ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126023.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo examine the pattern and incidence of sepsis occurring in neonatal units in Australia.DesignA one‐year prospective study of babies with systemic sepsis within 48 hours of birth (early‐onset sepsis) or after this time (late‐onset sepsis) in seven Australian neonatal units. Systemic sepsis was defined as clinical sepsis, plus either positive bacterial or fungal culture of blood and/or cerebrospinal fluid, or group B streptococcal antigen detected in the urine.ResultsThere were 241 episodes of sepsis, affecting 234 babies. One quarter (61) were early‐onset, a rate of 2.2 per 1000 live births. Group B streptococcus (GBS) was the commonest cause of early‐onset sepsis, with a rate of 1.3 per 1000 live births. The incidence of early‐onset GBS sepsis was lower at a hospital which screened for maternal carriage and used intrapartum antibiotic prophylaxis for all carriers. The rate of late‐onset sepsis was 4.4 per 1000 live births and coagulase‐negative staphylococci were the commonest cause. Meningitis occurred in 23% of babies with early‐onset and in 10% with late‐onset sepsis. The mortality from early‐onset sepsis was 15%, and from late‐onset sepsis was 9%. There were no major regional variations, other than for GBS.ConclusionsThe incidence of and mortality from neonatal sepsis is comparable to other countries, and shows no major regional varia‐tion. The use of intrapartum antibiotics may reduce the incidence of neonatal GBS sepsis. There are no previous comparable data on neonatal infections in Australia.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126024.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo describe our initial experience with transcatheter radiofrequency ablation as a day stay procedure for patients with supraventricular tachyarrhythmias resulting from aberrant atrioventricular pathways.DesignProspective study of the first 50 patients at the Royal Perth Hospital whom we intended to treat and discharge on the same day. Patients underwent a combined electrophysiological study and radiofrequency ablation.ResultsAccessory pathways were identified in 32 patients (successfully ablated in 30) and dual atrio‐ventricular nodal pathways in 18 patients (with successful ablation of the slow pathway in 17). Thirty‐eight patients were discharged on the same day (24 treated for accessory pathways, and 14 treated for dual atrioventricular nodal pathways). There were no late complications or r$eAadmissions in patients discharged on the same day.ConclusionsIn patients with supraventricular tachyarrhythmia, day stay transcatheter ablation can be planned without a definitive prior diagnosis of the physiological cause. Complications or other reasons for overnight admission are apparent at completion of the procedure.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126025.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo determine the efficacy of pravastatin in the treatment of primary hypercholesterolaemia in patients being treated with captopril for hypertension.DesignA double‐blind parallel group study comparing 12 weeks of pravastatin therapy (20‐40 mg/day) with placebo.Participants25 patients (age, 37‐73 years) with mild‐to‐moderate hypertension and hypercholesterol‐aemia (total cholesterol level, 5.5‐8.8 mmol/L).ResultsPravastatin reduced total cholesterol levels by 22% (from 7.1± 0.29 [SEM] to 5.5± 0.25mmol/L;P<0.001) and low‐density‐lipopro‐tein cholesterol levels by 32% (from 5.0 ±0.32 to 3.4 ± 0.28 mmol/L;P<0.001) in four weeks and these levels were maintained for the 12 weeks of therapy. Pre‐pravastatin values returned three weeks after stopping therapy. Levels of total cholesterol, cholesterol fractions and triglycerides remained constant or deteriorated in the placebo group. Pravastatin therapy was well tolerated. An integrated coronary risk score showed a 40% reduction in risk.ConclusionThis study indicates that pravastatin (combined with captopril) is an effective cholesterol‐lowering drug, but that treatment needs to be maintained.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126026.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo assess the incidence of local and systemic infection caused by central venous catheters in a general hospital population.SettingConcord Repatriation General Hospital, Sydney, April to August 1991 inclusive.DesignA prospective survey of all patients with in situ central venous catheters. Systemic catheter‐related infection was detected by blood and routine catheter tip culture, and local infection by clinical observation of the catheter exit site.Outcome measuresLocal and systemic infection and complications.Results479 central venous catheters were surveyed in 311 patients. Local infection developed in association with 54 catheters (11%) and systemic infection with 32 (6.7%). Local infection was predictive of systemic infection, but its absence did not exclude systemic infection. Haemodialysis catheters were responsible for a higher systemic infection rate than other catheter types, the most common organism responsible being methi‐cillin‐resistantStaphylococcus aureus.Twenty per cent of all bac‐teraemias (33/160) detected in the hospital occurred in patients with a central venous catheter and 24 of these (73%) were definitely or probably due to the catheter. Staphylococci were the predominant isolates and 40% of the methicillin‐resistantS. aureusbacteraemias detected were due to catheter‐related infection. Infection complications were few: three patients developed local abscesses; one endocarditis; and two died.ConclusionsCentral venous catheter‐related infection is com‐mon in general hospital populations. Staphylococcal bacteraemia and local infection in a patient with a central venous catheter are strongly suggestive of catheter‐related systemic infection. Empirical antibiotic treatment should include at least antistaphylococcal cover.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126027.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126028.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126029.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

For more than 70% of patients with diarrhoea, investigation can reveal a cause, which should be treated specifically whenever possible. Symptomatic treatment can be a useful adjunct or a mainstay if no cause can be found. Drug selection and doses are similar to those for younger age groups, but drug interactions and side effects, and dose adjustment because of renal failure, are more likely in the elderly.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126030.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126031.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126034.x

出版商:Wiley    

年代:1995

数据来源: WILEY