE CARDIAC CATHETERISATION — A SAFE AND ECONOMIC ALTERNATIVE
Authors: MURDOCK CHALLON J. , IRELAND MARK A. , DAVIS MICHAEL J. E. , PLATELL MARK 
Published: March 2008

Abstract:Cardiac catheterisation, as a day procedure, has been performed at the Royal Perth Hospital since November 1985. During the 23 month period from November 1985 to September 1987, there have been 1398 day procedures carried out. One hundred and twelve patients (8%) required overnight admission as a consequence of the procedure — 39 patients for routine observation, 41 patients for minor hemorrhage from the brachial arteriotomy or femoral artery puncture site; 12 patients for severe angina: three patients with reversible ischemic neurological deficits; two patients with stroke; four patients with transient brachial artery occlusion; two patients with arrhythmias and eight patients for miscellaneous reasons. One patient discharged on the day of the procedure required subsequent re‐admission for treatment of an acute myocardial infarction. There were no deaths. The financial cost saving to the hospital in real terms is estimated to be £41.50 per patient and to the community a further saving of £25 per patient due to a reduction in sick leave. The minimum total cost saving to the taxpayer for the 1,285 patients managed as day cases was £85,000.Cardiac catheterisation can be performed as a day procedure with low morbidity, low mortality and modest cost savings to a major hospital.
A CASE OF POLYMICROBIAL INFECTIVE ENDOCARDITIS INVOLVING NEISSERIA MUCOSA OCCURRING IN AN INTRAVENOUS DRUG ABUSER
Authors: GILES M. W. , ANDREW J. H. , TELLUS M. M. 
Published: March 2008

Abstract:The incidence of polymicrobial endocarditis has increased markedly in recent years, in association with the increasing level of abuse of intravenous drugs. Neisseria mucosa, an upper respiratory tract commensal, is a rare cause of infective endocarditis. We report the first case of polymicrobial infective endocarditis involving Neisseria mucosa occurring in an intravenous drug abuser.
TREATMENT OF RESISTANT WALDENSTROM'S MACROGLOBULINEMIA WITH HIGH DOSE GLUCOCORTICOSTEROIDS
Authors: JANE S. M. , SALEM H. H. 
Published: March 2008

Abstract:We examined the efficacy of high dose glucocorticosteroids in two patients with Waldenstrom's macroglobulinemia resistant to other forms of therapy. Both patients demonstrated marked falls in total protein, paraprotein and viscosity levels, after only short periods on this regimen. There was no significant toxicity. We conclude that high dose dexamethasone may offer significant benefits in the treatment of Waldenstrom's macroglobulinemia.
GASTROINTESTINAL BLOOD LOSS FROM A NEW BUFFERED ASPIRIN (OSTOPRIN): MEASUREMENT BY RADIOCHROMIUM AND HEMOQUANTTM TECHNIQUES
Authors: LYNCH N. M. , McHUTCHISON J. G. , YOUNG G. P. , DEACON M. , ST JOHN D. J. B. , BARRACLOUGH D. 
Published: March 2008

AbstractOccult gastrointestinal blood loss induced by a new buffered aspirin preparation (Ostoprin, 4.0 g per day) was compared with that from an enteric‐coated aspirin (Ecotrin, 3.9 g per day) in 40 patients with osteoarthritis. Blood loss was measured by the radiochromium method and compared with the HemoQuantTM assay of fecal heme and heme‐derived porphyrins. By radiochromium, mean daily blood loss during the first week of treatment with Ostoprin increased 1.6 ml above basal compared to 0.8 ml above basal with Ecotrin (p= 0.06). When aspirin was ceased, blood loss returned more rapidly towards normal in the Ostoprin group (p < 0.01). By HemoQuant,TM mean fecal hemeporphyrin excretion rose 0.63 mg hemoglobin equivalent per g feces during the first week of treatment by Ostoprin compared with 0.40 mg/g for Ecotrin (p= 0.06). There was a significant linear relationship between the two methods (r = 0.65, p < 0.001). Serum salicylate levels achieved with both preparations were almost identical and encompassed the therapeutic range. HemoQuantTM is sufficiently sensitive to detect low‐level aspirin‐induced bleeding. Ostoprin appears to be a safe alternative to Ecotrin and has similar bioavailability.
ENDOCRINE DYSFUNCTION IN LYMPHOMATOID GRANULOMATOSIS
Authors: LEEDMAN P. J. , MATZ L. R. , PULLAN P. 
Published: March 2008

AbstractEndocrine abnormalities in lymphomatoid granulomatosis are rare and have never been a major determinant of the clinical course. We describe three patients who illustrate that a wide range of endocrine dysfunction (hypoadrenalism, hypercalcemia, hypothyroidism, diabetes insipidus and hypogonadism) may be encountered in this disorder. Moreover, such endocrine manifestions may be the major feature at presentation, the treatment of which may significantly influence the subsequent clinical outcome.
VERY HIGH DOSE INTRAVENOUS GAMMAGLOBULIN IN THROMBOCYTOPENIA OF PREGNANCY
Authors: GIBSON JOHN , LAIRD PAUL P. , CHILD ANDREW , HARRIS JOHN , JOSHUA DOUGLAS E. , KRONENBERG HARRY 
Published: March 2008

AbstractA 22‐year‐old woman with severe idiopathic thrombocytopenic purpura, complicating pregnancy, was unresponsive to high‐dose corticosteroids and three separate infusions of high‐dose intravenous immunoglobulin using the conventional schedule of 400 mg/kg/d for five days. A dramatic albeit transient, elevation of her platelet count followed a six day course of very high dose immunoglobulin (1000 mg/kg/d) thus allowing elective lower segment cesarean section to be performed without complications and with the delivery of a live, female infant. Two months later a further course of very high dose gammaglobulin was again effective in raising the patient's platelet count prior to elective splenectomy. No adverse reactions were seen to either infusion.
ASPIRATION BIOPSY OF PALPABLE LYMPH NODES AND THE DIAGNOSIS OF LUNG CARCINOMA
Authors: DUGGAN C. J. , DELOHERY J. F. , PHILIPS J. N. 
Published: March 2008

AbstractOver a six‐year period at this institution aspiration biopsy of palpable lymph nodes has been used in the diagnosis and follow‐up of 40 primary lung cancers. Small cell carcinoma was the commonest cell type. In the majority of the patients this was the initial diagnosis of lung cancer, however there were patients with recurrence after chemotherapy and after surgical management. Diagnosis and classification of tumour using this simple, rapid and safe procedure negates the need for more invasive and costly investigations.
NUTRITIONAL STATUS OF HOME HEMODIALYSIS PATIENTS
Authors: TALEMAITOGA A. S. , SANDERS B. A. , HINTON D. , LYNN K. L. 
Published: March 2008

AbstractWe studied the nutritional status of 32 patients (23 men), aged 50 (SD14) yr, on home hemodialysis (HHD) for one‐138 months. No formal dietary restrictions were imposed. Anthropometric measurements were made using standard techniques, diet assessed by three‐day dietetic diary and interview and plasma concentrations of nutrients were measured. Mean caloric intake was 29.4 (SD 10.7) kcal/kg; 24 (75%) patients had lower energy intakes than recommended for normals. Protein, vitamin C and folate intakes were above recommended minimum safe intakes. Intakes were less than recommended for calcium in four (13%) patients, iron in one (3%) and vitamin B12 in two (6%). One‐third of both sexes had body mass indices (kg/m2) <25th percentile for normals, but none was <80% of ideal bodyweight. Arm muscle circumference was <10th percentile for normals in six men and three women. Triceps skin fold thickness was <10th percentile in four men (17%) and five women (55%). No anthropometric measurements were correlated with energy, protein or fat intake. Biochemical measurements were not useful in predicting protein intake. Neither nutritional intake nor anthropometric measurements were correlated with the duration of HHD. There was little evidence of malnutrition and wasting in this group of well rehabilitated HHD patients.
ATRIAL FIBRILLATION AND MORTALITY IN AN ELDERLY POPULATION
Authors: LAKE F. R. , CULLEN K. J. , de KLERK N. H. , McCALL M. G. , ROSMAN D. L. 
Published: March 2008

AbstractProspective data from Busselton, Western Australia, collected during triennial surveys from 1966–81 with follow‐up of subjects to 1983, showed that atrial fibrillation (AF) was frequent in elderly people and associated with increased mortality.Of 1770 people aged over 60 years, 40 were in atrial fibrillation when first seen and a further 47 developed it during follow‐up. Atrial fibrillation was positively associated with angina, history of a myocardial infarction and left bundle branch block.Relative mortality in those with atrial fibrillation compared with those without it, was 1.92 for all causes, 1.82 for death from cardiovascular causes (excluding stroke) and 3.78 for deaths from stroke, after adjustment by proportional hazards regression for confounding effects of age, sex, history of a myocardial infarction, an abnormal electrocardiogram, angina, cholesterol level, systolic blood pressure and Quetelet's Index (weight/height2).The excess relative mortality declined with increasing age for both women and men. This raised relative mortality remained constant with time from the first detection of AF for all causes and cardiovascular causes but appeared to increase with time from detection for stroke death. The risk of death from stroke was greatest in the younger women. The observed risk of death from stroke in patients with AF suggests that anticoagulant use should be considered in selected patients.
RESTORATION OF SPERMATOGENESIS WITH PULSATILE GONADOTROPHIN RELEASING HORMONE THERAPY IN HYPOGONADOTROPHIC HYPOGONADISM OF TRAUMATIC ETIOLOGY
Authors: FOK A. C. K. , TSAKOK F. H. M. , SUM C. F. , CHEAH J. S. 
Published: March 2008

AbstractHead trauma is one of the rarest reported causes of hypogonadotrophic hypogonadism and treatment of this condition with pulsatile gonadotrophin releasing hormone (GnRH) has not been previously described.A 36‐year‐old man with azoospermia from hypogonadotrophic hypogonadism following head trauma was given pulsatile GnRH therapy. 10 μg of GnRH was administered every 90 minutes through a subcutaneous catheter in the abdominal wall. After 15 months, the ejaculate contained 34 × 106 spermatozoa/ml of semen.Prolonged pulsatile GnRH therapy can restore gonadal function in males with hypogonadotrophic hypogonadism of traumatic etiology. Our experience adds to the growing spectrum of hypothalamic disorders causing hypogonadism that is amenable to treatment by this method.
ANTI‐NEURONAL AUTOANTIBODIES AND NEUROLOGICAL PARANEOPLASTIC SYNDROMES
Authors: ANDERSON N. E. 
Published: March 2008

Abstract‘Remote effects’ of cancer on the nervous system, or paraneoplastic syndromes, are diseases of unknown cause that occur exclusively or with increased frequency in patients with cancer. Several hypotheses have been used to explain the pathogenesis of these disorders. One hypothesis is that the tumour and the nervous system share antigens, so that an autoimmune response generated against the tumour causes the neurological disorder. The best evidence for this hypothesis is found in the Lambert‐Eaton myasthenic syndrome which can be transferred to animals by injecting them with IgG from patients. The identification of autoantibodies against Purkinje cell cytoplasmic protein antigens in patients with paraneoplastic cerebellar degeneration, autoantibodies against neuronal nuclear antigens in patients with paraneoplastic syndromes associated with small cell lung cancer and autoantibodies against retinal ganglion cells in patients with small cell lung cancer and retinal degeneration supports this hypothesis. The possible role of these autoantibodies in the pathogenesis of paraneoplastic neurological disease is discussed.
CHRONIC STRONGYLOIDIASIS IN TASMANIAN VETERANS—CLINICAL DIAGNOSIS BY THE USE OF A SCREENING INDEX
Authors: OLIVER N. W. J. , ROWBOTTOM D. J. , SEXTON P. , GOLDSMID J. M. , BYARD R , TOOTH M. , THOMSON K. S. 
Published: March 2008

Abstract Chronic infection with Strongyloides stercoralis presents a diagnostic problem because of the low recovery of the organism from stools and the insensitivity of current serological tests.Of 150 former Far East POWs, 26 (17%) had S. stercoralis in stools. The clinical features in 18 stool‐positive patients were compared to those in 24 stool‐negative patients and showed that strongyloidiasis was associated with a higher frequency of alteration in bowel habit, upper abdominal discomfort, rash and eosinophilia. On the basis of these features, a screening index was devised which largely separated stool‐positive and stool‐negative patients and led to helpful therapy in three of four patients with compatible symptoms who lacked a definitive diagnosis.Treatment with thiabendazole appeared to be superior to treatment with mebendazole.
TWO DIMENSIONAL ECHOCARDIOGRAPHY AND LEFT VENTRICULOGRAPHY IN CARDIAC SARCOIDOSIS
Authors: BOWER S.P.C. , THOMSON A. 
Published: March 2008

AbstractA 48‐year‐old woman with histologically proven pulmonary sarcoidosis presented with congestive heart failure. Two dimensional echocardiography showed a peculiarly ragged appearance at the left ventricular apex which was confirmed on left ventriculography. This echocardiographic finding has not been previously described in cardiac sarcoidosis.
DANAZOL AND HEPATIC NEOPLASIA: A CASE REPORT
Authors: MIDDLETON C. , McCAUGHAN G. W. , PAINTER D. M. , STEPHEN M. S. , BEALE M. , FRASER I. 
Published: March 2008

AbstractAlthough hepatic side‐effects of danazol are well known, the occurrence of hepatic tumours is not well documented. We report a case of hepatocellular adenoma occurring in a 35‐year‐old woman with endometriosis who had been taking danazol over a three year period.
Mucor cerebral abscess associated with intravenous drug abuse
Authors: Fong K. M. , Seneviratne E. M. E. , McCormack J. G. 
Published: March 2008

AbstractWe report on a case of a 26‐year‐old intravenous narcotic abuser with a primary cerebral mucormycotic abscess caused by Rhizopus oryzae. He was treated with a combination of intravenous and intraventricular amphotericin B and surgical drainage with a successful outcome. There was no evidence that his infection was acquired by the rhinocerebral route, it seems likely that he injected himself with a contaminated batch of narcotic or amphetamine. Mucormycosis presenting in this way has been described previously but this is only the second such case to survive. Early diagnosis and treatment is essential for a favourable outcome in this condition.
Selective inhibition of platelet cyclooxygenase with controlled release, low‐dose aspirin
Authors: Vial J. H. , McLeod L. J. , Roberts M. S. , Seville P. R. 
Published: March 2008

AbstractThe hypothesis that slow administration of low doses of aspirin may selectively inhibit platelet cyclooxygenase and thromboxane A2 formation was evaluated using controlled release aspirin formulations. In the first study, doses of either 50, 100, 325 and 1,300 mg of these formulations and 300 mg soluble aspirin were ingested daily by healthy volunteers for one week. In the second study, doses of 5, 10, 25 and 50 mg controlled release aspirin, 50 mg soluble aspirin and 100 mg aspirin and glycine formulation were ingested daily for ten days. Platelet function and urinary prostaglandin production were assessed immediately before and on the seventh day of dosing in both studies and in the second study, repeated on the tenth day of dosing.Platelet function and serum thromboxane B2 production were fully inhibited by all formulations of 50 mg aspirin and above, but not by doses of controlled release aspirin below 50 mg doses. The excretion of urinary 6‐keto‐PGF1α (a major metabolite of prostacyclin) was significantly reduced at controlled release aspirin doses above 100 mg and at all doses of rapidly absorbed aspirin tested. As no significant reduction in the urinary 6‐keto‐PGF1α production was observed at doses of controlled release aspirin of 50 and 100 mg and below, it appeared that these doses did not inhibit the systemic vascular cyclooxygenase. These data are consistent with a selective inhibition of platelet function by daily doses of 50 and 100 mg of the controlled release formulation of aspirin.
Brief upper airway (laryngeal) dysfunction
Authors: Campbell A. H. , Mestitz H. , Pierce R. 
Published: March 2008

AbstractWe describe in six men, recurrent episodes recurring over months or years, of sudden, brief complete obstruction to respiration followed by dyspnoea with loud inspiratory stridor lasting two to five minutes. Attacks occurred during wakefulness and/or sleep. In one patient an episode was witnessed endoscopically: the initial obstruction was seen to be caused by complete laryngeal closure. The false vocal cords then opened, but the vocal cords remained adducted and caused inspiratory stridor. The similarity of the attacks described by the other patients suggests that they were all caused by laryngeal closure. Furthermore, they could simulate the episodes by voluntarily adducting their vocal cords. The symptoms were usually preceded by a sensation of throat irritation and in four cases symptoms of upper respiratory infection were present. Associated features present in some of the patients included post‐nasal discharge, snoring, sleep apnoea and gastro‐oesophageal reflux. None was hypocalcaemic. Although stimulation of laryngeal receptors is known to produce reflex laryngeal closure, cough is the usual response during wakefulness. Treatment aimed at reducing upper airway irritation and voluntary inhibition of coughing appeared successful in reducing the incidence and severity of the episodes. Recognition of the condition is important as it may be confused with other causes of acute dyspnoea and it appears to respond to specific management.
Streptococcus Pyogenes Pneumonia with Abscess Formation
Authors: McIntyre H. D. , Armstrong J. G. , Mitchell C. A. 
Published: March 2008

AbstractA 30‐year‐old female with mild asthma presented with high fever, hypotension, pleuritic chest pain, vomiting and diarrhoea. Chest radiograph showed consolidation of the right upper lobe, and S. pyogenes was cultured from blood and sputum. Following initial rapid recovery the patient relapsed ten days after antiobiotics were ceased, with rapid development of a large abscess cavity. Clinical improvement occurred following reinstitution of treatment including intravenous penicillin. Progressive radiological resolution eventuated during outpatient follow‐up. This case demonstrates that S. pyogenes pneumonia may occur without an antecedent viral infection or major predisposing condition, cause rapid cavitation despite antibiotic therapy and resolve satisfactorily with prolonged penicillin therapy.
Myocardial and skeletal muscle injuries following adenine arabinoside therapy
Authors: Mak K. H. , Boey M. L. , Wan S. H. , Lee Y. S. 
Published: March 2008

AbstractA healthy young male with chronic persistent hepatitis associated with positive HBsAg and HBeAg and without any predisposing factors for coronary artery disease was treated with a course of prednisolone and adenine arabinoside. At the end of therapy, he developed myocardial and skeletal muscle injuries. The temporal relationship between the administration of the drug and the monophasic nature of the myotoxic injuries strongly suggests that adenine arabinoside induced the clinical manifestations in the patient.
Long‐term cardiopulmonary function after human heart‐lung transplantation
Authors: Glanville A. R. , Baldwin J. C. , Hunt S. A. , Theodore J. 
Published: March 2008

AbstractWe present cardiac and pulmonary function data obtained at serial annual reviews in 21 heart‐lung transplant (HLT) recipients followed for up to four years postoperatively, reflecting the entire Stanford experience as of June 1987. A total of 50 cardiac catheterisation procedures and endomyocardial biopsies yielded the following results: rejection on biopsy (0/50) (0% of patients), angiographic coronary artery disease (1/50) (5%), pulmonary hypertension (2/50) (10%), elevated pulmonary vascular resistance (PVR) (1/50) (5%), and low cardiac index (CI) (4/50) (14%). Systemic hypertension was common, with an elevated systemic vascular resistance (SVR) (26/44) (76%) and an elevated mean aortic pressure (MAP) (22/44) (67%). Pulmonary function testing frequently revealed abnormalities. Airflow limitation was manifested by a reduction in both FEV,/FVC ratio (17/50) (52%) and FEF25–75 (30/50) (71%), and was often associated with arterial hypoxaemia (13/50) (52%). Subsequently, five patients with these findings have died with obliterative bronchiolitis (OB), one underwent retransplantation for OB, six have stable OB, and one has progressive OB. Length of survival was highly correlated with the resting Pa02 at the first annual review (r = 0.99) (p < 0.001), and, to a lesser degree, on the reduction in FEF25–75 (r = 0.73) (p<0.05) and FEV1/FVC ratio (r = 0.77) (p<0.05). Resting Pa02 was determined by ventilatory (r = 0.80) (p< 0.001) rather than circulatory factors and all patients with airflow limitation who died had OB at post‐mortem examination.These results support the continued study of HLT as a therapeutic modality for selected patients with irreversible pulmonary hypertension. They demonstrate that, in the absence of severe OB, haemodynamics, cardiac function, and coronary patency are preserved for several years after HLT. Whereas the value of regular pulmonary function testing has become evident, there does not appear to be a clinical need for annual surveillance with invasive cardiac procedures in long‐term survivors of HLT.
Flucloxacillin induced delayed cholestatic hepatitis
Authors: Miros M. , Kerlin P. , Walker N. , Harris O. 
Published: March 2008

AbstractWe report four cases of severe delayed cholestatic hepatitis induced by flucloxacillin. All patients presented with deep jaundice and pruritus which developed soon after ceasing flucloxacillin. Liver function tests were abnormal in all patients with markedly elevated serum bilirubin concentration, alkaline phosphatase and aspartate transaminase levels. Extrahepatic biliary obstruction and infective hepatitis were excluded in all cases. Liver biopsies showed centrilobular cholestasis with portal and lobular inflammation and eosinophil infiltration. Although symptoms resolved within six weeks in all patients, cholestatic liver function tests have persisted in two patients for more than six months. With the increasing usage of this drug and the delayed presentation of cholestasis, flucloxacillin needs to be considered in the differential diagnosis of all patients presenting with cholestatic jaundice.
Proarrhythmic actions of antiarrhythmic drugs: a review
Authors: Campbell TJ. 
Published: March 2008

AbstractThe ability of antiarrhythmic drugs to aggravate and even cause arrhythmias is now well‐established. The incidence of such effects for a wide range of agents is of the order of 3–15%. The two major mechanisms are facilitation of reentry circuits and the production of triggered activity due to early afterdepolarisations. This latter effect probably underlies the drug‐induced long QT syndromes and associated arrhythmias including ‘torsade de pointes’ and is more likely to occur in association with bradycardia, hypokalaemia, or concomitant digitalis therapy. While some or all of these mechanisms are capable of producing or aggravating both supraventricular and ventricular arrhythmias, this review deals only with ‘proarrhythmic’ effects in the ventricles. These are known to be more likely in the presence of poor ventricular function (left ventricular rejection fraction < 35%). Optimal management may include withdrawal of antiarrhythmic agents, replacement of potassium, infusion of magnesium and overdrive pacing.