Showing papers in "The Medical Journal of Australia in 1971"

Methotrexate-induced congenital malformations

Abstract: The tenth reported case of methotrexate‐induced congenital malformations is presented. The abnormalities were mainly of the skull bones. The mother was given the methotrexate as treatment for psoriasis during early pregnancy. The case is reported to emphasize the need for adequate contraceptive advice when methotrexate is used for the treatment of women who may become pregnant.

Physical disease in alcoholism. Initial survey of 1,000 patients.

Abstract: Between July, 1964, and August, 1969, 1,000 alcoholic patients (825 men and 175 women) attended an Alcoholism Clinic voluntarily for treatment They were referred from medical and nonmedical agencies mainly within the Melbourne metropolitan area. Their physical disabilities, past and presenting, have been categorized together with sociological data and details of drinking patterns.

Renal artery stenosis in renal transplantation 1

Abstract: Thirty‐six angiograms of cadaver renal transplants have been taken from six weeks to 46 months after transplantation. Two types of renal artery abnormalities were seen. The first was a diffuse irregularity of the renal artery seen in three patients who were undergoing severe acute rejection episodes within six weeks after transplantation. The second was a smooth stenosis of the renal artery occurring distal to the anastomosis which was seen in 14 patients, usually associated with hypertension and a bruit. An end‐to‐side arterial anastomosis of donor renal artery to iliac artery was performed in 34 of these 36 cases, and must be considered an Important factor in the development of these lesions. No other factor, such as histoincompatibility, preformed cytotoxic antibodies or serum cholesterol levels, could be associated with their development. Correction of one such lesion led to a marked reduction in hypertension and improvement in renal function.

Migration and suicide.

Abstract: In keeping with studies conducted elsewhere, suicide rates among Immigrants to Australia are substantially higher than those prevailing in their countries of origin and among the Australian‐born population. However, not all racial groups show this tendency, which is most pronounced among Immigrants from Great Britain, Ireland and New Zealand. Southern European immigrants, in contrast, show rates lower than those existing in Australia.

Viraemia in influenza. A report of two cases.

Abstract: Influenza A2/Hong Kong virus was Isolated from the blood of two patients suffering from primary Influenza virus pneumonitis. One patient died, and the virus was recovered from multiple sites at post mortem. The occurrence and importance of viræmia in influenza are discussed.

Cirrhosis of the liver. A comparative study of the four major aetiological groups.

Abstract: Four hundred and fourteen unselected patients with hepatic cirrhosis, who were admitted to the Royal Brisbane and Princess Alexandra Hospitals between 1960 and 1969, were reviewed. The incidence of the four common causes was alcoholic cirrhosis, 35·3%; cryptogenic cirrhosis, 21·2%; hæmochromatosis, 10·9%; active chronic hepatitis, 7·7%. A further 6·8% of patients, grouped as “unclassified” because of inadequate information about alcohol intake, were probably mostly alcoholic. “Latent” hepatic cirrhosis, diagnosed incidentally during life or unexpectedly at necropsy, accounted for 6·2% of alcoholics, 26·2% of patients with cryptogenic cirrhosis, and 8·8% of patients with hæmochromatosis. These four etiological groups differed with respect to sex incidence, presenting symptoms and signs, pathological features, associated diseases, complications and prognosis. However, there was little difference in the incidence of portal hypertension and hepatocellular failure between alcoholic and cryptogenic patients. Tissue antibodies were usually absent in patients with alcoholic cirrhosis or hæmochromatosis, and there was considerable overlap between the other groups. Australia antigen was present in none of 40 patients tested.

Urinary calculi. Clinical, biochemical and radiological studies in 619 patients.

Abstract: 1. Six hundred and nineteen consecutive patients (399 males, 220 females) with urinary calculi were investigated.

Temporary cushing's syndrome from percutaneous absorption of betamethasone 17-valerate

Abstract: A female Infant presented at the age of five months with the typical external manifestations of Cushing's syndrome, due to percutaneous absorption of betamethasone 17‐valerate which had been applied to areas of seborrhœic dermatitis present for the previous two months. Some equivocal results were obtained from investigations performed to exclude a primary adrenal disorder, but the situation was clarified by the gradual disappearance of the Cushingold features after the topical application of betamethasone 17‐valerate was stopped.

Ultrasonic visualization of the breast.

Abstract: Ultrasonic visualization of the breast allows a detailed cross‐sectional representation of the tissue composition of the breast and the underlying structures. The technique has been found useful in determining the extent of involvement of breast disease and in particular for demonstrating the size, position and attachment of space‐occupying masses.

The epidemiology of attempted suicide as seen in the casualty department, Alfred Hospital, Melbourne.

Abstract: Over the last three or four years, a sharp increase has occurred in the numbers of patients presenting at the casualty department, Alfred Hospital, Melbourne, after suicidal acts. The increases are a continuation of a trend evident over at least 12 years, are present to an equal degree in both sexes, and are most marked in the 15 to 24 years age groups. Presentation of women patients continues to be more than twice as frequent as of men patients, and is also concentrated around weekends.

Thermographic studies in vascular headache.

Abstract: “AGA Thermovision” has been used to record the temperature of the face and scalp in normal subjects and patients susceptible to vascular headache. Even when free of headache, the latter group showed asymmetry of heat loss from the forehead more often than normal controls. During migraine headache, the skin temperature was lower on the affected side by about 1°C in 8 out of 12 of the patients with hemicrania. The reduction of skin temperature on the side of migraine headache, in spite of dilatation of the extracranial arteries, Indicates that blood Is shunted away from the skin during the attack. Asymmetry of heat loss persisted for some time after the relief of migraine headache by intravenous serotonin or oral ergotamine tartrate therapy, suggesting that these agents achieve their effect through constriction of the extracranial arteries rather than dilatation of skin capillaries.

The effect of prescribing folic acid during pregnancy on birth-weight and duration of pregnancy. A double-blind trial.

Abstract: The purpose of this double‐blind controlled trial in 692 pregnant women was to see whether a generous oral supplement of folic acid (5 mg a day) affected the duration of pregnancy or the birth‐weight of babies. The trial showed no significant difference in effect between folic acid and a placebo.

Repetition injuries in process workers.

Abstract: An investigation was undertaken in a large electrical factory to determine the nature of upper‐ limb injuries attributed to process work. Methods included analysis of injury records of 77 women whose injuries caused them to lose time at work, examination of some of these subjects, and a study of their tasks. The Injuries fell into two broad groups, namely well‐defined clinical syndromes such as supraspinatus tendinitis and tennis elbow, and ill‐defined symptom complexes. Work overload and faults in job and equipment design were principal influences in causation. There is need for ergonomic appraisal in the design of process work, and for adequate occupational medical surveillance.

Evaluation of renin and angiotensin assays and their clinical application.

Abstract: A brief review of the biochemistry and physiological functions of the renin‐angiotensin system is presented. A critical analysis is given of the various methods, both bioassay and radioimmunoassay, for measuring plasma renin and angiotensin levels. With the development of radioimmunoassay, specific, precise and rapid measurements of renin and angiotensin levels may now be made. Various factors that may influence the plasma level of renin are discussed, and the clinical applications for plasma renin measurements are listed.

Amitriptyline and asthma.

Abstract: In eight asthmatics, amitriptyline produced clinical improvement and reduction in use of other anti‐asthma medication. In another series of 12 asthmatics, the FEV, was increased by a mean of 17% after an intramuscular injection of 25 mg of amitriptyline. In guinea‐pigs, amitriptyline counteracted the bronchoconstrictor actions of histamine, 5‐hydroxytryptamine and acetylcholine. It was more potent than imipramine or desmethyl‐ imipramlne. It is suggested that amitriptyline may prove of use in the treatment of asthma. Its effect is probably not due to an antidepressant action; it may be due to antagonism of bronchoconstrictor substances.

The drinking driver or the driving drinker? Alcohol, alcoholism and other factors in road accidents.

Abstract: THIS STUDY HAS INVESTIGATED THE AGE AND DRINKING HABITS OF PERSONS KILLED IN ROAD TRAFFIC ACCIDENTS, AND THE EVIDENCE OF ALCOHOL-CAUSED LIVER DAMAGE IN THESE SUBJECTS. OVER A PERIOD OF 14 MONTHS, THE RECORDS AND ACCIDENT DATA OF 120 FATALITIES IN BRISBANE WERE EXAMINED, A SOCIAL WORKER OBTAINED DATA ABOUT PAST HEALTH, DRINKING HABITS AND OTHER DETAILS FROM FRIENDS AND FAMILITIES OF THE DECEASED. AMONG 46 DRIVERS AND MOTOR CYCLISITS THERE WAS A PREPONDERANCE OF YOUNGER MEN, MANY OF WHOM WERE REGARDED AS MODERATE DRINKERS, BUT WHO OFTEN SHOWED HIGH BLOOD ALCOHOL LEVELS. ONLY SIX OF THE DRIVERS COULD BE CLASSED AS ABNORMAL DRINKERS. THE 48 PEDESTRIANS WERE SOMEWHAT OLDER THAN THE DRIVERS AND OFTEN HAD BEEN DRINKING HEAVILY. TWENTY-FIVE PASSENGERS WERE ALSO KILLED AS A RESULT OF THESE ACCIDENTS. THERE WERE 31 SINGLE VEHICLE ACCIDENTS, PREDOMINANTLY INVOLVING YOUNGER MEN, MANY OF WHOM HAD BEEN DRINKING BEFOREHAND. ONLY SIX SUBJECTS SHOWED CIRRHOSIS OF THE LIVER, OF WHOM TWO WERE DRIVERS. THE STUDY WAS NOT ABLE TO CONFIRM THAT MAJOR LIVER DAMAGE RESULTING FROM ALCOHOL WAS A COMMON FINDING AMONG DRIVERS KILLED ON THE ROADS. THE OVERALL IMPRESSION WAS THAT YOUNG MEN, NOT NECESSARILY ALCOHOLICS OR HEAVY DRINKERS, MADE A DISPROPORTIONATE CONTRIBUTION TO DRIVER FATALITIES AFTER AN UNUSUAL AMOUNT OF ALCOHOL HAD BEEN CONSUMED. IN THE LIGHT OF THE RESULTS AND THE SOCIAL WORKER'S INVESTIGATIONS, A NUMBER OF RECOMMENDATIONS HAVE BEEN MADE TO TRY TO REDUCE DRUNKEN DRIVING AND TO ASSIST THE FAMILIES OF THE VICTIMS OF ROAD ACCIDENTS. /AUTHOR/

Results of treatment of 361 patients with malignant melanoma in Queensland.

Abstract: Three hundred and sixty‐one patients treated for malignant melanoma in Queensland in 1963 and 1964 have been followed up. Melanoma was most commonly seen in patients in the middle decades of life. The commonest site of the primary lesion was on the trunk in males, and on the extremities, especially the leg below the knee, in females. There was clinical evidence of spread of the disease beyond the primary site when the patient was first treated in 14·7% of all the patients, but in only 10% of the 342 patients who had an identifiable primary lesion. One‐quarter of the lesions showed only a superficial level of invasion, and the remaining three‐quarters were invading into the dermis or beyond.

Eisenmenger's syndrome and pregnancy.

Abstract: Nine cases of Eisenmenger's syndrome associated with pregnancy are described, and the relevant literature is reviewed. Prior diagnosis of Eisenmenger's syndrome is a very strong contraindication to pregnancy. However, when pregnancy occurs, each patient should be managed on her own merits. It is felt that termination of pregnancy is of very little help, as the risks of surgery or of continuing the pregnancy are comparable. Great care should be taken to avoid blood loss in any surgical procedure or with delivery, and tubal ligation should only be recommended in a remote relationship to pregnancy. Anticoagulant therapy is recommended after both delivery and surgery.

Increase in average height of Australian aborigines.

Abstract: Average weights of Aborigines living on a Commonwealth Government settlement at Yuendumu in the Northern Territory of Australia were compared with weights of Aborigines living in the same region in the 1930s and the 1950s. Present‐day young adults were heavier than their counterparts of the 1930's by 6‐4 kg for men and 4‐7 kg for women. Older men measured in the 1960s were heavier than those measured in the 1930s and the 1950s by almost 9 kg. The weight increases appear to date from about the time of the establishment of the settlement in 1946. They probably result from more adequate nourishment, better medical care, and improved living conditions at the settlement. The weight increases were greater than could be expected as a result of height increases between the 1930s and the 1960s.