ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04863.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to evaluate the immediate and long‐term clinical and haemodynamic effects of Percutaneous Balloon Aortic Valvuloplasty (PBAV). Thirty‐three procedures were performed in 27 patients, 11 males and 16 females with a mean age of 72 years. The peak to peak systolic gradient across the aortic valve decreased by 52%, from 67 ± 24 mmHg to 31 ± 15 mmHg (p<0.0001) and the aortic valve area increased by 35%, from 0.48 ±0.16 to 0.67 ± 0.21 cm2(p<0.001) after PBAV. There were no procedural deaths. Minor complications occurred in seven patients. Eighty‐one per cent of patients (27 procedures) showed immediate symptomatic improvement, five remained symptomatic and one died in hospital before discharge. In a mean follow‐up of 17 ± 12 months (range six to 38 months), eight patients died due to congestive cardiac failure, six underwent repeat PBAV, three died due to noncardiac causes and three had recurrent symptoms controlled on medical therapy. Event free survival at 15 months was 43%.In conclusion PBAV produces a satisfactory immediate clinical and haemodynamic result, however, considering the high rate of symptom recurrence, this procedure has a beneficial role only in short‐term palliation of severely symptomatic patients who are unable to undergo aortic valve replacement. (Aust NZ J Med 1992; 22:

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04864.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractSera from 103 patients with chronic inflammatory bowel disease (IBD) were tested prospectively for antibodies against neutrophil cytoplasmic antigens (anti‐neutrophil cytoplasm antibodies, ANCA) and endothelial cell surface antigens (anti‐endothelial cell antibodies, AECA) by indirect immunofluorescence (IIF) and assays based on whole fixed neutrophils, purified neutrophil enzyme substrates and human umbilical vein endothelial cells.Using IIF, ANCA were found in 26 IBD sera (25%) and in none of 51 controls. Twenty‐two positive sera (85%) were from patients with ulcerative colitis (UC). The pattern of distribution of immunofluorescence was always perinuclear (P‐ANCA). A majority of UC patients positive for these autoantibodies (68%) had active colitis, but none had evidence of vasculitis. Using a whole neutrophil ELISA, binding was demonstrable in 73% of UC sera compared to 27% of Crohn's (CD) sera and only 4% of controls. Unlike vasculitis sera, UC sera with P‐ANCA did not bind strongly to myeloperoxidase (MPO). Forty‐five per cent of IBD sera tested positive for IgG AECA in an endothelial cell ELISA, compared to seven of 51 (14%) controls. Binding correlated with both active and extensive colitis.A type of P‐ANCA, in most cases distinct from MPO‐specific P‐ANCA observed in vasculitis, is detected in a significant proportion of patients with UC, but rarely Crohn's colitis and therefore may be of differential diagnostic value. IgG AECA are also frequent in CIBD sera but are less disease specific than ANCA. (Aust NZ J Med 1992;

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04865.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04866.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractWe used cyclophosphamide at a dose of 7 g/m2in patients with advanced cancer and compared the efficacy of this treatment to generate peripheral blood stem cells (PBSC) with the previously reported regimen of cyclophosphamide 4 g/m2in a similar group of patients. None of these patients received haemopoietic growth factors. Twenty‐two patients received 7 g/m2and 37 received 4 g/m2. PBSC were collected by apheresis after the leukocyte count recovered to 1.0times109/L.The yield of colony forming unit‐granulocyte macrophage (CFU‐GM) was higher for the 7 g/m2group with a median of 35 times 104/kg versus 15 times 104/kg body weight (BW) (p

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04867.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractOne hundred and one subjects were randomised to receive either aspirin 100 mg or aspirin 100 mg + dipyridamole 300 mg daily before undergoing coronary bypass surgery. The drugs were commenced at least 36 hours before operation and patients were followed for one year. There were three perioperative deaths and 37 withdrawals, of which 14 were drug related (aspirin four, aspirin + dipyridamole ten). Cineangiocardiograms at nine weeks and one year showed vein graft patency rates of 93% and 87% for subjects treated with aspirin alone; and 90% and 89% in those who received aspirin + dipyridamole. During the follow‐up period 14% of 232 coronary lesions in the aspirin treated group advanced by more than two grades compared with 15% of 315 lesions in the aspirin + dipyridamole group.The study did not establish superiority of one regimen over another in terms of graft patency or progress of lesions in native vessels. However, low dose aspirin was better tolerated than combination therapy. (Aust NZ J Med 1992; 22: 665ndash;670

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04868.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04869.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractWhile most patients with disseminated non‐seminomatous germ cell tumours (NSGCT) are cured by treatment with cisplatinum‐based chemotherapy, a subset die from refractory or relapsing disease. Poor prognostic factors at diagnosis include bulky disease, visceral involvement, high serum marker levels and an inadequate rate of fall in these markers in response to treatment.There are a number of approaches to poorer risk patients. One is to use conventional induction chemotherapy followed by second‐line salvage regimens in those who fail induction. Results with this approach have been disappointing. A second approach is to use more intensive induction regimens, in some cases with growth factor support; whether these are superior to standard treatment has yet to be established by randomised studies. A third approach, based on the chemotherapy‐dose responsiveness of NSGCT, consists of the administration of very high dose chemotherapy followed by haematological rescue with autologous marrow to patients failing initial therapy. Review of autograft studies suggest that durable remissions can be obtained in most patients with responsive disease, but not if the disease is chemotherapy‐refractory. A new approach may be elective early autografting in patients identified at diagnosis to have very poor prognosis disease. (Aust NZ J Med 1992; 22: 679n

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04870.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04871.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractA 1:1 matched case‐control study was carried out to assess whether comments written about a candidate during a semi‐structured interview can identify students likely to withdraw from a medical course better than global numerical scores. Fifty‐nine students who withdrew from the undergraduate medical course at the University of Newcastle prior to completion were matched for sex, year and mode of entry into the course, prior academic qualifications and age at entry, with 59 students who had not discontinued or been excluded from the course.No significant differences were found between the numerical scores allocated for personal attributes to students who later withdrew from the course and those who continued. However, students who withdrew had statistically significantly more negative comments made about them at interview with respect to their supportive and encouraging behaviour (p= 0.04) and their motivation to become doctors (p= 0.05). Although no other comparisons reached statistical significance, students who withdrew consistently received more negative comments and fewer positive comments than their continuing peers. A stepwise logistic regression procedure identified the number of negative comments made by interviewers about a candidate on their supportive and encouraging behaviour as the only statistically significant predictor of later withdrawal (odds ratio 1.65 95% confidence interval 1.01–2.70). (Aust NZ J Med 1992; 22: 692nda

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb04872.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY