Idiopathic- and scleroderma-related pulmonary arterial hypertension: outcomes and QOL on bosentan.

Idiopathic pulmonary arterial hypertension (previously known as primary pulmonary hypertension) is a devastating disease of insidious onset, late diagnosis, progressive functional disability and poor prognosis. However, treatment with pulmonary arterial hypertension-specific agents has already changed the outlook wherever these agents are accessible. The process of economic evaluation of treatment for idiopathic pulmonary arterial hypertension is challenging due to limitations common to clinical studies in rare diseases, such as small patient numbers limiting survival information, lack of directly comparable trials for the efficacy of different drugs and a paucity of quality of life measurements.

The relationship between quality of life, Mini-Mental State Examination, and the Instrumental Activities of Daily Living in patients with Alzheimer's disease.

Alzheimer's disease (AD) affects the cognitive function and capacity for independent living of the elderly, however little is known about the measurement of patient's overall health-related quality of life (HRQoL) and its relationship to these effects. We examined the relationship between patient/caregiver-rated HRQoL and cognition (using the Mini-Mental State Examination (MMSE)) or Instrumental Activities of Daily Living (IADL). One hundred AD patients participating in an open-label trial of donepezil were followed for 6 months.

Identification of the tautomeric form of formycin A in its complex with Escherichia coli purine nucleoside phosphorylase based on the effect of enzyme-ligand binding on fluorescence and phosphorescence.

Fluorescence and phosphorescence emission spectroscopy were employed to study the interaction of Escherichia coli purine nucleoside phosphorylase (PNP) with its specific inhibitor, formycin A (FA), a close structural analogue of adenosine (natural substrate), in the absence and presence of phosphate (P(i), substrate). Formation of enzyme-FA complexes led to marked quenching of enzyme tyrosine intrinsic fluorescence and phosphorescence, with concomitant increases in fluorescence and phosphorescence of FA. Fluorescence resonance energy transfer from the protein Tyr160 residue to the FA base moiety was identified as a major mechanism of protein fluorescence quenching, increased by addition of P(i).

Interpretation of fluorescence decays using a power-like model.

A power-like decay function, characterized by the mean excited-state lifetime and relative variance of lifetime fluctuation around the mean value, was applied in analysis of fluorescence decays measured with the aid of time-correlated single photon counting. We have examined the fluorescence decay, in neutral aqueous medium, of tyrosine (L-tyrosine and N-acetyl-L-tyrosinamide), and of the tyrosine residues in a tryptophan-free protein, the enzyme purine nucleoside phosphorylase from Escherichia coli in a complex with formycin A (an inhibitor), and orthophosphate (a co-substrate). Tryptophan fluorescence decay was examined in neutral aqueous medium for L-tryptophan, N-acetyl-L-tryptophanamide, and for two tryptophan residues in horse liver alcohol dehydrogenase.

Lead dust in broken hill homes--a potential hazard for young children?

Objective: To determine the potential hazard posed by indoor lead dust to young children in Broken Hill, a silver-lead-zinc mining town in outback Australia, and the degree to which lead flux is influenced by factors such as geographical location, house construction type and condition.

Methods: 116 homes were selected and 93 (80%) studied from 10 localities in Broken Hill during the spring of 1995. Lead flux was measured using 85 mm diameter polystyrene petri dishes.

A comparative study of E-cadherin and stromelysin-3 expression in de novo and ex adenoma carcinoma of the colorectum.

An apparent exception to the colorectal adenoma-carcinoma carcinogenetic pathway is the so-called "de novo" carcinoma which has no evidence of adenoma in its vicinity. Despite the fact that they are often quite small, these lesions appear to be more aggressive (i.e.

Pterygium in Australia: a cost of illness study.

Purpose: The aim of this report was to describe the number of Australians affected by pterygium in recent years, treatment options, number of treatment encounters and costs of treatment.

Method: A review of published literature was conducted to identify the prevalence of pterygium in Australian populations. Costs of primary care were based on national general practitioner (GP) survey data.

E-cadherin, beta-catenin and stromelysin-3 expression in de novo carcinoma of the colorectum.

An apparent exception to the colorectal adenoma-carcinoma carcinogenic pathway is the so-called "de novo" carcinoma that has no evidence of adenoma in its vicinity. Despite the fact that they are often quite small, these lesions appear to bhe more aggressive (i.e.

Serological evidence of infection with Chlamydia pneumoniae is related to the severity of asthma.

There is evidence that infection with Chlamydia pneumoniae is associated with asthma of recent onset and that it can influence the severity of asthma. This has led to the suggestion that macrolide antibiotics may be useful in the treatment of asthma in subjects infected with C. pneumoniae.

Comparison of family history measures used to identify high risk of coronary heart disease.

We examined 15 published continuous family history measures (scores) as well as two new formulations in terms of several desirable properties. We applied the scores to sample pedigrees and found that some systematically increase with family size. In contrast to aggregate scores, non-aggregate scores are sensitive to the age, sex, and covariate status of individual relatives but are unstable when the families are small.

Outdoor air pollution and children's respiratory symptoms in the steel cities of New South Wales.

Objective: To investigate the relationship between outdoor air pollution and the respiratory health of children aged 8 to 10 years.

Design: A cross-sectional survey (between October 1993 and December 1993) of children's health and home environment. Summary measures of particulate pollution (levels of particles with an aerodynamic diameter less than 10 microns [PM10] each 6th day) and SO2 (daily mean and maximum hourly values) were estimated for each area (using air quality monitoring station data from July 1993 to June 1994).

Air pollution and hospital admissions in Sydney, Australia, 1990 to 1994.

Objectives: This study examined the effects of outdoor air pollutants on daily hospital admissions in Sydney, Australia.

Methods: A time-series analysis of counts of daily hospital admissions and outdoor air pollutants (1990 to 1994) was performed, by means of Poisson regression that allowed for overdispersion and autocorrelation.

Results: An increase in daily maximum 1-hour concentration of nitrogen dioxide from the 10th to the 90th percentile was associated with an increase of 5.

Epidemiological association of airway inflammation with asthma symptoms and airway hyperresponsiveness in childhood.

The role of airway inflammation in childhood asthma is not well defined, despite modern treatment approaches recommending potent anti-inflammatory therapy for an increasing number of children. In this study, induced sputum analysis was used to investigate the relationships among sputum inflammatory cells (eosinophils and mast cells), asthma symptoms, and airway hyperresponsiveness to hypertonic saline in a cohort of 170 children aged 8-14 years. Children who reported asthma symptoms in the past 2 wk had a 2.

Risk associated with various definitions of family history of coronary heart disease. The Newcastle Family History Study II.

The authors carried out a population-based case-control study to estimate the risk of an acute coronary disease event associated with various definitions of a family history of coronary heart disease (CHD). A detailed family history questionnaire was completed by 403 cases and 236 controls in Newcastle, New South Wales, Australia from 1992 to 1994. Odds ratios of an acute coronary disease event adjusted for proband age and sex ranged from 2.

Correction for biases in a population-based study of family history and coronary heart disease. The Newcastle Family History Study I.

In this paper, the authors report on the design of a population-based case-control study of family history as a risk factor for coronary heart disease (CHD). They studied the characteristics of subjects who completed a detailed family history questionnaire in 1992-1994 as well as the accuracy of recall of family history in order to quantify both selection and recall biases. Coronary disease cases were enrolled through the Newcastle MONICA Project (Monitoring Trends and Determinants in Cardiovascular Disease), which registered all suspected heart attacks and sudden cardiac deaths in the Lower Hunter region of New South Wales, Australia, between August 1984 and March 1994.

Severe exacerbation of chronic obstructive airways disease: health resource use in general practice and hospital.

The objective of this study is to examine the treatment of exacerbations of chronic obstructive airways disease (COAD) in the hospital and in the community setting using a retrospective study of patients admitted to a major teaching hospital combined with a general practice chart audit. The admission records for 248 admissions from 128 patients were reviewed. Most patients (70%) had visited their GP within 2 weeks of admission, antibiotics were prescribed for 30% of the exacerbations while 51% were treated with ingested corticosteroids.

A double-blind randomized clinical trial on the effectiveness of a daily glycolic acid 5% formulation in the treatment of photoaging.

Background: Low-strength daily formulations of glycolic acid are widely promoted for the treatment of photoaging. However, there are few clinical studies that objectively confirm the benefits of such formulations.

Objective: The purpose of this study was to determine the effectiveness of a 5% unneutralized formulation of glycolic acid in the treatment of facial and neck photoaging.

Air pollution and daily mortality in Sydney, Australia, 1989 through 1993.

Objectives: This study examined the effects of outdoor air pollutants in Sydney, Australia, on daily mortality.

Methods: Time-series analysis was performed on counts of daily mortality and major outdoor air pollutants (particulates, ozone, and nitrogen dioxide) in Sydney (1989 to 1993) with adjustment for seasonal and cyclical factors. Poisson regression was calculated with allowance for overdispersion and autocorrelation.

Reproducibility of brachial ultrasonography and flow-mediated dilatation (FMD) for assessing endothelial function.

Background: High-resolution brachial artery ultrasonography is used to study vasodilator response induced by physiologic reactive hyperaemia. We examined the reproducibility of measuring flow-mediated dilatation (FMD) on two occasions.

Aims: To determine the degree of variability of this technique in our vascular laboratory for the design of clinical research studies.

Gender differences and other determinants of the rise in plasma homocysteine after L-methionine loading.

The methionine load test is widely used to identify subjects with mild homocysteinemia. We studied factors influencing the rise in plasma homocysteine (tHcy) levels following oral methionine loading, after taking into account determinants of the basal level. The study population comprised 522 persons (mean age 53, range 17 to 95; 63% male; 60% with coronary disease).

Opportunistic blood lead testing in a paediatric inpatient population.

We report a simple protocol which has potential to estimate community paediatric blood lead levels using opportunistic testing. Permission to use leftover blood for a lead assay was sought from parents or guardians of 397 children one month to 13 years of age who were admitted to general paediatric wards of John Hunter Hospital, Newcastle, between May and August 1993 and who had blood for a full blood count taken for any reason. Results were reviewed by a medical officer and returned to parents.

Fasting and post-methionine homocyst(e)ine levels in a healthy Australian population.

Background: Plasma homocyst(e)ine (H[e]) is frequently measured in patients with occlusive vascular disease, but levels vary between populations and between laboratories.

Aims: We sought to derive reference values for an Australian population over a wide age range.

Methods: We measured plasma H(e) in the fasting state and after methionine loading in 116 volunteers selected at random from the Hunter districts of the New South Wales electoral roll and in 49 apparently healthy, active subjects recruited from the region's lawn bowling clubs.