The Medical journal of Australia
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The ocular manifestations of acute methyl alcohol intoxication were studied in 24 men during an outbreak in Port Moresby, Papua New Guinea. The visual acuity, pupillary reactions to light, fundal appearances and visual fields were recorded in all patients within 72 hours of ingestion of methanol and again three months later. Three groups were identified. ⋯ The incidence of permanent ocular abnormalities was found to correlate with the incidence of metabolic acidosis (P less than 0.01), and with the stated volume of methanol consumed (P less than 0.05). An inverse correlation was found between stated volume of methanol consumed and onset of blurred vision. The difficulties in management and rehabilitation of these patients are discussed.
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Six trromboplastins commonly used for prothrombin time determinations were studied. Prothrombin times of patients who were receiving oral anticoagulant therapy varied widely, depending on the origin of the thromboplastins. The therapeutic range which is recommended with one thromboplastin is often quite different from that recommended with another, and as a result, the therapeutic ranges of different institutions may show no overlap. Management of patients and comparison of therapeutic results would be facilitated if all thromboplastins in use in Australia were standardized by comparison with the Australian Reference Thromboplastin.
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The response of Parkinsonism to three ergot derivatives which modify dopaminergic transmission was studied. CF 25-397 behaved more as an antagonist than an agonist. ⋯ Bromocriptine is an effective anti-Parkinsonian agent, particularly useful in patients with prominent dyskinesia or "on-off" reactions to levodopa; in most patients optimal results have been obtained by combining from 40 to 90 mg of bromocriptine daily with approximately 60% of the previous maximal dose of levodopa. Unfortunately, only some 50% of patients tolerate long-term bromocriptine therapy, but all adverse reactions have been dose dependent and reversible.
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Ten Caucasian patients with perhexiline maleate neurotoxicosis and weight loss are presented. Weight loss preceded symptomatic neuropathy which was detected on electromyography in one patient. Weight loss and neuropathy may be marked, but clinical improvement follows drug withdrawal.
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Over a 12-year period, from 1965 to 1977, 43 women under 46 years of age were documented with angiographic evidence of coronary atherosclerosis at St Vincent's Hospital, Sydney. Twenty-five of the women were able to be followed up at a mean interval of 31 months. This group of young women with coronary artery disease was compared with an age-matched control group of 660 "healthy" women drawn from the general population. ⋯ Only one patient out of 43 showed neither hyperlipikaemia, nor hypertension, nor smoked cigarettes, and multiple risk factors were commonly present. The level of high density or alpha-lipoprotein was significantly reduced in young women with coronary artery disease. These results highlight the presence of classical risk factors in these young women, as well as the importance of alpha-lipoproteins.