ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01368.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.tb01369.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractHospital records of patients with asthma admitted to teaching hospitals in Perth, Western Australia between 1976 and 1980 were examined retrospectively to identify characteristics of the illness which were associated with subsequent death. From 5722 admissions there were 195 deaths to December 1982, 186 of whom had records available (cases); 452 of the surviving subjects were used for comparison (controls). There was no difference in age of onset of asthma or cigarette smoking habits between the two groups, but ischaemic heart disease as an associated condition was significantly more frequent in cases. On admission to hospital an arterial Pco2<45 mmHg was more frequent in those who died, but there were no differences in arterial Po2, lowest pH, highest or lowest FEVi and FVC. Cases more frequently used home nebulisers and were more frequently prescribed corticosteroids, antibiotics and sedatives or tranquillisers prior to admission, corticosteroids and sedatives or tranquillisers during admission and sedatives or tranquillisers on discharge. These results suggest that cases had more severe asthma in that they were more often treated with home nebulisers, corticosteroids and antibiotics, but with the exception of PaCO2the commonly used measurements of severity of asthma did not identify those at risk of death. The prescription of sedatives or tranquillisers appears to be associated with an increased risk of death in subjects with asthma.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01370.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractTen patients given HLA‐identical sibling marrow transplants for lymphoid malignancy received recombinant human granulocyte macrophage‐colony stimulating factor (GM‐CSF) from day 7 to day 13 inclusive post transplant. Patients were prepared for transplantation with busulphan 16 mg/kg and cyclophosphamide 120 mg/kg.Immunosuppression to minimise the risk of graft‐versus‐host disease (GVHD) was cyclosporin/short methotrexate. Results were compared with a historical control group of patients (n = 16) given matched sibling transplants for acute leukaemia and receiving the same immune suppressive regime but not given GM‐CSF. Recovery of total white cells, neutrophils, monocytes and lymphocytes was more rapid in the GM‐CSF recipients (p<0.02). There was a suggestion of a decrease in non‐viral infections in the first 30 days in the GM‐CSF recipients (p = 0.09). There was, however, no significant difference in the severity of oropharyngeal mucositis nor in the duration of the transplant hospitalisation. Surprisingly, the severity of acute GVHD was higher in the GM‐CSF recipients with six of eight evaluable patients having grade II‐IV acute GVHD (p = 0.003). Two GM‐CSF recipients developed a fluid retention/capillary leak syndrome. These findings indicate a need for caution in the use of GM‐CSF after allogene

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01371.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractHuman recombinant erythropoietin (r‐HuEPO) improves quality of life in patients on maintenance haemodialysis, but the haemoglobin (Hb) level necessary to achieve this improvement is unknown. In this study, quality of life, functional capacity and symptoms of 28 haemodialysis patients with an initial Hb of 67 ±2 (mean ± SEM) g/L were assessed after 0, 6 and 12 months of r‐HuEPO, the dose of which was titrated to achieve a stable Hb of between 90 and 100 g/L.At six and 12 months Hb was 97 ± 2 and 93+2 g/L, and mean r‐HuEPO dose between three and six, and between nine and 12 months was 88 ± 6 and 62 ± 9 U/kg/week intravenously respectively. There was a significant improvement in level of activity and satisfaction with various aspects of life, and a reduction in fatigue, weakness, dyspnoea, angina and restless legs. Patients were able to walk 50% further in six minutes. The improvement in quality of life and function was similar to that reported from other centres whose target Hb was between 100 and 120 g/L, and where the r‐HuEPO dose was 75% higher than in this study.Costs of r‐HuEPO therapy were assessed. The drug itself costs $A3681/yr/patient, to which was added the estimated cost of additional dialyses and medications, bringing the total to $A5177/yr/patient. There was, however, a reduction in both hospitalisation by 8.3 days/yr/patient and medical consultation by 3.9 hours/yr/patient. Five patients commenced full‐time work, one took up full‐time study aimed at finding work, three transferred to home haemodialysis and six fewer patients drew social security benefits. The net cost saving from using low dose r‐HuEPO was more tha

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01372.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractA prospective study of elderly Australians commenced in 1988 in Dubbo, NSW. Its goals are to identify predictors of mortality, hospitalisation and placement in long‐term care, with special focus on risk factors for cardiovascular disease. The study population were non‐institutionalised subjects, comprising 1237 males and 1568 females 60 years and over. This report describes the baseline findings: demographic, educational and economic data; tobacco and alcohol usage, self‐medication and other habits; medical contacts and past diagnoses; prescribed medication and in study diagnoses; psychosocial variables, functional health and social support; blood lipid and lipoprotein data; blood pressure, spirometry and glucose data; heights and weights. Where comparison has been feasible, the findings in Dubbo closely resemble those obtained from the rest of Australia. The findings presented provide the basis for aetiological studies of future out

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01373.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractA quality assurance survey of synovial fluid examination for crystals was performed at six teaching hospitals. Aliquots of 12 different fluids (three with no crystals, one with betamethasone crystals, four with calcium pyrophosphate dihydrate (CPPD) crystals and four with monosodium urate monohydrate [urate] crystals) were examined by all six laboratories. Four laboratories performed well (10 or more correct out of 12) but two did poorly (50% or less correct). False positive crystal identification occurred in eight of 72 samples, but all false positive reports were from two laboratories. CPPD and urate crystals were missed in seven of 24 (29%) and five of 24 (21%) samples respectively.The standard of synovial fluid examination for crystals in Sydney teaching hospitals is not uniform and in some cases appears unsatisfactory.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01374.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThe effects of metformin on glycaemia, insulin and c‐peptide levels, hepatic glucose production and insulin sensitivity (using the euglycaemic, hyperinsulinaemic clamp) were evaluated at fortnightly intervals in 9 Type 2 diabetic patients using a stepwise dosing protocol: Stage 1 ‐ no metformin for four weeks; stage 2 ‐ metformin 500mg mane; stage 3 ‐ metformin 500mg thrice daily; stage 4 – metformin 1000mg thrice daily. Results are expressed as Mean ± SEM. Fasting blood glucose decreased from basal values (9.7 ±1.0 mmol/L) by 13% at stage 2, 34% at stage 3 and 41% at stage 4 (p<0.02 vs basal for all stages; p<0.02 stage 2 vs stage 3). Post‐prandial glycaemia was significantly improved only with metformin 3000mg/day (p<0.05). Fasting, meal‐stimulated and total insulin and c‐peptide levels showed no change. Hepatic glucose output did not change significantly with metformin. Insulin sensitivity, measured as total glucose utilisation during hyperinsulinaemia, increased from stage 1 (10.3 ± 2.1 μmoL/kg/min) by 23% at stage 3 (p<0.05) and by 29% at stage 4 (p<0.02). Basal metabolic clearance of glucose increased compared to stage 1 (1.69 ±0.16 mL/kg/min) by 30% at stage 2, 53% at stage 3 and 44% at stage 4 (all p<0.02). This study demonstrates that improved efficiency of glucose utilisation, both basally and under conditions of euglycaemic hyperinsulinaemia, is the basis of metformin's antih

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01375.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThe gene causing adult polycystic kidney disease (APKD) in most northern European families has been localised to the short arm of chromosome 16, close to the alpha globin gene (PKD1). A DNA probe 3' to the alpha globin locus (3'HVR) has been used to test such families but a second genetic locus (PKD2) was recently proposed when two families from Italy failed to show linkage to that locus. The presence of two or more loci could significantly reduce the value of linked probe analysis as a tool for the diagnosis of APKD and we have therefore examined five Mediterranean families using the 3'HVR probe. In these families we have not demonstrated any mutations at the second locus. The 3'HVR gene remains the most useful probe in making the diagnosis of APKD disease in an Australian Caucasian population, and the certainty with which the diagnosis is made may be enhanced by the additional use of other nearby probes when the defect involves the PKD1 locus.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01376.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractA simple, rapid, highly reproducible enzyme‐linked immunosorbent assay detecting anti‐gliadin antibodies in serum to screen for coeliac disease (CD) is described. By combining the results of anti‐gliadin IgA and IgG determinations the overall sensitivity of the assay was found to be 100% and the specificity 96% for children and 99% for adults. Significantly elevated anti‐gliadin IgA and IgG antibodies were detected in all 20 children and all 25 adults with untreated CD. False positive results were found in 1/79 histologically normal control and 5/86 disease control children, while for adults false positive rates were 0/74 and 1/34 for the healthy and disease control groups, respectively. Anti‐gliadin IgA and IgG was measured in serum samples from 52 coeliac patients (11 children and 41 adults) treated with a gluten‐free diet (GFD). Each of the children and 28 of the adults who followed a strict GFD had significantly lower IgA and IgG levels than untreated CD patients. The serum anti‐gliadin IgA and IgG levels of the 13 adults not complying with a GFD were similar to those found for untreated CD patients. This assay is recommended as a screening test for CD as well as a tool for follow‐up of t

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb01377.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY