摘要:

Summary:Medicine, men and politics throughout the ages.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03678.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:A study of the treatment received by 135 gastric ulcer patients in a Western community.A study was made of the treatment received by 135 gastric ulcer patients within one month and within six months of diagnosis. The treatment was divided into three types. Effective measures included surgery and those measures that have been shown favourably to influence the initial healing rate of chronic gastric ulcer (i.e. hospital admission and carbenoxo/one sodium). Ineffective measures included those that have been shown convincingly not to accelerate ulcer healing–diet, antacids, sedatives and no treatment at all. Anticholinergic drugs were included in the third group where the evidence is conflicting. The patient's therapeutic status was assessed one month and six months after diagnosis.Within six months of diagnosis only 32% of patients received treatment that clinical trials have shown favourably to influence the course of gastric ulcer and approximately half received treatment that has never been shown favourably to influence the course of gastric ulcer. The social class of the patients and whether they were seen by a consultant physician or family doctor made no difference to the form of therapy receive

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03679.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:The nephrotic syndrome in Papua New Guinea: aetiological, pathological and immunological findings.K. C. Powell, R. Meadows, R. Anders, C. C. Draper and C. Lauer,Aust. N.Z. J. Med.,1977, 7, pp. 243–252.Studies were carried out on 34 patients with the nephrotic syndrome within Papua New Guinea to determine the aetiology, with special reference to the role ofP. malariae.Biopsies were taken and examined by light microscopy, with a few additionally examined for immunofluorescence. Sera were studied for titre of malarial antibody, presence of select viral antibodies, Australia Antigen, immunoglobulins IgA, IgG and IgM, and for the third component of complement (C3). The selectivity of proteinuria was examined by a method using IgG and transferrin. Control subjects were used when appropriate.Histological findings showed a wide range of changes with the Minimal Lesion type being very uncommon. Proliferative lesions accounted for 24 of the 34. Focal lesions were uncommon, in contrast to findings of an earlier publication concerning New Guinea patients. Immunofluorescence studies on nine showed the presence of complement, IgG, IgM or IgE, findings accepted as consistent with the concept of immune complex disease.The serum results showed a low level of total IgG, a low IgG specific forP. malariae,a normal level of IgM specific forP. malariaeand a raised total IgM. These serological findings, along with the histological findings, are strongly againstP. malariaebeing a common cause of the nephrotic syndrome.The viral findings excluded type B hepatitis virus and some arboviruses, as causing the nephrotic syndrome. The ASOT titres were usually normal and the VDRL readings all non‐reactive. Leptospira! infections were excluded as a cause. The cause(s) of the nephrotic syndrome in Papua New Guinea remains obsc

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03680.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:Analgesic abuse, renal papillary necrosis and concomitant drug intake.In a retrospective survey of 145 patients coming to autopsy at a hospital in Sydney, 31 were found to have some form of renal papillary necrosis (RPN). Sixteen (52%) of those abused analgesic mixtures, there being a marked female preponderance (70%). A further two cases may have been linked with indomethacin and phenylbutazone. On the other hand, 15 (48%) of other analgesic abusers did not develop RPN and the differences between the two groups of abusers and a third group of non‐abusers were studied in the hope of isolating a precipitating factor. Examination of concomitant drug intake revealed a positive correlation of RPN in abusers with the taking of diuretics and antihypertensive drugs. While these drugs may have been prescribed to correct the sequelae of a silent renal lesion, an interactive component in its pathogenesis cannot be ruled out. Analgesic abuse but not RPN was linked with an increased consumption of barbiturates, psychotropic drugs, cardiac glycosides and antacids. Drug interactive effects may partly explain the sudden emergence of analgesic nephropathy 20 years ag

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03681.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:A cheap oral therapy for Paget's disease of bone.Nine patients with painful Paget's disease of bone were treated for 200 days with a drug combination designed to elevate plasma calcium, hence stimulating the production of endogenous calcitonin and suppressing that of parathyroid hormone. This combination was oral calcium, a thiazide diuretic, a low phosphorus diet and aluminium hydroxide.Eight of the nine patients experienced sustained pain relief after 20–70 days. The mean plasma alkaline phosphatase (expressed as a percentage of the pre‐treatment level) commenced to fall after 30 days of treatment and at 120 days was 58% of the pre‐treatment level; this fall was sustained at 200 days. There was a mean rise of 0 08 mmol/l in plasma calcium; there was no significant change in plasma inorganic phosphorus or plasma creatinine. In view of the extremely low cost of this drug combination and its lack of side‐effects, it is suggested it be considered as a treatment for Paget's disease

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03682.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:Treatment of hypercholesterolaemia with oral lecithin.An open clinical trial was performed to evaluate the plasma cholesterol‐lowering potential of oral lecithin in large doses (20–30 g/day), with or without supplementary blofibrate. Three healthy subjects and seven patients with hypercholesterolaemia were studied over periods ranging from eight weeks to 11 months. In one‐third of healthy subjects and in 3/7 patients, lecithin therapy led to a significant fall in plasma cholesterol concentration (10–18% fall). Combination of lecithin and clofibrate in two of the patients led to still lower plasma cholesterol levels (21 and 22% fall). Most of the change in plasma cholesterol concentration, when it occurred, was due to a reduction in beta lipoproteins. Evidence is presented that oral lecithin may reduce plasma cholesterol levels by acting as a source of linole

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03683.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:Serotypes of pneumococci in pneumonia, meningitis and other pneumococcal infections.During a five‐year period, 1965 to 1969 inclusive, pneumococci from 294 patients with acute pneumococcal infections were serotyped. Pneumococci of 33 serotypes were encountered, of which types 3 and 19 were most frequent. The spectrum of infections included pneumonia, meningitis, peritonitis, otitis media and mastoiditis, wound infection and conjunctivitis. At least 17 infections were fatal, all of which, with one exception, occurred either in infants or in adults over 50 years of age.In pneumonia, type 3 pneumococcus was predominant, being isolated from 21 of 101 patients. In 67 cases of pneumococcal meningitis, most of which were in children, the commonest type was 14. If a pneumococcal vaccine is produced for use in Australia, inclusion of serotypes 1, 3, 4, 6, 9, 14, 19 and 23 should be considered. These eight types caused 52% of the cases of pneumonia and 67% of the cases of meningitis in this stud

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03684.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:A comparison of oral theophylline and oral salbutamol in exercise‐induced asthma.Ten patients with exercise‐induced asthma were premedicated with oral salbutamol and oral theophylline on separate occasions before performing a standardised exercise test. Although both agents produced bronchodilatation, reflected by increases in peak expiratory flow rates (PEFR) at rest, they were generally ineffective in preventing an abnormal post‐exercise fall in PEFR. Only one patient was afforded protection by salbutamol and another two patients by theophy

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03685.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:Myocardial ouabain content and susceptibility to ouabain cardiotoxicity associated with circulatory volume overload in the dog.The influence of circulatory volume overload on the myocardial uptake of ouabain and on cardiotoxicity was studied in the unanaesthetised dog with aorto‐caval fistula. One hour after tritiated ouabain (0.02 mg/kg IV) both ventricles and atria contained more ouabain than did those of normal dogs (left ventricle (LV), 166±23 (SD) ng/g vs. 97 ± 19 ng/g, P<0001) while concentrations in skeletal muscle, liver, kidney and plasma were not different in the two groups. In other experiments ouabain was infused to cardiotoxicity (7.5 μg/kg followed by 3 μg/kg/min), Cardiotoxicity occurred earlier in dogs with fistula than in normals (16.5 ± 2.7 min vs. 24.1 ± 2.4 min, P<0001). Ouabain concentrations in myocardium were not different (LV, 434 ± 58 ng/g, vs. 442 ± 42 ng/g) while concentrations in liver and kidney were less in those with fistula (181 ±35 ng/g vs. 278 ± 69 ng/g, P<0.001; 1422 ± 189 ng/g vs. 2747 ±479 ng/g, P<0001). Average content of skeletal muscle was also less, in proportion to administered dose. The increment in myocardial ouabain content associated with aorto‐caval fistula appears to be physiologically active and hence is presumably specifically bound to the digitalis receptor. The observations in this model suggest the possibility of augmented cardiac glycoside uptake in some clinical c

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03686.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:Control of blood glucose in diabetics using an artificial pancreas.Studies have been performed using an on‐line computer system programmed for blood glucose control of insulin and dextrose infusion (artificial pancreas). The aim of these studies was to test performance of the artificial pancreas and to suggest directions for future optimisation. Blood glucose stabilisation studies of diabetic volunteers were extended throughout the day and included three main meals and light exercise periods. Monitoring of blood glucose profiles of the same diabetics after depot insulin were performed on a separate occasion for comparison. The presence of insulin antibodies did not impair operation of the artificial pancreas. Most of the insulin infused by the artificial pancreas was to initially correct hyperglycaemia with relatively little required to subsequently maintain euglycaemia. The afternoon intra‐meal average infusion rate was 0–9 U/hr. It is suggested that correction of fasting hyperglycaemia and maintenance of euglycaemia in diabetics be treated as separate control problems for the artificial pancreas. The overall ability of the artificial pancreas to control blood glucose to a degree not attainable by conventional insulin therapy is confirmed, in this case under conditions which include patient act

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb03687.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY