ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127511.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Equivocal evidence so far does not support a major clinical application of the drug

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127482.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Rural Australia is inadequately served by specialist forensic pathologists; health policy may suffer from the loss of information

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127483.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Experience shows that it's worth waiting for a direct test of this and other inherited diseases

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127484.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Few Australians at risk of developing Huntington's disease made use of the genetic testing procedure of family linkage analysisObjectiveTo assess the demand for genetic testing for Huntington's disease among at‐risk individuals and for prenatal testing among parents at risk of transmitting the disease, from January 1987 to March 1993.MethodsQuestionnaires were sent to all State coordinators of genetic testing services.ResultsOne hundred and ninety adults (5.S% of those at risk) and 56 fetuses were tested. Nine per cent more women than men used the service. Most people tested were married and had offspring. Men generally presented for testing at an older age than women.ConclusionThe low uptake for testing is not surprising given the severity and untreatability of the illness. Careful monitoring is required, particularly of the effects on individuals told of their genetic status and of possible abuse of the information by third parties.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127485.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

Direct testing for the CAG repeat sequence in the Huntington's disease gene is quick, accurate and more acceptable to individuals at risk thank previous methodsObjectiveTo develop an accurate presymptomatic test for Huntington's disease.MethodAn improved polymerase chain reaction method was used to investigate the pattern of expansions of a CAG repeat sequence located in the 5' region of a gene recently found to produce the protein called Huntingtin. We documented the range of trinucleotide repeat expansions in the responsible gene in 82 affected individuals compared with SO control subjects from a Western Australian population.ResultsThe number of expanded repeats ranged from 40 to 73 in affected individuals and from 13 to 38 in normal controls.ConclusionPolymerase chain reaction analysis of a CAG repeat sequence in the Huntington's disease gene clearly differentiated between normal and mutated alleles, providing an accurate diagnostic test for the disorder in individuals at risk. This predictive test has met with greater acceptance and demand than methods using family based linkage studies.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127486.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127512.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo investigate the relationship between motivational fac‐tors and physical and biological causes of heat exhaustion in fun run entrants.Design and settingCase‐control study, The Sun‐Herald City to Surf fun runs in Sydney in 1991 and 1992.ParticipantsThere were 63 732 race entrants who completed the run and received a finishing time; 79 runners with heat exhaustion and 310 age, sex and performance matched controls were enrolled in the study.Main outcome measureA diagnosis of heat exhaustion was made if a runner collapsed and, when first receiving medical care, had a rectal temperature of 38°C or higher.ResultsTwo readily identifiable groups of runners were at high risk of heat exhaustion—accomplished non‐élite (preferred) runners and runners of good ability (Group A). The attack rate was highest among accomplished non‐élite runners, but a combination of a relatively high rate and the large number of entrants in Group A runners accounted for most cases. Four major risk factors for heat exhaustion were identified: motivation to exceed previous performance tar‐gets; failure to drink fluids during the run; failure of trained runners to acclimatise for the race by training in the warmer parts of the day; and previous history of heat exhaustion.ConclusionInformation from this investigation will enable more effective targeting of educational prevention programs in The Sun‐Herald City to Surf fun run and provide baseline data for monitoring the effectiveness of these programs to modify high risk behaviour by participants.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127487.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo investìgate the quality of coronial postmortem examinations performed in rural New South Wales by Government Medical Officers.MethodsWe reviewed 100 cases, examining the history of the case provided by police officers, referral letters from Government Medical Officers and macroscopic reports of the postmortem findings. Tissue specimens received were correlated with histological findings.ResultsOnly 11 cases were adequately recorded. Macroscopic description was poor in 42 cases. Major deficiencies identified included illegible hand written reports, inadequate description of organ systems, incorrect description of pathological findings and incorrect formulation of cause of death. Major diagnostic errors were identified in referred tissue samples in 13 cases —most commonly, mistaking postmortem blood clot for massive pulmonary embolism. Often organs were insufficiently or incorrectly dissected.ConclusionsCoronial postmortem examinations performed by Government Medical Officers in rural New South Wales are generally of a lower standard than should be accepted by the medicolegal community. These examinations should be viewed as specialist procedures and be performed by specialist pathologists only.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127488.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectivesTo determine the change in prevalence of hepatitis B virus infection among “at risk” patients attending the Sydney Sexual Health Centre between 1982 and 1991 and to determine the hepatitis B vaccination status of the 1991 group.Study populationConsecutive patients attending the Centre between 1 July and 31 December 1991 who belonged to at least one of the following risk groups: men who have sex with men (n = 3S1); female prostitutes (n = 124); and injecting drug users (n = 1S3).DesignHepatitis B infection status was assessed on the basis of patient history and blood testing. All patients without a history of hepatitis B infection or vaccination were offered screening for serum markers of hepatitis B infection. Hepatitis B infection status was correlated with age, sex, country of birth, sexual behaviour and injecting drug use and was analysed separately according to risk category.ResultsThe prevalences of any hepatitis B marker were: men who have sex with men 38.2% (61.0% in 1982;P<0.0001); local female pros‐titutes 14.1% (28.8% in 1982;P=0.024); international female prostitutes 58.4%; and injecting drug users 42.0%. Of those in the 1991 sample without a history of hepatitis B infection, 27.6% of men who have sex with men, 27.9% of local female prostitutes, 18.2% of international female prostitutes and 7.1% of injecting drug users were vaccinated.ConclusionsThe significantly lower prevalences of serum markers of hepatitis B infection among men who have sex with men and local female prostitutes when compared with 1982 suggest widespread adoption of safer sexual practices. The high prevalence of chronic hepatitis B infection among international female prostitutes indicates a potentially significant source of sexually transmitted hepatitis B infection in Sydney. The low vaccination rates provide an argument for mass vaccination against hepatitis B.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127489.x

出版商:Wiley    

年代:1994

数据来源: WILEY