摘要:

Summary:A patient with a lifelong bleeding diathesis is described. Studies of haemostatic function revealed a prolonged bleeding time and reduced glass bead adhesiveness. All other routine studies of haemostatic function yielded normal results, in particular the Factor VIII level, estimated both by antibody and coagulation techniques. Ristocetininduced platelet aggregation was absent and could be corrected by the addition of plasma or serum from normal controls or haemophiliacs, but not from patients with Von Willebrand's disease. It is apparent that the Von Willebrand plasma factor is either reduced in amount or inactive in this patient without an accompanying reduction in the Factor VIII level. It is postulated that Factor VIII may have two separate sites of biological activity, one concerned with the intrinsic pathway of coagulation and the other with platelet glass bead adhesiveness and skin bleeding time. It is proposed that this patient possesses a specific abnormality in the latter site, in contradistinction to the specific defect in the site concerned with intrinsic coagulant function in haemophilia.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03086.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:Despite the many available sources of postgraduate medical education, there is little Australian research into more efficient utilisation. A questionnaire survey of 42 general practitioners and 54 specialists in the ACT was carried out. Aspects surveyed included time ideally devoted to postgraduate education, responsibility, sources and motivation.The impact of voluntary self‐assessment, mandatory attendance, and periodic recertification is discussed, and it is concluded that a reorganisation of the health care system and implementation of problem‐orientated records may be necessary to solve the problems of post‐graduate medical education satisfact

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03087.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:Forty‐five per cent of patients with active pulmonary tuberculosis receiving mainly first line anti‐tuberculous chemotherapy and whose erythrocyte sedimentation rate on admission was less than 20 mm Hr developed hypersensitivity reactions to their drugs. Where the corresponding erythrocyte sedimentation rate was greater than 20 mm Hr only 15% of patients reacted. The correlation held for those with minimal and moderately advanced lesions but not for far advanced disease. A raised lymphocyte count also appeared to influence the likelihood of drug allergy.Despite the apparently high incidence of hypersensitivity in this series it is doubtful if it exceeds those reactions from certain non‐tuberculous drugs. No evidence to implicate immunological changes induced by tuberculosis was found. It is felt that substitution of paraaminosalicylic acid by ethambutol or rifampicin would be justified in those with a low initial erythrocyte sedimentation

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03088.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:In vitroandin vivoeffects of trimethoprim on folate metabolism have been studied in patients with normoblastic and megaloblastic haemopoiesis.In concentrations achieved in the plasma on standard dosages of trimethoprim, no significant disturbance of folate metabolism in normal bone mar‐row was detectable, eitherin vitroorin vivo. In vitro, higher concentrations produced abnormalities of folate metabolism which were partially corrected by pteroylglutamic acid (PGA) and completely corrected by tetrahydrofolic acid (THF). This suggested competitive inhibition of dihydrofolate reductase (DHR) by the trimethoprim.In vitro, in vitamin B12or folatedeficient marrows, trimethoprim at therapeutic concentrations caused a further deterioration of the defective deoxyribonucleic acid (DNA)‐thymine synthesis which appropriate haematinics failed to correct.In vivostudies after a standard course of trimethoprim con‐firmed this effect.These studies support previous claims that many of the haemopoietic side‐effects of trimethoprim are the result of the potentiation of defective DNA‐thymine synthesis in situations of pre‐existing folate or vitamin B1

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03089.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:The effect of smoking on gastric acid secretion was studied in 16 smokers and 16 non‐smokers. The basal, smoking, and peak acid outputs were determined. Statistical analysis showed the following results: No significant difference was found between the mean basal acid output and mean smoking acid output, in both smokers and non‐smokers. The mean peak acid output was significantly much higher than both the mean basal and smoking acid out‐puts, in smokers and non‐smokers. There was no significant difference in the mean basal, smoking, and peak acid outputs between smokers and non‐smokers. When the difference between basal and smoking acid outputs were considered in each individual case, however, the smoking acid output tended to be lower than basal in smokers, but higher than basal in non‐smokers. This difference was just significant. It is concluded that while smoking has no significant effect on gastric acid secretion in smokers and non‐smokers, there appears to be a significant difference in the gastric secretory response to smoking between smokers an

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03090.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:The clinical and pathologal features are presented of thirteen (13) young Australian aboriginal children with diarrhoea who died over a recent two year period.Clinical evidence of malnutrition was present in six patients and fatty in tration of the liver was found in nine the twelve children examined. In most patients the clinical features were co plicated by parasitic infestations bacterial and fungal infections.These findings emphasise the importance of malnutrition in determining the disproportionately high mortality rate in aboriginal children compared with other Australian children.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03091.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:Cholic acid‐carboxy/14C was administered to five control subjects, seven patients with tropical sprue and two patients with ileal resection and the daily excretion of the label in the faeces measured for seven to 13 days. Contrary to previous assumptions, the excretion was not always exponential. The practice of calculating decay constants from faecal excretion studies is therefore not valid.Four out of seven patients with sprue had an increased rate of excretion of the label, which in two subjects was similar to that of the patients with ileal resection. This indicates defective reabsorption of bile salts and may contribute to the pathogenesis of the steatorrhoea of tropical spru

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03092.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:Four patients are described in whom a bile duct carcinoma co‐existed with chronic ulcerative colitis. They were seen over a 14 year period at the Royal Melbourne Hospital. During this time 29 patients were diagnosed as having bile duct carcinoma, and 292 patients were admitted on one or more occasions with a diagnosis of ulcerative colitis; the observed frequency of ulcerative colitis in patients with bile duct cancer was 14%, while bile duct cancer occurred in 1.4% of inpatients with ulcerative colitis. We conclude that bile duct carcinoma is significantly, and presumably consequentially, associated with ulcerative colitis but the nature of the association is uncertai

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03093.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:The incidence of four autoantibodies—antinuclear factor (ANF), smooth muscle antibody (SMA), mitochondria) antibody (MIA) and parietal cell antibody (PCA)—was studied in two groups of patients suffering from cryptogenic cirrhosis of the liver and hepatocellular carcinoma (mostly with underlying cirrhosis) respectively and in a group of age‐ and sex‐matched controls. SMA and MIA were present in fairly low incidence in the liver patients compared with that reported elsewhere, and were detectable only in low titres, though they were found in significantly higher frequencies than in the controls. This may simply reflect the presence of chronic liver damage in the patients and does not support the hypothesis of an autoimmune hepatitis being of aetiological importance in cryptogenic cirrhosis in the presen

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03094.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:In a prospective clinicopathological study, 50 cases of acute alcoholic hepatitis were found in a three year period, in Singapore. This Singapore series was compared to two western series and the results were analysed statistically. The results showed the following significant differences. Clinical jaundice, hepatic coma and deaths were significantly more frequent in the Singapore series than the western ones. A significantly higher incidence of hypokalaemia was probably responsible for the higher incidence of hepatic coma in the Singapore series. Macrocytic anaemia was the commonest type of anaemia in the western series but was not found in the Singapore series, in which hypochromic anaemia was the commonest. The SG PT level was more frequently raised in Singapore patients than the western ones. However, serum transaminase levels were normal in some cases of acute alcoholic hepatitis in both Singapore and western series. It is concluded that serum transaminase levels are not reliable in the diagnosis of acute alcoholic hepatitis. A liver biopsy is essential for a firm diagnosis. In the liver histology, the incidence of cirrhosis in the Singapore series was significantly higher than that of one of the western series, but lower than that of the other.The incidence of Mallory's hyaline in the Singapore series was lower than the western series because it was not essential for diagnosis in the Singapore patients. Besides these few differences, acute alcoholic hepatitis was fairly similar in Singapore and western countries.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb03095.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY