bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE CHOICE OF ULCER HEALING AGENT INFLUENCES DUODENAL ULCER RELAPSE RATE AND LONG‐TERM CLINICAL OUTCOME
Authors: McLEAN A. J. , HARRISON P. M. , IOANNIDES‐DEMOS L. , BYRNE A. J. , MCCARTHY P. , DUDLEY F. J. 
Published: March 2008

Abstract:The mode of pharmacological healing influences subsequent ulcer relapse. Duodenal ulcer relapse following healing and withdrawal of active therapy has been studied in 18 prospectively randomised comparative studies involving cimetidine and alternative healing agents. Most studies (eleven of the 18) showed comparative agents with a lower (> 10%) incidence of relapse than cimetidine while a minority (seven of the 18) showed equal (±10%) relapse. The probability of this distribution occurring by chance is less than 1:1000 (p = 0.0005, sign test).In three of the 11 published comparative studies the relapse rate was significantly higher in those who had previously received cimetidine (p<0.05, two‐sided significance test). This was despite the fact that most of the individual studies were small and required a substantial difference in results for the 5% significance level to be reached.Paired comparative incidences of relapse at six months were converted to relapse rates (percentage of healed population relapsing monthly), average rates for comparative agents were 8.05±2.7% while those for cimetidine were 16.9±4.4% (x±SEM, n = 5); cimetidine relapse rates derived from non‐comparative trials were 17.0 ± 1.9% (x± SEM, n = 7). Higher relapse rates translate into larger numbers of patients at risk and in need of active therapy.These results are of biological and clinical significance. Differences in relapse must reflect beneficial effects of one group of agents on the ulcer diathesis or adverse effects of the comparator, cimetidine. Each alternative reflects negatively on cimetidine as an antiulcer medication; however, confirmation of adverse effects would force radical review of most current therapy of ulcer disease. Research into ulcer therapeutics must emphasise both the relapse and the healing potential of pharmacological agents. (Aust NZ J Med 1985; 15: 367–374.)
THE EXTRACRANIAL–INTRACRANIAL BYPASS STUDY: HOW WILL THE OUTCOME AFFECT US?
Authors: DONNAN G. A. , BLADIN P. F. , WOODWARD J. M. 
Published: March 2008

Abstract:Extracranial‐intracranial bypass is now a commonly performed procedure in centres with a high level of neurosurgical and vascular expertise. Bypass of surgically inaccessible stenoses or occlusions appears to be a logical technique to prevent future stroke but there is much uncertainty about the clinical indications for surgery and even the natural history of the lesions being bypassed. To answer these questions, the International EC/IC Bypass Study was set up in 1977 with relatively broad entry criteria. The data will be analysed in June 1985 and if the results support the use of bypass as a means of preventing subsequent stroke, the procedure should become firmly established. However, if the results are negative, or inconclusive, rather than discard the procedure, subsets of higher risk patients should be sought, in particular using newer methods of assessing cerebral perfusion and metabolism. (Aust NZ J Med 1985; 15: 386–391.)SummaryECAC bypass represents a remarkable technological advance and may be an important means of preventing stroke in selected individuals. It is one of the few procedures in medicine being evaluated stringently in terms of efficacy early in its development. The results of the multicentre EC/IC bypass study are being eagerly awaited around the world. If the study shows that bypass is beneficial, the procedure will become firmly established as a legitimate form of stroke prophylaxis. If the study is negative, rather than discard the procedure altogether, we should re‐examine the indications for surgery, particularly in the light of new technologies capable of sensitive assessments of cerebral perfusion and metabolism.
PROTEIN LOADING TEST BEFORE AND AFTER KIDNEY DONATION
Authors: CHAN M. K. 
Published: March 2008

Abstract Renal response to a 60 g protein load was investigated in 33 normal subjects in terms of creatinine clearance and urinary protein excretion. The test was repeated in 10 of these subjects six months after donor nephrectomy. Creatinine clearance and urinary protein excretion increased significantly one and two hours after ingestion of the protein load (in the form of casein mixture); the change in urinary protein excretion correlated significantly with the change in creatinine clearance (p <0.0001). Plasma urea, calcium, and phosphate concentrations increased after protein ingestion, while plasma creatinine and uric acid decreased. Six months after donor nephrectomy the creatinine clearance had decreased but baseline protein excretion had increased.The pre‐nephrectomy renal response to protein ingestion (i.e. increase in creatinine clearance and urinary protein excretion) did not predict creatinine clearance of the kidney after donor nephrectomy. After donor nephrectomy, the single kidney was able to increase creatinine clearance after a protein load, although qualitativel the response was different from that obtained with two kidneys in situ. (Aust NZ J Kned 1986; 16: 691–694.)
A COMPARATIVE DOUBLE‐BLIND TRIAL OF THE EFFECTIVENESS AND ANTIGENICITY OF SEMISYNTHETIC HUMAN INSULIN AND PURIFIED PORCINE INSULIN IN NEWLY TREATED DIABETIC SUBJECTS
Authors: LARKINS R. G. , ZAJAC J. , SAUNDERS R. , READ A. , HOPPER J. L. 
Published: March 2008

Abstract A double‐blind comparative trial of the effectiveness and antigenicity of semisynthetic human insulin (Novo) and highly purified (Monocomponent) porcine insulin was performed over a 12 month period in 20 diabetic subjects newly treated with insulin. Human insulin was shown to be indistinguishable from porcine insulin of comparable purity with respect to plasma glucose and glycosylated hemoglobin levels and insulin dose requirements. Human insulin was no less antigenic than porcine insulin; significant IgG‐associated insulin binding activity was detected in six of the ten patients in the human insulin treated group and four of the ten patients in the porcine insulin treated group. In all patients, the binding activity was of low capacity. No adverse reactions to human insulin were noted.It is concluded that semisynthetic human insulin, like purified porcine insulin, is safe and effective. Although there may be advantages for human insulin in the setting of insulin allergy, this study does not indicate that human insulin has advantages over purified porcine insulin with respect to elicitation of antibodies of the IgG class.
HYPOTHYROIDISM AND GRAVES' DISEASE AFTER MANTLE IRRADIATION: A FOLLOW UP STUDY
Authors: MORTIMER R. H. , HILL G. E. , GALLIGAN J. P. , BRANSDEN A. I. , TYACK S. A. , ROESER H. P. 
Published: March 2008

Abstract Fifty of 66 patients whose thyroid function had previously been assessed 7–139 months after irradiation for Hodgkin's disease were re‐evaluated 35 ± 3 months later. They could be divided into three groups: those whose thyroid function had been normal in the first study (N= 26), those who had had asymptomatic impaired thyroid reserve (N= 19), and those in whom evidence of Graves' disease had developed (N= 5).The 26 patients who had been euthyroid when first studied had developed significant increases in mean throid‐stimulating hormone (TSH) levels basal and following thyrotrophin releasing hormone) without changes in mean free thyroxine index (FTI). In three of these patients, each studied within six years of irradiation, basal TSH had risen to hypothyroid levels. There were no significant changes in mean FTI or basal and peak TSH in 19 patients who had demonstrated impaired thyroid reserve in the first study. The cumulative incidence of impaired thyroid reserve in the total cohort is now 30/66 (45%) but only one of these 30 has developed clinical hypothyroidism. Five patients developed evidence of Graves' disease. Two patients with thyrotoxicosis and one with euthyroid Graves' disease were found in the initial study. On re‐evaluation, a third patient had developed frank thyrotoxicosis and another euthyroid Graves' disease, giving a cumulative incidence of Graves' disease of 5/66 (7%). Three of these five were HLA‐DR3 and three had measurable thyrotrophin binding inhibiting immunoglobulins. We conclude that impaired thyroid reserve continues to develop within six years of mantle irradiation in adults but once established appears to remain stable. There also appears to be a high incidence of Graves' disease after mantle irradiation.
INHIBITION OF COMPLEMENT‐MEDIATED SOLUBILISATION OF ANTIGEN‐ANTIBODY COMPLEXES BY SERUM FACTOR(S) IN PATIENTS WITH VARIOUS CONNECTIVE TISSUE DISEASES
Authors: Webb J. , Zoma A. , Cobb S. , Veitch J. , Whaley K. 
Published: March 2008

AbstractControl of immune complex formation is important to limit disease resulting from their deposition in tissues. Any inhibition of immune complex solubilisation is thus significant in the pathogenesis of immune complex diseases. More than half of our patients with various rheumatic connective tissue diseases were demonstrated to have serum inhibition of immune complex solubilisation (12/16 rheumatoid arthritis, 22/37 systemic lupus erythematosus, 16/29 primary Sjogren's syndrome, and eight of nine with mixed connective tissue disease). This serum inhibitory activity did not correlate well with serum levels of IgM rheumatoid factor or circulating immune complexes, and its nature remains to be elucidated. (Aust NZ J Med 1986; 16: 445–451.)
REITER'S SYNDROME: CHRONICITY OF SYMPTOMS AND EMPLOYMENT
Authors: Hart H. H. , Mcguigan L. E. , Gow P. J. , Grigor R. R. 
Published: March 2008

AbstractTo assess the chronicity of symptoms and long term prospects for employment in patients with Reiter's syndrome, a follow‐up study of 111 patients was performed. Ninety‐eight patients were available for follow‐up; these had a mean disease duration of 7.9 years (range two months to 39 years). At follow‐up, 55 patients had symptomatic joints and 26 objective evidence of synovitis, but only seven had chronic joint deformity. Seven patients fulfilled criteria for ankylosing spondylitis. Ninety‐three patients were in functional class I or II, 86 patients were working, 26 had changed employment, and 11 were unemployed because of the disease. No prognostic features of value were identified. The tissue antigen HLA B27 was associated significantly with anterior uveitis and radiological sacroiliitis. (Aust NZ J Med 1986; 16: 452–456.)
A MATCHED PAIRS COMPARISON OF CYCLE ERGOMETRY AND TREADMILL EXERCISE TESTING IN THE EVALUATION OF CORONARY HEART DISEASE
Authors: CALVERT A. F. , PATER G. , PYE D. , MANN J. , CHALMERS D. , AYRES B. 
Published: March 2008

Abstract In 105 patient pairs, matched for sex, aged within a ten‐year range and with closely similar coronary disease, the sensitivity and specificity of treadmill testing using the Bruce Protocol was compared to cycle ergometry using the 100 kpm/min (16 W/min) increment protocol, and found to be similar. The parameters of use were ST segment depression (sensitivity of 52% for treadmill and 61% for cycle), test angina (65% and 61%), significant work impairment (66% and 68%) and impaired blood pressure response (31% and 20%). The sensitivity was increased (treadmill to 84%, cycle to 89%) if the four parameters were grouped, and abnormality in any one of them was regarded as a positive test.The equivalent severity of coronary disease resulted in more severe work impairment on the cycle than on the treadmill. The mean work level of the treadmill group was 80%, and of the cycle group, 61% of their respective, nomographically predicted, normal values. The difference was similar for the zero. sinale and multivessel disease aroum. This difference should be recognised when comparing the two techniques. (xust NZ J Med 1987; 17: 472–478).
ARE HIGH BLOOD SUGAR LEVELS IN THE ELDERLY IGNORED?
Authors: CHALMERS J. , BEAVEN D. W. , SAINSBURY R. 
Published: March 2008

Abstract In a survey of 530 patients, aged 75 years and older, who were admitted to a general teaching hospital in Christchurch, 60 (11.3%) were known diabetics. One hundred and seventy‐six other patients (33.2%) had a last measured laboratory blood glucose level of >7.8 mmol/l, of whom 27 people (5.1% of all patients) had significant hyperglycemia (over 11 mmol/l).The Geriatric Assessment and Rehabilitation Unit (ARU) and acute general medical wards of the Princess Margaret Hospital made little use of the specialised Diabetes Services for help in managing known or newly diagnosed diabetics. The mean in‐hospital laboratory blood glucose value for all diabetics was an unphysiological value of 12.2 mmol/l, compared with a community mean of 4.9 mmol/l and hyperglycemia persisted after resolution of acute medical problems. ARU diabetic patients had significantly lower blood glucose values than those achieved by physicians in acute medical wards. Prescribed medications such as steroids or diuretics contributing to insulin resistance were rarely modified.It is concluded that 16.4% of elderly patients had significant hyperglycemia or poorly managed diabetes mellitus, and that both general and geriatric physicians underestimated both the severity and consequences of elevated blood sugars in older patients in a regional New Zealand community with a ‘high’ diabetes profile. (Aust NZ J Med 1987; 17: 485–490).
JUVENILE RHEUMATOID ARTHRITIS IN AUCKLAND: A LONG TERM FOLLOW‐UP STUDY WITH PARTICULAR REFERENCE TO UVEITIS
Authors: McGILL N. W. , GOW P. J. 
Published: March 2008

Abstract Although features of juvenile rheumatoid arthritis (JRA) have been well described in British, American, and to a lesser extent Australian communities we can find no previous study of the clinical characteristics of this disease in a New Zealand population or indeed in any population containing Polynesians.In a follow‐up study of 55 Auckland residents with juvenile rheumatoid arthritis, current information was obtained for 78% of the study group with a mean interval from disease onset to follow up of 9.3 years. The outcome for the group as a whole was excellent although patients with a polyarticular course, regardless of onset subtype, had a poorer outcome with respect to both ongoing disease activity and functional disability. Polynesian patients were represented in all onset subtypes in proportion to their frequency in the general community and there was no recognisable influence of race on the course of the disease.Despite careful ophthalmological examination only one case of mild uveitis was detected, a much lower incidence than in British and American reports.
HUMAN CRYPTOSPORIDIOSIS IN NORTH QUEENSLAND
Authors: CRUICKSHANK R. , ASHDOWN L. , CROESE J. 
Published: March 2008

Abstract:During a 12‐month period, feces from 780 persons from the Townsville region were evaluated by the Kinyoun acid‐fast strain, and 36 (4.6%) immunocompetent patients were found to have Cryptosporidium oocysts. Twenty‐five index cases were identified; 13 (8.6%) cases from 151 patients were from Palm Island, an isolated Aboriginal community in the wet tropics and 12 (1.9%) cases from 629 patients were from the dry tropics of Townsville. All 11 secondary cases were associated with a person‐to‐person outbreak in the nursery of a Townsville day‐care centre. Infection occurred mainly in two distinct age groups: the under five‐year‐old (27 cases), and the 25 to 35‐year‐old (six cases). A prodrome of dry cough, rhinorrhea and vomiting often preceded symptoms of fever, weight loss, abdominal pain, persistent cough and vomiting, and acute diarrhea with frequent, non‐bloodstained, watery, mucous stools. Although 13 patients were hospitalised because of their illness, the infection was self‐limiting and all 36 patients recovered with symptomatic treatment. Cryptosporidium was the third most commonly identified enteric pathogen after Rotavirus and Giardia. Infection did not appear to depend on seasonal variation and no animal or environmental sources of infection were identified. Cryptosporidiosis in immunocompetent persons is endemic and common in North Queensland and routine investigations for this parasite in symptomatic patients are warranted.
HIGH INCIDENCE OF EARLY LEUKEMIC RELAPSE IN PATIENTS GIVEN CYCLOSPORIN AND T CELL DEPLETED HLA‐IDENTICAL SIBLING MARROW TRANSPLANTS FOR ACUTE LEUKEMIA IN FIRST REMISSION*
Authors: ATKINSON K. , BlGGS J. , DODDS A. , CONCANNON A. , DOWNS K. , ASHBY M. , McKENZlE I. F. C. 
Published: March 2008

Abstract:Twelve patients with acute nonlymphoblastic leukemia (ANL, n = 6) or acute lymphoblastic leukemia (ALL, n = 6) in first complete remission received cyclophosphamide 120 mg/kg and total body irradiation (TBI) 12 Gy followed by HLA‐identical sibling marrow that had been depleted of T cells by incubation with anti‐CD2 (with or without anti‐CD8) monoclonal antibody and rabbit complement. These 12 patients were compared historically to 25 patients with ANL (n = 15) or ALL (n = 10) in first remission given cyclophosphamide 120 mg/kg and TBI 12 Gy followed by non‐T cell depleted HLA‐identical sibling marrow for parameters of relapse and survival. Thirty‐six of the 37 patients received cyclosporin as post transplant prophylaxis for graft‐versus‐host disease (GVHD). All surviving patients have been followed for a minimum of one year from transplant. The actuarial rate of leukemic relapse in the T‐depleted group was 62% compared to 37% in the non‐depleted group (p< 0.02). Additionally, relapse occurred significantly earlier post transplant in the T‐depleted recipients (p = 0.012). Actuarial survival at two years post transplant was 24% for the T‐depleted recipients and 41 % at six years post transplant for the non‐depleted recipients (not significant, p = 0.37). We have previously shown that GVHD is less severe in patients given T cell depleted transplants. Taken together, these findings suggest that (under the protocol conditions used) a graft‐versus‐leukemia effect is not separable from a GVHD effect in man. More effective anti‐leukemia therapy must be devised before the benefit of T cell depletion can be applied to patients with ANL or ALL receiving HLA‐identical sibling marrow transplants in first remission. (Aust NZ J Med 1988; 18: 587–593).
ASSESSMENT OF AORTOCORONARY BYPASS GRAFT PATENCY BY INTRA‐ARTERIAL DIGITAL SUBTRACTION ANGIOGRAPHY COMPARED TO SELECTIVE GRAFT ANGIOGRAPHY
Authors: GRIGG L. E. , HUNT D. , CHAN W. , THOMSON K. 
Published: March 2008

AbstractThe value of digital subtraction angiography (DSA), in assessing aortocoronary bypass graft patency, was evaluated by studying 22 consecutive patients with 54 aortocoronary saphenous vein bypass grafts, who had postoperative angina pectoris. Each patient underwent selective graft angiography and non‐gated DSA. The DSA consisted of a run of 15 to 20 frames, taken at 2.3 frames per second during injection of diluted contrast in the ascending aorta, performed after a test exposure was made.Thirty‐two of the 54 grafts (59%) were patent. Thirty of the 32 grafts were seen to be patent by both selective graft angiography and DSA. In addition, a further two grafts were found to be patent on DSA, but were not able to be selectively catheterised and were not seen on the conventional aortogram. Selective graft angiography revealed four tight proximal graft stenoses, of which one only was seen on DSA; and poor distal run‐off in five grafts, two of which showed up as late filling grafts on DSA.In summary, the accuracy of intra‐arterial DSA in assessment of bypass graft patency was excellent. All grafts seen to be patent on selective graft angiography were also seen by DSA alone and in addition two grafts which could not be selectively catheterised were found to be patent. However, in patients with postoperative chest pain, selective graft angiography is probably required as non‐gated intra‐arterial DSA does not provide sufficient information to assess graft stenoses, distal flow and the native coronary vessels.
AUTOIMMUNE CARDIOLIPIN‐BINDING ANTIBODIES IN ORAL ANTICOAGULANT PATIENTS
Authors: EXNER T. , KOUTTS J. 
Published: March 2008

AbstractIn a routine clinic of patients taking regular oral anticoagulant therapy (warfarin, n= 140) 14% were found to have elevated levels (>4 SD above normal) of anticardiolipin antibody (ACA) assessed by a well standardised enzyme linked immunosorbent assay (ELISA).There was a higher incidence of raised ACA in patients being treated for thrombotic episodes (9/47 = 19%) than in cases with heart valve replacements (8/75 = 11%). Furthermore, the highest ACA titres were in younger patients with thromboses scheduled for short‐term anticoagulant treatment. Borderline DNA binding studies, together with some positive ANA results, suggested autoimmune etiology in the minority of these cases. Lupus anticoagulant was strongly detectable in only one such patient.The ACA were predominantly IgG (14/17) and did not appear to compromise the conditions of patients while on anticoagulant therapy. Raised ACA may be a highly significant marker for an acquired prothrombotic state.
USE OF A DNA PROBE IN THE DIAGNOSIS OF ADULT POLYCYSTIC KIDNEY DISEASE
Authors: SAVIGE J. A. , PATRIKIOS V. , ALDRED P. , KINCAID‐SMITH P. 
Published: March 2008

AbstractAdult polycystic kidney disease (APKD) is one of the most common inherited diseases in man. A diagnosis based on the demonstration of renal cysts with ultrasonography or computerised tomography may be inconclusive in early adulthood, the crucial years before child‐bearing is complete. Here we describe the improved diagnostic probability that is possible using genetic linkage studies.A 24‐year‐old woman, whose father and younger sister were affected by APKD, was demonstrated to have a single cyst in each kidney. These findings were insufficient for a diagnosis of APKD1 and for this reason genetic linkage studies were undertaken. DNA was extracted from peripheral blood leukocytes from the presenting individual, and her immediate and extended family; the DNA was cut with the restriction enzyme PvuII, electrophoresed in a 0.7% agarose gel and blotted onto nitrocellulose before probing with a 32P‐labelled 4 kb fragment. This contained DNA from the hypervariable region (3′ hypervariable region, 3′HVR) that is linked to the gene for APKD on the short arm of chromosome 16 and has been used in other family studies by Reeders et al.2 We correlated the findings on Southern blotting with ultrasound evidence of APKD and found that the disease segregated with a 7.0 kb fragment in the presenting individual's father and sister. She was shown to have inherited this allele also; the use of this technique thus increased the probability of her having APKD from 50% to 96.5%.3
MYCOBACTERIUM BOVIS AS AN OCCUPATIONAL HAZARD IN ABATTOIR WORKERS
Authors: ROBINSON P. , MORRIS D. , ANTIC R. 
Published: March 2008

AbstractFive cases of bovine tuberculosis occurred in a two year period in South Australia, which represents a higher incidence than in previous years. All five patients had a history of employment in an abattoir (although four different abattoirs were involved) and four of the cases had pulmonary or pleural TB. A voluntary survey of one of the abattoirs was conducted which discovered the fifth case of active pulmonary TB.We suggest that bovine TB should be considered an occupational hazard in abattoir workers, and that suitable pre‐employment screening programmes for workers be established. The transmission of disease in these cases is almost certainly by inhalation causing pulmonary TB and is therefore different from the ‘classic’ form of bovine TB transmitted by ingestion of infected milk and resulting in extrapulmonary disease.