The Medical journal of Australia
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Comparative Study
Viral hepatitis: a four-year hospital and general-practice study in Sydney. 2. Transmission of viral hepatitis among residential contacts in Sydney.
Clinical and serological study of household contacts of index patients suffering from acute viral hepatitis showed the high infectivity of hepatitis A viral (HAV) for susceptible contacts. The anti-HAV specific IgM developed in sera of 67% of susceptible children and 31% of susceptible adult contacts. Of 81 susceptible contacts whose sera became anti-HAV positive, 28.4% developed clinically overt hepatitis. ⋯ Of 25 susceptible contacts whose sera became HBV-marker positive, 24% developed clinical illness. Transmission occurred probably both by parenteral and non-parenteral means. It is currently not possible to determine susceptibility or seroconversion to hepatitis non-A non-B agents.
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A patient with rheumatoid arthritis developed an infection in the right hand after she administered an antibiotic capsule to her cat. Two weeks after this, septic arthritis developed in her right knee. The organism isolated was Pasteurella multocida, which is part of the feline normal oral flora. The infection was treated with penicillin and drainage.
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Ninety-one patients (56 men) were admitted with bleeding oesophageal varices on 132 occasions from 1972 to 1980 to the haematemesis and melaena unit of Prince Henry's Hospital, Melbourne. For 73 patients, alcoholic liver disease was the cause of portal hypertension. The management protocol for varices included early endoscopy, medical-surgical liaison, balloon tamponade for continued bleeding and strict criteria for surgery. ⋯ The mean transfusion requirement was 9.7 units per admission. Balloon tamponade was necessary on 103 occasions and failed to control bleeding on six of them. The results suggest that mortality from bleeding oesophageal varices can be reduced by a protocol which includes early endoscopy, intensive care, balloon tamponade, close medical-surgical liaison and portacaval shunt for recurrent bleeding in "good' risk patients.