bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti‐neutrophil cytoplasmic antibodies (ANCA) in myelodysplasia and other haematological disorders
Authors: Savige J. A. , Chang L. , Smith C. L. , Duggan J. C. 
Published: March 2008

Abstract Background: Anti‐neutrophil cytoplasmic antibodies (ANCA) are typically associated with small vessel vasculitides. They are also found in situations where other autoantibodies are common, sometimes after infections and possibly in individuals who have received multiple blood transfusions. Aims: The aim of this study was to determine the incidence of ANCA in a variety of haematological disorders, where these predisposing factors may be at work. Methods: Sera from patients with myelodysplasia (n= 26), acute myeloid leukaemia (AML) (n= 3), and myeloproliferative (n= 25) or lymphoproliferative syndromes (n= 16) were screened for ANCA using a crude neutrophil cytoplasmic extract ELISA and indirect immunofluorescent examination of normal peripheral blood neutrophils. Positive results were confirmed by ELISAs for anti‐proteinase 3, anti‐myeloperoxidase or anti‐elastase antibodies. Results: ANCA were demonstrated in two patients with myelodysplasia, both with chronic myelomonocytic leukaemia and greater than 5% blasts in the bone marrow. Both of these individuals were infected at the time that ANCA were demonstrated and other autoantibodies were present. One of these individuals had never had evidence of any vasculitis; the other probably developed myelodysplasia after treatment with cyclophosphamide for Wegener's granulomatosis. ANCA were demonstrated in one individual with AML secondary to myelodysplasia. ANCA were also found in a patient with lymphoma in whom autoantibodies against red cells and platelets were already noted. ANCA were demonstrated in one further individual with lymphomatoid granulomatosis, a condition that resembles Wegener's granulomatosis clinically and histologically, but which is treated as a lymphoma. No ANCA were present in any of the patients with myeloproliferative syndromes. Discussion: ANCA probably occur secondary to immune dysregulation in myelodysplasia and the lymphoproliferative conditions and they are not necessarily associated with the presence of a vasculitis.
Aspirin reduces the incidence of colonic carcinoma in the dimethylhydrazine rat animal model
Authors: Davis A. E. , Patterson F. 
Published: March 2008

Abstract Background: Epidemiological studies in humans suggest that regular use of non‐steroidal anti‐inflammatory drugs (NSAIDs) especially aspirin significantly decreases the risk of developing colorectal cancer. Aims: The purpose of this study was to investigate the effect of aspirin on colonic carcinogenesis using the dimethylhydrazine (DMH) colonic cancer model in rats. Methods: Groups of animals were given daily doses of aspirin either 0, 5, 30 or 60 mg/kg for 18 weeks. Half of each group also received 18 × 30 mg/kg/wk injections of DMH. Results: Aspirin at doses of 5, 30 or 60 mg/kg/dy had a progressive effect on the reduction of tumour numbers and the percentage of tumours greater or equal to 5 mm in diameter. Aspirin at doses of 30 and 60 mg/kg/dy significantly reduced tumour incidence. Conclusion: These findings support the epidemiological studies in humans. The rat DMH model would appear to be suitable for investigating the mechanism of action of aspirin in reducing colonic tumour formation.
Screening for genetic haemochromatosis in a rheumatology clinic
Authors: Olynyk J. , Hall P. , Ahern M. , Kwiatek R. , Mackinnon M. 
Published: March 2008

Abstract: Background: Recent data indicate that the prevalence of genetic haemochromatosis (GH) is greater than previously recognised and suggest that this disease is underdiagnosed. Aims: To determine the prevalence of GH in a rheumatology clinic population. Methods: Over a 12 month period 339 consecutive patients, mean age 67.0 years, attending a rheumatology clinic were screened for iron overload. Results: Twenty three patients had elevated initial screening tests (transferrin saturation [Tf %] > 55% ferritin > 500 μg/L). Repeat fasting Tf % and ferritin concentrations were obtained in 20 of these patients. Twelve patients had persistently elevated results, and of these patients four had liver biopsy tissue hepatic iron indices consistent with GH. One patient in the group had the diagnosis established by liver biopsy just before the screening commenced. Thus, the prevalence of GH in this population was 1.5% ‐ five times that anticipated for the general population. Three of the patients with GH presented with an arthropathy which was not characteristic of the disease. The increased prevalence of GH in this group of patients with peripheral arthropathy provides an excellent justification for the routine screening of patients with peripheral arthritis for the exclusion of iron overload.
HLA non‐identical T‐cell‐depleted bone marrow transplantation for primary immunodeficiency diseases
Authors: Giri N. , Vowels M. , Ziegler J. B. , Ford D. , Lam‐Po‐Tang R. 
Published: March 2008

Abstract: Background: Bone marrow transplantation (BMT) is usually the only procedure offering cure for children with life‐threatening immune deficiency disorders, but compatible sibling donors are frequently unavailable. Aims and Methods: To examine the outcome of HLA non‐identical T‐cell‐depleted BMT carried out between April 1985 and May 1992 in 11 patients with primary immunodeficiency diseases and to seek prognostic factors. Results: Eight patients achieved sustained engraftment, one after a second BMT. One further patient engrafted transiently, but rejected the graft five months later. Acute graft‐versus‐host disease (GVHD) grade II was seen in one and chronic GVHD was seen in three children. Seven patients survived beyond six months, six with donor T cell and five with donor B cell engraftment. At present, five patients (46%) are alive with immune reconstitution at a median follow‐up of 14 months (range 6 to 78 months). The major factor associated with outcome was the presence of any infection within one week of BMT (p= 0.01). The presence of lung infection also tended to be a poor prognostic factor (p> = 0.06) but did not reach significance, presumably because of the small sample size. HLA non‐identical (parental) T‐cell depleted BMT plays an important role in the cure of children with immunodeficiencies who do not have an identical sibling donor. Survival can be further improved if the diagnosis of immunodeficiency disease is made early and BMT undertaken before significant infections occur. Conclusions: The availability of T‐cell depleted haploidentical parental bone marrow transplant can be anticipated to improve outcome significantly for children with severe immunodeficiency, especially when diagnosed early.
Experience with the Gianturco‐Roubin stent for abrupt vessel closure complicating percutaneous transluminal coronary angioplasty
Authors: Carey L. , Cameron J. , Aroney C. , Bett N. , Holt G. , Mahononda N. , McEniery P. 
Published: March 2008

Abstract: Background: Emergency coronary artery bypass grafting (CABG) has previously been the only option in the treatment of refractory abrupt vessel closure complicating percutaneous transluminal coronary angioplasty (PTC A), and has been associated with high rates of morbidity and mortality. Intracoronary stenting now provides an alternative to emergency CABG. Aim: To assess our initial experience with emergency coronary artery stenting as a new technique. Methods: Retrospective case study review with clinical and angiographic follow‐up. Results: The Gianturco‐Roubin (GR) stent was deployed in 13 patients in whom PTCA was complicated by abrupt vessel closure refractory to standard balloon techniques. Indications for PTCA were unstable angina (six), stable angina (six) and acute myocardial infarction (MI) (one). The arteries stented included left anterior descending (LAD) artery lesions (eight) and right coronary artery lesions (five). Two patients required urgent CABG, one due to failed stent deployment and one for inadequate control of vessel dissection. In seven of the stented patients the creatine kinase rose to greater than twice the upper limit or normal. Three patients had subacute thrombotic occlusion at seven to 19 days post stent deployment, managed with intravenous thrombolysis or repeat PTCA. At seven months follow‐up, 11 patients were free of angina, two patients had Canadian Heart Association class II angina and there were no deaths. Eleven patients had repeat angiography at mean six months post stent. Five patients had evidence of restenosis managed with repeat PTCA in four and CABG in one. Conclusions: The GR stent is an effective alternative to urgent CABG in the treatment of refractory abrupt vessel closure complicating PTCA.
The prognosis for end‐stage renal failure in spinal cord injury and spina bifida ‐ Australia and New Zealand, 1970–1991*
Authors: Patrickf G. M. , Mahony J. F. , Disney A. P. S. 
Published: March 2008

Abstract: Background: The outcome of patients with end‐stage renal failure (ESRF) and spinal cord injury or disease has not been clearly documented. Methods: Fifty patients (two groups: 25 ‐ spinal cord injury, 25 ‐ SB) were identified retrospectively by questionnaire to individual renal units. Additional information was obtained from the Australia and New Zealand Dialysis and Transplant Registry. Dialysis and transplant history, degree of disability and cumulative survival with integrated treatment were compared between the two groups. Results: Haemodialysis was the most common form of treatment (75.8% of total treatment time in the spinal cord injury group and 66.1% in the SB group). Home or self‐care dialysis for a period of more than six months was achieved in 68% of patients in each group. Ten year cumulative survival with integrated treatment was statistically better in the SB group (p < 0.01). In the 42% of all patients who underwent renal transplantation cumulative patient survival was 94% at one year and 82% at five years, with allograft survival being 73% and 70% respectively. In conclusion ESRF and spinal cord injury or SB has a good prognosis in the longer term with an integrated approach to treatment. Aims: The aim of this study was to define the prognosis and social consequences for patients with spinal cord injury or spina bifida (SB) treated for ESRF in Australia and New Zealand from 1970 to 1991.
A review of observational studies on the relationship between cholesterol and coronary heart disease
Authors: Calvert G. Dennis 
Published: March 2008

Abstract:The likelihood that an association observed in epidemiological studies is one of cause and effect is often evaluated using criteria first put forward by Bradford Hill. The evidence on whether abnormal concentrations of cholesterol and lipoproteins in the blood plasma cause coronary heart disease (CHD) is considered using Bradford Hill's criteria. Evidence from observational studies, backed by evidence from clinical, animal and laboratory studies, leaves no doubt that a high plasma cholesterol concentration is a cause of CHD.
A prospective study of screening upper gastrointestinal (GI) endoscopy prior to and after bone marrow transplantation (BMT)
Authors: Forbes G. M. , Rule S. A. J. , Herrmann R. P. , Davies J. M. , Collins B. J. 
Published: March 2008

Abstract Background: Upper gastrointestinal (GI) endoscopic abnormalities are common in symptomatic bone marrow transplant (BMT) recipients but the incidence of occult gastrointestinal disease in these patients is unknown. Aims: To examine the role of screening upper GI endoscopy before and after BMT. Methods: Endoscopy was performed routinely on allogeneic (n = 24) and autologous (n = 17) BMT patients before transplant and at 30 and 120 days after transplant. Results: Twenty‐one of 41 patients (51%) had an endoscopic abnormality on one or more occasions which necessitated a change in treatment. These abnormalities were present in ten of 41 (24%) pre‐transplant endoscopies, ten of 32 (31%) endoscopies at day 30 after BMT, and in seven of 22 (32%) day 120 endoscopies. Abnormalities included mucosal erosions or ulcers (n = 22 endoscopies), infections (n = 5) or previously undiagnosed GI graft‐versus‐host disease (n = 3). Mucosal erosions or ulcers were present in eight of 28 endoscopies despite regular anti ulcer drug therapy. Conclusions: Screening upper GI endoscopy before and after BMT is generally safe and detects a high yield of significant GI abnormalities. However, it remains to be demonstrated that treatment of these lesions will improve the clinical outcome in BMT recipients without GI symptoms.
Autologous blood stem cell transplantation for haematological malignancy: treatment‐related mortality of 2%
Authors: Atkinson K. , Dodds A. , Milliken S. , Concannon A. , Fay K. , Harris M. , Flecknoe‐Brown S. , Lind D. , McKinley R. , Rutovitz J. , Rosenfeld D. , Harvey M. , Downs K. , Flattery D. , Song J. , Green A. , Quigley V. , Hawkins T. 
Published: March 2008

Abstract Background: Lengthy remission or cure has remained elusive for patients with many of the common haematological malignancies. Thus high dose chemotherapy followed by autologous haemopoietic stem cell transplantation is being increasingly utilised in these diseases. Aim: To assess the safety of high dose chemotherapy and autologous stem cell transplantation in haematological malignancy. Methods: Forty‐eight patients with haematological malignancy were given high dose chemotherapy followed by an infusion of previously cryopreserved autologous peripheral blood stem cells with (patients with acute myeloid leukaemia [AML]) or without (patients with acute lymphoblastic leukaemia [ALL], chronic myeloid leukaemia, non‐Hodgkin's lymphoma, Hodgkin's disease and myeloma) autologous bone marrow. Results: All patients except one had sustained engraftment. The median (range) number of days to attain a neutrophil count of 0.5 × 109/L was 12 (10–42) and a platelet count of 20 × 109/L unsupported by platelet transfusions was 15 (eight to 155). Other than oropharyngeal mucositis and febrile neutropenia, morbidity was low. Two patients had haemorrhagic cystitis, one hepatic veno‐occlusive disease and one interstitial pneumonitis; all resolved. The treatment‐related mortality was 2% ‐ a single patient with AML died of failure of sustained engraftment. Conclusions: Autologous blood stem cell transplantation to support high dose chemotherapy is a relatively safe procedure and its efficacy is currently being explored in a wide range of haematological malignancies. (Aust NZ J Med 1995; 25; 483–489.)
Acute renal failure following cardiac surgery: incidence, outcomes and risk factors
Authors: Mangos G. J. , Horton D. , Brown M. A. , Trew P. , Chan W. Y. L. , Whitworth J. A. 
Published: March 2008

Abstract Background: Acute renal failure (ARF) is a recognised complication following cardiac surgery, but the incidence varies widely in the published literature and there are no Australian data available to help predict the risks of ARF in patients with pre‐existing renal disease. Aim: To determine the incidence, outcome and risk factors for ARF following cardiac surgery. Methods: A retrospective case control analysis of 903 consecutive patients who had cardiac surgery (795 CABG, 68 valve/septal surgery, 40 combined valve/CABG) in 1992‐93. ARF was defined as doubling of serum creatinine concentration (Cr) to >0.13mmol/L if serum Cr was <0.13 mmol/L pre‐operatively, or else a rise in serum Cr of 2:0.10 mmol/L after cardiac surgery. For each subject with ARF, two case control subjects were matched for date of surgery, surgeon, age, sex, type of surgery and pre‐operative serum Cr to permit analysis of the influence of preoperative factors (hypertension, diabetes mellitus, left ventricular systolic dysfunction) and for the comparison of cardiopulmonary bypass time upon the development of ARF. Subsidiary endpoints were mortality, need for dialysis and length of hospital stay. Results: ARF developed in only 1.1% of patients with ‘normal’ pre‐operative renal function (creatinine 0.13 mmol/L) and none required dialysis. ARF developed in 16%of those with impaired pre‐operative renal function, 20% of whom required dialysis. Mortality from ARF was 13%. The risk of ARF rose from 10.4% in those with pre‐operative serum Cr 0.14‐0.20 mmol/L to 36.8% if the serum Cr was >0.20 mmol/L (p< 0.01). Mortality was higher (4.2%vs 0.7%, p< 0.01) and length of hospital stay longer (14.5 vs nine days [median], p< 0.001) in those with impaired pre‐operative renal function. ARF was more likely in those over 65 years, if valve surgery was included and where there was prolonged cardiopulmonary bypass time. Conclusions: These data confirm that ARF following cardiac surgery is uncommon without preoperative impairment of renal function but currently carries a mortality rate of 13%. Impaired renal function alone is associated with higher mortality and prolonged hospital stay. Studies to prevent ARF in this setting should focus on the high risk subsets described in this study.
Leptomeningeal and brain biopsy in chronic meningitis
Authors: Anderson N. E. , Willoughby E. W. , Synek B. J. L. 
Published: March 2008

Abstract Background: The cause is not found in one third of patients presenting with chronic meningitis. Biopsy of the leptomeninges and brain is often recommended in these patients, but the value of a biopsy is uncertain. Aims: To review the results of leptomeningeal and brain biopsies and their effect on diagnosis and management in patients with chronic meningitis, if the diagnosis was uncertain after clinical assessment, lumbar puncture and radiological investigations. Methods: The clinical features, investigations and the results of leptomeningeal and brain biopsies were reviewed retrospectively in 25 patients presenting with chronic meningitis between 1967 and 1990. Results: The biopsy identified the cause of the chronic meningitis in five patients (neoplastic meningitis in three, tuberculous meningitis in one, granulomatous angiitis in one). In 17 patients the biopsy was abnormal but it did not identify the cause (non‐gran‐ulomatous lymphocytic meningitis in eight, granulomatous meningitis in two, non‐specific abnormalities in seven). In two patients the biopsy was normal and in one patient the tissue was used only for culture. The results of the biopsy led to a beneficial change in treatment in two patients but did not influence management in the other patients. Conclusions: A leptomeningeal and brain biopsy was of limited practical value in diagnosis and management in most patients with chronic meningitis.
Assessment of coronary artery disease by dobutamine stress echocardiography (DSE)
Authors: Chan R. K. M. , Tonkin A. M. , Byrgiotis S. , Calafiore P. 
Published: March 2008

Abstract Background: Dobutamine stress echocardiography (DSE) is a new non‐invasive imaging modality which combines two‐dimensional echocardiography with cardiovascular stress induced by dobutamine infusion. Its use in patients with suspected or documented coronary artery disease (CAD) is currently under extensive investigation. Aims: To illustrate the clinical utility, safety and diagnostic value of DSE. Methods: One hundred and thirty‐seven consecutive patients referred for DSE were studied. Eighty‐four patients also underwent coronary angiography. Results: Eleven patients (8%) did not undergo DSE because of poor image quality. Of the remaining 126 patients, 110 (87%) achieved their target heart rate or reached a pre‐determined end point during DSE. Eight patients (6%) developed non‐cardiac side effects during DSE, none of which required premature termination of the procedure. Cardiac arrhythmias were documented in 15 patients (12%) but only one required intervention. In 84 patients who underwent coronary angiography, DSE showed a sensitivity and specificity of 88% and 83%, respectively, in detecting the presence of, and 75% and 75%o, respectively, in localising significant CAD. In 35 patients who underwent DSE after uncomplicated myocardial infarction, the positive and negative predictive values for cardiac events following infarction in a six‐month follow up period were 74% and 62%, respectively. Conclusions: DSE is a well tolerated, safe and useful test in detecting and localising significant CAD. It can also provide useful post‐infarctional prognostic information. (Aust NZ J Med 1995; 25: 707‐715.) Key words: Echocardiography, dobutamine, coronary artery disease.
Developmental regulation of the human β‐globin cluster
Authors: Jane STEPHEN M. , Amrolia PERSIS , Cunningham JOHN M. 
Published: March 2008

Abstract:Expression of the genes of the human β‐globin cluster is subject to stringent developmental regulation. An integral component of this control is competition between the γ‐ and β‐promoters for the upstream regulatory sequences of the Locus Control Region (LCR). We have defined two stage selector elements (SSE and SSE‐2), located in the proximal γ‐promoter and y‐gene 5′UTR which mediate the preferential interaction of the γ‐gene with the L CR in the foetal developmental stage. The activity of both elements is dependent upon the binding of foetal and erythroid‐specific proteins. We have purified the protein binding the proximal SSE and characterised it as a complex between the ubiquitous transcription factor CP2 and a 40 kD partner protein. Comparative studies between human CP2 and the chicken stage selector protein, NF‐E4, demonstrate homology between the protein complexes. These findings demonstrate that competitive silencing of globin genes mediated by developmentally‐specific protein complexes is conserved in evolution.
Comparison of optimised planar scintigraphy with SPECT thallium, exercise ECG and angiography in the detection of coronary artery disease
Authors: Roach P. J. , Hansen P. S. , Scott A. M. , Cooper R. A. , Hoschl R. , Wiseman J. C. , Bernar A. , Edwards A. C. 
Published: March 2008

Abstract Background: Thallium SPECT has been shown to be more sensitive than planar imaging in the detection of coronary heart disease (CAD) in a number of reported series. Early (< 10 minutes) redistribution on planar imaging has been demonstrated in clinical studies and this may partly contribute to its lower sensitivity. Aim: To determine whether thallium SPECT is superior to planar scintigraphy (with the timing of imaging performed optimally so that it was commenced within five minutes of injection) in the detection of CAD. Methods: Planar and SPECT studies were performed in 44 patients with significant (>70% stenosis) CAD, seven patients with borderline stenoses (50–69%) and in 18 patients with no significant CAD. Results: The sensitivity of planar imaging was 66% which was higher than exercise ECG 54% (ns) but significantly lower than SPECT 86% (ρ<0.005). The specificity of planar thallium scintigraphy was 100% which was higher than SPECT (83%) and significantly higher than exercise ECG 72% (ρ<0.05). SPECT had a significantly higher sensitivity for LAD and single vessel disease than planar imaging and this was unrelated to a history of prior myocardial infarction. Conclusion: Even when planar imaging is timed optimally to minimise the impact of early redistribution, SPECT is more sensitive than either planar imaging or exercise ECG in the detection of CAD, but its specificity is lower.