bluuebunny/crossref_metadata_2025_split huggingface dataset:
ARTICULAR MANIFESTATIONS OF ACROMEGALY
Authors: PODGORSKI M. , ROBINSON B. , WEISSBERGER A. , STIEL J. , WANG S. , BROOKS P. M. 
Published: March 2008

Abstract:Forty‐five patients with acromegaly or gigantism were reviewed for musculoskeletal abnormalities. Abnormalities of peripheral joints occurred in 74% of the patients and spinal involvement in 47%, leading to significant morbidity. Joint abnormalities most frequently affected the large joints (hips, knees and shoulders) but the wrist and hand were also involved. The radiological features of acromegalic arthropathy are described, including vertical widening of the hip joint, enthesopathy and osteophytosis. A favourable response to treatment is associated with a less severe arthropathy and a good functional outcome.
ENCEPHALOPATHY FOLLOWING CISPLATIN, BLEOMYCIN AND VINBLASTINE THERAPY FOR NON‐SEMINOMATOUS GERM CELL TUMOUR OF TESTIS
Authors: HITCHINS R. N. , THOMSON D. B. 
Published: March 2008

Abstract:A 22‐year‐old man developed severe encephalopathy, grand mal seizures and visual disturbance after combination chemotherapy with cisplatin, vinblastine and bleomycin for metastatic testicular carcinoma. After excluding treatable causes, only supportive management was given, and the symptoms and signs resolved over several months. We suggest a clinical syndrome of encephalopathy, seizures and visual disturbance represents a rare toxicity of cisplatin‐based therapy. Given the wide spread usage of cisplatin, this should be drawn once again to the attention of medical oncologists.
WISKOTT‐ALDRICH SYNDROME IN IDENTICAL TWINS: ABNORMALITY OF CD4 AND CD8 POSITIVE LYMPHOCYTES
Authors: FORSYTH K. , SESHADRI R. , MATTHEWS C. , HEDDLE R. 
Published: March 2008

Abstract:The rare occurrence of Wiskott‐Aldrich syndrome (WAS) in identical twin brothers without a preceding family history of the disease is described. Investigation into the nature of the lymphocyte abnormality in the surviving twin suggests that the frequency of T cell clone forming cells is markedly decreased. Further analysis of the T cell clones showed a deficiency of CD8 positive cytotoxic/suppressor cells. This alteration may be an underlying mechanism in the development of some of the clinical manifestations of WAS
DISSEMINATED TUBERCULOSIS COMPLICATED BY THE HEMOPHAGOCYTIC SYNDROME
Authors: BROWETT P. J. , VARCOE A. R. , FRASER A. G. , ELLIS‐PEGLER R. B. 
Published: March 2008

Abstract:A 43‐year‐old Polynesian presented with fever, abnormal liver function tests, bilateral pulmonary infiltrates, and a progressive neutropenia and thrombocytopenia. Bone marrow examination showed extensive and striking hemophagocytosis which raised the diagnosis of malignant histiocytosis. Mycobacterium tuberculosis was subsequently cultured from both urine and bone marrow. Hemophagocytosis is now a recognised association of several infections and we draw attention to this finding, particularly as the confident exclusion of malignancy can be very difficult and management is obviously very different.
NON CAMPYLOBACTER PYLORI SPIRAL ORGANISMS IN THE GASTRIC ANTRUM
Authors: LEE A. , ECKSTEIN R. P. , FEVRE D. I. , DICK E. , KELLOW J. E. 
Published: March 2008

AbstractColonisation of the human gastric antrum with non Campylobacter pylori spiral organisms is described. A moderately severe histological gastritis was present despite the fact that these organisms, in contrast to C. pylori, were not closely associated with the epithelial cell surface. Although in vitro culture of the organisms was unsuccessful, in vivo culture was achieved in the mouse stomach. Further study of these spiral organisms should provide important clues to the role of bacteria in upper gastrointestinal disease.
CYCLOSPORIN A IN THE TREATMENT OF CHILDHOOD GLOMERULONEPHRITIS
Authors: JAMES R. W. , BURKE J. R. , PETRIE J. J. B. , RIGBY R. J. , WILLIAMS M. 
Published: March 2008

AbstractSeven children with steroid resistant nephrotic syndrome (focal segmental sclerosis in six, mesangial proliferation in one) were treated with Cyclosporin A for 12 weeks. Five of these children were also resistant to cyclophosphamide. All patients had normal renal function. Cyclosporin was started at 8mg/kg/day then increased until a trough blood level of 100–300 ng/ml (HPLC) was achieved. Three of the seven patients achieved complete remission, and the other four had a significant reduction in their proteinuria (p < 0.05). In the three patients who achieved complete remission, relapse of proteinuria occurred within six weeks of ceasing Cyclosporin. All patients experienced some impairment in renal function with mean creatinine clearance decreasing from 12919 to 9113 ml/min/1.73m2 (p < 0.05). One child was subsequently treated with Cyclosporin for 12 months. He remains in remission with a repeat renal biopsy showing no evidence of nephrotoxicity.One other child with steroid sensitive minimal change nephrotic syndrome who had severe steroid toxicity was treated with a lower dose (5mg/kg/day) for 12 months. She remained in remission off steroids, but relapsed 16 weeks after Cyclosporin was ceased. A renal biopsy after 12 months showed no nephrotoxicity. Cyclosporin should be considered in steroid resistant nephrotic syndrome, and in children with minimal change disease who show signs of steroid toxicity and short remission period after cyclophosphamide. Serial renal biopsies are recommended with prolonged therapy.
INFERIOR PETROSAL SINUS SAMPLING IN ACROMEGALY
Authors: CROCK P. A. , GILFORD E. J. , HENDERSON J. K. , CUMMINS J. , CALENTI A. J. , BEST J. D. , ALFORD F. P. 
Published: March 2008

AbstractIn view of the diagnostic value of bilateral simultaneous inferior petrosal sinus sampling (BSIPSS) in localising preoperatively the site of the microadenoma in pituitary dependent Cushing s disease, the clinical value of BSIPSS was evaluated in five acromegalic patients with equivocal or negative pituitary CT scans. Intersinus GH gradients were obtained for all patients (range 1.6–4.2) but in only one case was the gradient correctly localised to the side of the tumour. Gradients of several other pituitary hormones, particularly prolactin (range 1.6–4.0), also demonstrated gradients parallel to the GH intersinus gradients. Despite the paradoxical intersinus GH gradients, the surgeon was able to readily identify the tumour at the time of surgery. Thus BSIPSS is of little assistance to the surgeon for the preoperative radiological evaluation in acromegaly and these results caution against the universal adoption of the BSIPSS technique in the radiological assessment of all secretory pituitary microadenomas.
THE EFFECT OF HISTAMINE CHALLENGE ON PLATELET COUNT AND PLATELET ACTIVATION
Authors: DUGGAN C. J. , PARMENTIER M. D. , CASTLE W. D. , BEREND N. 
Published: March 2008

AbstractThere is conflicting evidence of platelet involvement in asthmatic bronchoconstriction. We sought direct evidence of platelet activation and indirect evidence of platelet sequestration following histamine challenge (HC) in 14 asthmatics and seven non asthmatic control subjects. Peripheral platelet counts and levels of β thromboglobulin (BTG) were measured immediately before and following HC in the 21 subjects. There were no significant differences in the platelet counts or BTG levels, before or after HC, within or between the two groups. These results do not support platelet activation or accumulation in the lungs occurring immediately following histamine induced bronchoconstriction in asthmatics.
VENTILATORY RESPONSES TO HYPOXIA AND HYPERCAPNIA IN ASTHMATICS WITH PREVIOUS RESPIRATORY FAILURE
Authors: TOWN G. I. , ALLAN C. 
Published: March 2008

AbstractThe ventilatory response to hypoxia and the ventilatory and mouth occlusion pressure response to hypercapnia was measured in 13 subjects who had previously developed respiratory failure or respiratory arrest during an acute asthma attack, In 11 of 12 subjects tested there was a normal response to hypercapnia. Six of the 13 subjects had an impaired response to hypoxia. Impaired hypoxic responsiveness may Contribute to the early onset of hypercapnic respiratory failure during acute severe asthma.
PROTEINURIA, GLOMERULOMEGALY AND FOCAL GLOMERULOSCLEROSIS IN A GROSSLY OBESE MAN WITH OBSTRUCTIVE SLEEP APNEA SYNDROME
Authors: BAILEY R. R. , BURRY A. F. , LYNN K. L. , DRENNAN C. 
Published: March 2008

AbstractA grossly obese (149 kg) man with the sleep apnea syndrome was found to have proteinuria and a supernormal glomerular filtration rate. Renal histology showed glomerulomegaly and focal glomerulosclerosis. It is suggested that obesity may induce glomerular hyperfiltration and in turn glomerulosclerosis.
GUILLAIN‐BARRÉ SYNDROME AND RELATED CONDITIONS IN VICTORIAN TEACHING HOSPITALS 1980–84
Authors: STOREY E. , COOK M. , PEPPARD R. , NEWTON‐JOHN H. , BYRNE E. 
Published: March 2008

AbstractCases of Guillain‐Barré syndrome, its variants, and chronic inflammatory demyelinating neuropathy presenting during the period 1980–84 were identified through computer‐based record systems. Case notes were examined, and cases that did not meet standard criteria for diagnosis were excluded. A hundred and ten patients were identified, giving an annual adult incidence rate of 0.9/100,000 and a male:female ratio of 1.3:1. The majority of cases developed severe tetraparesis, but unusual presentations included the Miller‐Fisher variant, paraplegia, and bibrachial involvement. There was wide variation in peak disability, ranging from ambulant with weakness (32%), through bedfast but without significant respiratory involvement (29%), to respiratory involvement requiring admission to an intensive care unit (38%). Of those discharged directly home, the average hospital stay for those less than 50 years was 27 days, whilst that for those over 50 was 49 days. CSF protein was measured in 87 patients, and was ≥0.6 g/L in 76% of these. Nerve conduction studies were performed in 52 patients, and were abnormal in 90% of these. Guillain‐Barré syndrome and allied conditions represent a major drain on health resources, and the need to provide adequate plasmapheresis facilities for patients early in the course of severe disease is stressed.
ACUTE LEAD ARSENATE POISONING
Authors: TALLIS G. A. 
Published: March 2008

AbstractThree cases of acute lead arsenate poisoning which occurred in South Australia during a 12 month interval are described. The case reports demonstrate a number of features of the characteristic clinical syndrome which may follow ingestion of lead arsenate. The recommended management is immediate gastric lavage and subsequent chelation therapy with calcium EDTA and dimercaprol. Early gastric lavage may prevent significant lead absorption. However, arsenic acid (produced in the stomach when lead arsenate reacts with hydrochloric acid) is relatively water soluble and prompt gastric lavage is unlikely to prevent extensive arsenic absorption. It remains controversial as to whether chelation with dimercaprol prevents arsenical neuropathy.
CHLOROQUINE ABUSE AND HEART BLOCK IN AFRICANS
Authors: IHENACHO H. N. C. , MAGULIKE E. 
Published: March 2008

Abstract:Twelve of 30 Africans with heart block gave a history of chronic chloroquine abuse. Eleven of these had evidence of chloroquine retinopathy whereas four of the 18 nonabusers had abnormal ophthalmologic findings, thought to be senile changes. The chronic chloroquine abusers were all male and were younger (mean age 51.6 years) than the non‐abusers (mean age 61.2), nine of whom were female. Serum chloroquine levels were not helpful diagnostically.In the absence of other etiological factors, chronic chloroquine toxicity is important in the causation of heart block in Africans. (Aust NZ J Med 1989; 19: 17–21.)
CUTANEOUS VASCULITIS DUE TO CYCLOPHOSPHAMIDE THERAPY FOR CHRONIC LYMPHOCYTIC LEUKEMIA
Authors: GREEN R. MALCOLM , SCHAPEL GRAHAM J. , SAGE ROBERT E. 
Published: March 2008

Abstract:A 55‐year‐old male with chronic lymphocytic leukemia developed a skin eruption after receiving oral cyclophosphamide. Subsequent rechallenge with parenteral cyclophosphamide led to recurrence of the skin lesions, which on biopsy were shown to be vasculitic in nature. (Aust NZ J Med 1989; 19: 55–57.)
Endometrial adenocarcinoma presenting as pituitary apoplexy
Authors: Lieschke G. J. , Tress B. , Chambers D. 
Published: March 2008

AbstractThe novel combination of disseminated primary endometrial adenocarcinoma and a symptomatic pituitary metastasis presenting as pituitary apoplexy is described for the first time. Pituitary apoplexy is an unusual manifestation of metastatic pituitary disease. The more common clinical features of pituitary metastases and an approach to their management are discussed. The usefulness of magnetic resonance imaging in assessing the base of skull is emphasised.
Comparison of methods of assessment of renal function in patients with cancer treatedwith cisplatin, carboplatin or methotrexate
Authors: Robinson B. A. , Atkinson C. H. , Frampton C. M. , Fitzharris B. M. , Colls B. M. 
Published: March 2008

AbstractIn patients with cancer treated with cisplatin, carboplatin or methotrexate creatinine clearance calculated using the Cockcroft‐Gault formula was compared with measured clearance and with the glomerular filtration rate. In 106 patients the average squared difference for calculated and 24 hour urine creatinine clearance was 0.288, n = 606; and for calculated creatinine clearance and glomerular filtration rate (measured using diethylenetriaminepenta‐acetic acid, DTPA), 0.212, n = 34.On 35 of 606 occasions (6%) in 18 patients (17%), the calculated clearance overestimated the 24‐hour urine creatinine clearance when it was less than 1 mL/s. In all but one patient, this was explained by factors leading to renal impairment (seven patients) or overestimation of clearance (ascites in two patients) or by an isolated low value for 24‐hour urine creatinine clearance (eight patients). Declining renal function with increasing total dose of cisplatin was detected by both calculated and 24‐hour urine creatinine clearance in patients with germ cell tumours.Derivation of an equation to predict creatinine clearance showed a linear association with plasma creatinine concentration, patient age, weight and gender. Variability in cancer patients was similar to that in the original Cockcroft‐Gault study. Calculation of creatinine clearance can be used in cancer patients to monitor treatment with renally‐eliminated chemotherapy agents.
Clinical benefit of transdermal glyceryl trinitrate when used with an eight hour patch‐free period
Authors: Whalley D. W. , Hellestrand K. J. 
Published: March 2008

AbstractThe 24‐hour application of transdermal nitrate patches has been associated with rapid development of therapeutic tolerance. Recent reports suggest maintenance of clinical benefit by introducing a daily patch‐free period. This study investigates, by means of serial treadmill testing, the efficacy of a new transdermal delivery system when used with an eight hour patch‐free period in 16 subjects with chronic stable angina. Concomitant antianginal therapy was permitted. After demonstration of exercise test reproducibility and nitrate responsiveness, subjects entered a double‐blind randomised placebo‐controlled crossover trial comprising one week of active nitroglycerin patches (10mg/24hrs) and one week of an identical placebo patch. Exercise tests were conducted four hours after patch application on the last day of each of the treatment arms. Daily angina frequency and nitroglycerin consumption were also monitored.There was significant improvement in total exercise duration (16.5%), time to onset of angina (26%), time to 1mm ST depression (22%), and peak heart rate blood pressure product with active patch application. Angina frequency was reduced during the week of active therapy. These results demonstrate the additional efficacy of intermittent transdermal nitroglycerin in a group of subjects with continuing angina despite therapy with beta‐blockers and calcium antagonists.
Effects of an ethyl ester preparation of fish oils (HIMEGAR) on lipids and lipoproteins in hyperlipidaemia
Authors: Simons L. A. , Parfitt A. , Simons J. , Balasubramaniam S. 
Published: March 2008

AbstractClinical trials were conducted to assess the utility of HimegaR in the management of hyperlipidaemia. Himega is an ethyl ester concentrate from fish oil containing at least 50% n‐3 fatty acid and minimal cholesterol. In Study 1, 13 subjects with primary hypertriglyceridaemia consumed Himega or a triglyceride‐based fish oil in a randomised, double‐blind crossover study for 12 weeks. Nine subjects took 2 g/day of n‐3 fatty acid but four subjects with marked hypertriglyceridaemia took 4 g/day. Plasma triglycerides were reduced by approximately 50% with either product. There was a very similar effecton all lipid and lipoprotein parameters, including an 18% increase in LDL cholesterol and23% increase in serum apolipoprotein B. In Study 2, nine subjects with primary hypercholesterolaemia took 2 g/day of n‐3 fatty acid (Himega) or placebo (olive oil) in a randomised, double‐blind crossover study for nine weeks. Plasma cholesterol was reduced by 6%, without significant change in LDL. cholesterol. Fish oils in the form of ethyl esters or triglyceride are assimilated to a similar degree and lead to equivalent triglyceride‐lowering in hypertriglyceridaemia, while simultaneously increasing LDL particle numbers. Himega does not reduce LDL levels in hypercholesteraemia, despite being a product with minimalcholesterol content.
Covert self poisoning with brodifacoum, a ‘superwarfarin’
Authors: Wallace S. , Worsnop C. , Paull P. , Mashford M. L. 
Published: March 2008

AbstractThe clinical course of a patient poisoned with the ‘superwarfarin’ brodifacoum and a method for estimation of plasma levels is described. It was characterised by prolonged depression of Vitamin K‐dependent clotting factors poorly responsive to Vitamin K administration.
An overview of bilateral synchronous inferior petrosal sinus sampling (BSIPSS) in the pre‐operative assessment of Cushing's disease
Authors: Boolell M. , Gilford E. , Arnott R. , McNeill P. , Cummins J. , Alford F. 
Published: March 2008

AbstractThis study examines the role of bilateral synchronous inferior petrosal sinus sampling (BSIPSS) in resolving two major issues in the pre‐operative assessment of Cushing's disease, namely proof of pituitary dependent disease and accurate lateralisation of tumour within the pituitary. BSIPSS was technically successful in 16 of 20 patients. The central to peripheral ACTH gradients, supporting the diagnosis of pituitary dependent disease, was <2.0 (2.0–27.2) in all patients with histologically proven ACTH‐secreting pituitary tumours and in those who remained in remission following pituitary surgery. In addition, BSIPSS accurately localised the site of the tumour within the pituitary in 13 of the 16 technically satisfactory studies and thus contributed to the outcome of surgical treatment. In contrast CT scan demonstrated a definite tumour in only two patients.
Antacid‐induced phosphate depletion syndrome presenting as nephrolithiasis
Authors: Harmelin D. L. , Martin F. I. R. , Wark J. D. 
Published: March 2008

AbstractA 29‐year‐old insulin‐dependent diabetic woman developed phosphate depletion, nephrolithiasis and bilateral ureteric obstruction due to antacid abuse. Unlike previous descriptions of chronic phosphate depletion, myalgia, weakness and bone pain were absent. Biochemical features included hypophosphataemia, hypercalciuria, hypophosphaturia, elevated plasma 1,25‐dihydroxyvitamin D and low plasma intact parathyroid hormone. These abnormalities were corrected when antacid ingestion was reduced and phosphate intake supplemented. Wepropose that phosphate depletion secondary to antacid abuse caused 1α‐hydroxylase activation and elevation of the plasma 1,25‐dihydroxyvitamin D level, leading to marked hypercalciuria. Once diagnosed, antacid abuse is a readily reversible cause of hypercalciuria and renal stones. Moreover, antacid‐induced phosphate depletion may present with nephrolithiasis in the absence of musculoskeletal symptoms. This report is intended to draw attention to this important cause of renal stone disease.
Aspirin concurrently administered with ranitidine does not delay healing of duodenal ulcer
Authors: Misra S. P. , Kumar N. , Anand B. S. 
Published: March 2008

AbstractSixty‐nine patients with endoscopically diagnosed duodenal ulcer were randomised to either Group I or Group II. Group I patients (n= 35) received tablet ranitidine 150 mg twice daily along with tablet aspirin 600 mg three times a day while Group II patients received only tablet ranitidine 150 mg twice daily. Eight patients (four in each group) dropped out of the trial but were included in the final analysis as failure of treatment. At the end of four weeks 51.4% ulcers healed in Group I compared to 58.8% in Group II. The difference between the two groups was not significant. There was also no statistical difference in the time required for relief of pain, number of patients relieved of pain and the complication rate. It is concluded that aspirin concurrently administered with ranitidine is safe and does not delay the healing of uncomplicated duodenal ulcers.
Pulmonary toxicity following MOPP chemotherapy
Authors: Millward M. J. , Cohney S. J. , Byrne M. J. , Ryan G. F. 
Published: March 2008

AbstractPulmonary toxicity is a well recognised side effect of anticancer agents particularly bleomycin, cyclophosphamide, methotrexate, and busulphan.1 In contrast this problem has been infrequently reported following MOPP (nitrogen mustard, vincristine, prednisolone, procarbazine) chemotherapy for Hodgkin's disease and has been attributed principally to the procarbazine.2–8 We report a further instance of MOPP associated pulmonary toxicity. This case and a review of previously published cases indicate that MOPP chemotherapy may be associated with the development of permanent lung damage as well as an acute reversible hypersensitivity lung disease.
Electrical ablation of posteroseptal accessory pathways
Authors: Vohra J. , Strathmore N. , Kertes P. , Hunt D. 
Published: March 2008

Abstract Electrical ablation of a posteroseptal accessory pathway by delivery of direct current electrical energy at the coronary sinus ostium was attempted in six patients.As a result of 12 procedures in these six patients, the posteroseptal accessory pathway was successfully ablated in one patient. Retrograde conduction only was affected in a further three patients, abolishing paroxysmal supraventricular tachycardia in two and reducing the tachycardia rate in one. One of the six patients developed coronary sinus perforation requiring prompt pericardial aspiration.The procedure is complicated, time consuming, of limited efficacy and coronary sinus perforation is a significant risk. Surgery remains the preferred option as a curative procedure for arrhythmias due to posteroseptal accessory pathway.