ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122006.x

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Questions remain about virus transmission, the natural history of infection and the role of interferon in management

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122007.x

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Meta‐analyses validate the NHMRC recommendations on responsible drinking

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122008.x

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Further studies are required before claims can be made of a beneficial effect of oily fish consumption on asthma

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122009.x

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

ObjectiveTo investigate the association between diet and airway disease in children in the light of epidemiological studies suggesting that consumption of fish more than once a week reduces the risk of developing airway hyperresponsiveness (AHR).DesignDiet was assessed by a detailed food frequency questionnaire and airway disease by respiratory symptoms or airway responsiveness to exercise.MethodsA questionnaire, containing questions about the frequency of eating more than 200 foods, was sent to the parents of 574 children in whom we had measured recent wheeze (by questionnaire), AHR (by exercise) and atopy (by skin prick tests) six months before this study. We defined current asthma as the presence of both recent wheeze and AHR.ResultsResponse rate to the questionnaire was 81.5% (n=468). After adjusting for confounders such as sex, ethnicity, country of birth, atopy, respiratory infection in the first two years of life and a parental history of asthma or smoking, children who ate fresh, oily fish (>2% fat) had a significantly reduced risk of current asthma (odds ratio, 0.26; 95% confidence interval, 0.09–0.72;P<0.01). No other food groups or nutrients were significantly associated with either an increased or reduced risk of current asthma.ConclusionThese data suggest that consumption of oily fish may protect against asthma in childhood.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122010.x

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

ObjectiveTo compare the National Health and Medical Research Council (NHMRC) recommendations on responsible, hazardous and harmful alcohol intake with their effects on all‐cause mortality in men and women and on the occurrence of 10 specific neoplastic, cardiovascular and alimentary diseases.DesignMeta‐analyses of relative risks of mortality in relation to usual level of alcohol intake pooled from 16 cohort studies (mostly of adults over 35 years), and alcohol and selected conditions from a further 132 epidemiological studies. Results reported by authors were assigned to sex‐specific exposure categories defined by the NHMRC based on median alcohol intakes. Pooled estimates of relative risk were calculated using precision‐based weighting.SettingThe assessment was part of a comprehensive meta‐analysis of epidemiological research undertaken for the National Drug Strategy.ResultsRelative risk of all‐cause mortality in male drinkers compared with abstainers fell to 0.84 at 1.0–1.9 standard drinks per day, returned to 1.01 by 3.0–3.9 drinks, and increased to 1.37 at six or more drinks. In female drinkers the lowest relative risk (of 0.88) was at 0–0.9 drinks per day, and by 2.0–2.9 drinks the risk exceeded that in abstainers by 1.13; at six drinks the relative risk was 1.58. Based on NHMRC categories, the relative risks of mortality were 0.93 (0.93–0.94) in responsible drinkers, 1.24 (1.22–1.27) in hazardous drinkers and 1.37 (1.35–1.49) in harmful drinkers. Risk of cancers of the oropharynx, oesophagus, liver, larynx and female breast and of cirrhosis of the liver increased with increasing alcohol intake level.ConclusionsA pattern of usual alcohol intake consistent with the NHMRC recommendations will confer a mortality risk similar to or less than that observed in abstainers. The biologically effective dose of alcohol on mortality in women is approximately two standard drinks per day less than in men. Our validation is most reliable for drinkers aged 35 years or older.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122011.x

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

ObjectiveTo describe the epidemiological and clinical features of acute rheumatic fever and rheumatic heart disease in the Top End of the Northern Territory.MethodsA retrospective review (in some instances as far back as the 1960s) of all cases of known or suspected acute rheumatic fever or rheumatic heart disease, with prospective validation of clinical status where necessary. Cases were ascertained from hospital and community medical clinic records and medical staff; and from records and health staff of 10 rural communities.ResultsThree hundred and eighty‐six revised Jones criteria‐confirmed episodes of acute rheumatic fever were documented in 249 individuals (99% Aboriginal). The annual incidence of confirmed acute rheumatic fever between 1989 and 1993 was 254 per 100000 Aboriginal people aged 5 to 14 years. A more accurate estimate of 651 per 100000 came from 10 rural communities with more complete information. As of 1995, there were 286 people living with established rheumatic heart disease (95% Aboriginal). The point prevalence of rheumatic heart disease among Aboriginal people was 9.6 per 1000, with a rate of 24 per 1000 in one large rural community. Sydenham's chorea was common, and associated with later rheumatic heart disease in 49% of cases. There was a preponderance of females with acute rheumatic fever, rheumatic heart disease and chorea.ConclusionsIn Aboriginal people in rural northern Australia the incidence of acute rheumatic fever is higher than that reported anywhere in the world, and the prevalence of rheumatic heart disease is among the highest in the world. While continuing attention must be paid to alleviating the causes of these diseases of poverty, immediate action is needed to improve diagnosis of acute rheumatic fever, adherence to secondary benzathine penicillin prophylaxis regimens, and follow‐up of rheumatic heart disease cases.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122012.x

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

ObjectiveTo identify independent patient, disease and viral characteristics that predict a sustained biochemical or viral response to interferon alfa therapy in patients with chronic hepatitis C.DesignComparison of interferon responders and non‐responders by univariate and multivariate analysis.SettingThe hepatitis clinic of the Alfred Hospital, Melbourne (a tertiary referral hospital), between July 1989 and June 1994.SubjectsAll patients with chronic hepatitis C who were treated with interferon alfa (IFN‐α; 3 million IU, three times a week or more) for at least 12 weeks.Outcome measuresPatient demographic and epidemiologic characteristics, pretreatment serum alanine aminotransferase (ALT) and γ‐glutamyl transpeptidase (GGT) levels, histological grading of hepatic steatosis, necroinflammatory activity and fibrosis, serum hepatitis C virus (HCV) RNA titres and genotype and post‐treatment serum ALT levels and presence of HCV RNA.ResultsOf 58 patients, 13 (22%) had a sustained (six months or longer) biochemical response to IFN‐α therapy, including 12 (21%) with a sustained viral response. Univariate analysis showed that young patients with a normal serum GGT level, grade 0–1 steatosis and fibrosis, low viral titre and infection with genotypes 3a and 2a were more likely to have a sustained response. Infection with genotypes other than 1a and 1b was the only independent variable associated with both a sustained biochemical and viral response. After adjusting for genotype, a hepatic fibrosis grade of 0–1 was also independently associated with viral response. This logistic regression model accurately predicted the virological response in 80% of cases.ConclusionIn Australian patients with chronic hepatitis C, a sustained viral response to IFN‐α therapy is most likely in those infected with a genotype other than 1a or 1b and with minimal hepatic fibrosis.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122013.x

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Hypospadias is a deformity of urethral and penile development in the male. Some cases are secondary to more serious disorders of sexual differentiation. Simple clinical rules can sort the common morphological defect of hypospadias from the rarer but more dangerous diagnosis of intersex.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122014.x

出版商:Wiley    

年代:1996

数据来源: WILEY

摘要:

Australasian medical graduates who wish to work in the United States are advised to prepare about 18 months in advance. They need to complete medical licensing examinations, obtain a full or restricted licence to practise in the State of employment, as well as a work visa. The National Resident Matching Program matches applicants to enrolled residency and fellowship programs. With some guidance and planning, the challenge of a residency or fellowship position in the United States is waiting for you!

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1996.tb122015.x

出版商:Wiley    

年代:1996

数据来源: WILEY