Can thyroid stimulating hormone levels by TSH (IRMA) predict relapse of thyrotoxicosis following carbimazole treatment?

Serum thyrotrophin receptor antibody (TRAb) and thyroid stimulating hormone (TSH) (IRMA) levels were measured in 38 patients at one month after the end of a course of carbimazole/T3 therapy for Graves' disease. Despite the increased sensitivity of the IRMA assay a TSH measurement at this stage was found to be of no predictive value, in contrast to estimation of serum TRAb levels which correctly predicted relapse and remission in 90% of patients.     

促甲状腺激素抑制治疗对分化型甲状腺癌患者甲状腺功能的影响

目的观察促甲状腺激素(TSH)抑制治疗对分化型甲状腺癌患者甲状腺功能的影响及抑制肿瘤复发的效果。方法选取2012年1月～2013年6月我院收治的58例分化型甲状腺癌患者为研究对象,按照其病理类型将其分为甲组(乳头状癌)34例与乙组(滤泡状癌)24例,均给予TSH抑制治疗,对比两组患者的治疗效果、甲状腺功能变化情况及预后。结果甲组总有效率为91.18%,乙组总有效率为91.67%,组间比较差异无统计学意义(P0.05);治疗前,两组甲状腺功能各指标比较,差异无统计学意义(P0.05);治疗后两组患者甲状腺功能与治疗前比较,均优于治疗前,差异有统计学意义(P0.05),但两组治疗后数据对比,差异无统计学意义(P0.05)。且两组患者肿瘤复发率、颈部淋巴结转移率、远处转移率比较,差异无统计学意义(P0.05)。结论 TSH抑制治疗对分化型甲状腺癌患者的价值显著,可有效改善患者甲状腺功能及抑制肿瘤复发,临床推广价值高。     

Amyloidosis: a global problem common in Papua New Guinea

The increase in different precursor proteins that have been shown to form amyloid fibrils and the identification of common properties have not yet led to any unifying theory or mechanism for the pathogenesis of amyloidogenesis. Papua New Guinea holds a unique place in the story of amyloidosis and in this article we review the current status of amyloidosis research indicating how this relates to those forms relevant to Papua New Guinea. This review concentrates on secondary reactive amyloid (AA), which is found in the highest frequency in the world in parts of Papua New Guinea, and kuru, in which the amyloid protein itself is infectious. The history, pathogenesis and future prospects for these diseases are discussed in the light of what is known about other forms of amyloidosis.     

Tropical arthritis in Papua New Guinea: a reactive arthritis

An idiopathic, asymmetrical oligoarthritis affecting young adults is prevalent in the tropical regions of Africa, Asia and Melanesia. A serological study was undertaken in 23 consecutive patients with polyarthritis. Each patient was assigned two paired control subjects. A standardized history, physical examination and investigations were performed. Acute and convalescent sera were examined for evidence of recent infection. The presence of HLA-B27 was determined. Twelve (52%) of the 23 patients had more than one of the clinical features of a reactive arthritis. No serological evidence was found of acute infection with viruses (arboviruses, enteroviruses, mumps, rubella, adenoviruses, Epstein-Barr virus and hepatitis B), Chlamydia, Mycoplasma, Yersinia or syphilis. HLA-B27 was found in 14 (61%) of the 23 patients in contrast with in seven (17%) of the 41 control subjects (P less than 0.001). In two patients with HLA-B27, diagnostic titres of antibodies to Campylobacter jejuni-Campylobacter coli indicated recent infection. The presence of HLA-B27 antigen was significantly (P less than 0.05) associated with the presence of the clinical features of reactive arthritis. This study suggests that "tropical arthritis" commonly is a reactive arthritis that is associated with the presence of HLA-B27.     

The monitoring of foodhandlers in Papua New Guinea

In early 1987 guidelines were re-enforced for pre-employment medicals and 6-monthly health checks on foodhandlers in the Ok Tedi mining project in Papua New Guinea. The health monitoring program was stepped up as a result of two typhoid cases imported from the highlands and catering subcontractors failing to comply with the necessary pre-placement medicals for foodhandlers. Highlanders made up 28% (49/174) of the Ok Tedi catering department's workforce in 1987. The initial screen of 155 foodhandlers and 85 non-foodhandlers in February 1987 showed 6-7% of each group asymptomatically harbouring Salmonella spp. or Shigella spp. A second survey of 160 foodhandlers in August, including private fast-food establishments, detected only one Shigella boydii infection at a local fast-food-takeaway shop. Salmonella typhi was not detected in foodhandlers but was isolated from two non-foodhandlers recently returned from the highlands; in one case this resulted in a contact becoming infected at Tabubil. Infected persons were treated accordingly and foodhandlers were relieved of catering duties until follow-up cultures proved negative. Helminth infections were detected in 38% (309/811) of the stool samples examined. The low prevalence of Ascaris lumbricoides (2.5%) and Trichuris trichiura (1.1%) acquired locally, and a significant difference compared with outside groups supports the view that these species have recently been introduced to the North Fly (Ok Tedi) region. The majority of all Ascaris and Trichuris infections detected (61% and 73%, respectively) were found in highlanders, infection rates ranging from 3 to 15% depending on province of origin. Infections were treated accordingly to prevent possible transmission via food.(ABSTRACT TRUNCATED AT 250 WORDS)     

促甲状腺激素、甲状腺球蛋白抗体对甲状腺结节良、恶性的评估

目的 分析促甲状腺激素和甲状腺球蛋白抗体对甲状腺结节良恶性的判断价值.方法 整群选取2012年1月—2015年3月经该院病理切片确诊的23例甲状腺恶性结节(恶性组)、25例甲状腺良性结节(良性组)及健康志愿者20例(对照组)作为研究对象. 记录和比较所有研究对象进行促甲状腺激素、甲状腺球蛋白抗体水平及异常比例. 结果 恶性组促甲状腺激素[(3.46±1.23)vs(2.35±1.08)]和甲状腺球蛋白抗体[(135.43±49.46)vs(83.62±28.69)]水平高于良性组,差异有统计学意义(P<0.05);但两组2指标定性比较差异无统计学意义(P>0.05). 结论 促甲状腺激素、甲状腺球蛋白抗体在甲状腺良、恶性结节的确存在差异,但不宜采用人体正常参考值作为分别甲状腺良、恶性结节的标准.     

Isolation of Haemophilus ducreyi from a chancroid in Papua New Guinea

Haemophilus ducreyi was isolated from a patient who presented with a genital ulcer at the Port Moresby Clinic for Sexually Transmitted Diseases. This provides documentation for the occurrence of chancroid in Papua New Guinea. The differentiation of this disease from donovanosis is discussed.     

Improving immunisation: coverage in a province in Papua New Guinea

The effect on immunisation coverage of applying guiding principles to the management of primary health care services in a province in Papua New Guinea is described. These principles were: (a) Each health centre should have a defined geographical area of responsibility. (b) Each health centre should be responsible for a defined population. (c) Each health centre should have defined target groups for immunisation and child health clinic enrollment. (d) An accurate and meaningful reporting system is essential. (e) Each health centre should receive regular feedback on its achievements. Immunisation coverage in the province, as judged by the proportion of children under 1 year of age receiving their second dose of triple antigen, improved from 57-67% in 1980-2 to 89-94% in 1983-4. Immunisation is the most cost effective preventive activity undertaken in child health care. The application of these guiding principles would be relevant in the United Kingdom.     

Twenty-five years of medical graduates in Papua New Guinea

1989 is the 25th anniversary of the first doctors trained in Papua New Guinea at the Papuan Medical College (PMC). By the end of 1970 PMC had produced 44 doctors. The following year it became the Medical Faculty of the University of Papua New Guinea (UPNG), which had graduated 318 doctors by February 1989. National doctors now make up approximately two-thirds of the total number of doctors in the country. The largest category of national doctors includes those working with the Health Department, but not at headquarters or specialist medical officer (SMO) level. Private practitioners constitute the second largest category, with almost one-fifth of fully registered national doctors. While postgraduate training programs have been established for clinical and public health specialists, vocational training for general practitioners has been mainly ignored. Private practitioners represent a considerable, and growing, manpower resource in urban areas, and ways need to be found to utilize their services in the public sector. 20% of national private practitioners have the M. Med. degree and 24% of those with the M. Med. are currently in private practice. Medical graduates from PMC and UPNG have a good record in postgraduate education: 37 have passed the M. Med., 62 have obtained a postgraduate medical diploma from UPNG and many have obtained overseas postgraduate diplomas and degrees. It is projected that 80% of SMOs will be national doctors within five years. An increased intake of national medical students into the Medical Faculty is needed now if most doctors in the country are to be nationals by the year 2000.