ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126042.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Baume's latest report really says that there are adequate numbers of most surgeons

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126043.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

As outbreaks of new infectious diseases continue to threaten the health of humans and animals, we must maintain surveillance

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126044.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

The concept is simple and irrefutable, but more time is needed to fully mobilise the system

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126045.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Having children earlier and freezing embryos for later use are stategies to circumvent the premenopausal decline in women's fertility

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126046.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo carry out a systematic quality review and meta‐analysis of all randomised trials ofmammographic screening that included women aged under 50 years.Data sourcesReports ofrandomised trials of mammographic screening were identified via MEDLINE and checks of the bibliographies of retrieved articles and reviews.Data synthesisIdentified trial were as essed for: (i) method of randomisation; (ii) documented comparability of baseline data; (iii) standardised criteria for breast cancer death; (iv) blinded review of cause of death; (v) completeness of follow‐up; and (vi) use of an “intent ion‐totreat analysis”. Seven randomised trial including almo t 160000 women aged under 50 were studied. The combined estimate of relative risk was 0.95 (95% confidence interval, 0.77‐1.18), a stati tically non‐significant reduction of 5%. Adju tment for the cluster randomisation of two trials, and for degree of compliance, did not substantially change this result.ConclusionsThese analyses suggest little, if any, benefit for women under 50 years of age. The results are not explained by the quality of the trials or the radiology. We recommend that women in this age group intending to be screened should be fully informed of the ere ults.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126047.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo assess the long term effect of a nutrition program in a remote Aboriginal community (Min jilang).DesignEvaluation of nutritional outcomes over the three years before and the three years after a health and nutrition program that ran from June 1989 to June 1990. Turnover of food items at the community store was used as a measure of dietary intake at Minjilang and a comparison community.SettingA community of about 150 Aboriginal people live at Minjilang on Croker Island, 240 km north‐east of Darwin. A similar community of about 300 people on another island was used as the comparison.ResultsThe program produced lasting improvements in dietary intake of most target foods (inclu ding fruit, vegetables and wholegrain bread) and nutrients (including folate, ascorbic acid and thiamine). Sugar intake fell in both communities before the program, but the additional decrease in sugar consumption during the program at Iinjilang “rebounded” in the next year. Dietary improvements in the comparison community were delayed and smaller than at Minjilang.ConclusionsThe success of the program at Minjilang was linked to an ongoing process of social change, which in turn provided a stimulus for dietary improvement in the comparison community. When Aboriginal people themselves control and maintain ownership of community‐based intervention programs, nutritional improvements can be initiated and sustained.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126048.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectivesTo identify risk factors for the development of amoxycillin‐clavulanic acid associated jaundice.DesignRetrospective case‐control study. Cases were selected from those reported to the Adverse Drug Reactions Advisory Committee from the time of introduction of amoxycillin‐clavulanic acid to Australia in 1986 until December 1993.SubjectsThirty‐four cases, defined as individuals who developed jaundice within eight weeks of starting amoxycillin‐clavulanic acid, with a biochemical picture of cholestasis, normal calibre bile ducts and no other recognised causes of jaundice or recent use of other hepatotoxic drugs, were selected. For each case, four controls who had been prescribed amoxycillin‐clavulanic acid without developing jaundice were randomly selected from the patient register of the prescribing doctor.ResultsIncreasing age was a risk factor for amoxycillin‐clavulanic acid associated jaundice; patients over 55 years had an odds ratio of 16.1 (95% confidence interval [Cl], 2.9‐88.9) compared with patients less than 30 years. Men hadan odds ratio of 2.5 (95% Cl, 1.1‐5.4) compared with women, although the proportion of men in the study group was larger than in the reported cases overall. History of serious medical illness, drug dose, route and duration of therapy, other medications, smoking and previous drug allergies or use of amoxycillin‐clavulanic acid were not significantly associated with jaundice.ConclusionsBecause of the higher risk of jaundice with increasing age, the risk‐benefit ratio of amoxycillin‐clavulanic acid should be carefully considered in older patients. Further assessment is necessary to clarify the association between jaundice and male sex.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126049.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo describe the clinical and epidemiological features of an outbreak of a viral infection affecting humans and horses.SettingStables in Hendra, a suburb of Brisbane.SubjectsAffected horses and humans, and at‐risk human contacts.Results: A pregnant mare died two days after arrival from a paddock elsewhere in Brisbane. Eight to 11 days later, illness (depression, anorexia, fever, dyspnoea, ataxia, tachycardia, tachypnoea and nasal discharge) was reported among 17 other horses from the same or an adjoining stable. Fourteen horses died or were put down. Five and six days after the index mare's death, a stable‐hand and then a horse trainer, both of whom had had close contact with the sick mare's mucous secretions, developed influenza‐like illnesses. The stable‐hand recovered but the trainer developed pneumonitis, respiratory failure, renal failure and arterial thrombosis, and died from a cardiac arrest seven days after admission to hospital. A morbillivirus cultured from his kidney was identical to one isolated from the lungs of five affected horses. The two affected humans and eight other horses were seropositive for the infection, which was reproduced in healthy horses following challenge by spleen/lung homogenates from infected horses. There was no serological evidence of infection in 157 humans who had had contact with the stables or the sick horses or humans.ConclusionsA previously undescribed morbillivirus infected a probable 21 horses and two humans; one human and 14 horses died. That no further cases were detected among humans suggests that the virus was of low infectivity. The source of infection remains undetermined.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126050.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectivesTo determine the extent and patterns of benzodiazepine use among heroin users, and whether preferences for different benzodiazepines exist among this group.Subjects and methods210 heroin users who were current users of benzodiazepines volunteered for the study and completed a structured questionnaire.ResultsHeroin users had used a median of five different benzodiazepines, most commonly diazepam. Almost half the subjects (48%; 95% Cl, 41‐55) had injected benzodiazepines, 17% (95% Cl, 12‐22) within the preceding six months. Diazepam and temazepam were the most widely injected benzodiazepines.ConclusionsFlunitrazepam, diazepam and temazepam should be prescribed to heroin users with caution. A less popular and rarely injected benzodiazepine, nitrazepam, may be a better option for this group.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb126051.x

出版商:Wiley    

年代:1995

数据来源: WILEY