ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02640.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02641.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Between January 1975 and December 1977, 264 adult patients with acute non‐lymphocytic leukaemia entered the Australian National Leukaemia Trial. Of 251 evaluable patients, three induction regimens achieved similar complete response (CR) rates. CROP (cytosine arabinoside, daunorubicin, vincristine, prednisolone) produced CR in 41% of patients, 7 and 3 (cytosine arabinoside, daunorubicin) in 42% and 7 and 3 plus hydroxyurea in 52%. Remission duration and survival were similar when induction regimens were compared. Fortyfive patients reaching maintenance therapy were randomised to either chemo‐immunotherapy (BCG plus intradermal leukaemic blast cells) or chemotherapy alone. The duration of CR in these two groups was almost identical, though patients receiving chemotherapy alone had prolonged survival (median 161 weeks) when compared to the chemo‐immunotherapy group (84 weeks, p = 0.07). Institutions with less developed supportive facilities reported lower CR rates (p =0.04). Leucocytosis, (>100 × 109/I) and older age (>50 years) were associated with shortened survival. The Trial has failed to show any advantage for this form of immunot

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02642.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:It is generally held that thyroid cancer is uncommonly associated with thyrotoxicosis. We report here nine patients with thyroid cancer amongst 720 patients with thyrotoxicosis.Three patients presented with features of malignancy together with thyrotoxicosis (Group A), one of whom had triiodothyronine (T3)‐toxicosis. The remaining six patients were diagnosed following histological examination of tissues removed during subtotal thyroidectomies for hyperthyroidism (Group B). Two patients in Group A had follicular carcinoma; the rest were papillary in type. All the patients were rendered euthyroid initially, followed by ablative therapy for two patients in Group A and four patients in Group B. All but one are alive after one to nine years (mean of 3–4 years).The diagnosis of thyroid carcinoma is infrequently considered in the presence of thyrotoxicosis. The association is not clinically apparent in the majority of patients. The optimum management of such occult malignancies in thyrotoxicosis remains to be defi

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02643.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:A family of seven is described in which a teenage boy and two siblings were found to have Rotor's syndrome. Total urinary coproporphyrin excretion was found to be significantly elevated in the patients with Rotor's syndrome (mean 59 0 μmol/mol creatinine), when compared with control subjects (mean 16‐3 μmol/mol creatinine) (p<0.005). Similarly, urinary excretion of both coproporphyrin isomer I and coproporphyrin isomer III was greater in the subjects with Rotor's syndrome than in controls (p<0.005). Coproporphyrin I comprised 60 2% of total urinary coproporphyrin excretion in the subjects with Rotor's syndrome, compared with 38 6% in the controls, but the difference was not significant. In the parents and clinically unaffected siblings neither total urinary coproporphyrin excretion (13‐3 and 19‐3 nmol/mol creatinine respectively) nor percentage coproporphyrin I excretion (36 ‐8 and 30‐4%) differed from controls. Thus, although we have confirmed the previous finding of increased urinary coproporphyrin excretion in subjects with Rotor's syndrome, we have not found the previously noted intermediate increase in coproporphyrin I excretion amongst phenotypically normal relatives of subjects with this autosomal recessi

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02644.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Sixteen patients with severe coronary artery disease and unstable angina, refractory to standard therapy with nitrates, beta‐blockers or calcium antagonists, were given intravenous nitroglycerine (500 μg/ml) in an open trial. The infusion was started at 0–17 ml/min. The final infusion rate ranged from 0 17 ml/min to 2 04 ml/min, depending on the symptomatic and haemodynamic response of the individual patient. At the slow infusion rates, the actual dose was probably only 15% of the delivered dose because of the adsorption of nitroglycerine to PVC tubing.There was significant pain relief in all patients. In six patients, pain relief was complete; in ten patients, occasional episodes occurred during the nitroglycerine infusion but they were less frequent and less severe and few were associated with ST segment changes. Systolic blood pressure fell by a mean of 100 mmHg at the commencement of therapy but there was no significant change in heart rate. Apart from mild headaches, no other adverse effects were observed. The mean treatment time was 3‐2 days (range 1–8 days). Eight patients were discharged on oral and/or cutaneous nitrate therapy and eight patients had coronary artery surgery.Intravenous nitroglycerine is useful for controlling symptoms in patients with unstable angina refractory to conventional therapy and may be particularly valuable for settling these patients before coronary arteriography and during preparation for coronary

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02645.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Left ventricular mass (LV mass) and function were assessed in 16 acromegalic patients by echocardiography, and rest and exercise gated blood pool scanning (GBPS) respectively. At the time of study, five patients had active acromegaly, five were hypertensive and three had coexisting coronary artery disease. Increased LV mass was found in six (38%) patients, of whom four were hypertensive and two others had active acromegaly of long duration. One normotensive patient, who did not have coronary disease, had increased LV mass associated with persistently elevated growth hormone (GH) levels for the previous 11 years. Abnormal LV function, as detected by GBPS, occurred only in the three patients with coronary disease. Thus, acromegaly is associated with increased LV mass in hypertensive patients and normotensive patients who have prolonged elevation of GH levels prior to adequate treatment. We found no detectable impairment of LV function, at rest or exercise unless other cardiac disease was present.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02646.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Within the spectrum of denial behaviour exhibited by patients recovering from myocardial infarction, we have identified three broad types — Independent, Dependent and Healthy. The management of patients in these groups is essentially non‐confrontational, assertive and facilitative respectiv

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02647.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Twenty‐eight patients with mild essential hypertension were treated with placebo for six weeks and then with active medication for a further 32 weeks. Twelve patients were well‐controlled with 160–320 mg/day of slow release oxprenolol alone, 12 required oxprenolol and chlorthalidone, and four also required hydrallazine. β‐adrenergic blockade reduced the basal level of plasma free fatty acid (FFA) by 41%. A sub‐maximal exercise test reduced the level of FFA by 34% during placebo treatment. The same exercise test during β‐blockade reduced the already lowered basal FFA level by a further 45%. Only female subjects experienced exercise‐induced leg fatigue during β‐blockade. They always had higher FFA levels than males, but the relative changes in FFA concentration were similar in both sexes. Exercise testing induced a 52 mmHg rise in systolic blood pressure, but this was reduced to only 14 mmHg during treatment.Patients controlled on oxprenolol alone showed no significant change in plasma lipid and lipoprotein levels. Those patients ultimately requiring combination drug therapy experienced a statistically significant rise in plasma triglycerides and a significant fall in high density lipoprotein cholesterol. The biological importance of these ch

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02648.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:The use of gold therapy in rheumatoid arthritis is not without risk. Although the better known side effects are bone marrow suppression and renal involvement, gold induced enterocolitis has been described. This paper reports a 59‐year‐old female recently treated with gold therapy for rheumatoid arthritis who developed bloody diarrhoea, toxic dilatation and perforation of her colon. The absence of features of inflammatory bowel disease or infection indicates gold as a possible causative agent. Pathogenesis, therapy and a review of the literature of gold induced enterocolitis are descri

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb02649.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY