ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124511.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Should threatening public health information ever be censored?

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124512.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Lessons from a case of apparent clearance of perinatally acquired HIV

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124513.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Unless the profession starts monitoring prescribing, someone else will do it for them

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124514.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Artificial State barriers are being broken down

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124515.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo determine the symptoms and signs of eucalyptus oil poisoning in infants and young children, to e timate the to xic do se and to recommend management trategies.Design and settingRetrospective analysis of case histories of children admitted to the Royal Children's Hospital, Melbourne, between 1 January 1981 and 31 December 1992 with a diagno is of eucalyptus oil poisoning.Main outcome measuresDemographic data, circumstances of ingestion, doses, clinical effects, management, complications and duration of hospital stay.Results109 children (mean age, 23.5 month; range, 0.5‐107) were admitted; clinical effect were ob erved in 59%. Thirty‐one (28%) had depresion of consciou state; 27 were drowsy, three were unconscious after ingesting known or estimated volumes ofbetween 5mL and 10mL, and one was unconscious with hypoventilation after ingesting an estimated 75 mL. Vomiting occurred in 37%, ataxia in 15% and pulmonary disease in 11%. 0 treatment was given for 12%. Ipecac or oral activated charcoal was given for 21%, nasogastric charcoal for 57%, and gastric lava ge without anaesthesia for 4% and under anaesthesia for 6%. All patients recovered. Hazardou treatment and overtreatment were common. For 105 children, mean hospital stay was 22 hour (range, 4‐72 h) and for 13 patients mean intensive care unit stay was 18 hours (range, 4‐29 h). In 27 patients who ingested known doses of eucalyptus oil, 10 had nil effects after a mean of 1.7 mL, 11 had minor poi oning after a mean of 2.0 mL, five had moderate poisoning after a mean of 2.5 mL and one had major poisoning after 7.5 mL (P=0.0198).ConclusionsIngestion of eucalyptus oil caused significant morbidity in infant and young children. Significant depression of conscious state hould be anticipated after ingetion of 5mL or more of 100% oil. Minor depression of consciousness may occur after 2‐3 mL. Airway protection should precede gastric lavage.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124516.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124517.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectivesTo investigate the use of controlled‐release morphine sulfate (MS Contin, Pharmacia) in Queensland, 1990‐1993.Patients and designRecords of 434 patients notified to the Drugs of Dependence Unit (DDU) for prolonged use of MS Contin (as at 16 August 1993) were analysed, the information was verified, and the patients' diagnoses were coded (ICD‐9). Estimates of daily drug consumption were calculated from computerised prescription data.ResultsControlled‐release morphine su lfate was being used for indications other than its licensed indication “chronic severe pain of cancer”: 39.9% of the patients received the drug for non‐malignant conditions. The dose escalation for patients with non‐malignant conditions was significantly less than that of the patients with malignant conditions (P = 0.002).ConclusionsDespite controversy about the use of controlled‐release morphine sulfate for chronic pain of non‐malignant origin, its use is widespread.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124518.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo evaluate the role of voluntary antenatal testing in HIV surveillance and prevention by examining antenatal HIV antibody testing practice and policy in Australia.DesignCross‐sectional study using a self‐administered questionnaire.Subjects and setting: Specialist obstetricians and gynaecologists and general practitioners (GPs) affiliated with the Royal Australian College of Obstetricians and Gynaecologists and Australian public hospital antenatal clinics, August‐November 1992.Main outcome measuresThe percentage of public hospital antenatal clinics and specialist and GP obstetricians in Australia who tested pregnant women for HIV antibody as part of their antenatal care, and the proportion of pregnant women in Australia who had an antenatal HIV antibody test in the 1991‐92 financial year.ResultsQuestionnaires concerning antenatal HIV antibody testing were completed by 90% (993/1108) of specialists, 87% (2134/2461) of GPs and 93% (215/230) of public hospitals surveyed. Of the 706 specialists and 1503 GPs who reported that they were currently engaged in obstetric care, approximately 60% (430/706 and 935/1503, respectively) offered antenatal HIV testing either to all pregnant women or to selected groups at risk. There were significant differences in testing patterns between States and Territories. For the 95 public hospitals with antenatal clinics, 81% (77) offered the HIV antibody test to all or selected groups of pregnant women; these percentages did not differ significantly between States and Territories. It was estimated that 25% of pregnant women seen by specialists, 29% seen by GPs and 9% seen in public hospital clinics were tested for HIV antibody as part of their antenatal care in 1991‐92.ConclusionsIn Australia approximately one in five pregnant women were tested for HIV antibody as part of their antenatal care in 1991‐92. Voluntary HIV testing in pregnancy may provide unrepresentative data for measuring the prevalence of HIV infection in pregnant women.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124519.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo investigate differences in the characteristics of general practitioners (GPs) and patients, referral rates, rates of prescribing and ordering of tests and x‐rays, and types of counselling and consultation, between private and community health centre (CHC) GPs in Victoria.Method: All 51 full‐time Victorian CHC GPs were invited to enrol in the Australian Morbidity and Treatment Survey (AMTS) developed by the Family Medicine Research Unit at the University of Sydney in 1992. The control group comprised the 114 Victorian GPs involved in this survey in 1991.ResultsThirty‐nine CHC GPs (76%) provided complete data. CHC GPs were more likely to be younger, female, and to have less experience in general practice. Patient age and gender distributions were similar. CHC GPs had higher rates of offering counselling and advice and of referral to allied health professionals, but similar rates of referral to medical specialists to those of private GPs. We found no differences in prescribing after multivariate analysis.ConclusionsCounselling, and referral to allied health professionals, were the only striking differences after multivariate analysis. It may be that any movement toward non‐throughput‐related remuneration may, in isolation, have less impact on general practitioner work patterns than imagined. Patient throughput was not measured, and this would be important in any future global assessment of the cost‐effectiveness of CHC and private general practitioners.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb124520.x

出版商:Wiley    

年代:1995

数据来源: WILEY