ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121362.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121363.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121364.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121365.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectivesTo estimate the prevalence of passive smoking in an Australian population, the magnitude of risk of myocardial infarction or coronary death associated with passive smoking and the extent to which fibrinogen concentrations might be affected by passive smoking.DesignA population‐based case–control study of myocardial infarction or coronary death and passive smoking, and measurement of fibrinogen in a random sample from the same population.Setting and participantsResidents of the Lower Hunter Region of New South Wales aged 35–69 years in 1988–1989. Case subjects were all those who suffered myocardial infarction or coronary death. Control subjects were participants in a risk factor prevalence survey.Outcome measuresMyocardial infarction or coronary death, defined by criteria of the WHO MONICA Project, and fibrinogen concentration (measured in controls only).ResultsPrevalence of passive smoking at home was 20% for male case subjects, 13% for male control subjects, 29% for female case subjects and 19% for female control subjects. The corresponding prevalence rates for passive smoking at work were 40%, 44%, 41% and 37%. Odds ratios of myocardial infarction or coronary death for active smokers compared with non‐smokers were 4.70 (95% confidence interval [CI], 3.35–6.58) in women and 2.71 (95% CI, 2.07–3.53) in men. For women the odds ratios of myocardial infarction or coronary death for those exposed to passive smoking at home were 2.46 (95% CI, 1.47–4.13) among non‐smokers and 1.48 (95% CI, 0.67–3.30) among ex‐smokers. For men the odds ratios for passive smoking at home were 0.97 (95% CI, 0.50–1.86) for non‐smokers and 1.78 (95% CI, 1.13–2.79) for ex‐smokers. The odds ratios for passive smoking at work did not suggest increased risk. Fibrinogen concentrations were generally higher among people exposed to passive smoking at home or work compared with those not exposed but were not as high as concentrations in active smokers.ConclusionsPassive smoking increases the risk of coronary heart disease and increased fibrinogen concentration provides a marker of its effect.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121366.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectiveTo estimate the national prevalence of smoking.DesignA total of 4820 adults aged 16 years and over (2364 men, 2456 women) were surveyed throughout Australia in 1989 by a large market research company.SettingInterviews were conducted in the participants’ homes.ResultsOverall, 30.2% of men and 27.0% of women were current smokers; 29.8% of men and 19.3% of women were past smokers. The mean daily consumption of factory‐made cigarettes among male smokers was 22 and among female smokers 18.9. Taking into account the published tar content of the brand smoked, it was estimated that the average daily exposure to tobacco tar for men was 204 mg and for women 157 mg. Occupational and educational status were inversely related to the prevalence of smoking. The most popular packet size was 25 (preferred by 48% of smokers) and those in lower occupational and educational categories were more likely to purchase cigarettes in large packet sizes.ConclusionsComparison with an earlier series of studies commenced in 1974 showed that the national prevalence of smoking among adults has continued to fall, particularly among men.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121367.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectiveTo determine the prevalence of previously undiagnosed problem drinking and thereby to assess the suitability of the emergency department for early intervention.DesignThree hundred and fifty ambulatory care patients were assessed by means of a structured interview schedule, physical examination and blood tests. Alcohol intake and presence of alcohol‐related problems were recorded, along with history of past advice on drinking and self‐perception of an alcohol problem.SettingThe ambulatory care section of the emergency department of Royal Prince Alfred Hospital, Sydney.PatientsThree hundred and fifty subjects, aged between 18 and 55 years, were sequentially selected over an 18‐month period.ResultsForty‐one per cent of subjects (95% confidence interval, 36%‐46%), 50% of men and 26% of women, were classified as problem drinkers on the basis of hazardous or harmful levels of alcohol consumption, frequent drinking to intoxication, evidence of dependence, or experience of alcohol‐related problems. Of these, 63% had not previously received advice on drinking from a health professional and only 28% perceived they had a problem. Of particular note was that 24% of men and 4% of women were drinking 12 or more drinks (120 g of alcohol or more) in a single session on a weekly or more frequent basis.ConclusionsMany of the problem drinkers attending the emergency department have not previously received advice about their drinking from a health professional. The emergency department therefore offers considerable potential as a site for early detection and intervention in patients with hazardous and harmful alcohol use and related disorders.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121368.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObejectiveTo test the hypothesis that children attending child care centres are more likely to be prone to acute respiratory illness.DesignA case‐control study.SettingA community‐based study in the Adelaide metropolitan area.ParticipantsA randomly selected sample of Adelaide children whose births were registered in 1983.Main outcome measureA respiratory illness score was calculated for each child, based on parents’ reports of acute respiratory illness in the previous 12 months.ResultsInformation was obtained by postal survey for 2618 children (mean age at time of study, 26 months). Eight hundred and nineteen of these children (31%) were reported to be regular or occasional attenders of child care centres or creches. Home interviews were carried out with parents of children whose respiratory illness scores fell in the top 20% of the range and those whose score was in the bottom 20%. Children prone to respiratory illness were more likely to be users of child care centres or creches than the children who were not prone (odds ratio = 2.28; 95% confidence interval, 1.53–3.40). The risk of being prone to respiratory illness increased with the frequency of use of child care, and tended to be greater the younger children were when they first attended child care centres. Adjustment in multivariate analysis for confounding factors made little difference to the strength of the association of proneness to respiratory illness with the use of child care (adjusted odds ratio = 2.23; 95% confidence interval 1.38–3.61).ConclusionUse Of child care centres is an important cause of acute respiratory illness among Australian children.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121369.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectiveTo compare the value of exercise testing and coronary angiography in the management of patients with effort angina.DesignA retrospective follow‐up study.SettingA university teaching hospital.PatientsFour hundred and thirty‐four patients with a history of angina, who developed pain or ST segment changes during an exercise test and who were followed‐up at up to nine years after their exercise test.InterventionsCoronary angiography was offered to patients for disabling angina only. Bypass surgery was generally offered to patients with multiple vessel coronary artery obstruction.Main outcome measurePatient survival.ResultsStepwise regression analysis based on the Cox proportional hazards model indicated that the decision to perform coronary angiography (P<0.001) and the amount of ST segment depression on exercise testing (P<0.01) were predictors of survival. With ST segment depression set at 1 mm and age set at 53.5 years (both sample median values) the probability of survival at five years was 86% in patients who did not undergo coronary angiography compared with 96% in patients who did undergo angiography. There were eight deaths in 59 patients who did not show any ST segment depression during the exercise test and who were treated medically without coronary angiography.ConclusionsCoronary angiography is a superior technique to exercise testing for detecting patients with effort angina who are at high risk of premature mortality. Coronary bypass surgery makes a big improvement in the chance of five‐year survival in such patients.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121370.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121371.x

出版商:Wiley    

年代:1991

数据来源: WILEY