Population-based analysis of sociodemographic predictors, health-related quality of life and health service use associated with obstructive sleep apnoea and insomnia in Australia.

Although there is growing recognition of the effects of living with sleep disorders and the important role of primary care in their identification and management, studies indicate that the detection of sleep apnoea (OSA) and insomnia may still be low. This large representative community-based study (n=2977 adults) used logistic regression models to examine predictors of self-reported OSA and current insomnia and linear regression models to examine the association of these sleep conditions with both mental and physical components of health-related quality of life (HRQoL) and health service use. Overall, 5.6% (95% confidence interval (CI) 4.6-6.7) and 6.8% (95% CI 5.7-7.9) of subjects self-reported OSA (using a single-item question) and current insomnia (using two single-item questions) respectively. Many sociodemographic and lifestyle predictors for OSA and insomnia acted in different directions or showed different magnitudes of association. Both disorders had a similar adverse relationship with physical HRQoL, whereas mental HRQoL was more impaired among those with insomnia. Frequent consultations with a doctor were associated with a lower physical HRQoL across these sleep conditions; however, lower mental HRQoL among those frequently visiting a doctor was observed only among individuals with insomnia. The adverse relationship between sleep disorders and physical and mental HRQoL was substantial and should not be underestimated.

Immune thrombocytopenia complicating pulmonary tuberculosis: case report and investigation of mechanisms.

Immune thrombocytopenia and pulmonary tuberculosis presented concurrently in a 20 year old Thai man as a bleeding diathesis. Intravenous immunoglobulin rapidly corrected the thrombocytopenia. Immunofluorescence and immunoblot studies with platelets and mycobacteria showed the presence of platelet surface membrane IgG.

Mycobacterium asiaticum as a potential pulmonary pathogen for humans. A clinical and bacteriologic review of five cases.

Mycobacterium asiaticum was isolated from pulmonary material from 5 persons residing in Queensland, Australia. All patients had repeated positive specimens, but the organism was considered responsible for pulmonary mycobacteriosis in only 2 of them. This is the first report of disease caused by M. asiaticum. Clinical, bacteriologic, and epidemiologic details are presented.

Percutaneous paraquat absorption. An association with cutaneous lesions and respiratory failure.

Striking cutaneous lesions and death owing to respiratory failure occurred in a middle-aged woman eight weeks after initial cutaneous contact with the herbicide paraquat (1,1'dimethyl-4,4'dipyridylium dichloride). While similar changes have been described in animals, to our knowledge, serious morbidity or mortality owing to percutaneous absorption has not been described in man. This case report illustrates the extreme toxicity of this herbicide and demonstrates that lethal quantities of the drug may be absorbed from apparently trivial skin wounds. Stricter precautions, including the mandatory use of protective clothing, should be recommended whenever this material is used.

Effect of sodium ascorbate concentration on the stability of samples for determination of serum folate levels.

Sodium ascorbate can be used as a preservative of patient samples for folate assay when freezing of serum is impractical. To evaluate the effect of sodium ascorbate on folate levels in human serum, it was added to pooled human sera in 1 g/l increments from 0 to 10 g/l serum. Free folate levels remained constant when the sodium ascorbate concentration was 6 g or less per liter of serum. At more than 6 g/l serum, free folate levels decreased. Bound folate levels increased when sodium ascorbate levels were 4 g/l or less, but remained stable at more than 4 g/l. A sodium ascorbate concentration of 5.0 +/- 1 g/l serum provided optimal preservation of folate in patient samples, indicated by obtaining constant values for four days when serum was kept at room temperature.