School of Medicine Publications - UQ eSpace

Acute and late radiation therapy effects

2010-12-20T00:00:00Z

Acute and long-term effect of alpha-glucosidase inhibitor on dumping syndrome in a patient after a vagotomy and pyloric surgery *

2007-08-15T00:00:00Z

Acute and persistent diarrhea

Grimwood, Keith og Forbes, David A. — 2010-09-15T00:00:00Z

Socially disadvantaged Indigenous infants and children living in western industrialized countries experience high rates of infectious diarrhea, no more so than Aboriginal children from remote and rural regions of Northern Australia. Diarrheal disease, poor nutrition, and intestinal enteropathy reflect household crowding, inadequate water and poor sanitation and hygiene. Acute episodes of watery diarrhea are often best managed by oral glucose-electrolyte solutions with continuation of breastfeeding and early reintroduction of feeding. Selective use of lactose-free milk formula, short-term zinc supplementation and antibiotics may be necessary for ill children with poor nutrition, persistent symptoms, or dysentery. Education, high standards of environmental hygiene, breastfeeding, and immunization with newly licensed rotavirus vaccines are all needed to reduce the unacceptably high burden of diarrheal disease encountered in young children from Indigenous communities.

Acute appendagitis: emergency presentation and computed tomographic appearances

Subramaniam, R. — 2007-08-15T00:00:00Z

Acute epiploic appendagitis is an uncommon cause of abdominal pain. It is caused by torsion of an epiploic appendage or spontaneous venous thrombosis of a draining appendageal vein.1 The diagnosis of this condition primarily relies on cross-sectional imaging and is made most often after computed tomography (CT). Clinically, it is most often mistaken for acute diverticulitis. Approximately 7.1% of patients investigated to exclude sigmoid diverticulitis have imaging findings of primary epiploic appendagitis.

Acute asthma exacerbation in children

Robinson, Paul og Chang, Anne B. — 2011-12-20T00:00:00Z

Acute bilateral iliac artery occlusion secondary to blunt trauma: Successful endovascular treatment

2011-03-14T00:00:00Z

Acute calcium disorders

Venkatesh, B. — 2009-04-20T00:00:00Z

Acute chest infections in children 3-12 months

Chang, A. B. — 2007-08-14T00:00:00Z

Acute colonic perforation associated with colorectal cancer

2011-06-15T00:00:00Z

Our purpose was to evaluate long-term outcome in patients presenting with acute colonic perforation in the setting of colorectal cancer. We conducted a retrospective review of 48 consecutive patients presenting with acute colonic perforation associated with colorectal cancer at a single institution. Patients presented either with free air or acute peritonitis. No patients with colonic obstruction were included. Forty-eight patients presented with colon perforation. Thirty-six had perforation at the tumor, 11 proximal to the tumor, and one distal to the primary tumor. Patients who perforated proximal to the tumor were older (74.5 ± 2 vs 64.7 ± 3; P < 0.04) and had a longer length of stay (46.8 ± 17 vs 11.6 ± 1 P < 0.001). Fourteen patients had stage II disease, 19 stage III, and 15 stage IV. Thirty-day mortality was 14 per cent (n = 7) with nine in-hospital deaths. Of 30-day survivors 29 (60%) had curative resection (21 with local perforation and nine with proximal perforation). Of these 14 received adjuvant chemotherapy. Eleven patients (33%) had either unresectable or metastatic disease on exploration. Mean follow-up was 21.5 months. Ten patients developed metastatic disease after potentially curative resections. Of these nine patients had perforations of the primary tumor. Three patients developed local recurrence and all had local tumor perforations. One-year survival was 55 per cent (n = 16). Five-year disease-free survival was 14 per cent (n = 4). There were no long-term survivors after perforation proximal to the tumor, although disease stage was comparable in both groups. We conclude that perforation proximal to a cancer is associated with a higher perioperative mortality and worse long-term outcome when compared with acute perforations at the site of the tumor. Long-term survival requires both aggressive management of the concomitant sepsis and definitive oncologic surgery.

Acute colonic perforation associated with colorectal cancer - Discussion

2011-06-15T00:00:00Z

Acute coronary syndromes: Consensus recommendations for translating knowledge into action

2010-07-25T00:00:00Z

Recent National Heart Foundation of Australia (NHFA) guidelines for management of acute coronary syndromes (ACS) recommend increasing the rates of early invasive management of ACS and providing equal access for all Australians to percutaneous coronary intervention (PCI) facilities. • For patients with ACS managed in regional hospitals without PCI facilities, review of the evidence does not show unequivocal benefit of early routine PCI over selective PCI for patients with non-ST-segment-elevation ACS or ST-elevation myocardial infarction. • The current pattern of transfer based on the NHFA guidelines is expensive and disruptive of patient care, as well as undermining regional health care services. • Further increase in transfer rates and increases in PCI facilities would divert resources away from supporting the regional infrastructure needed to provide evidence-based therapies, without any evidence that lives would be saved.

Acute coronary syndromes: Exploring the best way forward in optimising care

Scott, Ian A. — 2010-01-06T00:00:00Z

Acute dapsone overdose: The effects of continuous veno-venous haemofiltration on the elimination of dapsone

2012-03-21T00:00:00Z

Acute Disseminated Encephalomyelitis

Pender, Michael P. — 2004-04-30T00:00:00Z

Acute disseminated encephalomyelitis (ADEM) (post-infectious encephalomyelitis or post-vaccinal encephalomyelitis) is an acute inflammatory demyelinating disease of the central nervous system (CNS). Typically it follows infection by a virus, but it may also follow infection by other agents or may complicate vaccination. Sometimes it occurs without any obvious triggering factors. The clinical manifestations are diverse and include presentation with acute transverse myelitis. Acute haemhorrhagic leukoencephalitis is a rare and more severe form of ADEM with a high mortality and morbidity. There is good evidence that ADEM and acute haemhorrhagic leukoencephalitis are autoimmune diseases similar to acute experimental autoimmune encephalomyelitis (EAE) and hyperacute EAE repectively.

Acute diverticulitis in heart- and lung transplant patients

2011-06-15T00:00:00Z

Significant gastrointestinal complications have been observed in patients following heart- and lung transplantation. These complications can occur in the immediate post-operative period or remote from the time of transplantation. We retrospectively reviewed the medical records of 268 consecutive, patients who received either heart- or lung transplants at Henry Ford Hospital between 1985 and 1998. Two hundred and thirty-three patients received heart transplants and 35 underwent lung transplantation. Two patients developed acute diverticulitis post transplant, both requiring surgery. Management of acute diverticulitis in the heart- and lung transplant population requires a high index of suspicion. Early and aggressive diagnosis is mandatory. Surgical intervention must be prompt when indicated, with meticulous attention to surgical technique. With appropriate intervention, reasonable outcomes can be expected.

Acute effects of treadmill running on lipoprotein(a) levels in males and females

2012-10-17T00:00:00Z

Acute elevation of lipids does not alter exercise hemodynamics in healthy men: a randomized controlled study

2013-01-27T00:38:43Z

Acute elevation of triglycerides increases left ventricular contractility and alters ventricular-vascular interaction

2011-08-10T00:00:00Z

Acute epiglottitis in childhood: Report of an increased incidence in Victoria

Sly, P.D. og Landau, L.I. og Wagener, J.S. — 2010-11-17T00:00:00Z

The incidence of acute epiglottitis treated in Melbourne, Australia at the Royal Children's Hospital (RCH) has increased from an average of 14 cases per year during 1975-79 to 49 cases per year during 1980-81. Less marked increases have occurred for H. influenzae meningitis and bacteremia and H. influenzae (untyped) isolation from respiratory tract cultures. A review of 171 cases of acute epiglottitis showed no significant differences between the 1975-79 and 1980-81 patients with respect to sex, age, seasonal incidence, prodromal length, prodromal symptoms geographical location, polymorphonuclear cell count, or disease severity. Patients treated in 1980-81 had fewer complications (12% versus 22%, p<0.02), and a shorter hospital stay (3.0 versus 3.3 days, p<0.003). The increased incidence of H. influenzae type b infections may be due to an increased bacterial presence within our community.

Acute epiglottitis: Surgical emergency

2011-06-16T00:00:00Z

Acute flaccid paralysis from echovirus type 33 infection

2010-02-19T00:00:00Z

During a community echovirus type 33 outbreak, the virus was detected in the feces and cerebrospinal fluid of a 3-year-old boy with right arm weakness that followed a mild nonspecific febrile illness. This is the first time an association between echovirus type 33 infection and acute flaccid paralysis has been reported. Copyright © 2003, American Society for Microbiology

Acute fluid shifts influence the assessment of serum vitamin D status in critically ill patients

2011-03-16T00:00:00Z

Acute generalised exanthematous pustulosis induced by the herbal remedy Ginkgo biloba

Pennisi, R. S. — 2007-08-15T00:00:00Z

Acute generalised exanthematous pustulosis (AGEP) is a clinical reaction pattern that is induced, in over 90% of cases, by systemic drugs (most frequently antibacterial drugs). This is the first reported case of AGEP caused by the herbal remedy Ginkgo biloba.

Acute global hypoxia - do all babies respond in the same way?

2007-08-23T00:00:00Z

Acute global hypoxia - do all babies respond in the same way?

2007-08-23T00:00:00Z

Acute hepatic failure caused by an acute aortic dissection with cardiac tamponade: Case report

2010-01-05T00:00:00Z

An acute cardiac tamponade from any cause may result in rapid deterioration of hepatic function in a previously healthy patient. We describe a case of an acute ascending aortic dissection that presented as acute hepatic failure, due to an acute cardiac tamponade and severe right heart failure. The differential diagnosis of the aetiology of acute liver failure is extensive and includes poisonings, vascular obstruction and sepsis, particularly on the background of decompensated liver disease. Many of these conditions are associated with hypotension. The acute presentation in our patient, combined with the lack of a characteristic history delayed the diagnosis of a proximal (type A) dissection with tamponade and subsequent hepatic failure. Severe right-sided heart failure as a result of conditions such as cardiac tamponade should be excluded in patients presenting with acute hepatic failure of unknown aetiology.

Acute human self-poisoning with bispyribac-containing herbicide Nominee (R): a prospective observational study

2010-08-29T00:00:00Z

Acute human self-poisoning with imidacloprid compound: A neonicotinoid insecticide

2010-03-23T00:00:00Z

Acute hydrothorax complicating peritoneal dialysis: A case report

2011-03-28T00:00:00Z

Acute hyperammonemic encephalopathy in adult onset ornithine transcarbamylast deficiency

2009-08-21T00:00:00Z

Objectives To report the clinical manifestations of acute hyperammonemic encephalopathy in adult onset ornithine transcarbamylase deficiency (OTCD). Design Case report. Setting Intensive care unit of a tertiary medical centre. Patient A 48-year-old Caucasian male body builder who developed acute loss of consciousness after a febrile illness. Interventions The patient was immediately started on hemodia-filtration, protein elimination and ammonia scavenging medications. Measurements and results Serum ammonium was elevated and plasma and urine amino acids had a pattern indicative of a urea cycle defect. DNA studies revealed a mutation of the urea cycle enzyme, ornithine transcarbamylase. The encephalopathy resolved and the patient slowly recovered though with some cognitive impairment. Conclusions Adult presentation of OTCD is rare and the mortality and morbidity rates are high. However, survival is possible with rapid correction of hyperammonemia. As the clinical manifestations are non-specific, a high index of suspicion is necessary for the correct diagnosis and management.

Acute hypertrophic cardiomyopathy possibly associated with Mycoplasma pneumoniae infection

2010-09-15T00:00:00Z

Mycoplasma pneumoniae is a common acute respiratory pathogen causing atypical pneumonia, tracheobronchitis, bronchiolitis and pharyngitis. A wide spectrum of extrapulmonary Mycoplasma disease is recognized and includes various exanthems, Stevens-Johnson syndrome, arthritis, meningoencephalitis, hemolytic anemia and perimyocarditis. Complications may be seen in up to 30% of Mycoplasma infections. Cardiac involvement is uncommon and has been reported rarely in children. We report a child with M. pneumoniae pharyngitis, pneumonia and a transient acute hypertrophic cardiomyopathy which to our knowledge has not been described previously. The diagnosis was supported by the detection of M. pneumoniae deoxyribonucleic acid in nasopharyngeal aspirate fluid with the polymerase chain reaction (PCR) and positive serology for M. pneumoniae by IgM immunofluorescence and particle agglutination.

Acute increase in femoral artery resistance in response to direct physical stimuli in the human fetus

2009-03-19T00:00:00Z

Acute infectious diarrhea lessons learned from the past?

2012-12-16T00:52:17Z

Acute intentional self-poisoning with a herbicide product containing fenoxaprop-P-ethyl, ethoxysulfuron, and isoxadifen ethyl: a prospective observational study

2010-02-14T00:00:00Z

Background. Herbicides are commonly ingested for self-harm, but relatively little has been published on poisoning with herbicides other than paraquat and glyphosate. We report here a case series of patients with acute exposure to a combination herbicide (brand name Tiller Gold or Whip Super) containing the selective phenoxy herbicide compounds fenoxaprop-P-ethyl and ethoxysulfuron and a safener isoxadifen ethyl. Method. Clinical data on all patients presenting with Tiller Gold or Whip Super poisoning to two General Hospitals in Sri Lanka from 2002-2008 were collected prospectively until discharge. Results. Eighty-six patients with a history of Tiller Gold or Whip Super ingestion were included. The main clinical features were an epigastric burning sensation and vomiting; however, most of those who vomited had received gastric lavage or forced emesis. Eight patients had a reduced level of consciousness on admission (Glasgow coma scale 9-14) that resolved without intervention over several hours. Only symptomatic and supportive care was required. The median hospital stay was 1 day (IQR: 1-2) and the case fatality was zero (95% confidence interval: 0-4.2%). This low case fatality compared favorably with the case fatality of other common herbicides in our cohort: paraquat >40%, propanil >10%, 4-chloro-2-methylphenoxyacetic acid > 5%, and glyphosate >2%. Conclusion. This combination herbicide product appears to be safe in patients with acute self-poisoning, particularly in comparison with other herbicides, and causing few clinical features

Acute in-vivo trial of a novel rotary BIVAD/TAH

2012-09-14T00:00:00Z

Acute ischemic stroke treatment: State of the art

Patel, Rajan A. G. og White, Christopher J. — 2011-09-11T00:00:00Z

Acute leukaemia

Joseph Ting — 2010-04-21T00:00:00Z

Acute limb ischemia

2011-09-20T00:00:00Z

Acute lipopolysaccharide priming boosts inflammasome activation independently of inflammasome sensor induction

2012-08-31T14:23:38Z

Acute liver failure associated with the use of herbal preparations containing black cohosh

2011-03-09T00:00:00Z

Acute liver failure in children: A regional experience

2007-08-15T00:00:00Z

Objective: To review the outcome of acute liver failure (ALF) and the effect of liver transplantation in children in Australia. Methodology: A retrospective review was conducted of all paediatric patients referred with acute liver failure between 1985 and 2000 to the Queensland Liver Transplant Service, a paediatric liver transplant centre based at the Royal Children's Hospital, Brisbane, that is one of three paediatric transplant centres in Australia. Results: Twenty-six patients were referred with ALF. Four patients did not require transplantation and recovered with medical therapy while two were excluded because of irreversible neurological changes and died. Of the 20 patients considered for transplant, three refused for social and/or religious reasons, with 17 patients listed for transplantation. One patient recovered spontaneously and one died before receiving a transplant. There were 15 transplants of which 40% (6/15) were < 2 years old. Sixty-seven per cent (10/15) survived > 1 month after transplantation. Forty per cent (6/15) survived more than 6 months after transplant. There were only four long-term survivors after transplant for ALF (27%). Overall, 27% (6/22) of patients referred with ALF survived. Of the 16 patients that died, 44% (7/16) were from neurological causes. Most of these were from cerebral oedema but two patients transplanted for valproate hepatotoxicity died from neurological disease despite good graft function. Conclusions: Irreversible neurological disease remains a major cause of death in children with ALF. We recommend better patient selection and early referral and transfer to a transplant centre before onset of irreversible neurological disease to optimize outcome of children transplanted for ALF.

Acute low back pain

2007-08-14T00:00:00Z

Acute lung injury in pediatric intensive care in Australia and New Zealand: a prospective, multicenter, observational study

2012-04-13T00:00:00Z

Acute lung transplant rejection is associated with localized increase in T-cell IFN gamma and TNF alpha proinflammatory cytokines in the airways

2011-11-30T00:00:00Z

Acute myelomonocytic leukemia presenting as a benign-appearing cutaneous eruption

2011-06-15T00:00:00Z

Acute myocardial infarction: Initial manifestations, management, and prognosis

Lavie, C. J. og Gersh, B. J. — 2011-03-14T00:00:00Z

In patients with suspected acute myocardial infarction (AMI), obtaining a thorough history is important for identifying both the cause of chest pain and any concurrent conditions that may complicate the management. Physical examination - including cardiac ausculation and determining the status of the peripheral vasculature - is important as a guide to immediate management and as a baseline for future comparison. The differential diagnosis of AMI is extensive, and various laboratory tests, such as electrocardiography, cardiac enzymes, radionuclide techniques, echocardiography, and cardiac catheterization, can aid in the diagnosis. The routine management of patients with AMI can include medical therapy with antithrombotic agents, nitrates, β-adrenergic blockers, or calcium channel blocking agents. The major differences between Q-wave and non-Q-wave infarction are discussed. Some factors that affect early and late prognosis in patients with AMI are age of the patient, residual left ventricular function, residual myocardial ischemia, and substrates for sustained ventricular arrhythmias. Although much of the current enthusiasm in management of AMI is related to revascularization strategied, other important aspects of diagnosis and treatment should not be overlooked.

Acute neuropathic pain: Diagnosis and treatment

Gray, Paul D. — 2009-04-10T00:00:00Z

Acute neurotoxicity in children with advanced stage B-non-Hodgkin’s lymphoma and B-acute lymphoblastic leukaemia treated with the United Kingdom children cancer study group 9002/9003 protocols

2010-01-14T00:00:00Z

Acute otitis media

Pirozzo, S. og Del Mar, C. — 2007-08-14T00:00:00Z

A 3-year-old girl is brought to your office by her mother because she has a fever and complains that her ear hurts. She has no significant medical history. The child is not pleased to be in the physician's office and has been crying. Her mother explains that she developed a cold about 3 days ago with sniffles. Her temperature is 37.8 degreesC (100 degreesF), and the rest of the physical examination is completed with some difficulty. The only abnormalities are slight redness of the throat. a nose full of thick green mucus, and injected tympanic membranes. You wonder what findings other than red tympanic membranes should lead you to diagnose otitis media and also consider the recent controversy about whether to treat acute otitis media (AOM) with antibiotics.

Acute pancreatitis related to therapeutic dosing with colchicine: A case report

Ting, Joseph Yuk Sang — 2009-06-10T00:00:00Z

Background Colchicine is used in the treatment and prophylaxis of gout. It possesses a narrow therapeutic window, frequently resulting in dose-limiting gastrointestinal side-effects such as diarrhoea and emesis. As colchicine is a cellular anti-mitotic agent, the most serious effects include myelosuppression, myoneuropathy and multiple organ failure. This occurs with intentional overdose or with therapeutic dosing in patients with reduced clearance of colchicine due to pre-existing renal or hepatic impairment. Acute pancreatitis has rarely been reported, and only in association with severe colchicine overdose accompanied by multi-organ failure. Case presentation We report a case of acute pancreatitis without other organ toxicity related to recent commencement of colchicine for acute gout, occurring in an elderly male with pre-existing renal impairment. Conclusion 1) Colchicine should be used with care in elderly patients or patients with impaired renal function. 2) Aside from myelosuppression, myoneuropathy and multiple organ failure, colchicine may now be associated with acute pancreatitis even with therapeutic dosing; this has not previously being reported.