ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121085.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121086.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121087.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

We report a study of 347 patients with snake bite envenomation in PapuaNew Guinea. The male: female ratio of the victims was 1.6:1 and their mean age was 24.5 years; 26% were children less than 15 years old. In all cases In which the bite site was known (334) the snake had bitten the extremities of the victim, with 71.3% of these bites being on the ankle or below. The patients came from three regions: urban Papua, rural Papua and (mostly rural) New Guinea. Snake bites occurred more frequently during the daytime in all regions, but this pattern was less obvious in New Guinea (P=0.004), reflecting the predominance of the deah adder (Acanthophis antarcticus) in New Guinea and of the taipan (Oxyuranus scutellatus canni) in Papua. Bites were commoner in the rainy season (November to April) in all groups, but this was less noticeable in rural Papua and New Guinea (P=0.004). This may relate to seasonal activities of the rural population. The female:male ratio for patients from rural areas was higher for those 30 years of age and over than for those under 30 (P=0.034), probably reflecting the increased gardening workload of older women. The incidence of envenomation and mortality rates after snake bite in Papua appear to have changed little over 25 years. However, increased relative numbers of taipans seem to be occurring incentral Papua possibly related to the cane toad (Bufo marinus) and deforestation. We calculate the annual incidence of envenomation and the mortality rate per 100 000 to be 81.8 and 4.3, respectively, for rural central Papua, 21.8 and 2.1 for urban central Papua, and 3.0 and less than 1.0 for the Madang region of New Guinea. The importance of a standard management protocol and of improved first aid are emphasised

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121088.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Volatile substance abuse has been reported in the literature over the past 20 years or so, and has apparently increased as countries have become more industrialised. This review attempts to clarify trends in volatile substance abuse, problems associated with this behaviour and possible solutions. Data sources included a Med line Search on volatile substance abuse over the last fiveyears, Commonwealth publications, recent State and Territory in house publications, three research monographs from the National Institute on Drug Abuse (NIDA) and an article library from the author's workplace. Some 250 articles and monographs were identified, reviewed and categorised into sections relating to epidemiology (inclUding mortality), physiological effects and responses to the problem. Articles were used for reference where they reflected the most up‐to‐date information or where they were seen as authoritative statements. While the body of knowledge concerning volatile substance abuse has improved, little progress has been made in finding effective solutions to the problem. The fact that users are typically young and that there is a real risk of sudden death associated with even initial use suggests that continuing research is needed to develop innovative approaches to the problem.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121089.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121090.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectiveThis case report illustrates the threat to life posed by tiger snake venominduced coagulopathy, the importance of first‐ald, precautions with antivenom administration, the dose of antivenom and the necessity to monitor the coagulation status.Case summaryAn 11‐year‐old child was envenomated several times by a tiger snake (Notechis scutatus). Despite administration of three ampoules (9000 units) of tiger snake antivenom, fatal cerebral haemorrhage occurred. Inadequate tirst‐aid had been applied. The bite site was covered with a loose bandage instead of a pressure mmobilisation bandage. In hospital, facilities to monitor coagulation status were unavailable.ConclusionsMore public education is required in first‐aid management of snake envenomation. Frequent monitoring of coagulation status Is necessary to optimise antivenom and coagulation factor therapy.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121091.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

A case of spontaneous perforation of the cervical oesophagus is presented. It appears to be the tenth such case in the worldmedical literature, and the first to be reported from the Southern Hemisphere. The need for awareness of this pathologic entity Is stressed, and cold water polydipsia is suggested as a diagnostic marker.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121092.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Patients with severely impaired left ventricular function are known to have a poor prognosis. We describe a 20‐year‐old man with end‐stage renal failure, on dialysis, with severely impaired left ventricular function which dramatically improved after renal transplantation. This suggests that poor left ventricular function need not preclude renal transplantation and may, in fact, offer an alternative to combined renal and cardiac transplantation.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121093.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

A 19‐year‐old virgin presented with severe menorrhagia and a haemoglobin level of 76 giL as a problem of management. A 5 cm diameter submucous fibroid was identified at hysteroscopy and biopsied but was unable to be removed. The luteinising hormone releasing hormone agonist, buserelin, was used in an attempt to produce symptomatic relief. One week after commencing buserelin therapy, severe menorrhagia occurred and the patient was admitted to hospital with a haemoglobin concentration of 24 giL. Buserelin treatment was continued and no further menstruation occurred over he following year. As the patient was now well, hysteroscopic submucous fibroid resection was contemplated. Due to cervical rigidity in this teenager, a 1 mg gemeprost pessary was inserted into the posterior vaginal fornix three hours before surgery. This allowed an operative hysteroscope to be inserted into the uterus and a fibroid resection to be performed. Menstrual blood loss has been normal for six months after hysteroscopy. A combined medical and surgical approach may avoid hysterectomy in such problem patients.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121094.x

出版商:Wiley    

年代:1991

数据来源: WILEY