The Medical journal of Australia
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In view of the recognized high prevalence of diabetes mellitus in Malta compared with Australia, 75 g oral glucose tolerance tests were performed on 396 Maltese-born residents of Melbourne. Eighteen (4.5%) were found to have diabetes mellitus and 19 (4.8%) were found to have impaired glucose tolerance by current criteria. Glucose tolerance was correlated with family history of diabetes, with age, with obesity and with parity in women, but not with length of residence in Australia. ⋯ This was most marked in women. The results suggest that Maltese immigrants to Australia after years of residence, still run a higher risk of becoming affected with diabetes mellitus or ischaemic heart disease than the average for the Australian population. The relative importance of genetic and environmental factors involved in this difference should be the subject of continuing study in the future.
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Since the advent of modern antibiotic therapy and active surgical treatment of bacterial endocarditis, septic embolization of the systemic circulation is rarely seen. An unusual presentation of a mycotic aneurysm with gastrointestinal haemorrhage in a patient with non-Hodgkin's lymphoma and aortic valvular endocarditis which had been managed by aortic valve replacement six weeks before the haemorrhage occurred is reported.
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Two cases of abuse of bromochlorodifluoromethane (BCF - a fire-extinguishing agent) by inhalation are reported. In the first case, a 15-year-old youth presented in ventricular fibrillation; the second youth was dead on arrival at hospital. Port-mortem toxicological investigations confirmed BCF inhalation in the latter patient. ⋯ Community agencies report that BCF inhalation occurs frequently on the Gold Coast, Queensland. This behaviour can be associated with sudden death from ventricular arrhythmias after cardiac sensitization to endogenous adrenaline. The "lone sniffer" is at greatest risk, and identification of such individuals may prevent a fatal outcome.
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Case Reports
Fulminant hepatic failure and fatal encephalopathy associated with Epstein-Barr virus infection.
A case of fulminant hepatic failure, associated with infectious mononucleosis, in a previously healthy 14-year-old girl is reported. Despite intensive therapy, which included the use of acyclovir, charcoal haemoperfusion, and measures to control her raised intracranial pressure (guided by serial EEG and auditory brainstem-evoked response recordings), the outcome was fatal.