ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00265.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractFifty‐four per cent of 52 patients presenting to the University of Malaya Medical Centre with a myelopathy for which appropriate investigations uncovered no definite etiology, subsequently developed clinically definite or probable multiple sclerosis. In the subgroup of patients with a presentation indicative of acute/subacute transverse myelopathy, 14 or 52% also went on to develop clinically definite or probable multiple sclerosis, a far higher proportion than previously recorded in the literature. This finding is probably a further manifestation of racial difference in the behaviour of multiple sclerosis. For the group as a whole, the only factor which appeared to be associated with an increased risk of developing multiple sclerosis was female sex; 67% of 33 female patients went on to develop multiple sclerosis after a mean follow‐up period of 5.5 years. Other factors such as age of onset, racial composition, level of spinal cord involvement, presence of fever and CSF finding were found not to be import

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00266.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractWe studied the nutritional status of 32 patients (23 men), aged 50 (SD14) yr, on home hemodialysis (HHD) for one‐138 months. No formal dietary restrictions were imposed. Anthropometric measurements were made using standard techniques, diet assessed by three‐day dietetic diary and interview and plasma concentrations of nutrients were measured. Mean caloric intake was 29.4 (SD 10.7) kcal/kg; 24 (75%) patients had lower energy intakes than recommended for normals. Protein, vitamin C and folate intakes were above recommended minimum safe intakes. Intakes were less than recommended for calcium in four (13%) patients, iron in one (3%) and vitamin B12in two (6%). One‐third of both sexes had body mass indices (kg/m2)<25th percentile for normals, but none was<80% of ideal bodyweight. Arm muscle circumference was<10th percentile for normals in six men and three women. Triceps skin fold thickness was<10th percentile in four men (17%) and five women (55%). No anthropometric measurements were correlated with energy, protein or fat intake. Biochemical measurements were not useful in predicting protein intake. Neither nutritional intake nor anthropometric measurements were correlated with the duration of HHD. There was little evidence of malnutrition and wasting in this group of well rehabilitated HHD pat

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00267.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractFactor V inhibitors are uncommon, bleeding manifestations variable and recommendations for management are unclear. We present a patient with non‐Hodgkins lymphoma who developed gastrointestinal bleeding and was found to have a Factor V inhibitor. The inhibitor was active against both plasma Factor V and platelet associated Factor V, and was associated with a five‐fold increase in platelet associated IgG. Fresh frozen plasma was ineffective in preventing bleeding. Resolution of bleeding was associated with a fall in the levels of the inhibitor and of platelet associated IgG. The patient had no further bleeding episodes nor evidence of progression of his lymphoma, but six months later died as a result of metastatic adenocarcin

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00268.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00269.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThis study describes the efficacy of the drug simvastatin. It is likely to be the first HMG CoA reductase inhibitor in Australia and New Zealand available for the treatment of hyperlipidemia.Twenty‐four patients, 12 men and 12 women with primary hypercholesterolemia were randomly allocated to treatment by cholestyramine (eight patients) or to simvastatin (16 patients) for a 12‐week period.With simvastatin, total cholesterol levels decreased by 37.5% from a baseline mean of 10.33 mmol/L to 6.4 mmol/L after 12 weeks. Low density lipoprotein (LDL) cholesterol concentration decreased by 48.2% from 8.40 mmol/L to 4.39 mmol/L. These effects were better than observed for cholestyramine alone where cholesterol and LDL‐cholesterol reductions were 24.9% and 33.1% respectively.Thirteen patients, however, did not achieve target LDL levels of 3.62 mmol/L, or below, and therefore were treated with a combination of cholestyramine and simvastatin, resulting in a decrease of total cholesterol and LDL‐cholesterol by 45.5% and 53.5% of baseline values studied over an eight‐week period.No major clinical side‐effects were encountered. One patient appeared to have had a change in colour vision at the end of the study at 20 weeks, without loss of vi

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00270.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractProspective data from Busselton, Western Australia, collected during triennial surveys from 1966–81 with follow‐up of subjects to 1983, showed that atrial fibrillation (AF) was frequent in elderly people and associated with increased mortality.Of 1770 people aged over 60 years, 40 were in atrial fibrillation when first seen and a further 47 developed it during follow‐up. Atrial fibrillation was positively associated with angina, history of a myocardial infarction and left bundle branch block.Relative mortality in those with atrial fibrillation compared with those without it, was 1.92 for all causes, 1.82 for death from cardiovascular causes (excluding stroke) and 3.78 for deaths from stroke, after adjustment by proportional hazards regression for confounding effects of age, sex, history of a myocardial infarction, an abnormal electrocardiogram, angina, cholesterol level, systolic blood pressure and Quetelet's Index (weight/height2).The excess relative mortality declined with increasing age for both women and men. This raised relative mortality remained constant with time from the first detection of AF for all causes and cardiovascular causes but appeared to increase with time from detection for stroke death. The risk of death from stroke was greatest in the younger women. The observed risk of death from stroke in patients with AF suggests that anticoagulant use should be considered in selected pat

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00271.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00272.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThere is conflicting evidence of platelet involvement in asthmatic bronchoconstriction. We sought direct evidence of platelet activation and indirect evidence of platelet sequestration following histamine challenge (HC) in 14 asthmatics and seven non asthmatic control subjects. Peripheral platelet counts and levels of β thromboglobulin (BTG) were measured immediately before and following HC in the 21 subjects. There were no significant differences in the platelet counts or BTG levels, before or after HC, within or between the two groups. These results do not support platelet activation or accumulation in the lungs occurring immediately following histamine induced bronchoconstriction in asthmatics

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00273.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractInfection due to yersinia enterocolitica is a common antecedent illness in patients with reactive arthritis in Scandinavia, but appears to be less frequent in other countries. In order to examine the frequency of yersinia infection in patients with seronegative arthritis in Australia we examined 22 patients, 15 with ankylosing spondylitis (AS) and seven with Reiter's syndrome (RS). A sensitive ELISA assay was used to detect serum antibodies to the most common serotypes. Six patients (29%) had positive yersinia serology, all were HLA B27 and four had a history of diarrhea preceding the onset of their disease. Four patients with positive yersinia serology had AS and two had RS. Antibodies were directed against Y. enterocolitica biotype 0:3 in three cases, Y. enterocolitica 0:9 in two cases and Y. enterocolitica 0:8 in one subject. Twenty‐nine control subjects (13 HLA B27) had no serum antibodies to yersinia.The results of this study indicate that preceding yersinia infection occurs in a significant (p<0.05; compared to controls) proportion of patients with HLA B27 related seronegative arthropathie

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1989.tb00274.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY