摘要:

Abstract::This paper reports a family in which idiopathic megaduodenum occurred. The index case was a 17 year old male with lifelong steatorrhea, episodic vomiting of food consumed days before, offensive belching, and recurrent abdominal pain and distention. The diagnosis was made by a barium meal examination, but only after a failed small bowel biopsy suggested some anatomical abnormality. Direct questioning about family “ft members then revealed that his father, aged 43 years, had similar symptoms and a subsequent barium meal confirmed the diagnosis. Screening of the family revealed megaduodenum in the 20 year old sister who was totally asymptomatic and had normal fecal fat levels but an abnormal breath test. The remainder of the family members were asymptomatic and had normal radiology. This family, in which idiopathic megaduodenum occurred in three of six members, is reported because it illustrates some of the features of idiopathic megaduodenum and chronic idiopathic intestinal pseudo‐obstruction. It also demonstrates the need to investigate the families of apparent sporadic cases. Such investigation may uncover additional symptomatic and asymptomatic individuals who may be presenting diagnostic difficulty, and who, by virtue of an early diagnosis, may be spared unnecessary surg

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02720.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract::Zinc is an important trace metal and, in liver disease, abnormal zinc metabolism has been reported. In this study of patients with fulminant hepatic failure progressing to grade IV encephalopathy, plasma zinc concentrations fell during the illness to reach levels significantly below normal; during this time urinary zinc excretion was markedly elevated.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02721.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract::Low dose cytarabine (10 mg m‐2,12 hourly by subcutaneous injection) was used to treat four patients with acute non‐lymphoblastic leukemia, two of whom had failed standard induction chemotherapy, and two patients with refractory anemia with excess blasts in transformation. Following treatment two patients entered complete remission (CR) and two patients had survivals of ten and 18 months in stable partial remission. All patients have died, four of progressive or recurrent leukemia, one of a treatment‐related intracerebral hemorrhage, and one of lung carcinoma while in CR. Our experience, and a review of the literature, suggest that in general low dose cytarabine is well tolerated, although myelosuppression is common and thrombocytopenia can be a major problem. This form of treatment appears to offer a useful alternative to intensive induction chemotherapy in those patients in whom such treatment is usually poorly tolerated, and has the advantage of being able to be given to an outpa

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02722.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02723.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract::In 44 out of 758 patients (5.8%) with non‐Hodgkin's lymphoma presenting between 1971 and 1982, the central nervous system (CNS) was involved. Patients with a diffuse histology had a 7.6% (34/449) incidence of CNS involvement compared to 3.9% (10/257) for patients with nodular lymphoma. In 63% of patients there was evidence of progressive systemic lymphoma at the time of diagnosis of CNS disease and in 23% CNS relapse occurred in clinical remission. Bone marrow was involved in 34% of patients at diagnosis and in 52% at some time prior to the onset of CNS complications. Cerebrospinal fluid cytology was positive in 63% and an elevated protein level was found in 95% of patients. The median length of survival of the 44 patients was only 3.2 months, but patients who responded to treatment of CNS lymphoma survived significantly longer than those who showed no response or progressed on therapy. Complete response to CNS treatment was achieved in five patients, of whom none relapsed in the CNS and two are long‐term disease‐free survivors. CNS prophylaxis appears justified for patients with lymphoblastic lymphoma, Burkitt's tumour, and diffuse undifferentiated lymphoma, who are at high risk of developing CNS complications. Patients with diffuse histiocytic, and diffuse poorly differentiated lymphocytic, lymphoma who have bone marrow involvement may also benefit from CNS prophy

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02724.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract::A randomised trial was undertaken to compare the efficacy and safety of netilmicin and cefoperazone for the treatment of severe or complicated urinary tract infections. Thirty‐two patients completed the study. Fifteen of 16 patients treated with netilmicin and nine of 16 treated with cefoperazone were cured. This difference was statistically significant (p = 0.037). No serious side effects or toxicity occurred with either drug, although five patients developed diarrhea after treatment with cefoperazone. (Aust NZ J Med 1985; 15: 22–

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02725.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract::Of 1,247 consecutive patients who underwent cardiac surgery, 297 (24%) developed a post‐operative atrial tachyarrhythmia. Of these patients, 201 were suitable for treatment according to the study protocol. All patients were initially given digoxin 0.75 mg intravenously (i.v.). After two hours, those 156 patients whose atrial arrhythmias persisted were given a 2 mg/kg loading dose of disopyramide (i.v.), followed by a constant i.v. infusion (0.4 mg kg‐1tr1) or oral therapy (600 mg daily). Within a further 12 hours, 75 patients (48%) reverted to sinus rhythm, 24 within one hour. Thus 120/201 patients (60%) reverted to sinus rhythm within 14 hours of commencing therapy. Reversion rates of those patients with both atrial fibrillation and flutter (AF/AFL) were significantly lower than those with AF (p<0.001) or AFL (p<0.02)alone. A further 70 patients reverted to sinus rhythm in one to 13 (mean four) days on continued drug therapy. Elective cardioversion restored sinus rhythm in six subjects. Atrial arrhythmias persisted in five patients (2.5%) at hospital discharge. Side‐effects of disopyramide were noted in 19% of patients. Urinary retention was common (11.5%). Four patients with atrial flutter developed 1:1 atrioventricular conduction with the disopyramide loading dose. One patient with atrial fibrillation developed ventricular tachycardia during injection of the loading dose of disopyramide, but was successfully cardioverted to sinus rhythm. Two further patients developed significant hypotension (<90 mmHg systolic). Disopyramide is effective in the treatment of post‐operative atrial tachyarrhythmias, but its routine use in this situation may be associated with an unacceptably high incidence of side

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02726.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02727.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract::Intra‐aortic balloon counterpulsation became ineffective in a 63 inch (160 cm) 14 year old girl while console operation proceeded almost normally. The problem was simulated in a hydraulic model of the aorta and could be reproduced when the proximal end of the balloon engaged in the introducing sheath. Measurements of the balloon catheter and sheath against the patient indicated that such engagement had occurred during counterpulsation. The* findings provide an explanation for apparent catheter ‘kinkage’ in other patients where there was difficulty running the Kontron console in automatic mode. Problems are preventable by total or partial withdrawal of the inserting s

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02728.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract:Thirty‐four samples of warm waters from 12 psychiatric centres in Victoria and New South Wales were examined for legionellae by guinea‐pig inoculation.Legionella pneumophilawas isolated from 20 of the samples collected from ten of the establishments investigated. The detected prevalence proportion ofL. pneumophilain waters of temperatures 36 to 43oC was 0.9 (18/20), whereas the prevalence in waters of temperatures 45 to 54.2oC was 0.14 (2/14). The two ‘positive’ waters within the latter range showed evidence of low numbers ofL pneumophila.No significant antibody titres to relevant serogroups were detected in the 112 exposed residents tested from seven psychiatric hospitals in New South Wales.The findings show that the temperature range with the greatest prevalence ofL. pneumophilain warm waters is 36 to 43oC. The presence of legionellae in these warm water‐distribution systems contrasts with their absence from the water‐distribution systems of Victorian hospitals in an earlier survey and underlines the value and simplicity of the usual Australian practice of maintaining hospital hot water temperatures at about 70oC in the control ofL

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1985.tb02729.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY