ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00172.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractRespiratory symptoms, bronchial hyperresponsiveness (BHR) and atopic status were measured in 1 217 schoolchildren, aged 8 to 12 years, living in the Villawood area of the city of Sydney. The findings are compared to those from studies previously conducted, using identical protocols, in the inland town of Wagga Wagga and in the coastal town in Belmont, NSW.There was a higher prevalence of respiratory symptoms in Villawood and Wagga Wagga (40%) than in Belmont (29%). The prevalence of BHR was 15% in Villawood and Belmont and 20% in Wagga Wagga. However, the distribution of severity of BHR was similar in each study town, reflecting the same pattern of responsiveness. The percentage of children who were atopic was higher in Villawood (44%) than in inland Wagga Wagga (39%) or coastal Belmont (40%). Children in the three areas differed in their reactions to the predominant allergen groups. There were more children who were reactive to grass pollens in the inland area and more children who were reactive to house dust mites in the coastal area. Children in Villawood had a high prevalence of reactivity both to house dust mites and to grass pollens.The Villawood children who were born in Australia had a higher prevalence of respiratory symptoms, of BHR and of atopy than the foreign‐born childre

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00173.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractIn a prospective study of 175 adults with acute pneumonia, percutaneous lung aspiration (PLA) was performed in 144 in an attempt to obtain a bacteriological diagnosis. Positive cultures were obtained from PLA in 90/144 cases (62.5%). The most common organisms isolated wereStreptococcus pneumoniae(60%) gram‐negative bacilli includingHemophilus influenzae(26%) andStaphylococcus aureus(11%). In 39% of those patients with positive PLA cultures, the same organism was isolated on blood cultures. Complications of PLA were uncommon, with hemoptysis in 4% and chest wall hematoma in 0.7% of patients. The incidence of post‐aspirate pneumothorax was not determined in this study. PLA was found to be a safe and effective method of obtaining a bacteriological diagnosis in adult patients with pneumo

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00174.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractThere is a paucity of information regarding the natural history and treatment outcome of diffuse histiocytic lymphoma (DHL) in Australia. Case records from 80 patients treated for DHL at the Royal Adelaide Hospital between 1965 and 1985 were reviewed to determine treatment outcome and prognostic information. Pathological review of biopsy specimens confirmed the correct diagnosis in 78 patients.The Ann Arbor staging criteria were unsatisfactory for prognostic purposes. We identified three prognostic groups: Localised disease (82% five‐year survival), Advanced disease marrow negative (36% five‐year survival), and Advanced disease marrow positive (11 % five‐year survival). An elevated plasma lactate dehydrogenase (LDH) and calcium (Ca++) predicted a poorer outcome; no patient with a LDH>500 IU achieved longterm survival (p<0.001). Survival was identical for patients reclassified histologically as intermediate grade or high grade (Working Formulation).Localised disease was associated with a good prognosis (82% five‐year survival) regardless of treatment modality. The outcome of patients with advanced disease has markedly improved over the last two decades, particularly with the introduction of combination chemotherapy containing doxorubicin in 1974 (p<0.005). Using these regimens, complete remission was achieved in 65% of patients, with a 39% five‐year

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00175.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractFrom August 1974 to January 1985, 53 patients (26 men; seven Maoris) mean age 45 (SD 15) years, with diabetes mellitus for a mean of 12 (SD nine) years had a renal biopsy and were followed. Indications for biopsy were nephrotic syndrome (24), proteinuria (23), renal impairment (five) and hematuria (one). Mean plasma creatinine concentration was 0.22 (SD 0.18) mmol/L and protein excretion 3.4 (SD 2.5) g/24 h. Diabetic nephropathy was demonstrated in 39 patients and significantly associated with retinopathy and insulin dependent diabetes mellitus (IDDM). Of the 39 patients followed for 25.7 (SD 22.8) months, 18 had died (nine myocardial infarction, six uremia, two sepsis, one stroke) and nine had begun dialysis. The five‐year cumulative renal survival was 28%. The presence of the nephrotic syndrome and the plasma creatinine concentration at presentation were the best predictors of survival. Diabetics with IDDM of 20 years duration, retinopathy and heavy proteinuria, who survive the other complications of their disease, are likely to have diabetic nephropathy requiring renal replacement therap

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00176.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractDiabetic amyotrophy is a syndrome whose recognition may be difficult or delayed. We reviewed thirteen patients with this disorder, all of whom had significant proximal lower limb wasting and weakness as the predominant feature and eleven of whom had pain in the affected limbs. Significant weight loss was common. In nine patients the deficits were largely or totally reversible. Important variations from the classical features were observed. Only five patients displayed asymmetric proximal lower limb wasting, weakness and pain, motor deficits in the remainder being either unilateral or bilateral and symmetrical. The shoulder girdle and arms were also involved in two patients. Proximal limb pain was not invariable, a distal sensory peripheral neuropathy was common, and diabetic control at diagnosis was likely to be good. No prognostic factors were identified. Thus, not all patients with diabetic amyotrophy exhibit the classically‐described features. Other than careful clinical examination, a thorough bilateral electromyographic and nerve conduction study remains the most helpful diagnostic test. Appreciation of the clinical spectrum and context of diabetic amyotrophy should facilitate its differentiation from other disorders, including other forms of diabetic neuropath

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00177.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractAll patients diagnosed with multiple myeloma in Western Australia have been registered since 1960; 337 men and 280 women were registered in the period 1960–84. During this period there was a 25% increase in incidence. Age adjusted incidence rates rose from 2.34 per 100 000 person years in men and 1.64 in women during the decade 1960–69 to 2.95 in men and 1.92 in women in 1980–84. Overall, the incidence was 1.36 times higher in men than in women (95% confidence interval 1.16–1.59).Survival from multiple myeloma improved substantially during the period. In 1960–69, median survival for both sexes was six months, in 1970–79 it was 19 months, and in 1980–84 median survival in men was 43 months while in women it was at lea

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00178.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractWe report a case of tracheal papillomatosis in a 69‐year‐old woman who presented with stridor and functional evidence of large airway obstruction. She was successfully treated by endobronchial resection using a Neodymium Yag laser. This provided lasting symptomatic relief of dyspnea. Respiratory papillomatosis is a disease predominantly of the childhood larynx and its presentation with predominant tracheal involvement late in life is extremely uncommon. Laser therapy provides an extremely effective treatment modality for this condit

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00179.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractA 24‐year‐old woman with multiple sclerosis had frequent episodes of an ocular motility disorder and a crossed corticospinal tract deficit. This symptom complex illustrates a distinctive form of paroxysmal disorder in multiple sclero

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00180.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractThe case is reported of an infant with cystic fibrosis and duodenal obstruction relieved by surgery and caused by an affected submucosal ectopic pancreas in the third part of the duodenum.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb00181.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY