ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142289.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142290.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142291.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To determine the knowledge and attitudes of adolescents with respect to reproductive health, with particular emphasis on their knowledge of the symptoms and transmission of sexually transmitted diseases (STDs), preventive strategies and sources of information.Design:Questionnaire survey of a stratified random sample of Year 10 students followed by group interviews with volunteers from the sample.Setting:The study was carried out in 33 Victorian secondary schools.Participants:The questionnaire was administered to a stratified random sample of 1351 Year 10 students. Group interviews were conducted with 533 volunteers from the sample.Measurements and main results:Considerable gaps were identified in knowledge of STDs and their short‐term and long‐term effects on reproductive health. An STD Knowledge Score was constructed based on responses to 46 items. The mean score for the full sample was 22.7 (49.3% correct) with a standard deviation of 6.4. As a group, country students scored better than city students (mean, 23.8 v. 22.2,t= 3.97,P<0.001) and females better than males (mean, 23.5 v. 21.9,t= 4.21,P<0.001). Medical practitioners were rarely identified as a source of preventive advice.Conclusion:The deficiencies identified in knowledge about reproductive health suggest that young people need better access to health information. Schools and the medical profession need to work together both to provide information and to help young people develop the confidence to use available information sources.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142292.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:We tested the hypothesis that there is no difference in the change in serum creatinine level following computed tomography (CT) between those given high osmolality contrast, low osmolality contrast and those not receiving contrast material.Design:Patients were assigned according to current radiological practice to receive one or other type of radiocontrast material or to have a scan without intravenous contrast (plain scan).Setting:The CT unit of Royal Newcastle Hospital, a tertiary referral institution.Patients:Of 3188 inpatients having a CT scan between June 1988 and December 1989, 1041 patients were eligible (having a first scan in “office hours” outside holiday periods, not due for imminent discharge, aged 18 years or more and not presenting to the Intensive Care Unit or with acute trauma). Twenty‐five patients were excluded as baseline measures of renal function were missing and 132 subjects were lost to follow‐up, leaving 884 study subjects.Interventions:CT scans using high osmolality, low osmolality or no contrast (plain scan).Main outcome measure:Renal impairment as defined by a maximal increase in the serum creatinine level of ≥50% or>0.04 mmol/L from the baseline level on at least one of the subsequent four days.Results:Renal impairment was seen in 4% (12 of 292), 12% (23 of 187) and 4% (16 of 405) of patients given high osmolality, low osmolality or no contrast respectively. Age and the baseline level of serum creatinine were independent predictors of the development of renal impairment (P=0.04 and 0.02 respectively) and those given low osmolality contrast were 3.2 times (95% confidence interval, 1.6–6.3) more likely to develop renal impairment than those given no contrast. There was no excess risk with the use of high osmolality contrast compared to no contrast (odds ratio, 1.06; 95% confidence interval, 0.5–2.3). Selection factors (sicker patients being given low osmolality contrast) are likely to have accounted for the excess risk in the low osmolality group as mortality in hospital was higher in this group than in the others. The 51 patients who developed renal impairment (cases) were matched for age, sex, type of contrast and pre‐existing renal impairment with up to three controls (150 patients in total). Cases were more likely to have had a blood transfusion (odds ratio, 6.40; 95% confidence interval, 2.18–22.63) or surgery (odds ratio, 3.22; 95% confidence interval, 1.19–7.65) than controls.Conclusions:Confounding by other factors which impair renal function is likely to explain previous suggestions of an effect of radiocontrast material on renal function. There does not appear to be a risk of renal impairment from the use of high osmolality radiocontrast material (although a small effect or an effect in particular subgroups cannot be excluded by our study). Fear of causing or exacerbating renal damage should not be a reason to use low osmolality contrast material, nor should it be a reason for withholding contrast studies.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142293.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To determine the recent pattern of use of hypolipidaemic drugs in the Australian community.Design:Drug utilisation study employing prescription data collected during the operation of the Australian Pharmaceutical Benefits Scheme (PBS).Setting:Non‐hospital drug use in Australia.Patients:All patients, pensioners and non‐pensioners, who received prescriptions for hypolipidaemic agents under the PBS between January 1987 and December 1989.Main outcome measures:The total number of prescriptions, average quantity dispensed with each prescription, defined daily doses (DDD) and Australian population figures for pensioners and non‐pensioners were used to express the consumption of hypolipidaemic agents as DDD/1000 individuals/day.Results:Between the March quarter 1987 and the December quarter 1989 prescribing of hypolipidaemics for the Australian community increased from 68 120 to 304 760 prescriptions per quarter, which translates to a rise in use from 1.2 to 5.2 DDD/1000 inhabitants/day. This included a rise in the use of clofibrate from 0.6 to 2.6 DDD/1000 inhabitants/day, and of cholestyramine from 0.6 to 1.9 DDD/1000 inhabitants/day. Prescribing of hypolipidaemics for pensioners increased from 29 569 to 123 440 prescriptions per quarter. This translated into a rise in use from 3.7 to 14.8 DDD/1000 pensioners/day. Notable rises were seen for clofibrate, 1.9 to 8.1 DDD/1000 pensioners/day, and cholestyramine, 1.6 to 4.7 DDD/1000 pensioners/day. In comparison published data from the Nordic countries and the United States showed a lower overall use of hypolipidaemics and declining consumption of clofibrate.Conclusions:The trend in Australia was unusual in that the use of clofibrate increased to a greater‐extent than that of the resins, cholestyramine and colestipol which are generally preferred for treatment of hyper‐cholesterolaemia. Possible reasons for this include: the better tolerability of clofibrate; its readier availability during the study period; the recommendation by the Pharmaceutical Benefits Advisory Committee that clofibrate was the preferred drug when triglyceride levels were also elevated and the limited availability of newer hypolipldaemic agents.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142294.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To outline recently described movement disorders during sleep which are common and poorly recognised.Data sources:Computer‐based literature search up to July 1990 (with the index terms sleep disorders, sleep myoclonus, nocturnal myoclonus, periodic movements in sleep, REM behaviour disorder and parasomnias) supplemented by a manual search through the references of papers obtained by computer search and a manual search through contents of the following journals:Sleep, Sleep Research, NeurologyandBrain.Data synthesis and conclusion:There is a group of common and poorly recognised movement disorders during sleep. The patient usually presents complaining of disturbed sleep, daytime somnolence and abnormal nocturnal behaviour. These conditions are susceptible to precise diagnosis and effective treatment.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142295.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

It's what you learn after you know it all that counts.John Wooden

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142296.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To suggest interim therapeutic guidelines for stroke following truncal herpes zoster on the basis of the first reported Australian case, in a patient who showed good clinical response related temporally to antiviral therapy.Clinical features:A 70‐year‐old patient with no known underlying immune disorder presented with left‐sided hemiplegia one week after right‐sided truncal herpes zoster. In all probability the neurological deficit was due to large artery vasculopathy with thrombosis.Intervention and outcome:Clinical improvement (not to pre‐morbid levels) was noted soon after commencement of antiviral therapy with acyclovir.Conclusion:Stroke following herpes zoster may be a treatable condition. In view of the previously described occurrence of viral antigen within the walls of intracerebral vessels, the occasional progression of the syndrome over months, the generally low toxicity of acyclovir and the clinical response of the few patients treated with antiviral agents to date, early antiviral therapy in patients presenting with delayed contralateral hemiplegia associated with herpes zoster is recommended as prudent.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142297.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142298.x

出版商:Wiley    

年代:1991

数据来源: WILEY