ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00369.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThe complications and causes of death of 105 patients with B cell chronic lymphocytic leukaemia followed for a median period of 5.5 years are described. Infection and secondary primary malignant tumours were the most common complications and also caused most deaths.S. pneumoniae, S. aureus, S. haemolyticus, E. coliand the zoster‐varicella virus accounted for most infections and the lungs, skin and urinary tract were the sites affected. Even trivial infections were potentially serious. Haemolytic anaemia and vascular complications were also common. Older patients tended to have a shorter survival than the mean for the group whereas younger patients fared better. The mean survival was 6.2 years. Analysis confirmed the prognostic value of Rai staging. Advancing disease increased the liability to major infection. Light bone marrow infiltration five years post diagnosis indicated a good prognosis and preservation of normal immunoglobulin levels seemed beneficial. Immunoglobulin deficiency is the factor that correlates best with the frequency, severity and pattern of infection. Early stage disease provides a distinct benefit and there may be advantages in prompt diagnosis, regular assessment by immunoglobulin levels and bone marrow pattern and treatment on the first evidence of advancing disease. Fresh symptoms should be investigated in their own right because of the likelihood of second tumour

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00370.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractA sero epidemiological study was carried out on human sera from all regions of New South Wales for the presence of antibodies to nine bunyaviruses viz Aino, Akabane, Belmont, Gan Gan, Kowanyama, Mapputta, Peaton, Tinaroo, Trubanaman and the orbivirus Corriparta. Neutralising antibodies were found in titres up to 1280 to Gan Gan and to 640 to Trubanaman viruses, prevalences 4.7% and 1.4% respectively. Neutralisation titres up to 40 were found to Belmont, Aino, Peaton and Corriparta viruses but the significance of these is uncertain since they may represent either non‐specific inhibitors or cross reacting antibodies to related but currently unknown viruses. No antibodies were found to Akabane, Kowanyama, Mapputta or Tinaroo viruses in New South Wales sera.Gan Gan virus appeared to be pathogenic for man being associated with an acute epidemic polyarthritic like illness. Trubanaman virus is suspected of being pathogenic. This is the first report of the pathogenicity of these Australian bunyaviruse

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00371.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractA study was made of 52 patients considered to probably have chronic non‐A, non‐B hepatitis who were seen during an eight‐year period at Westmead Hospital, Sydney. The patients were followed for a median of 28 months to assess the natural history of the disease and, in a small number of patients, the effect of immunosuppressive therapy on disease progression was examined. In 94% of cases, infection appeared to have been acquired by a parenteral route; the remainder were sporadic infections. Fifty‐six per cent of the patients had mild constitutional symptoms and the remainder were asymptomatic. Similarly, 54% of patients had no signs of chronic liver disease and none exhibited signs of hepatic decompensation. Liver biopsies were performed in 42 patients; chronic active hepatitis with or without cirrhosis was present in 90%. However, neither the presence of symptoms nor the degree of biochemical abnormality were predictive of disease severity as determined histologically. Among eight patients treated with corticosteroids (with or without azathioprine), six underwent follow‐up liver biopsy. Quantitative analysis of inflammatory and fibrotic changes indicated significant (p<0.01) progression of histological severity during a median 33 months (range 7–98 months) between biopsies with cirrhosis developing in four instances. In contrast, among the seven untreated patients rebiopsied after a median of 16.0 months (range 11–37 months) there was no overall change in histological severity and only one patient developed cirrhosis. It is concluded that histological assessment is required in all patients suspected of having chronic non‐A, non‐B hepatitis as other means of assessment are unreliable. At present, immunosuppressive therapy cannot be recommended for patients with this form of chronic viral hepatitis; as well as being unhelpful, such treatment may accelerate di

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00372.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThree proven cases and one presumed case ofPneumocystis cariniipneumonia are presented in which the radiological appearance mimics tuberculosis.The classic and unusual X‐ray findings ofP. cariniipneumonia are discusse

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00373.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00374.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractTwo cases of the ‘Shrinking Lungs Syndrome’ in patients with systemic lupus erythematosus are described to highlight an infrequently recognised feature of this condition. Respiratory muscle weakness, improved by steroid therapy, was demonstrated in each patient and considered to be the mechanismunderlying the respiratory sympt

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00375.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractWegener's granulomatosis is a chronic relapsing condition requiring long term immunosuppressive treatment. Periodic exacerbations may require increased dosage of steroids and/or cyclophosphamide. We present a case of a patient with end‐stage renal failure who had repeated pulmonary cavitating lesions but was unable to tolerate high dose standard therapy. After only a few months with cyclosporin A there was almost complete resolution of his lung lesion

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00376.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractWe report on a case of a 26‐year‐old intravenous narcotic abuser with a primary cerebral mucormycotic abscess caused byRhizopus oryzae.He was treated with a combination of intravenous and intraventricular amphotericin B and surgical drainage with a successful outcome. There was no evidence that his infection was acquired by the rhinocerebral route, it seems likely that he injected himself with a contaminated batch of narcotic or amphetamine. Mucormycosis presenting in this way has been described previously but this is only the second such case to survive. Early diagnosis and treatment is essential for a favourable outcome in this condit

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00377.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractA Chinese engineer presented with non‐specific palpitation, atypical chest pain and normal electrocardiogram both at rest and during exercise, was documented to develop electrocardiographic evidence of left ventricular hypertrophy and abnormal isotopic cardiac scintigraphy during stress test within a period of three years. His echocardiogram remained unremarkable. Cardiac catheterisation and cineventriculogram confirmed the presence of apical hypertrophic cardiomyopathy, without any outflow tract obstruction or coronary artery disease. This case, together with 14 others detected recently in Hong Kong, will arouse the existence of this form of hypertrophic cardiomyopathy in the Chinese. The emergence of all diagnostic features in this patient within a short time will support an aetiological hypothesis that apical hypertrophic cardiomyopathy can be acquired in patients with genetic predispositio

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00378.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY