Melioidosis in the Northern Territory of Australia.

Melioidosis is being diagnosed with increasing frequency in the northern part of the Northern Territory, but the mortality rate remains high in the acute septicaemic form of the disease largely because of associated chronic debilitating illnesses. This paper reviews epidemiological and clinical features of human melioidosis in 37 cases seen between 1960 and 1979. Infection with Pseudomonas pseudomallei is most often contracted during the wet season by persons who have regular contact with soil or ground water, probably through pre-existing skin lesions or penetrating wounds and, occasionally, through the genitourinary tract. The clinical features of melioidosis are protean, and definitive diagnosis can only be made by bacterial culture. Certain strongly indicative features, however, may justify vigorous early treatment with antibiotics (tetracycline or doxycycline in some combination with chloramphenicol, kanamycin or trimethoprim/sulphamethoxazole) which can be life-saving in fulminant septicaemic melioidosis. These indicative features are a severely prostrating fever with signs of respiratory tract infection in a patient with a chronic debilitating condition (particularly chronic alcoholism, diabetes mellitus, malnutrition or leprosy), with regular soil contact, and with chronic or recurrent skin lesions or a recent history of a penetrating wound. In subacute or chronic forms of melioidosis, which usually localize in an organ system, the diagnosis is commonly an unexpected bacteriological finding and the prognosis is generally good.

Sarcoidosis in an Australia Aboriginal.

A case of sarcoidosis in a fullblood Aboriginal woman is reported. This condition appears not to have been recognized in Australian Aboriginals hitherto and some implications of this are discussed.

Granuloma inguinale simulating advanced pelvic cancer.

This paper describes a case of multiple disease in an Aboriginal woman. Granuloma inguinale, of unusual severity and extent, which closely simulated advanced pelvic malignant disease, was included. Some problems of the diagnosis are discussed.

Bile salts and calcium absorption.

1. The study of the effect of bile salts on enhancing calcium absorption in the rachitic chick has been extended to bile salts not present in chick bile, e.g. glycine conjugates and bile alcohol sulphates. 2. Bile and bile salts cause an increase in calcium absorption from sparingly soluble calcium hydrogen phosphate when compared with a suspension of calcium hydrogen phosphate in saline. 3. If the bile ducts of normal rats are tied the absorption of calcium from calcium hydrogen phosphate decreases but can be restored by giving bile salts with the calcium salt. 4. Bile salts increase solubility in water of the sparingly soluble calcium salts, phytate and phosphate at pH values between 6 and 8. 5. Bile salts increase the solubility in lipid solvents of calcium in approximately the same proportion as they increase the absorption of calcium from the gut. 6. The physiological role of bile in calcium absorption and its mode of action are discussed.

Bile and the absorption of strontium and iron.

1. Strontium absorption was studied in vivo with loops of ileum in rachitic chicks and found to be increased by vitamin D(3), bile salts and sodium lauryl sulphate. 2. Bile salts and sodium lauryl sulphate rendered strontium soluble in butanol-benzene (1:1, v/v). 3. Bile was not concerned in the absorption of iron in rats from its water-soluble form, ferrous sulphate. 4. Ligation of the bile ducts in rats caused a decrease in the absorption of iron presented as its sparingly soluble phosphate. 5. The effect of bile on cation absorption is discussed.