ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139561.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139562.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139563.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139564.x

出版商:Wiley    

年代:1988

数据来源: WILEY

摘要:

We report here data on 1510 pregnancies that resulted from in‐vitro fertilization in 12 in‐vitro fertilization units in Australia and in one unit in New Zealand in the period 1979 to 1985. Live births occurred in 57.5% of all pregnancies (including preclinical abortions) and in 69.0% of clinical pregnancies. There was a high incidence of ectopic pregnancies (5.2% of clinical pregnancies) and spontaneous abortions (24.3% of intrauterine pregnancies). Of 902 viable pregnancies, 202 (22.4%) pregnancies resulted in multiple births. There were 700 infants who were born after singleton births and 438 infants who were born after multiple births. The over‐all incidence of preterm delivery was 27.0%, with an incidence of 18.5% of singleton pregnancies. Low birth weight occurred in 34.8% of infants. The perinatal death rate was 47.5 deaths per 1000 births; still births accounted for three‐quarters of these deaths. These findings can be used to counsel infertile couples about the risks of reproductive losses after treatment by in‐vitro fertilization. National health surveys should include questions that relate to the prevalence of infertility to encourage studies of the prevention of infertility and to assess the requirements for clinical services.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139565.x

出版商:Wiley    

年代:1988

数据来源: WILEY

摘要:

Thirty‐eight children received 41 living‐donor kidney transplants in an 11‐year period; 73% of the grafts are functioning well. The parents of the recipients were the usual donors (60% of the donors were mothers and 25% of the donors were fathers); however, there were five donations from siblings and one donation from a donor who was related emotionally to the recipient. The most frequent perioperative complications were respiratory but these were not serious and did not cause any long‐term sequelae. The principal long‐term complications that related to — or were perceived by the donor as being related to — the procedure were incisional pain (20% of donors) and depression (25% of donors). These were not related to the success or otherwise of the transplantation. At follow‐up, five (12%) donors had diastolic blood pressure levels of greater than 90 mmHg or were receiving antihypertensive therapy; this prevalence is similar to that which is found in the community. Two donors had urinary protein excretion rates of greater than 200 mg/24 h (210 mg/24 h and 350 mg/24 h, respectively). Creatinine clearance rates fell by 15% in women and by 5% in men. Serum creatinine levels had risen by 40% in men and by 35% in women after the nephrectomy; these levels had changed little at follow‐up. All donors said that they would have proceeded with the donation even with foreknowledge of what they would experience during and after the donation. Living‐donor renal transplantation is a procedure with very low but definite operative risks which nevertheless provides a means for the early effective replacement of renal function in children with growth potential. The donors are enabled to make a major contribution to the life and well‐being of the child, and they regard the perioperative complications as minimal. There do not appear to be any serious long‐term complications of renal donation.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139566.x

出版商:Wiley    

年代:1988

数据来源: WILEY

摘要:

The performance of the Hudson Multi‐Vent oxygen mask was assessed by attaching it to a model of a head and generating varying inspiratory flows of oxygen through the mouth and nasal orifices. The oxygen concentration that was delivered by the mask varied with the inspiratory flow rate at all oxygen concentrations. This effect was proportionately similar at all levels of set oxygen concentration: about 50% of the increment of inspired oxygen was lost as the inspiratory flow rate increased from 20 L/min to 100 L/min. The performance of the mask was not affected by the route (oral or nasal) of inspiratory flow. Rotation of the mask in the coronal plane produced marked changes in delivered oxygen concentration; with the oxygen concentration set at 50%, and the inspiratory flow rate at 40 L/min, the delivered oxygen concentration was 45% when the mask was parallel to the coronal plane of the model, was 41% when it was angled 10° towards the face, and was 27% when it was angled 10° away from the face. The measurement of oxygen concentrations at different points inside the mask confirmed that the oxygen‐enriched gas is directed in a localized stream in the centre of the mask, and that air is entrained through the large ports that are sited at the sides of the mask to satisfy inspiratory flow. The measurement of inspired oxygen concentrations in 12 hospital inpatients confirmed that the model reflected accurately the performance of the mask when used in a routine way. We conclude that, in clinical use, the Hudson Multi‐Vent mask is unlikely to deliver the set oxygen concentration, and that the delivered oxygen concentration is net predictable.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139567.x

出版商:Wiley    

年代:1988

数据来源: WILEY

摘要:

The accuracy and validity of diagnoses of skin cancer that were made by experienced dermatologists in a Queensland community survey have been investigated. Histological examination confirmed 54% of 100 clinical diagnoses of basal‐cell carcinoma, squamous‐cell carcinoma or intraepidermal carcinoma. Clinical accuracy was higher for basal‐cell carcinoma (59%) than for squamous‐cell carcinoma (39%) or intraepidermal carcinoma (38%). Such levels of diagnostic accuracy are to be expected when an unselected population is surveyed because of the relatively low prevalence of skin cancer compared with that in the patient population of a specialist practice. This reduction in diagnostic accuracy is unrelated to clinical skills, and should be borne in mind when conducting any skin‐cancer screening programme in the general community.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139568.x

出版商:Wiley    

年代:1988

数据来源: WILEY

摘要:

The aim of this study was to evaluate the various treatment options, including radiotherapy, surgery and chemotherapy, when all patients with carcinoma of the oesophagus were assessed and managed by the same team. From December 1, 1979 to December 31, 1985, 144 patients with carcinoma of the oesophagus were referred to Westmead Hospital. Eighty‐five patients were men, 59 patients were women and the median age was 63 years. Twenty‐five patients were at stage I, 75 patients were at stage II, 24 patients were at stage III and 20 patients were at stage IV of oesophageal cancer. Forty‐two patients underwent surgical resection. Fifty patients underwent radical radiotherapy, 30 patients underwent palliative radiotherapy and 22 patients underwent palliative intubation. The operative mortality of those patients who underwent surgery was zero. The treatment mortality of those who underwent radical radiotherapy was 6%, and for those who underwent palliative radiotherapy, was 16.7%. The mortality after intubation was 12.5%. The prevalence of benign strictures was 7.5% after surgery, 33% after radical radiotherapy and 8% after palliative radiotherapy. The prevalence of malignant strictures (recurrent disease) was 2.5% after surgery, 21% after radical radiotherapy and 20% after palliative radiotherapy. The median survival after surgery was 12 months; that after radical radiotherapy, 12 months; that after palliative radiotherapy, six months; and that after intubation, 3.5 months. Where all patients with carcinoma of the oesophagus were managed by a team approach the treatment mortality was low but the long‐term survival remained poor.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139569.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb139570.x

出版商:Wiley    

年代:1988

数据来源: WILEY