ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02230.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract:We assessed outcome in 208 patients with small cell lung carcinoma two to seven years after treatment with combination chemotherapy, with or without chest and cranial radiotherapy. Fourteen patients (6.7%) survived cancer free for 30 months or longer. Nine of these (64%) had limited disease at diagnosis and four others had extensive disease with only one metastatic site. Two patients remain alive and disease free more than five years after diagnosis but median survival is still only 3.2 years. One patient died from intercurrent causes at 5.4 years but was free from small cell lung carcinoma at autopsy. Six patients are alive and disease free at intervals greater than 30 months but less than five years from diagnosis. All surviving patients are fully active with lifestyles similar to that prior to diagnosis. Five patients died from small cell lung carcinoma which relapsed more than 30 months after diagnosis. A few patients with small cell lung carcinoma are cured but 30‐month survival is insufficient to show cure as late relapses do occur. Late toxicity from aggressive therapy does not appear to outweigh the benefits of long‐term survival and potential cure in small cell lung carcin

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02231.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract:The Sydney AIDS Project is a prospective immunoepidemiological study of 996 homosexual/bisexual men enrolled between February 1984 and January 1985. By January 1987, 32 of 386 homosexual men who were seropositive at enrolment in the study had developed AIDS, yielding a crude progression rate of between 2.8% and 4.2% per annum. Of these subjects, 23 (72%) developed AIDS within 12 months of enrolment.In univariate analysis, the only lifestyle differences between seropositive subjects who progressed to AIDS and those that did not progress were less frequent oral sex activity and more use of marijuana in the three months prior to enrolment. In multivariate analysis, seropositive subjects who progressed to AIDS were more likely to have a lower percentage of CD4+ cells, a higher percentage of CD8+ cells and to have used marijuana in the three months prior to enrolment than the seropositive subjects who did not progress. No HIV seropositive subject who was asymptomatic and had normal T‐cell subsets at enrolment had developed AIDS by January 1987. Persistent generalised lymphadenopathy was not associated with progression to AIDS.Although there are a number of lifestyle factors that may be associated with HIV infection, this study did not implicate most of these in the progression of HIV seropositive subjects to end‐stage AIDS. We conclude that antecedent changes in T‐cell subsets are associated with progression to AIDS and we emphasise the prognostic value of enumeration of T‐cell subsets in HIV seropositive persons. (Aust NZ J Med 1988; 18

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02232.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractFour hundred and ninety‐three patients were admitted to the Royal Darwin Hospital in 1980 with urinary tract disease. Aboriginals had an increased incidence (p<0.005) of urinary tract infection and glomerulonephritis (p<0.001) compared with non Aboriginals. Aboriginals with post‐streptococcal glomerulonephritis tended to grow Group A Beta hemolytic streptococci from their skins, non Aboriginals tended to grow it from their throats. Aboriginals had a lower incidence of urolithiasis (p

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02233.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractOral inhibitors of angiotensin converting enzyme (ACE) now have an established place in the treatment of hypertension and heart failure. Captopril, the first of these agents, was initially used in high doses and was associated with adverse effects including proteinuria, skin rash and taste disturbance. We report 11 patients who developed side effects during captopril therapy (proteinuria two, rash four, taste disturbance four and taste disturbance with rash one) who were subsequently treated with enalapril, a second generation angiotensin converting enzyme inhibitor. Proteinuria did not recur in either patient, skin rash resolved in all five cases and taste disturbance resolved in four of five duringenalaprii therapy. We conclude that the side effects of proteinuria, skin rash and taste disturbance are consequences of captopril idiosyncrasy rather than inhibition of the angiotensin converting enzyme. The reported incidence of these side effects with the current recommended dosage of captopril is low.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02234.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02235.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract:Forty‐five patients with acromegaly or gigantism were reviewed for musculoskeletal abnormalities. Abnormalities of peripheral joints occurred in 74% of the patients and spinal involvement in 47%, leading to significant morbidity. Joint abnormalities most frequently affected the large joints (hips, knees and shoulders) but the wrist and hand were also involved. The radiological features of acromegalic arthropathy are described, including vertical widening of the hip joint, enthesopathy and osteophytosis. A favourable response to treatment is associated with a less severe arthropathy and a good functional outcom

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02236.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract:In order to assess the value of thyroid function testing during amiodarone therapy, we reviewed all available tests in 128 patients treated with this drug. Nine patients (7.0%) developed biochemical hyperthyroidism with elevation of both free thyroxine index (FT4I) and free triiodothyronine index (FT3I) and marked suppression of serum thyroid stimulating hormone (TSH) after 1–46 months of therapy; six of these nine patients had clear clinical evidence of thyroid overactivity. Where serial tests were available before development of hyperthyroidism, this complication developed suddenly, despite previously stable normal indices of thyroid function, and could not be predicted by currently‐available biochemical tests such as T4, T3, sensitive TSH, thyroglobulin or sex hormone binding globulin (SHBG) assays. Clinical features such as unexplained weight loss, proximal myopathy, exacerbation of arrhythmia, or heat intolerance appear to be the key to prompt diagnosis of this complication.Hyperthyroxinemia without T3excess was found in 32.8% of patients without progression to true hyperthyroidism. Serum TSH remained detectable by sensitive assay in 17 out of 18 patients with amiodarone‐induced euthyroid hyperthyroxinemia and was significantly higher than in patients with equivalent hyperthyroxinemia due to thyroxine therapy. Serial levels of SHBG were higher in patients with true hyperthyroidism than in those with euthyroid hyperthyroxinemia.The effect of combined treatment with propylthiouracil (800 mg/day) and potassium perchlorate (800 mg/day) was evaluated in five of the six clinically hyperthyroid patients. Biochemical euthyroidism was achieved after 7–19 weeks, a response slower than previously reported, indicating that this drug combination does not result uniformly in prompt resolution of amiodarone‐induced hyperthyroidism. (Aust N2 J Med 1987; 1

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02237.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02238.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract:Thirty‐eight Sydney Harbour Bridge workers were assessed for possible lead intoxication. Forty‐seven per cent were found to have significant lead intoxication as assessed by calcium disodium edetate chelation (Ca EDTA) testing and were subsequently effectively and safely treated with Ca EDTA. The prevalence of neurological, constitutional, gastrointestinal and musculoskeletal symptoms was significantly greater in those with, than those without, lead toxicity. Although blood lead levels and, to a lesser extent, hematological parameters were of some use in diagnosis, they were not sufficiently sensitive and thus should not be used in screening workers at risk of lead intoxication. Ca EDTA testing remains the diagnostic method of choice. Patients exposed to lead dust and fumes, in whom symptoms of lead intoxication are present, should undergo such testing and if a positive result is obtained, then EDTA chelation therapy should be instituted. (Aust NZ J Med 1988; 18: 46

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1988.tb02239.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY