ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142220.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142221.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142222.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142223.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To determine hospital‐based morbidity and mortality from bacterial infections among Aboriginal people with diabetes in central Australia.Design:Examination of medical records on diabetic inpatients between January 1984 and December 1986.Setting:Alice Springs Hospital in central Australia, covering an Aboriginal population of about 12 500 people.Patients:Subjects admitted with a bacterial infection (n=165) were selected from the database of all Aboriginal people known to have diabetes in the region (n= 374; all had non‐insulin dependent diabetes).Main outcome measures:Number of admissions, type and site of infections, causative organisms, duration of hospital stay and cause of death.Results:The 281 admissions for infections accounted for 4.6% of adult Aboriginal admissions to hospital. Thirteen patients died. Eleven patients required amputation of a digit or limb. In 1986, 13/200 patients admitted with diabetes had bacteraemia compared with 14/1885 patients who did not have diabetes. One patient had Fournier's gangrene, one had malignant otitis externa, one community acquiredAcinetobacterpneumonia, one pneumonia withSuccinivibriospp. found in blood cultures, and one meningitis and transverse myelopathy withStreptococcus millerifound in blood cultures.Conclusions:The frequency, type and severity of infections in the relatively young patients result in high personal costs to the community and financial costs to the health care system. Standard preventive measures must be implemented to control severe bacterial infections among subjects with diabetes in this socially and economically marginalised population group.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142224.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To study the distribution of blood cholesterol concentration in a sample of Western Australian schoolchildren.Design:The Reflotron dry‐chemistry system (Boehringer Mannheim, Germany) was used to measure cholesterol in finger‐prick blood samples obtained from Year 6 children aged 10–12 years attending government schools in metropolitan Perth. Recruitment methods ensured that children from different socioeconomic strata were represented.Participants:For the 1239 children enrolled in Year 6 in 30 government schools, parental consent to participate was obtained for 1144; of these cholesterol concentration was measured in 1112.Results:The measurement method proved practicable and was generally well accepted. Cholesterol levels were somewhat lower than those obtained using a laboratory reference method and a bias, relative to national quality assurance standards, was estimated to be ‐0.32 mmol/L. Mean cholesterol level in boys (4.28 mmol/L, SD 0.69) was not significantly different from that in girls (4.35 mmol/L, SD 0.72). Allowing for measurement bias, 52% of boys and 57% of girls had cholesterol levels exceeding the National Heart Foundation's designated “desirable” level of 4.5 mmol/L for children.Conclusions:The distribution of cholesterol levels in Australian children compares unfavourably with distributions in children in countries with low rates of cardiovascular disease and indicates a need for widespread, appropriate diet and lifestyle changes.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142225.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objectives:To construct the social, neurological and neuropsychological profiles of patients with suspected alcohol related brain damage, and to test the hypothesis that cognitive dysfunction develops in alcoholics before signs of alcohol related neurological disease.Design:The study design comprised: a retrospective analysis of patients’ records; a comparison of patients’ demographic and social variables with age‐matched population data from the 1986 Census; and a comparison of neuropsychological test scores of male patients with suspected alcohol related brain damage and age‐matched controls.Setting:The Neuropsychology Unit of Royal Prince Alfred Hospital, a tertiary referral teaching hospital.Participants:All patients (n= 641) referred to the Neuropsychology Unit for assessment of suspected alcohol related brain damage from July 1, 1987 to June 30, 1989, and a control group (n= 93) consisting of healthy volunteers who drank no more than 40 g of alcohol per day.Results:Of the patients, 515 (80%) were men and 410 (64%) were 55 years or younger; their median daily alcohol consumption was 180 g. Compared with the general population the patients were significantly more likely to be in receipt of social security payments, to be separated, divorced or widowed and living in rented or temporary accommodation. However, the proportion of professional and skilled individuals was the same as in the general population. Cerebellar degeneration (38%), peripheral neuropathy (34%) and ?seizures (14%) were the most frequent neurological disorders. Frontal lobe dysfunction (58%) and short‐term memory loss (32%) were the most frequent cognitive abnormalities. Dementia was relatively uncommon (4oAl). The mean age of male patients with alcohol related brain damage but no neurological disorders (43 years) was significantly less than the mean age of those with neurological disease (54 years;P<0.001). In the former, neuropsychological tests of frontal lobe function showed significant impairment compared with control subjects (P<0.001), despite normal intelligence.Conclusions:Cognitive impairment in alcoholics frequently takes the form of frontal lobe dysfunction and may be relatively subtle, requiring a neuropsychological examination for diagnosis. Signs of cognitive impairment may precede those of alcohol related neurological disorders by more than ten years.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142226.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To determine if personality and coping style are central determinants of drinking and smoking at risk to fetal health during pregnancy.Design, setting and participants:A sample of 99 women recently confined at a Sydney obstetric hospital received a semi‐structured interview and completed a number of questionnaires.Measures:Alcohol and cigarette consumption over designated intervals since conception were assessed by interview. Questionnaires assessed maternal anxiety and postnatal depression, as well as coping strategies and personality characteristics such as impulsiveness.Results:After confirmation of pregnancy, two‐thirds of those previously drinking ceased while only one‐third of those who had been smokers then abstained, with intake levels showing a similar pattern of a relatively greater decrease in alcohol than cigarette consumption over the course of the pregnancy. Personality and coping style differences were not demonstrated between the following contrasting groups: (a) smokers v. non‐smokers prior to confirmation of pregnancy; (b) on‐going drinkers v. relative abstainers during pregnancy; and (c) excessive smokers and drinkers before pregnancy v. all other subjects. Comparison of drinkers and non‐drinkers before pregnancy suggested less “mature” coping styles for the latter, an unexpected finding.Conclusion:There was little support for the hypothesis that drinking and smoking at risk to health (before and during pregnancy) are determined by the individual's personality and general coping repertoires.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142227.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective:To review the clinical features, operative details and course of adults with persistent ductus arteriosus.Design:Retrospective study. Information on subjects was obtained by case records review.Setting:The Cardiothoracic Unit, Royal Prince Alfred Hospital, Sydney.Patients:Twenty‐five adults aged 16 years and over with persistent ductus arteriosus, from 1974–1990.Intervention:Surgical division or ligation of persistent ductus, via left thoracotomy or median sternotomy.Main outcome measures:Preoperative clinical features; postoperative mortality and morbidity.Results:There was a high incidence of symptoms in this group of adults with persistent ductus arteriosus, many having anatomical (aneurysm, calcification) and/or haemodynamic (heart failure, pulmonary hypertension) complications. There was one death (mortality, 4%) of a young woman with significant preoperative pulmonary hypertension. The remaining 24 patients (96%) left hospital completely well between 4 and 12 days after surgery.Conclusions:Persistent ductus arteriosus, although primarily a paediatric problem, may present in adulthood. Closure by operative means (or in selected cases, by interventional catheter) is warranted in all adult subjects with left to right shunt, other than for patients over 60 years of age with neither heart failure nor cardiomegaly.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142228.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb142229.x

出版商:Wiley    

年代:1991

数据来源: WILEY