ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01336.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractTwenty patients with moderately severe Parkinson's disease entered an open study of the efficacy and safety of a slow release preparation containing levodopa 200mg and carbidopa 50mg per tablet (‘Sinemet CR4’). Following an initial four week baseline stabilisation period on conventional ‘Sinemet’ tablets, the patients were transferred to ‘Sinemet CR4’ and observed at intervals over the next 12 months. Fifteen patients completed the full year observation period. When compared with the baseline period, treatment with ‘Sinemet CR4’ was associated with longer periods of functional improvement and less fluctuation of response following each dose. The median (range) dose frequency was reduced from three (three‐12) to two (two‐seven) times daily (p<0.001) on ‘Sinemet CR4’ although median (range) total daily dose of levodopa was increased from 700 (375–2525) to 800 (400–2800) mg without any increase in adverse effects. Three patients developed peripheral neuropathy while receiving Sinemet CR4, but the association with this therapy is unclear. Overall ‘Sinemet CR4’ allowed a longer dosage interval and provided more stable control of disease manifestations than conventional ‘Sinemet’

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01337.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractHypercholesterolaemia is a known risk factor for coronary artery disease. This study describes a retrospective analysis of 176 patients admitted to the Coronary Care Unit (CCU) in a six month period with an admission fasting serum cholesterol of greater than 5.5 millimoles per litre (mmols/L). The patient records were examined at least six months after hospital discharge to determine what action, if any, was instituted in response to their hypercholesterolaemia.One hundred and thirty‐four (76%) patients had a discharge diagnosis of myocardial ischaemia or infarction. Of the 176 patients, 73 were referred to a dietitian, 31 were given dietary advice by a medical officer, 13 were commenced on lipid‐lowering drugs with nine continuing lipid‐lowering drugs and only 13 patients were referred to this hospital's lipid clinic. Sixty‐nine (39%) received no response to their hypercholesterolaemia.It is likely that our experience is not unique and greater attention to CCU measured lipid results and risk factor modification should be instituted by physicians. (Aust NZ J Med 1991; 21: 4

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01338.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractTwenty‐four patients with immune thrombocytopenia (ITP) were treated with vincristine (VCR) 1.0–2.0mg given as 4‐hr I.V. infusions at weekly intervals for four‐six weeks; four patients received further infusions, as maintenance therapy, at increasing intervals for up to 12 months. Eight often patients with recent‐onset (6 months' duration, seven showed a good or excellent but only transient response; sustained responses (two good, one partial) were seen only in the three patients who received maintenance therapy. The collective global experience with this novel therapeutic approach of targeted‐immunosuppression for ITP is still small, but results to date suggest a promising role for this approach, especially in patients with recent‐onset ITP. (Aust NZ J Med 1991;

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01339.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractTwenty‐eight patients aged 16–50 years with chronic myeloid leukaemia (CML) underwent allogeneic bone marrow transplantation (BMT) using human leukocyte antigen (HLA)‐identical sibling donors. Of the 28 patients, 21 were in chronic phase, five were in accelerated phase and two were in blast phase at the time of BMT. Twenty‐three of the patients survived more than 63–2187 days after BMT, 21 in continuous complete remission and two with haemato‐logic relapse of CML. Two patients died of interstitial pneumonitis and one died of relapsed CML, cerebral aspergillosis and cytomegalovirus enterocolitis.The overall probability of survival at six years was 78%± 9% (mean ± standard error) and of disease free survival 66 ± 11%. For patients transplanted in chronic phase, the survival probability was 90 ± 6%, while all of the patients undergoing BMT in chronic phase within the first year after diagnosis were alive with a relapse‐free survival of 88 ± 12%. The actuarial probability of occurrence of acute graft‐versus‐host disease (GVHD) was 57 ± 9%, while for Grades II and III GVHD it was 28 ±9%. Chronic GVHD occurred in 18 of 25 patients at risk. The majority of patients had a Karnofsky performance score at latest follow‐up of at least 90% (range 50–100). We conclude that allogeneic BMT is effective, curative therapy for CML and that BMT performed earlier in the natural history of the disease is associated with the best outcome. (Aust

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01340.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.tb01341.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractFourteen cases of acute severe pancreatitis complicated by non‐traumatic rhabdomyolysis are described and compared to case controls. Pancreatitis of various aetiologies was confirmed by surgical diagnosis, laparotomy, abdominal paracentesis, CAT scan and post mortem. Pancreatitis was severe with a high Ranson prognostic score (7.4 ± 0.5 vs controls 1.9 ± 0.4, p<0.001), longer ICU admission and a mortality of 79%. Rhabdomyolysis occurred two to 19 days after the onset of pancreatitis (with a median CPK peak at 6.5 days) and was accompanied by multiple organ failure in 93% of cases. Severe rhabdomyolysis and myoglobinuric renal failure occurred in three patients out of 12 with acute renal failure. Hypocalcaemia was common (93%), severe (with a mean minimum value of 1.79 ± 0.07 vs 2.34 ± 0.04mmol/L, p<0.01) and prolonged (remaining abnormal for 5.2 ± 0.8 vs 0.07 ± 0.07 days, p<0.001). Intravenous calcium supplements were required in 50% of patients. Plasma phosphate, potassium, urate and anion gap were elevated (all p<0.05) and accompanying clinical features included fever, ascites, leuco‐cytosis, hypoalbuminaemia and abnormal liver function tests.Rhabdomyolysis is associated with acute severe pancreatitis, appearing as a late phenomenon in the context of severe prolonged hypocalcaemia, multiple organ failure and a poor outcome. (Aust NZ J Med 1991; 21:

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01342.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractRenal failure due to cholesterol embolisation is an uncommonly recognised condition. It is usually associated with severe aortic atherosclerosis and in most cases follows a vascular event, such as angiography, vascular surgery, or aneurysm rupture. We report nine patients, all males, who presented to our unit. Six patients survived the initial event, although two died six and eight weeks later. This report emphasises that, although this condition has a high mortality, long term survival is not a rare event. (Aust NZ J Med 1991; 21: 418–421

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01343.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.tb01344.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractMost placebo‐controlled studies testing the hypo‐cholesterolaemic action of oat bran have compared high fibre against low fibre diets. To determine whether oat bran had greater cholesterol‐lowering action than another source of fibre (wheat bran) we compared the effect of breads of similar total fibre content containing either oat bran or additional wheat bran. Twelve hyperlipidaemic subjects (38–66 years) were stabilised on lipid‐lowering diets for at least three months prior to the study. Subjects were given each type of bread for four‐week periods in a single‐blind, cross‐over design.Cholesterol, triglyceride and LDL‐cholesterol levels did not change significantly during the oat and wheat bread periods. HDL‐cholesterol rose equivalently but only to a just significant level during the oat bran diet. Body weights, lipids and lipoprotein parameters were not significantly different between the two diet periods. Both diet treatments lowered serum cholesterol approximately 4%.We conclude that this oat bran bread consumed as part of a lipid‐correcting diet did not influence lipoproteins to any greater extent than wheat bread of similar total fibre content. (Aust NZ J M

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01345.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY