bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monoclonal immunoglobulin bands in the cerebrospinal fluid
Authors: McCombe P. A. , Barr A. E. , Brown N. N. , Parkin L. 
Published: March 2008

AbstractIsoelectric focusing and immunofixation allow the detection of abnormal immunoglobulin bands in the cerebrospinal fluid (CSF). In normal subjects, the immunoglobulins in the CSF are derived from serum. In inflammatory disorders of the nervous system, there may be intrathecal immunoglobulin synthesis usually seen as oligoclonal bands confined to the CSF. Monoclonal immunoglobulin bands in the CSF are not common. We surveyed 1490 CSF samples, and found that a total of nine had a monoclonal immunoglobulin band and that in three this was not present in the serum. Of these three, one patient had chronic inflammatory demyelinating polyneuropathy and the antibody may have been secreted by lymphocytes which had infiltrated the nervous system. The other patients had either lymphoma or lymphomatoid granulomatosis within or adjacent to the nervous system and the monoclonal immunoglobulin was probably secreted by B lymphocytes within those lesions. (Aust NZ J Med 1991; 21: 227–229.)
Infradiaphragmatic Hodgkin's disease, long term follow‐up of a rare presentation
Authors: Liew K. H. , Ding J. C. , Cruickshank D. , Quong G. G. , Wolf M. M. , Cooper I. A. 
Published: March 2008

Abstract:Hodgkin's disease limited to the infradiaphragmatic region was seen in 30 of 306 (9.8%) of all Stage I and II patients referred to the Peter MacCallum Cancer Institute between 1968 and 1980. The male:female ratio was 2.3:1 with median age of 43.5 years at presentation.Of the seven patients with clinical stage (CS) IA‐IIA disease who had staging laparotomy and splenectomy only one CSIIA patient had splenic involvement. The patients were staged as pathological stage (PS) IA 2, PSIIA 5, CSIA 4, CSIIA 10, CSIIB 9.Primary treatment was by radiation in 24 patients, combination chemotherapy in five and surgical excision in one. Twenty‐five patients achieved complete response. Relapse free survival (RFS) at five and ten years was 59% and the five and ten‐year survival was 75% and 67% respectively.On univariate analysis the significant prognostic factors for RFS and survival were stage, constitutional symptoms and presence of bulky disease.Using Cox regression analysis the only significant variable for RFS and survival was bulky disease (p= 0.01, 0.02).A treatment policy for patients with infradiaphragmatic Hodgkin's disease is recommended.
Kohlmeier‐Degos disease: a multisystem vasculopathy with progressive cerebral infarction
Authors: Burrow J. N. , Blumbergs P. C. , Iyer P. V. , Hallpike J. F. 
Published: March 2008

Abstract:Kohlmeier‐Degos disease, or malignant atrophie papulosis, is a rare and clinically distinctive vasculopathy characterised by cutaneous features with frequent gastrointestinal and neurological involvement and, almost invariably, with fatal outcome. The case is reported of a 22‐year‐old male who died of progressive cerebral infarction nine months from the time of development of pathognomonic skin lesions. Treatments with anti‐platelet agents and plasma exchange were ineffectual in altering the progressive course of the disease. At autopsy, there was an extensive small vessel occlusive vasculopathy with similar features in skin, brain and bowel wall. The aetiology of Kohlmeier‐Degos disease remains unknown. Diagnosis is on clinico‐pathological grounds. Awareness of the disease is important, particularly in the differential diagnosis of cerebrovascular‐arteritic‐syndromes presenting in young adults.
Doppler echocardiography and the early diagnosis of carditis in acute rheumatic fever
Authors: Abernethy M. , Bass N. , Sharpe N. , Grant C. , Neutze J. , Clarkson P. , Greaves S. , Lennon D. , Snow S. , Whalley G. 
Published: March 2008

Abstract Background: The incidence of acute rheumatic fever in New Zealand remains relatively high. Reliable early diagnosis of carditis is difficult and important in management. Aim: To determine if Doppler echocardiography contributed to the early diagnosis of carditis in acute rheumatic fever. Methods: Forty‐seven patients admitted to hospital with suspected acute rheumatic fever and 19 control patients, with a febrile illness due to a documented non‐cardiac bacterial infection, were assessed two days and two weeks following admission. Presence or absence of clinical carditis was determined by a cardiologist unaware of the suspected diagnosis, from clinical examination, chest radiograph, electrocardiogram (ECG) and two dimensional echocardiogram. Doppler echocardiography was then performed and interpreted by a second cardiologist unaware of the diagnosis. After completion of the study the Jones criteria were applied, to categorise the patients with suspected acute rheumatic fever into four groups for the final diagnosis: no acute rheumatic fever, possible acute rheumatic fever, definite acute rheumatic fever without carditis, and definite acute rheumatic fever with carditis. Results: In 19 patients with a final diagnosis of acute rheumatic fever and carditis at the baseline assessment carditis was detected by clinical assessment in 15 patients, compared with 19 patients with evidence of significant valve regurgitation by Doppler echocardiography. Following the two week assessment, all 19 patients had both clinical and Doppler evidence of carditis. Five patients with a final clinical diagnosis of possible acute rheumatic fever or definite acute rheumatic fever without carditis, had a Doppler abnormality detected. There was no clinical or Doppler abnormality in the febrile controls. Conclusions: Doppler echocardiography is more sensitive than clinical assessment in the detection of carditis in acute rheumatic fever, and can contribute to earlier diagnosis. (Aust NZ J Med 1994; 24: 530–535.)
Selection of patients for randomised trials: a study based on the MACOP‐B vs CHOP in NHL study
Authors: Stone J. M. , Laidlaw C. R. , Page F. J. , Cooper I. 
Published: March 2008

Abstract Background: Selection of patients for a clinical trial is affected by awareness of the existence of the trial, interest in the study question and clinical practices and views of the clinicians. Aims: To investigate the selectivity that may have occurred at Peter MacCallum Cancer Institute (PMCI) during the ANZ Lymphoma Group trial of MACOP‐B vs CHOP in non‐Hodgkin's lymphoma (NHL). Methods: NHL patients at PMCI in the study period were assessed against the trial's eligibility criteria. Comparisons were made between eligible (except for consent) non‐trial patients and all patients actually randomised into the trial. Results: Of 497 patients presenting during the trial period, 320 (64%) did not meet the specified eligibility criteria, 102 (21%) were unsuitable on other grounds (age and medical) and 75 (15%) were eligible. Of those eligible, 43 (57%) were entered into the trial and 32 (43%) were not. Four non‐trial patients had inappropriate application of eligibility criteria and 13 unknown reason. Eligible non‐trial patients were similar to trial patients in most patient and tumour characteristics and overall survival. Significantly more non‐trial patients had higher stage disease (p = 0.02). More non‐trial patients had lower grade histology, but this was not significant. Conclusions: Physician selectivity occurred with respect to patient entry, but trial and non‐trial patients were similar in most characteristics. Eligibility criteria should specify that patients can withstand all trial drugs and patient availability for treatment and follow‐up. PMCI trial accural could have been up to 33% greater. These results suggest the trial accrual period could have been 25% shorter. Patient entry into this trial by PMCI clinicians compared favourably with other centres. (Aust NZ J Med 1994; 24: 536–540.)
Volumetric and visual assessment of the mesial temporal structures in Alzheimer's disease
Authors: Desmond P. M. , O'Brien J. T. , Tress B. M. , Ames D. J. , Clement J. G. , Clement P. , Schweitzer I. , Tuckwell V. , Robinson G. S. 
Published: March 2008

Abstract Background: Alzheimer's disease is the commonest cause of dementia. Clinical diagnosis of Alzheimer's disease may be difficult. Magnetic resonance imaging has a role to play in diagnosis. Aim: To assess whether volumetric and/or visual assessment of the mesial temporal structures is useful in separating patients with Alzheimer's disease from age matched controls. Methods: Twenty‐four patients with Alzheimer's disease diagnosed by NINCDS/ADRDA criteria and 15 age matched controls were studied with magnetic resonance imaging (MRI) and volumetric techniques. Segmented volumes of the mesial temporal structures were assessed visually and volumetrically. Results: Volumetric analysis demonstrated significant (p<.001) differences between the two groups, but showed overlap in individual cases. Discriminant function analysis predicted correct group membership (patient or control) in 85% of cases. Visual assessment alone demonstrated a sensitivity of 92% and a specificity of 93% in distinguishing the Alzheimer patients from controls. Conclusion: Volumetric and visual assessment of the mesial temporal structures is useful in separating Alzheimer patients from controls. Overlap is present in individual cases. Visual assessment was as useful in separating the two groups as the volumetric analysis. (Aust NZ J Med 1994; 24: 547–553.)
Low serum cholesterol is not associated with depression in the elderly: data from an Australian community study
Authors: McCallum J. , Simons J. , Simons L. , Friedlander Y. 
Published: March 2008

Abstract Background: Low serum cholesterol may contribute to depressive symptoms in the elderly. Aims: To test the relationship between depressive symptoms and low serum cholesterol in an elderly cohort. Methods: This was an examination of cross‐sectional data in a community study of 1237 men and 1568 women aged 60 + years in Dubbo, NSW. Quintiles of serum cholesterol were defined for men and women. The Center for Epidemiological Studies Depression Scale was used as a continuous, dependent variable in multiple regression analyses. Results: Low serum cholesterol was not associated with depressive symptoms in older men or women. Health status, measured by poorer self‐ratings, recent hospitalisation, higher disability levels and higher consumption of prescribed and self‐prescribed drugs, predicted depressive symptoms. As well, the significance in the statistical model of financial difficulties, low self esteem, low feelings of self efficacy, the adequacy of practical help and emotional support, and recent widowhood, confirmed the importance of social origins of depressive symptoms. (Aust NZ J Med 1994; 24: 561–564.)
Comparative hospitalisation and mortality rates of Aboriginal and non‐Aboriginal Western Australians in their sixth and seventh decades
Authors: Gracey M. , Veroni M. 
Published: March 2008

Abstract Background: Aboriginals have higher hospitalisation and mortality rates and die, on average, about 15 years earlier than non‐Aboriginals in Western Australia (WA). Aims: To investigate Aboriginal morbidity and mortality rates in WA in comparison with the rest of the population, with particular reference to the ages of 50 to 65 years. Methods: Mortality rates from 1983–1989 inclusive for Aboriginals and non‐Aboriginals in WA were compared. Major causes of Aboriginal mortality in males and females were matched to the ages at which similar rates from the same causes occurred in non‐Aboriginals. Rate ratios (Aboriginahnon‐Aboriginal) for causes of death at ages 60–64 years were determined. Hospitalisation rates for Aboriginal and non‐Aboriginal people aged 50–64 years in WA in 1988 were used to estimate hospitalisation rate ratios. Results: Hospitalisation rates in WA were much higher among 50 to 64 year old Aboriginals than non‐Aboriginals for most diseases, particularly for infectious and parasitic diseases, and injury and poisoning. Admissions for circulatory diseases were double to four times as frequent among Aboriginals. The main causes of deaths in Aboriginal males were circulatory diseases, injury and poisoning, respiratory diseases, neoplasms, and digestive diseases; in Aboriginal females the main causes of deaths were circulatory diseases, neoplasms, diabetes, respiratory diseases, and injury and poisoning. Except for neoplasms, deaths from these causes occurred among 50–54 year old Aboriginals at rates that were experienced by non‐Aboriginal people ten to 30 years later in life. These results underline special needs of the Aboriginal population that have not been adequately met by appropriate services.
A study of scleroderma in South Australia: prevalence, subset characteristics and nailfold capillaroscopy
Authors: Chandran GEETHA , Ahern M. J. , Smith M. , Roberts‐Thomson P. J. 
Published: March 2008

Abstract Background: Scleroderma is a systemic rheumatic disorder seen in a wide range of clinical specialties. Aims: To establish the prevalence and mortality rates of scleroderma in South Australia (SA), to determine the relative frequency and characteristics of the three principal subsets (diffuse, limited and overlap), and to examine the role of nailfold capillaroscopy in subset identification and implied prognosis. Methods: Outpatient and discharge diagnostic indexes from five major teaching hospitals in SA were reviewed between February 1987 and November 1993. A total of 215 patients with scleroderma were identified. Case notes of 115 of these patients were reviewed in order to validate scleroderma diagnosis, and subset characteristics such as sex, mean age at diagnosis, extent of skin involvement, internal organ involvement and serology were analysed. Fifty‐two of these patients were then examined prospectively to confirm positive discharge diagnosis, and nailfold capillaroscopy was performed on these patients. Results: The point prevalence of scleroderma in SA for 1993 was estimated to be 208/106. This figure is a conservative estimate and is higher than most other reported series. The female to male ratio was 4:1. The majority of patients had limited disease with a ratio of 6:1:1.6 limited vs diffuse vs overlap. Systemic involvement excluding the oesophageal component in limited disease was found predominantly in the diffuse group. Autoimmune serology was positive in 90% of patients, with Scl‐70 being more common in diffuse scleroderma, anti‐centromere antibody (ACA) in the limited form and anti‐ribonucleoprotein (RNP) in the overlap form. Nailfold capillaroscopy was useful in predicting disease‐subtype as capillary dilatation was observed predominantly in limited disease, and capillary dropout in diffuse disease. Conclusions: Scleroderma is more common in SA than previously recognised. Limited disease is more common than diffuse or overlap disease, carries a better prognosis and is associated with ACA. Nailfold capillaroscopy is a useful tool in disease assessment and may provide useful diagnostic and prognostic information.
The surface glycoconjugates of parasitic protozoa: potential targets for new drugs
Authors: McConville MALCOLM J. 
Published: March 2008

Abstract:Protozoan parasites are the cause of many diseases in humans and their domestic livestock. Glycoconjugates (i.e. glycoproteins, glycolipids) on the cell surface of these extremely diverse and very primative eukaryotes play a crucial role in determining the specificity of the host‐parasite interaction and in protecting the parasites within their respective hosts. These molecules frequently share a common structural feature in that they are attached to the plasma membrane via a glycosylphosphatidylinositol (GPI) glycolipid. While GPI protein‐membrane anchors are ubiquitous among the eukaryotes, they are used with exceptionally high frequency in the protozoa. Some kinetopastidparasites also synthesise very high levels of GPI‐related glycolipids that are not linked to protein. Thus GPI‐anchored molecules or free GPI glycolipids tend to dominate the cell surface molecular architecture of these organisms. The highly elevated levels and specialised nature of GPI metabolism in the kinetoplastid and other parasites suggests that the GPI biosynthetic pathway might be a good target for the development of new chemotherapeutic agents. This article reviews the wide range of functions that GPI protein anchors and GPI‐related glycolipids are thought to perform in these organisms and some aspects of their biosynthesj?
Risk factors for ill‐health in a remote desert‐dwelling Aboriginal community in Western Australia
Authors: Gracey M. , Burke V. , Spargo R. M. , Beilin L. J. , Smith P. , Beilby J. , Smith R. M. , Chin C. 
Published: March 2008

Abstract Background: Living in small, isolated groups may promote health for Aborigines if traditional lifestyles are followed, but overall health risks in such communities are inadequately documented. Aim: To document health status of a remote Aboriginal community with reference to nutrition, cardiovascular risks, renal disease and infections and to identify areas where health might be improved. Methods: All residents of a small community in the Great Sandy Desert underwent medical examinations, anthropometry and measurement of blood pressure. Investigations included cholesterol, triglycerides, glucose, insulin, creatinine, lipoprotein (a), apolipoprotein E phenotype, angiotensin‐converting enzyme genotype, urinalysis, stool microscopy (children), liver function tests and full blood examination. Results: Children (n=26) were undernourished while 14% of adults (n=51) were underweight, 22% overweight and 40% of women and 13% of men were obese with central obesity in 90% of women and 48% of men. Fifteen per cent of the group were hypertensive. Insulin levels were increased in 55% of subjects, total cholesterol in 21% and triglycerides in 56%, while HDL was decreased in 78%. Angiotensin‐converting enzyme and apolipoprotein E typing and lipoprotein (a) did not suggest increased cardiovascular risk. Proteinuria was present in 39% of subjects, haematuria in 49% and definite or possible urinary tract infections in 30%. Faecal parasites were prevalent and a history of infections, including sexually transmitted diseases, was common. Conclusions: Increased cardiovascular risk, nutritional disorders, renal disease and infections are major problems in this community which had relocated several years previously from a mission environment closer to western influences, including alcohol.
Risk factors for sudden unexpected cardiac death in Tasmanian men
Authors: Sexton P. T. , Jamrozik K. , Walsh J. , Parsons R. 
Published: March 2008

Abstract Background: Sudden unexpected cardiac death (SUCD) accounts for approximately 25% of deaths from ischaemic heart disease (IHD) but is relatively poorly understood because of the difficulties involved in researching aetiology. Clinical differences between instances of SUCD and those cases of acute chest pain that survive long enough to be proven as myocardial infarction but are eventually fatal might reflect differences in aetiology. Aims: To determine the risk factors for sudden unexpected cardiac death in Tasmanian men. Methods: A population‐based case‐control method was used with the study population, an estimated 125,225 men aged 25–74 years living in the island State of Tasmania, Australia. The case group of 102 men who had a SUCD was validated using necropsy reports, hospital records and information provided by the usual general practitioner. Cases were matched with 204 community controls. Spouses or partners of eligible subjects answered a detailed questionnaire. Multivariate odds ratios (ORs) for risk factors were calculated using stepwise analysis. Results: Risk factors measured included: smoking habit, treated hypertension, hyper‐cholesterolaemia, diabetes mellitus, family history of IHD, alcohol intake and exercise habits. Independent risk factors for SUCD were: history of diabetes mellitus (OR=4.2, 95% CI: 1.39, 12.81), current smoking status (OR=3.5, 95% CI: 1.80, 6.82), and family history of IHD (OR=2.6, 95% CI: 1.34, 4.92). Conclusions: Some accepted risk factors for acute myocardial infarction (AMI) also predict sudden death in men with no history of coronary disease. Efforts to reduce smoking, the incidence of diabetes mellitus and mean blood pressure must be continued as SUCD is, by definition, untreatable but is potentially avoidable in many instances.
An analysis of the outcomes of treatment of small cell lung cancer in the elderly
Authors: Tebbutt N. C. , Snyder R. D. , Burns W. I. 
Published: March 2008

Abstract Background: Many cases of small cell lung cancer will occur in the elderly population but optimal management of the disease in this age group remains uncertain. Aims: To evaluate treatment of small cell lung cancer in the elderly in Australia and to compare treatment received and outcomes with those of younger patients. To draw insights from these observations into the optimal management of small cell lung cancer in the elderly. Methods: A retrospective review of treatment charts and case notes for 51 elderly patients and 102 younger patients was undertaken. Results: Elderly patients had similar baseline parameters with respect to disease stage and performance status. Elderly patients were mostly treated uniformly with combination chemotherapy, but suffered more dose reductions than younger patients. Benefits of chemotherapy were seen even in patients with poor performance status. Despite the dose reductions, response rates and survival times for elderly patients were usually similar to younger patients. Conclusions: Combination chemotherapy is beneficial to elderly patients with small cell lung cancer. Optimal therapy for the elderly may be different from that for younger patients and should be defined through prospective randomised clinical trials.
Trends in in‐hospital mortality following acute myocardial infarction (AMI) in Victoria, 1987–1994
Authors: O'Hara D. , McDonald I. 
Published: March 2008

Abstract Background: Death rates from coronary heart disease have exhibited remarkable declines in most industrialised countries. Cardiovascular mortality has been the subject of extensive research and we considered it important to analyse recent local population based data on hospital outcomes of acute myocardial infarction (AMI). Aim: To document the trends in in‐hospital mortality from AMI in Victoria from 1987–1994. Methods: This was a retrospective analysis of data from the Victorian Inpatient Minimum Database relating to all public acute care hospitals. All separations recording a principal diagnosis 410 (AMI) were selected. Changes in distribution of AMI separations, in‐hospital mortality, and changes in length of stay were examined. Results: The mean age of women admitted was 72 years compared with 64 years for men. Women comprised around a third of the overall sample but the proportion varied from 13% in those under 50 years to 57% among those aged 80 years and over. A striking decline in mortality was observed throughout the eight year period. The relative age adjusted decline was 33.5% (40% in males and 26% in females) with rates remaining higher in women. This decline occurred despite the increasing representation of those aged over 80 years. There was a significant decline in the mean length of stay (1.8 days) over the eight year period but this is likely to have had only minimal impact on mortality rates. Conclusion: We have documented welcome declines in in‐hospital mortality from AMI that are not an artefact of declining lengths of stay. Our observations parallel those in similar overseas studies. Large changes in medical management have taken place from the mid 1980s and may be partly responsible, but a change in disease process cannot be ruled out.