bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Problem Family and Community Medicine
Authors: Dax E. Cunningham , Hagger Rona 
Published: March 2008

Summary: The problem family and community medicine.The characteristics of problem families are described and especially their dependency upon the social services.They are of increasing importance to community medicine since as shown by the literature their members form 5—10% of the total population and use from 50–80% of the total social and corrective services.The social pathology of 16 root and 110 sub‐families was investigated; enquiries have also been made into the family dynamics and especially child rearing, learning problems and ill health. Infections, injuries and childhood disorders are particularly frequent.There are administrative advantages in regarding these families as socially handicapped.
Whipple's Disease Involving the Pericardium: Pathological Confirmation During Life
Authors: Vlietstra R. E. , Lie J. T. , Kuhl W. E. , Danielson G. K. , Roberts M. K. 
Published: March 2008

Summary: Whipple's disease involving the pericardium: Pathological confirmation during life. R. E. Vlietstra, J. T. Lie, W. E. Kuhl, G. K. Danielson and M. K. Roberts, Aust. N.Z. J. Med., 1978, 8, pp. 649–651.Cardiac involvement in Whipple's disease has been a frequent autopsy finding but is rarely recognized clinically. We report here a patient, a 63‐year‐old man, in whom Whipple's disease was diagnosed in 1974, based on a seven‐year history of arthralgia, one‐year history of weight loss and steatorrhea, and diagnostic small bowel biopsy. Despite complete regression of all joint and bowel symptoms following a prolonged course of tetracycline therapy, the patient developed incapacitating congestive heart failure and signs of constrictive pericarditis, for which a thoracotomy and pericardectomy was performed. Histologic examination revealed fibrous pericarditis with mononuclear infiltrates, including PAS‐positive histiocytes. The characteristic bacilliform bodies were identified by electron microscopy in the resected pericardium. This to our knowledge is the first such demonstration during life of Whipple's disease involving the heart.
Difficulties in the Use of D‐Penicillamine in the Treatment of Rheumatoid Arthritis
Authors: Stockman A. , Richter D. , Barraciough D. , Muirden K. D. , Macdonal I. , Kincaid‐Smith P. 
Published: March 2008

Summary: The difficulties encountered in administering D‐penicillamine to 40 patients with rheumatoid arthritis (RA) over a six to 24 month period are recorded. Side‐effects were frequent. Proteinuria occurred in 13 patients (33%) mainly in the fourth to the sixth month. Renal biopsies were performed in six patients and all showed light microscopy abnormalities. Electron microscopy performed in five patients revealed subepithelial deposits in all and in addition some had mesangial and subendothelial deposits. Seven patients (17.5%) developed eight episodes of thrombocytopaenia which was quickly reversed on cessation of treatment or reduction in dosage.On the positive side, there was significant improvement in most parameters of disease activity at six, 12 and 18 months compared to the pretreatment levels, but the results at two years were less impressive. Reduction in steroid dosage was considerable and was greater than half the mean pretreatment dose after two years but the absence of a control group makes the full significance of these uncertain.Patients on high and low dosage regimens were compared over a 12 month period of treatment. Although the differences were not statistically significant, withdrawals and side effects were less frequent in the low dose group.
Annular Subvalvular Left Ventricular Aneurysm Mimicking a Pericardial Effusion on Echocardiogram
Authors: Hickey A. J. , Braye S. 
Published: March 2008

Summary: Annular subvalvular left ventricular aneurysms are a rare form of herniation of the left ventricle, reported usually in negroes. These aneurysms are situated beneath the mitral or aortic valves and extend along the line of the valvular annulus. The aetiology remains speculative but is not associated with coronary artery disease.Our patient was Caucasian and a review of the literature reveals only four other documented cases in Caucasians. Our case corresponds completely in pathological detail with previous cases. This condition has never been reported in Australia.The echocardiographic features have not been described before. These are the presence of a large echo free space behind the left ventricle, without an anterior free space. These features are not specific but this type of aneurysm should be considered in the differential diagnosis of a loculated posterior pericardial effusion, along with a large left atrium and a hernia through a patent foramen of Morgagni.1
Home Blood Pressure Monitoring and Changes in Plasma Catecholamines During Once or Twice Daily Treatment with Atenolol in Patients with Mild Hypertension
Authors: McGrath B. P. , Beilin L. J. , Schofield T. , Benedict C. R. , Barker N. P. , Cooper R. 
Published: March 2008

Summary: Home blood pressure monitoring and changes in plasma catecholamines during once or twice daily treatment with atenolol in patients with mild hypertension. B. P. McGrath, L. J. Beilin, T. Schofield, C. R. Benedict, N. P. Barker and R. Cooper, Aust. N.Z. d. Med., 1979, 9, pp. 374–381.1. The effects of atenolol on diurnal blood pressure control, heart rate and plasma catecholamines were studied in nine hypertensive, six of whom also received diuretics. The patients completed a double‐blind trial in which the effects of once and twice daily administration of atenolol were compared with placebo.2. Atenolol (100 mg) given once a day produced significant reduction in diurnal blood pressures recorded at home but the effect was slightly less than either 50 mg given twice a day or 200 mg once a day.3. Effects on heart rate and blood pressure were seen within 36 hours of the first dose, and were near maximal at 72 hours. After cessation of the drug, mean resting heart rate increased gradually and reached pre‐treatment levels five days later, suggesting strong tissue binding of atenolol. Blood pressure increased more slowly over 8–10 days.4. Plasma noradrenaline levels were increased at rest with atenolol. This argues strongly against the antihypertensive effect of atenolol being due to a reduction of sympathetic nerve activity.5. Once daily administration of atenolol in this group of patients with mild hypertension produced satisfactory diurnal blood pressure control and beta blockade without “rebound” hypertension on cessation of therapy.
Heparinized Chemotherapy in the Treatment of Disseminated Lung Cancer
Authors: Jamieson G. G. , Angove R. C. 
Published: March 2008

Summary: Heparinized chemotherapy in the treatment of disseminated lung cancer. G. G. Jamieson and R. C. Angove, Aust. N.Z. J. Med., 1979, 9, pp. 381–384.Fourteen patients with inoperable or metastatic carcinoma of the lung were entered in this study. All of them received one or more courses of multiple chemotherapy (cyclophosphamide, 5‐fluorouracil, methotrexate and vincristine) with prior and concurrent heparin ant/coagulation.No tumour regression was noted in any patient although one patient is alive and well at two years. Five patients developed sudden increase in pleural effusion whilst on heparin therapy and in four of these patients the effusion was a significant factor in their death.
Lymphomatoid Granulomatosis in a Renal Transplant Recipient
Authors: Walter M. , Thomson N. M. , Dowling J. , Fox R. , Atkins R. C. 
Published: March 2008

Summary: Lymphomatoid granulomatosis in a renal transplant recipient. M. Walter, N. M. Thomson, J. Dowling. R. Fox and R. C. Atkins, Aust. N.Z. J. Med., 1979, 9, pp. 434–436.Lymphomatoid granulomatosis is a multisystem disorder of high mortality and characterised by angiocentric and angiodestructive lymphoreticular proliferative and granuiomatous change. A case is described of this disease occurring in a renal transplant patient. The patient underwent a rapid remission of the disease after a course of combined cytotoxic therapy and remains free of disease three years after treatment. This case is the second described renal transplant patient to develop the disease and the first to be successfully treated. It is likely that the disease originated as a consequence of immuno‐suppression similar to the development of lymphomas in allograft recipients.
Disseminated Cryptococcosis with Ocular Involvement
Authors: Kumar R. K. , Lykke A. W. J. 
Published: March 2008

Summary: Disseminated cryptococcosis with ocular involvement. R. K. Kurnar and A. W. J. Lykke, Aust. N.Z. J. Med., 1979, 9, pp. 444–447.A case of disseminated cryptococcosis with extensive ocular involvement is reported. The patient had pulmonary, meningeal, cerebral, cutaneous, lymph node, renal, adrenal and thyroid lesions, as well as granulomatous endophthalmitis.
Natural Killer Cells—A New Cytotoxic Mechanism Against Tumours?
Authors: Hersey P. 
Published: March 2008

Summary: Natural killer cells–a new cytotoxic mechanism against tumours? P. Hersey, Aust. N.Z. J. Med., 1979, 9, pp. 464–472.Lymphoid cells from the blood of most normal human subjects can kill a variety of cultured tumour cells in vitro. The cytotoxic activity of these cells (now referred to as natural killer cells) was initially detected during studies on known cytotoxic cells such as T cells, antibody dependent effector (K) cells and macrophages and was regarded as having no biological importance. Studies over the past few years have suggested, however, that natural killer cells may represent a major surveillance mechanism against tumours in vivo and may be the only cytotoxic mechanism against many tumours when those based on antigen recognition by the “conventional immune” cells fail.The nature of these cells and their cytotoxic mechanism has received considerable attention, but has so far not been clearly defined. A considerable body of evidence suggests they are of the T cell lineage but if so they are a sub‐population of T cells that develop independently of the thymus. Recent studies suggest that interferon may play a major role in the induction of natural killer activity and this finding promises to be an important advance in our understanding of this cytotoxic mechanism. The level of natural killer cell activity against tumours in both animals and humans appears to be genetically determined and may be linked to genes of the major histocompatibility complex.Evidence for the biological importance of these cells was suggested by experimental studies where the in vivo susceptibility of animals to tumour growth could be related to the levels of their natural killer cell activity. Conversely, the take of different tumour cells in animals was inversely related to their susceptibility to natural killer cells. Studies on transplantation of bone marrow in animals also indicated that natural killer cell activity may be the predominant mechanism responsible for rejection of these grafts.Studies of a similar nature in humans are as yet limited but initial results from those on melanoma patients support the view that these cells are also important against tumours in human subjects. No information is yet available as to their importance in rejection of bone marrow grafts in human recipients. NK cells are therefore the latest of the effector cells to be defined after T cells, 6 cells, macrophages and K cells. These studies suggest that measurement of the activity of these cells warrants further attention in patients with tumours and bone marrow transplants and that methods to alter their activity may assume an important role in therapeutic procedures against tumours or in transplantation of bone marrow.
Glucagon—New Concepts About an “Old” Hormone
Authors: Alford F. P. , Chisholm D. J. 
Published: March 2008

Summary: Recent technical advances have led to a great increase in information regarding the role of glucagon in normal human physiology and in diabetes. In man, physiological actions appear to be limited to stimulation of hepatic glycogenolysis, gluconeogenesis, and possibly ketogenesis. Glucagon plays an important role (with insulin) to maintain basal hepatic glucose output and acts synergistically with catecholamines and Cortisol as a counter‐regulatory hormone in preventing hypoglycaemia. On the other hand glucagon is relatively unimportant (in contrast to insulin) in the assimilation of a glucose or carbohydrate load.Glucagon secretion is mainly controlled by the nervous system, both sympathetic and parasympathetic. Nervous control of the pancreatic A (glucagon‐releasing) cell is in turn modulated by plasma concentrations of glucose and other substrates and by hormonal influences.Circulating “glucagon” consists of several different peptides of varying molecular weight and differing biological activity. Also “glucagon” may be secreted by tissues other than the pancreas. Both the liver and kidney are important sites of metabolism of the various “glucagons”.Glucagon levels are raised in human diabetes mellitus. It appears that the hyper‐glucagonaemia in human diabetes is secondary to the diabetic state, rather than a primary defect of the A cell. Glucagon may accentuate hyperglycaemia and ketogenesis but is not essential for the development of the diabetic state.A clinical syndrome of excess glucagon production from an islet cell tumour (glucagonoma) has recently been defined. Diabetes, though common, is not always present and the most prominent clinical feature is an unusual skin rash, migratory necrolytic erythema.Pharmacological doses of glucagon have a wide range of effects in humans. In addition to treating hypoglycaemia, glucagon may be used as an inotropic cardiac stimulant, or to inhibit gastrointestinal motility during endoscopy. Other suggested uses are mainly related to tests of endocrine function.
Lithium Associated Thyroid Cancer
Authors: Brownlie B. E. W. , Turner J. G. , Millner G. M. B. , Perry E. G. , Ding L. 
Published: March 2008

Summary: Lithium associated thyroid cancer. B. E. W. Brownlie, J. G. Turner, G. M. B. Millner, E. G. Perry and L. cling, Aust. N.Z. J. Med., 1980,10, pp. 62–63.This report documents papillary cell carcinoma of the thyroid occurring in a 55–year‐old woman after three‐and‐a‐half years of lithium therapy. She presented with unilateral thyroid enlargement causing tracheal deviation. There was no clinical suspicion of malignancy and the histological fin clings were totally unexpected.
Coronary Artery Spasm*
Authors: Freedman S. B. , Richmond D. R. 
Published: March 2008

Summary: Coronary artery spasm. S. B. Freedman and D. R. Richmond. Aust. N.Z. J. Med., 1980. 10, pp. 69–72.Variant angina with ST elevation indicates transmural myocardial ischaemia and is due to spasm of a large epicardial coronary artery. Spasm occurs in arteries with varying degrees of fixed obstruction, giving rise to different clinical profiles of variant angina. However, coronary angiography is required to differentiate between those with minor coronary disease, and those with significant (>70%) obstruction. In patients with minor coronary disease or normal arteries, β‐blockers are contraindicated, and treatment with calcium antagonist vasodilators should be commenced after documentation of spontaneous or ergo‐novine induced spasm. Patients with significant fixed coronary obstructions require bypass grafting if technically feasible. The role of coronary spasm is not confined to variant angina, as it causes angina at rest with ST depression, and may also cause myocardial infarction and sudden death.
Labetalol and Propranolol in Mild Hypertensives: Comparison of Blood Pressure and Plasma Volume Effects
Authors: Hunyor S. N. , Bauer G. E. , Ross M. , Larkin H. 
Published: March 2008

Summary: Labetalol and propranolol in mild hypertensives: Comparison of blood pressure and plasma volume effects. S. N. Hunyor, G. E. Bauer, M. Ross and H. Larkin, Aust. N.Z. J. Med., 1980, 10, pp. 162–166.Labetalol administered in a small to moderate dose (first month 400 mg/day, second month average 585 mg/day) was effective in lowering blood pressure (BP) (‐21/‐18 mmHg, recumbent) in 11 of 13 mild essential hypertensives over an eight‐week period, despite a significant (+294 ml) increase in plasma volume. The effect of propranolol (first month 160 mglday, second month average 234 mg/day) was significantly less on both blood pressure (‐9/‐9 mmHg) and plasma volume (+98 ml), although the pre‐propranolol BP was lower and the final BP achieved on the two medications was comparable (labetalol 147/89 mmHg, propranolol 145/89Six patients who continued labetalol for periods of up to 14 months had persistent plasma volume expansion. Three of these, taking a higher dose of labetalol, developed resistance to the drug's antihypertensive effect. Addition of a diuretic restored antihypertensive efficacy and led to a fall in plasma volume. No such plasma volume expansion was seen in six patients who were followed on long term propranolol therapySome plasma volume expansion with the combined alpha‐ beta‐adrenoceptor blocker labetalol may be appropriate to its vasodilator action. Provided this effect is not excessive, it appears not to lead to resistance to its antihypertensive action. Small to moderate doses of labetalol would, therefore, seem effective without concomitant diuretic. Such sole use of labetalol could help minimise orthostatic symptoms which can be a major side effect of combination therapy
Why Does Migraine Improve During a Clinical Trial? Further Results from a Trial of Cervical Manipulation for Migraine
Authors: Parker G. B. , Pryor D. S. , Tupling H. 
Published: March 2008

Summary: Why does migraine improve during a clinical trial? Further results from a trial of cervical manipulation for migraine. G. B. Parker, D. S. Pryor and H. Tupling, Aust. N.Z. J. Med., 1980, 10, pp. 192–198.It is generally accepted that migraine is sensitive to intervention, whether in a treatment situation or in a clinical trial, and a “placebo effect” is often suggested. The influence of a number of non‐specific therapeutic ingredients was examined in a recent six‐month trial of cervical manipulation for migraine, and results of a 20‐month follow‐up are reported. During the trial migraine attacks reduced significantly by 28%, and reduced a further 19% up to the follow‐up period. The possibility of a trial effect, whereby improvement might stem from circumstances of the trial, was dismissed as an explanation for improvement. There was some evidence to suggest that placebo influences made a slight contribution to improvement, with sex, social class and subjects' optimism about the therapist at the initial treatment being weakly associated with initial improvement. The possibility that improvement levels reflected spontaneous improvement in migraine symptoms is suggested. If this possibility proves valid, clinical trials assessing migraine therapies should be designed so as to consider the natural course of migraine. Degree of improvement at follow‐up could be predicted clearly from degree of improvement during the treatment phase and from degree of improvement at the end of the trial. This appears to be important to manipulative therapists who appear to practise without the benefit of valid predictors of response to therapy
HLA B27 Negative Ankylosing Spondylitis—A Rare Condition
Authors: Rudge S. R. , Treadwell B. L. J. 
Published: March 2008

Summary: HLA 627 negative ankylosing spondylitis—a rare condition. S. R. Rudge and B. L. J. Treadwell, Aust. N.Z. J. Med., 1980, 10, pp. 227–229.New strict criteria have recently been suggested for the definition of HLA B27 negative ankylosing spondylitis, which show it to be less common than was previously thought. We report two cases which conform to the new criteria, together with details of family us e use of these criteria in future studies of B27 negative disease is discussed
Mycobacterium Fortuitum: An Unsuspected Cause of Synovitis and Osteomyelitis
Authors: Williams G. V. 
Published: March 2008

Summary: Two men with progressive synovitis and osteomyelitis of the wrist were found to have infection with Mycobacterium fortuitum. Immunological defects were demonstrated in both cases in association with renal failure and renal transplantation respectively. Failure of appropriate antibiotic therapy to eradicate infection necessitated amputation in one case. M. fortuitum is frequently sensitive to only amikacin or kanamycin. Treatment with amikacin alone was unsuccessful.This organism is widespread in the environment and may need to be considered in undiagnosed chronic infection in the immunologically suspectible host, as it poses unusual problems in diagnosis and therapy.
A Clinical Evaluation of Serum Angiotensin Converting Enzyme in Sarcoidosis
Authors: Allen R. , Mendelsohn F. A. O. , Csicsmann J. , Weller R. F. , Hurley T. H. , Doyle A. E. 
Published: March 2008

Summary: Angiotensin converting enzyme was measured in the serum of 52 patients with sarcoidosis, 67 healthy control subjects and 64 patients with pulmonary and non‐pulmonary diseases. The patients with sarcoidosis were classified on clinical grounds as having active or inactive disease.In 26 patients with active sarcoidosis not taking corticosteroids the mean serum ACE was significantly higher than in normal controls (P < 0.001). 73% of these patients had elevated serum ACE. Only two out of 12 (17%) patients with inactive sarcoidosis not taking corticosteroids had elevated serum ACE. Serum ACE was normal in patients taking oral corticosteroids for longer than two weeks.Eighty per cent of patients with active sarcoidosis with radiological evidence of pulmonary parenchymal involvement had an elevated serum ACE compared to 25% in patients with normal chest X‐rays and 60% of those with bilateral hilar lymphadenopathy.All sarcoid patients with hypercalcaemia had elevated serum ACE whereas only half of those with normal serum calcium had elevated ACE.In the patients with other thoracic and granulomatous conditions serum ACE was normal or rarely marginally elevated.Serum ACE appears to be of value in the diagnosis of active sarcoidosis.
Comparison of 7 and 12 Day Bone Marrow CFUc Culture in Adult Acute Non Lymphoblastic Leukaemia*
Authors: Hill R. S. , Postlewaight B. F. , Blacklock H. A. , Matthews J. R. D. 
Published: March 2008

Abstract: Bone marrows from 17 patients with acute non‐lymphoblastic leukaemia (ANLL) were serially cultured on semisolid agar during periods of intensive remission induction chemotherapy and during remission.Of 12 patients achieving remission, six showed recovery of 7 and 12 day colony forming units (CFUc) culture to normal. However, in four of the six patients, recovery was short‐lived with reappearance of typically leukaemic culture patterns while still in remission by bone marrow and peripheral blood criteria.In individual patients, serial 7 day cultures frequently showed persisting or recurring leukaemia‐associated patterns while 12 day cultures were normal.This study confirms the heterogeneity observed in the cultural characteristics of the CFUc in acute non lymphoblastic leukaemia. Bone marrow cultures in patients with ANLL following intensive remission induction chemotherapy appear to provide a more reliable indication of persisting leukaemia or early relapse if they are interpreted earlier at 7 days.