摘要:

Abstract:A 63‐year‐old patient developed graft‐versus‐host disease (GVHD) after the transfusion of stored, random donor red cell concentrates with coronary artery surgery. The disease was characterised by skin rash, fever, diarrhoea, hepatic dysfunction, pancytopenia and the acquisition of cells bearing human leukocyte antigens of a blood donor. Clinical and histologic improvements were noted with antithymocyte‐globulin and corticosteroid therapy, as seen in some patients with acute GVHD following allogeneic bone marrow transplantation, but the pancytopenia failed to resolve prior to a fatal cerebral haemorrhage. Early aggressive immunosuppressive therapy may be beneficial for transfusion‐associated GVHD but strategies for its prevention, by limitation of the use of homologous blood need to b

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03000.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Coeliac plexus block is a safe procedure with relatively few side‐effects. We report two cases of persistent severe diarrhoea following coeliac plexus block and explore the possible reasons for this previously unrecognised side‐effect. We postulate that somatostatin analogue may be useful as treatment for diarrhoea following neurolytic coeliac plexus block that is unresponsive to conventional anti‐diarrhoeal a

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03001.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

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

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03002.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:We report two cases of heparin induced thrombocytopenia (HIT), in patients who required anticoagulation for extracorporeal procedures (haemodialysis and cardiopulmonary bypass) one associated with recurrent thrombosis of the artificial circuits. Resolution of thrombocytopenia and successful anticoagulation were achieved using a low molecular weight heparinoid (LMWH) Org 10172. Anticoagulation was monitored using estimations of plasma anti‐factor Xa activity.These cases demonstrate that LMWH provides safe and effective anticoagulation in patients in whom unfractionated heparin has caused HI

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03003.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:A small number of patients positive for the human immunodeficiency virus (HIV) have been reported as developing acute non‐lymphoblastic leukaemia (ANLL) and none has achieved remission despite attempts at treatment.We report on a 34‐year‐old HIV positive heterosexual intravenous drug user who presented with ANLL (FAB classification M5, Monoblastic) and entered remission following one cycle of cytosine arabinoside and daunorubicin according to the 7‐3 protocol of the Australian Leukaemia Study Group (ALSG). This was followed by consolidation of 5‐2 as per ALSG and one cycle of maintenance with low dose cytosine arabinoside. Ten months after remission, he relapsed but achieved a second remission with the ALSG 7‐3‐7 protocol (7‐3 plus etoposide) followed by consolidation with 5‐2‐5. He remained HIV positive but showed little progression towards the acquired immunodeficiency syndrome despite the intense immunosuppression. The duration of his second remission was five months. The patient died of septicaemia during the third attempt at remission induction 18 months after diagnosis.We conclude that HIV seropositivity is not an absolute contraindication to aggressive chemotherapy in those patien

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03004.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Oesophageal intramural pseudodiverticulosis is a rare condition that presents with dysphagia. The diagnosis is usually not apparent endoscopically and careful radiological evaluation is required. Previous reports suggest a benign course with good response of dysphagia to oesophageal dilatation and complications have not been described. Two cases are reported, one in whom life threatening haemorrhage developed following dilatation, and one complicated by a retro‐oesophageal collection. It is possible that oesophageal intramural pseudodiverticulosis results in an increased propensity to trauma and even perforatio

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03005.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:A case of sino‐atrial arrest due to temporal lobe epilepsy is described and compared with previously documented such cases in the literature. The rarity of bradycardias and sinus arrest due to arrhythmogenic seizures is discussed, as is the role of prospective ambulatory electroencephalographic and electrocardiographic studies in evaluating this associatio

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03006.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:About one third of adults surveyed in South Australia have shown evidence of past silent infection withLegionella pneumophilaserogroup 1. However, the annual notification rate for symptomatic disease is only about 0.5 per 100,000 residents in non‐epidemic years. The male to female ratio is 2.5 to one and approximately 50% of cases are at least 60 years of age. Cases have presented more in summer and in the metropolitan areas.Twenty cases of Legionnaires' disease occurred during the summer of 1985‐86. A cooling tower was held to be the principal source with aerosols being dispersed up to three kilometres away during an atmospheric thermal inversion.A subsequent outbreak of 22L. longbeachaeserogroup 1 infections had no marked geographic clustering. The outbreak commenced in spring and cases were distinguished as active gardeners.L. longbeachaewas found in garden soil and it is hypothesised that this soil inhabitant can become aerosolised and inhaled during gardening.The potential for primary prevention of Legionnaires' disease is discussed in relation to water‐handling equipment and the need for early precautionary treatment of all community‐acquired pneumonia as suspect Legionnaires' disease is emp

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03007.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03008.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb03009.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY