ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125859.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125860.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125861.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125862.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125863.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125864.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectivesTo assess patient knowledge about asthma management and to assess the risk of asthma‐associated morbidity in patients admitted to hospital with acute severe asthma.Subjects and settingPatients admitted to Fremantle Hospital with a primary diagnosis of acute severe asthma from July to September 1992.ResultsBronchodilator therapy had been used for more than 12 months by all 25 previously diagnosed asthmatics, with 88% knowing that the drug was a bronchodilator. Corticosteroid therapy had been used by 84% of patients but only 52% of these knew that it was anti‐inflammatory or “preventive” medication. Sixty per cent of patients did not recall seeing National Asthma Campaign advertisements. Twenty‐three patients (88%) were classified as being at high risk of morbidity.ConclusionsThe level of knowledge about asthma management in patients admitted to this hospital is poor. Most patients are at high risk of asthma‐associated morbidity.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125865.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo report a case of significant systemic side effects from an inhaled glucocorticoid at a reported dose in the upper recommended therapeutic range.Clinical featuresA 25‐year‐old white man with asthma treated with inhaled glucocorticoid (beclomethasone 1500 |ig daily), and primary testicular failure with inadequate androgen replacement, was referred with back pain. He was found to have osteoporosis, clinical features of Cushing's syndrome and complete suppression of endogenous adrenocortico‐trophic hormone adrenal function.Intervention and outcomeHe was recommended to receive adequate androgen replacement and to use a spacer device with the inhaled beclomethasone, or to change to budesonide via a Turbuhaler (AB Astra, Sweden).ConclusionsInhaled glucocorticoids should not be regarded as entirely safe, as serious systemic side effects may occur at doses at the upper level of the recommended therapeutic range.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125866.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo review the breast cancers detected in the first three years of the Central Sydney Area Health Service Breast X‐ray Programme, their histopathology and their surgical management within the program.DesignBetween March 1988 and March 1991, women screened in the program who had a suspicious lesion were referred for surgical assessment at the program assessment centre at Rachel Forster Hospital. These women were seen by staff of the assessment centre, including program surgeons, and were then treated at either Rachel Forster Hospital or Royal Prince Alfred Hospital. Features examined include cancer detection, clinical findings, diagnostic techniques, histopathological diagnosis of the lesions and surgical management.ResultsOne hundred and eight cancers were detected in 105 women, with 59% of the cancers impalpable. The benign to malignant ratio was 1.0:1.5. Twenty‐four cancers (22%) were ductal carci‐noma‐in‐situ with or without microinvasion, and 84 (78%) were frankly invasive. Of the 86 axillary dissections, 63 (73%) showed no node involvement on histological examination. At the time of diagnosis, 27% of the women had axillary node involvement proven by axillary dissection. The overall mastectomy rate was 58%. Radiotherapy, chemotherapy and tamoxifen were used in both stage I and stage II disease.ConclusionThe surgical management of cancers reflects similar findings reported in other screening programs. There is an increasing trend towards breast conservation surgery and up to 90% of the women in this study present with favourable prognostic factors for long term survival.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125867.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo examine knowledge, attitudes and practices of South Australian general practitioners (GPs) in relation to screening for colorectal cancer.DesignA descriptive study in which data were collected by means of postal questionnaires.Main outcome measuresUse of screening tests for colorectal cancer, knowledge in relation to colorectal cancer prevention, opinions on organisation and delivery of colorectal cancer screening.ResultsThe response rate to the survey was 66.3%. GPs showed considerable variability in screening practices, particularly for individuals who are at no increased risk of colorectal cancer. Mass screening with the faecal occult blood test (FOBT), particularly if it is centrally coordinated, was not widely endorsed, in contrast with strategies which provide a central role for the GP. On the whole, GPs preferred patient‐initiated, rather than doctor‐initiated, screening. We found a number of knowledge deficits in relation to FOBT screening; many GPs felt they had inadequate training in this area.ConclusionClear and consistent guidelines for colorectal cancer screening are required. Medical education about colorectal cancer should also be addressed.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb125868.x

出版商:Wiley    

年代:1994

数据来源: WILEY