bluuebunny/crossref_metadata_2025_split huggingface dataset:
FATAL HEPATIC NECROSIS ASSOCIATED WITH MULTIPLE ANTICONVULSANT THERAPY
Authors: SMITH D. W. , CULLITY G. J. , SILBERSTEIN E. P. 
Published: March 2008

Abstract:We report six fatal cases of hepatic necrosis in children associated with multiple anticonvulsant therapy. There was insufficient evidence to incriminate any single drug or combination of drugs, but it is noteworthy that sodium valproate was involved in only one case. We consider that an idiosyncratic metabolic reaction to the anticonvulsants was most likely. In five of the six cases hepatic failure was immediately preceeded by a prolonged fit and we speculate that metabolic change from excessive neuronal activity may unmask the hepatofoxicity of anticonvulsants.
A PROSPECTIVE RANDOMISED TRIAL OF CYCLOSPORIN VERSUS METHOTREXATE AFTER HLA‐IDENTICAL SIBLING MARROW TRANSPLANTATION FOR PATIENTS WITH ACUTE LEUKEMIA IN FIRST REMISSION: ANALYSIS 2.5 YEARS AFTER LAST PATIENT ENTRY
Authors: ATKINSON K. , BIGGS J. C. , CONCANNON A. , DODDS A. , DOWNS K. , ASHBY M. 
Published: March 2008

Abstract:The results of a prospective randomised trial comparing cyclosporin (CSP) with methotrexate (MTX) as immunosuppressive therapy after HLA‐identical sibling marrow transplantation for patients with acute leukemia in first remission were analysed 2.5 years after entry of the last patient into the trial. Patients given cyclosporin showed a faster rate of marrow engraftment, less oro‐pharyngeal mucositis, more azotemia and more diastolic hypertension than those receiving methotrexate. Actuarial four‐year survival was 69% for patients receiving MTX and 43% for those receiving cyclosporin (not significant). Actuarial four‐year survival in continuous complete remission from the time of transplant was 69% and 38% respectively (not significant, p = 0.09). While there was no difference in the incidence or severity of acute or chronic graft‐versus‐host disease, the actuarial rate of leukemic recurrence was 0% in the MTX and 36% in the CSP group (p = 0.02). This finding emphasises the importance of long‐term follow up for the full assessment of new therapeutic protocols of marrow transplantation in the treatment of hematological malignancy.
SURGERY FOR GASTRIC CANCER IN SINGAPORE, 1951–1980, WITH PARTICULAR REFERENCE TO RACIAL DIFFERENCES IN INCIDENCE
Authors: KANG J. Y. 
Published: March 2008

AbstractThe incidence of surgery for gastric cancer in Singapore increased during the period 1951 to 1980 (males from 3.5 to 8.7 per 100 000 per year: females from 0.5 to 4.2 per 100 000 per year). This increase occurred mainly during the first decade of the study and was confined to persons aged 55 and above. Chinese had the highest incidence, followed by Indians and then Malays. These racial differences remained unchanged over the period of study.
PANCYTOPENIA INDUCED BY LOW‐DOSE METHOTREXATE FOR RHEUMATOID ARTHRITIS
Authors: KEVAT S. G. , McCARTHY P. J. , HILL W. R. , AHERN M. J. 
Published: March 2008

AbstractFour cases of pancytopenia related to low‐dose weekly pulse methotrexate therapy for rheumatoid arthritis are described. All patients were aged above 60 years and had renal impairment. In every case marrow recovery followed withdrawal of methotrexate. However, one patient developed pneumonitis and died. Cholangitis, respiratory infection and increase in methotrexate dose were precipitating factors. Pharmacokinetic data indicated prolonged tissue drug exposure in two cases studied; dose‐related toxicity was further supported by successful resumption of methotrexate in reduced dosage in two cases. It is possible that methotrexate dose should be modified during intercurrent illness in patients older than 60 years who have renal impairment.
LUNG INFECTION CAUSED BY RHODOCOCCUS
Authors: HART D. H. L. , ANDREW J. H. , PEEL M. M. , BURDON J. G. W. 
Published: March 2008

AbstractWe report a case of lung infection, clinically resembling tuberculosis, caused by Rhodococcus rubropertinctus. The patient had no apparent immunosuppression which is unusual for disease caused by the ‘rhodochrous’ complex. The infection responded successfully to oral antituberculous therapy, which included rifampicin, and to oral tetracycline.
MYOPATHIES ASSOCIATED WITH HYPOTHYROIDISM: A REVIEW BASED UPON 13 CASES
Authors: MASTAGLIA F. L. , OJEDA V. J. , SARNAT H. B. , KAKULAS B. A. 
Published: March 2008

AbstractThe clinical and myopathological features of 13 patients with a myopathy occurring in association with hypothyroidism are presented. Seven patients had hypothyroid myopathy, including two with the Hoffmann syndrome and one with the Kocher‐Debre‐Semelaigne syndrome. Five patients had an inflammatory myopathy and one had polymyalgia rheumatica. Serum CK activity was elevated up to 12‐fold in the patients with hypothyroid myopathy and returned to normal after treatment with thyroxine. Pathological changes in these cases included type 1 or type 2 fibre atrophy or hypertrophy, myofibre necrosis and regeneration in four cases and, in one case, prominent core‐like areas containing amorphous granulo‐filamentous material. The findings in this series of cases illustrate the clinical and histopathological heterogeneity of patients with hypothyroid myopathy and the need to consider other myopathies in hypothyroid patients who present with muscular symptoms.
TOPHACEOUS GOUT OF THE AXIAL SKELETON
Authors: ARNOLD M. H. , BROOKS P. M. , SAVVAS P. , RUFF S. 
Published: March 2008

Abstract:A 72‐year‐old female with a recent episode of podagra, without peripheral tophi, presented with nocturnal back pain and a destructive lesion of the right lamina of L4. A tophus was excised at laminectomy. Evidence of an axial skeletal tophus causing an irritative radiculopathy via mass effect is presented.
PROTEIN‐LOSING ENTEROPATHY IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: EDMUNDS S. E. J. , GANJU V. , BEVERIDGE B. R. , FRENCH M. A. , QUINLAN M. F. 
Published: March 2008

Abstract:Two patients with systemic lupus erythematosus (SLE) presented with anasarca, pleural effusions and severe hypoalbuminema, Both were demonstrated to have protein‐losing enteropathy, a rare complication of SLE. Other causes of gastrointestinal protein loss were excluded. There were marked similarities in both cases including circulating ANF with speckled staining, anti‐(U1)RNP antibodies and low serum complement levels. Complete remission was achieved in both with prednisolone. Anti‐(U1)RNP may be a marker for a subset of SLE in which protein‐losing enteropathy is a major manifestation.
LONG‐TERM SURVIVAL IN SMALL CELL LUNG CARCINOMA
Authors: HITCHINS R. N. , PHILLIPS J. , WOODS R. L. 
Published: March 2008

Abstract:We assessed outcome in 208 patients with small cell lung carcinoma two to seven years after treatment with combination chemotherapy, with or without chest and cranial radiotherapy. Fourteen patients (6.7%) survived cancer free for 30 months or longer. Nine of these (64%) had limited disease at diagnosis and four others had extensive disease with only one metastatic site. Two patients remain alive and disease free more than five years after diagnosis but median survival is still only 3.2 years. One patient died from intercurrent causes at 5.4 years but was free from small cell lung carcinoma at autopsy. Six patients are alive and disease free at intervals greater than 30 months but less than five years from diagnosis. All surviving patients are fully active with lifestyles similar to that prior to diagnosis. Five patients died from small cell lung carcinoma which relapsed more than 30 months after diagnosis. A few patients with small cell lung carcinoma are cured but 30‐month survival is insufficient to show cure as late relapses do occur. Late toxicity from aggressive therapy does not appear to outweigh the benefits of long‐term survival and potential cure in small cell lung carcinoma.
THE SYDNEY AIDS PROJECT: DEVELOPMENT OF ACQUIRED IMMUNODEFICIENCY SYNDROME IN A GROUP OF HIV SEROPOSITIVE HOMOSEXUAL MEN
Authors: TINDALL B. , COOPER D. A. , DONOVAN B. , BARNES T. , PHILPOT C. R. , GOLD J. , PENNY R. 
Published: March 2008

Abstract:The Sydney AIDS Project is a prospective immunoepidemiological study of 996 homosexual/bisexual men enrolled between February 1984 and January 1985. By January 1987, 32 of 386 homosexual men who were seropositive at enrolment in the study had developed AIDS, yielding a crude progression rate of between 2.8% and 4.2% per annum. Of these subjects, 23 (72%) developed AIDS within 12 months of enrolment.In univariate analysis, the only lifestyle differences between seropositive subjects who progressed to AIDS and those that did not progress were less frequent oral sex activity and more use of marijuana in the three months prior to enrolment. In multivariate analysis, seropositive subjects who progressed to AIDS were more likely to have a lower percentage of CD4+ cells, a higher percentage of CD8+ cells and to have used marijuana in the three months prior to enrolment than the seropositive subjects who did not progress. No HIV seropositive subject who was asymptomatic and had normal T‐cell subsets at enrolment had developed AIDS by January 1987. Persistent generalised lymphadenopathy was not associated with progression to AIDS.Although there are a number of lifestyle factors that may be associated with HIV infection, this study did not implicate most of these in the progression of HIV seropositive subjects to end‐stage AIDS. We conclude that antecedent changes in T‐cell subsets are associated with progression to AIDS and we emphasise the prognostic value of enumeration of T‐cell subsets in HIV seropositive persons. (Aust NZ J Med 1988; 18: 8–15).
AMIODARONE‐INDUCED HYPERTHYROIDISM: ASSESSMENT OF THE PREDICTIVE VALUE OF BIOCHEMICAL TESTING AND RESPONSE TO COMBINED THERAPY USING PROPYLTHIOURACIL AND POTASSIUM PERCHLORATE*
Authors: NEWNHAM H. H , TOPLISS D. J. , GRAND B. A. LE , CHOSICH N. , HARPER R. W. , STOCKIGT J. R. 
Published: March 2008

Abstract:In order to assess the value of thyroid function testing during amiodarone therapy, we reviewed all available tests in 128 patients treated with this drug. Nine patients (7.0%) developed biochemical hyperthyroidism with elevation of both free thyroxine index (FT4I) and free triiodothyronine index (FT3I) and marked suppression of serum thyroid stimulating hormone (TSH) after 1–46 months of therapy; six of these nine patients had clear clinical evidence of thyroid overactivity. Where serial tests were available before development of hyperthyroidism, this complication developed suddenly, despite previously stable normal indices of thyroid function, and could not be predicted by currently‐available biochemical tests such as T4, T3, sensitive TSH, thyroglobulin or sex hormone binding globulin (SHBG) assays. Clinical features such as unexplained weight loss, proximal myopathy, exacerbation of arrhythmia, or heat intolerance appear to be the key to prompt diagnosis of this complication.Hyperthyroxinemia without T3 excess was found in 32.8% of patients without progression to true hyperthyroidism. Serum TSH remained detectable by sensitive assay in 17 out of 18 patients with amiodarone‐induced euthyroid hyperthyroxinemia and was significantly higher than in patients with equivalent hyperthyroxinemia due to thyroxine therapy. Serial levels of SHBG were higher in patients with true hyperthyroidism than in those with euthyroid hyperthyroxinemia.The effect of combined treatment with propylthiouracil (800 mg/day) and potassium perchlorate (800 mg/day) was evaluated in five of the six clinically hyperthyroid patients. Biochemical euthyroidism was achieved after 7–19 weeks, a response slower than previously reported, indicating that this drug combination does not result uniformly in prompt resolution of amiodarone‐induced hyperthyroidism. (Aust N2 J Med 1987; 18: 37–44.)
Rhodococcus Equi: An Emerging Opportunistic Pathogen?
Authors: Jones M. R. , Neale T. J. , Say P. J. , Horne J. G. 
Published: March 2008

AbstractHuman infection with Rhodococcus equi is apparently rare with most published reports describing the development of lung abscesses in immunocompromised hosts. Of only 18 cases of infection previously recorded, four have recently occurred in patients with the acquired immune deficiency syndrome (AIDS). In Australasia, R. equi has frequently been isolated from soil and infected farm animals yet no human infections have been reported thus far. Three cases of R. equi infection have occurred in New Zealand and, collectively, they cover a wider spectrum of disease than that previously recognised. The natural history of R. equi infections, their clinical features and treatment are described in the light of our recent experience. (Aust NZ J Med 1989; 19: 103–107.)
DECISION‐MAKING IN 100 PATIENTS REFERRED TO THE AUSTRALIAN NATIONAL LIVER TRANSPLANTATION UNIT
Authors: McCAUGHAN G. W. , DORNEY S. F. A. , GALLAGHER N. D. , PAINTER D. M. , VICKERY R. , KYD G. , RICKARD K. , BOOKALLIL M. , WAUGH R. , THOMPSON J. F. , STEPHEN M. S. , SHEIL A. G. R. 
Published: March 2008

AbstractOne hundred patients were referred to the Australian National Liver Transplantation Unit between January 1986 and August 1987. The commonest disorders for referral were chronic active hepatitis in adults (22 cases), fulminant hepatic failure (14), primary biliary cirrhosis (PBC) (12) and primary sclerosing cholangitis (PSC) (10). Of the 100 patients 31 were activated for transplantation while 35 were deferred and 34 were found to be unsuitable. The decision‐making in these patients is discussed according to disease category. Timing of transplantation in PBC and PSC seemed clearcut, with 50% of referred patients being activated. However, major difficulties in timing of transplantation were found, particularly in patients with chronic active hepatitis (CAH) and fulminant hepatic failure (FHF). Of 36 patients with CAH (22) or FHF (14) only five were put on the active waiting list and only two were transplanted. Overall, 25 of the 31 patients underwent orthotopic liver transplantation, with 16 alive two‐30 months later.
AN INTRACRANIAL ARTERIOVENOUS MALFORMATION AND PALATAL MYOCLONUS RELATED TO PSEUDOXANTHOMA ELASTICUM
Authors: CHALK J. B. , PATTERSON M. C. , PENDER M. P. 
Published: March 2008

AbstractPseudoxanthoma elasticum is a rare hereditary disorder of elastic tissue with central nervous system manifestations due to occlusive vascular disease and aneurysm formation. Here we report the first recorded case of an intracranial arteriovenous malformation (AVM) in a patient with pseudoxanthoma elasticum. The AVM, which was located in the pons, also had an unusual manifestation, namely palatal myoclonus.
PROSPECTIVE EVALUATION OF A FLEXIBLE PROTOCOL FOR STARTING TREATMENT WITH WARFARIN AND PREDICTING ITS MAINTENANCE DOSE
Authors: COSH D. G. , MORITZ C. K. , ASHMAN K. J. , DALLY R. J. , GALLUS A. S. 
Published: March 2008

AbstractWe have evaluated a flexible warfarin dose induction protocol by monitoring its performance in 100 elderly inpatients.The protocol (designed by Fennerty et al., has two aims: (a) to move the prothrombin time (PT) ratio smoothly and quickly into its therapeutic range, and (b) to predict the steady‐state warfarin requirement from the PT ratio measured on the fourth treatment day.It proved simple to use and reasonably successful, since after four days, 67/100 patients had achieved a therapeutic level of PT ratio, nine exceeded the therapeutic range, and 24 remained sub‐therapeutic, while none had bled due to excessive anticoagulation. Maintenance dose prediction was tested by comparing the predicted and observed maintenance doses in patients within the ‘therapeutic range’ of PT ratio after various median times of treatment. After ten days, the observed dose was within 1 mg of that predicted in 65/86 patients (76%). This proportion became 57/77 (74%) after 18 days, and 49/79 (62%) after 34 days.
TWO‐DIMENSIONAL DOPPLER ECHOCARDIOGRAPHIC FLOW IMAGING – EXPLORATION OF CLINICAL IMPACT AND PROBLEMS
Authors: McDONALD I. G. , GUTMAN J. M. , HAMILTON G. 
Published: March 2008

AbstractRecent advances in electronic engineering have allowed Doppler echocardiography to be presented in the form of a real‐time two‐dimensional image. The resulting image of blood flow has been described as a ‘non‐invasive angiogram’, but the analogy with angiography should not be pushed too far since the technical determinants of these images are entirely different. Nevertheless, the colour flow map does allow rapid and direct exclusion, detection and quantitation of regurgitant and stenotic lesions, and semi‐quantitative assessment of valvular regurgitation and shunts. To achieve optimum results, it is necessary to standardise recording procedure, to take account of patient variables which influence the image appearance and quality and to be aware of the possibility of artefact. As for all investigations, results which are not coherent with other echocardiographic data, with other investigations and with the clinical assessment should be subjected to particular scrutiny with the possibility of false diagnosis in mind.
CORONARY RISK FACTOR OUTCOMES FOLLOWING CORONARY ARTERY BYPASS SURGERY
Authors: OLDENBURG B. , PIERCE J. , SICREE R. , ROSS D. 
Published: March 2008

AbstractThe coronary risk factor status of patients prior to and following coronary artery bypass surgery (CABG) has been poorly investigated. Two consecutive series of CABG patients were surveyed following CABG. One hundred and thirty patients were assessed immediately following CABG and 530 patients were assessed 12–30 months following CABG. For the long‐term post‐CABG group, over 80% of those who had ever smoked had ceased. Sixty‐four per cent of these males and 50% of females were classified as being overweight. Twenty‐five per cent of males and 34% of females reportedly had high serum cholesterol (i.e. 6.5 mmol/L). Comparing these CABG data with age‐adjusted National Heart Foundation Risk Factor Prevalence Survey data, there was a higher prevalence of ex‐smokers, overweight, hypertension, and elevated cholesterol. It was concluded that on most coronary risk factors, except for smoking, these CABG patients had a worse profile than the general Australian community. This problem warrants further research and the development of appropriate treatment programs.
MASSIVE BENIGN THYMOMA PRESENTING AS OCULAR MYASTHENIA
Authors: GOADSBY P. J. , ADAMS R. W. , LANCE J. W. 
Published: March 2008

AbstractA case of ocular myasthenia was found to be associated with a massive benign thymoma and responded to its removal. This is an exception to the generalisation that larger tumours of the thymus gland are more likely to be malignant and that thymectomy is not the treatment of choice for ocular mysthenia.
THE ROLE OF BRONCHOALVEOLAR LAVAGE IN THE ASSESSMENT OF DIFFUSE LUNG DISEASES
Authors: GIBSON P. G. , ROBINSON B. W. S. , McLENNAN G. , BRYANT D. H. , BREIT S. N. 
Published: March 2008

AbstractBronchoalveolar lavage is a safe and simple technique for sampling the inflammatory cells of the lung. However, while its use in the evaluation of pulmonary pathogenic mechanisms is both well accepted and described, its clinical utility is more controversial. Marked variation in results may occur through variation in the lavage procedure. Standardisation of the lavage technique and laboratory processing of the specimen are essential for reliable results. This review examines the current clinical role of bronchoalveolar lavage in the assessment of patients with diffuse lung diseases, and immunocompromised patients with pulmonary infiltrates. In this latter category, for patients with Acquired Immunodeficiency Syndrome, lavage is of equal efficacy to lung biopsy and can establish the cause of pulmonary infiltrates in over 90% of cases. Bronchoalveolar lavage can detect abnormalities in patients with diffuse lung diseases prior to the development of irreversible fibrosis. Lavage features have been described for sarcoidosis, cryptogenic fibrosing alveolitis, extrinsic allergic alveolitis, connective tissue diseases, and asbestosis. In cryptogenic fibrosing alveolitis lavage data may be used to indicate a subsequent deterioration in the patient's condition, or predict a favourable response to therapy.
BLEEDING DUE TO AN ACQUIRED INHIBITOR OF PLATELET ASSOCIATED FACTOR V
Authors: GRIGG A. P. , DAUER R. , THURLOW P. J. 
Published: March 2008

AbstractFactor V inhibitors are uncommon, bleeding manifestations variable and recommendations for management are unclear. We present a patient with non‐Hodgkins lymphoma who developed gastrointestinal bleeding and was found to have a Factor V inhibitor. The inhibitor was active against both plasma Factor V and platelet associated Factor V, and was associated with a five‐fold increase in platelet associated IgG. Fresh frozen plasma was ineffective in preventing bleeding. Resolution of bleeding was associated with a fall in the levels of the inhibitor and of platelet associated IgG. The patient had no further bleeding episodes nor evidence of progression of his lymphoma, but six months later died as a result of metastatic adenocarcinoma.
SIMVASTATIN (MK 733): AN EFFECTIVE TREATMENT FOR HYPERCHOLESTEROLEMIA
Authors: LINTOTT C. J. , SCOTT R. S. , NYE E. R. , ROBERTSON M. C. , SUTHERLAND W. H. F. 
Published: March 2008

AbstractThis study describes the efficacy of the drug simvastatin. It is likely to be the first HMG CoA reductase inhibitor in Australia and New Zealand available for the treatment of hyperlipidemia.Twenty‐four patients, 12 men and 12 women with primary hypercholesterolemia were randomly allocated to treatment by cholestyramine (eight patients) or to simvastatin (16 patients) for a 12‐week period.With simvastatin, total cholesterol levels decreased by 37.5% from a baseline mean of 10.33 mmol/L to 6.4 mmol/L after 12 weeks. Low density lipoprotein (LDL) cholesterol concentration decreased by 48.2% from 8.40 mmol/L to 4.39 mmol/L. These effects were better than observed for cholestyramine alone where cholesterol and LDL‐cholesterol reductions were 24.9% and 33.1% respectively.Thirteen patients, however, did not achieve target LDL levels of 3.62 mmol/L, or below, and therefore were treated with a combination of cholestyramine and simvastatin, resulting in a decrease of total cholesterol and LDL‐cholesterol by 45.5% and 53.5% of baseline values studied over an eight‐week period.No major clinical side‐effects were encountered. One patient appeared to have had a change in colour vision at the end of the study at 20 weeks, without loss of visual acuity.
LIVER TRANSPLANTATION: AN UPDATE FOR PHYSICIANS
Authors: POWELL L. W. 
Published: March 2008

AbstractEnd‐stage irreversible liver disease, previously treated only by partially‐effective, symptomatic measures, can now be reversed by successful liver transplantation at reasonable cost and with comparatively little increase in resources. Three Australian liver transplant programs are now established with results comparable to those of more experienced overseas centres. New organ‐preservation techniques and reduced‐size orthotopic transplantation in children should significantly increase donor organ availability.Orthotopic liver transplantation should be considered as a therapeutic option once a patient has been diagnosed as suffering from intractable, non‐malignant chronic liver disease.