Australasian Medical Journal最新文献

{"title":"Management for elevated serum Gamma Glutamyl Transpeptidase in primary care settings","authors":"S. Kim","doi":"10.21767/amj.2017.3293","DOIUrl":"https://doi.org/10.21767/amj.2017.3293","url":null,"abstract":"Background One of the most frequently encountered problems in outpatient and health screening centres is the elevation of Gamma Glutamyl Transpeptidase(y-GTP) levels. The measurement of y-GTP is a very sensitive indicator for screening for the presence of hepatobiliary disease. Especially, when alkaline phosphatase is elevated, it is a useful test to distinguish the presence of cholestasis. The diseases for which y-GTP can be elevated include diabetes, pancreatic disease, fatty liver, primary and metastatic liver cancer, cirrhosis, neuromuscular disease, myocardial infarction, hyperthyroidism, chronic obstructive pulmonary disease, chronic renal failure, prostate cancer, rheumatoid arthritis, Obesity, drugs, etc. Since y-GTP has a relatively high sensitivity and low specificity, it is preferable to perform it with other blood tests rather than performing it independently. The measurement of y-GTP is used as a test to diagnose alcohol abuse. Aims What is the meaning of y-GTP when it is raised independently or in relation to other liver function tests and how is it interpreted? In this article, we will examine the meaning of y-GTP elevation and its clinical application in primary care settings.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68182862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexisting complete hydatidiform mole and live foetus","authors":"Ji Suk Han, Jong Soo Kim","doi":"10.21767/AMJ.2018.3379","DOIUrl":"https://doi.org/10.21767/AMJ.2018.3379","url":null,"abstract":"","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68184533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary, nodal, marginal zone lymphoma of a woman’s left breast imitated fibroadenoma","authors":"S. Strashilov, A. Yordanov, V. Nanev, M. Mihailova","doi":"10.21767/amj.2018.3494","DOIUrl":"https://doi.org/10.21767/amj.2018.3494","url":null,"abstract":"Background Primary breast lymphoma is a rare malignant neoplastic disease, accounting for around 0.5 per cent of all malignant diseases of that organ, and also 2.2 per cent of extranodal lymphomas. The most common histopathological types are: diffuse large B-cell lymphoma, extranodal B-cell marginal zone lymphoma and MALT lymphoma. The primary affected group is with median age between 55 and 62 years. The clinical manifestation is usually of a tumour process in the affected breast. Case presentation Here we present an extremely rare case of a 68 years old woman with primary, nodal, B-cell, marginal zone lymphoma of the left breast, presenting itself under the mask of a benign tumour process, found accidentally following a histopathological examination of excisional samples. Conclusions Primary, nodal, marginal zone, B-cell lymphoma of the breast is extremely rare. Its clinical and mammographic presentation completely overlaps with those of fibroadenoma, which makes diagnosing it preoperatively practically impossible. Main treatment method here is not surgical, but radiological and chemotherapeutic.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68186703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous coronary artery dissection with hypothyroidism in a 45-year-old man: A case report","authors":"Meiqin Wang, Gai-Xia Liu, Guofang Xue, Dong-fang Li, G. Zhu, C. Hölscher","doi":"10.21767/amj.2018.3528","DOIUrl":"https://doi.org/10.21767/amj.2018.3528","url":null,"abstract":"Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome in young persons, rarely found in men. There are currently no known direct causes of this condition, although some correlations have been found. We report the case of a 45-year-old man with unstable angina pectoris secondary to spontaneous diffuse spiral dissection in the right coronary artery. In addition, the patient was diagnosed with other autoimmune related diseases, for example hypothyroidism, chronic atrophic gastritis, lung emphysema, which suggesting that autoimmune mechanism is an important mechanism for the","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why volubility can predict the success of cochlear implantation","authors":"Paris Binos, Anna Polemikou, E. Loizou","doi":"10.21767/amj.2018.3518","DOIUrl":"https://doi.org/10.21767/amj.2018.3518","url":null,"abstract":"Background We sought to identify potential communication markers predicting the success of cochlear implantation, that might be observed within the first year of life. According the last ten years literature review volubility can be considered as a potentially important vocal measure predicting later language development. Aims The present review aims to review existing evidence related with: (i) why volubility posits a plausible marker of cochlear implantation success in infancy, and (ii) presents the clinical usefulness of volubility data in predicting later language trajectory. Methods Rate of vocalization or volubility measured in terms of frequency of syllable production and it is clearly affected by parental interactivity. A low percentage of volubility can be predictive of significant communication impairment. Vocalization growth during the first year of life, as demonstrated in publications examining sound production characteristics of normally hearing (NH) and hearing impaired (HI) infants fitted with CI, were reviewed. Results Literature results revealed differences in linguistic performance among NH and CI infants which are typically attributed to auditory deprivation. Infants received late CI, produce fewer syllables (low volubility) and exhibit lateonset babbling, especially those who underwent the procedure as late as the age of 12 months or thereafter. Early recipients (implanted before the age of 12-months) related with more vocalizations, which is thought to stem from CI-initiated auditory feedback. In sum, total syllables produced (volubility) demonstrate the developmental trajectory of language acquisition which in turn is a crucial factor related with the success of cochlear implantation. Conclusion Contemporary findings collectively endorse volubility as a plausible criterion of differentiation between successful and non-successful early CI. It is argued that volubility measures predict language development and, in doing so, carry vast implications on designing efficient clinical assessment and intervention practices.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful haemofiltration therapy in severe phenobarbital overdose","authors":"E. Tan, M. Moser, G. Duke","doi":"10.21767/AMJ.2018.3307","DOIUrl":"https://doi.org/10.21767/AMJ.2018.3307","url":null,"abstract":"In the 19 th century, barbiturates were first-line treatment as hypnotic and anticonvulsants, then gradually replaced by agents with a safer clinical profile. However, its ongoing use in Australian veterinary medicine and steadfast prescriptions in developing countries/our migrant population, still contributes to overdoses. We present a case of a middle-aged man with a lifethreatening phenobarbital overdose. Haemofiltration was trialled, causing a rapid fall in phenobarbital levels and a speedy recovery. Through a review of the literature, treatment options of barbiturate overdose presentations will be discussed. It is imperative clinicians are aware of barbiturate’s mechanism and its enhanced elimination through extracorporeal treatment.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68184198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil to lymphocyte with monocyte to lymphocyte ratio and white blood cell count in prediction of lung cancer","authors":"T. T. Phan, A. Nguyen, A. N. Nguyen, H. T. Nguyen, Toan Trong Ho, Suong Phuoc Pho, Binh T. Mai, Son Truong Nguyen","doi":"10.21767/amj.2018.3387","DOIUrl":"https://doi.org/10.21767/amj.2018.3387","url":null,"abstract":"Background Lung cancer is the most common cause of cancer deaths in both sexes, while it is very difficult for screenings and early detection. Aims This study aims to clarify the role of systematic inflammation markers, including white blood cell (WBC), neutrophil (NEU), monocyte (MONO), platelet (PLT), neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR) in prediction of lung cancer. Methods A case-control study was conducted on 1,315 primary lung cancer patients and 1,315 healthy adults with matched age and gender at Cho Ray hospital. NLR, MLR and PLR were calculated by using neutrophil, lymphocyte, monocyte and platelet count which were recalled from laboratory database. With 600 cases in the derivation set, the logistic regression with univariate analysis was used to identify the impacted marker, then developing the optimal prediction model for lung cancer by logistic regression with multivariate method. The diagnostic values of optimal model consisting of sensitivity (Sen), specificity (Spe), positive predictive value (PPV), negative predictive value (NPV) and the area under the ROC curve (AUC) value were extracted and verified on all data, in validation set. Results The median values of WBC, NEU, MONO, PLT, NLR, MLR and PLR in lung cancer were not significantly difference between histological subtypes and clinical stages (p>0.05), but higher than the values in control group (p<0.01). Multivariates analysis shows that NLR, MLR and WBC were three parameters that have the significant impact of the optimal prediction model (p<0.01). The AUC value, sensitivity and specificity of the optimal model for lung cancer detection were 0.881, 73.5 per cent (95 per cent CI:70.3–76.6) and 87.7 per cent (95 per centCI:85.2–89.9), respectively. Whereas, the PPV and NPV values of prediction model were 85.7 per cent (95 per cent CI:82.8–88.2) and 76.8 (95 per centCI:73.9–79.5), respectively. Among three biomarkers, the AUC values of NLR (0.853) and MLR (0.842) were higher than the value of WBC (0.752) (p<0.01). Conclusion The results of this study show that NLR with MLR and WBC in optimal prediction model are promising biomarkers for lung cancer screening that could be applied in clinical practice with the advantage of convenience and low cost.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68184940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does compulsory vaccination limit personal freedom? Ethical issues","authors":"M. Paternoster, R. Scotto, Faiza Saleem, A. Buonomo, N. S. Moriello, C. Casella, Emanuele Capasso, S. Nappa, I. Gentile, G. Borgia, V. Graziano","doi":"10.21767/AMJ.2018.3462","DOIUrl":"https://doi.org/10.21767/AMJ.2018.3462","url":null,"abstract":"","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68185463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lid abscess: An unusual presentation of melioidosis","authors":"Bhagwati Wadwekar, R. Ninan, S. Bhat, Sheela devi, R. RamyaS, R. Kanungo","doi":"10.21767/AMJ.2017.2809","DOIUrl":"https://doi.org/10.21767/AMJ.2017.2809","url":null,"abstract":"Melioidosis caused by Burkholderia pseudomallei (B. pseudomallei), is an emerging infection in India. Clinical manifestation of melioidosis is variable ranging from localized benign infection to fulminant septicemia. Ocular presentation of melioidosis is rare. However, cases of endophthalmitis, keratitis and orbital infections have been reported. We report the isolation of B. pseudomallei in a 40 year old male, presenting with fever and lid abscess. The patient was treated with meropenem during the acute phase and switched to trimethoprim/sulfamethoxazole for eradication phase.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68172810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systems multiple molecule drug design with less side-effects via drug data mining and genome-wide data identification","authors":"Bor-Sen Chen","doi":"10.21767/amj.2018.3439","DOIUrl":"https://doi.org/10.21767/amj.2018.3439","url":null,"abstract":"Background Drugs fail in the clinic for two main reasons; one is that they do not work and another is that they are not safe. As such, two of the most important steps in developing new drugs should be drug targets identification and side-effect validation. Aims The identification of drug targets and their restoration of cellular dysfunctions to normal cellular functions with less side-effects are considered as drug design specifications of systems medicine discovery. Since the effect on the normal expression of house-keeping genes and proteins is also considered as a restriction on drug design, the proposed multi-molecules drug strategy might be helpful for systems drug design with less-side effects. Methods By systems biology method, genetic and epigenetic networks (GENs) are constructed to identify network biomarker for drug targets of diseases by genome-wide high throughput data. An integration of computational networkbased approach for multiple drug targets with drug data mining is also proposed for systems drug discovery with more precise medicine and less side-effects. Finally, some systematic drug design specifications for drug design are proposed to restore to the normal functions of multiple drug targets with less side-effects. Results A systematic method is introduced to find multiple drug targets based on pathogenic mechanism investigated by network identification through genome-wide highthroughput data. Then a multi-molecule drug design strategy is also proposed to select a set of multi-molecule drugs with less side-effects via drug data mining method. Conclusion Systematic engineering design methods seem applicable to systems drug discovery and design.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68185437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}