ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116362.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116363.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116364.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116365.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116366.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective: We report the findings of the first survey of the practice of electroconvulsive therapy (ECT) for the treatment of depression in Australia and New Zealand. The major aim was to examine the frequency of use of unilateral and bilateral electrode placement, as bilateral ECT has been recently recommended as the treatment of choice by the Royal College of Psychiatrists (UK).Design: A questionnaire about details of ECT given in the second half of 1989 was forwarded to the medical superintendents of 130 psychiatric hospitals and units in Australia and New Zealand.Results: Reports were received from 96 psychiatric institutions representing a response rate of 74%. In these units, 915 patients were treated with ECT during the study period. In contrast to depressed patients in the United Kingdom or the United States, a majority of Australian and New Zealand patients given ECT were found to receive unilateral ECT (63%). There were marked regional differences in practice, with patients in New South Wales being more likely to receive unilateral ECT, and those in Queensland and New Zealand bilateral ECT. In the majority of units, bilateral ECT was not considered to be indicated in preference to unilateral ECT for either severe, suicidal or psychotic depression.Conclusion: The discrepancies between regional practices probably reflect the current uncertainty regarding the balance between the relative efficacy and morbidity of these two forms of treatment. Until these central issues of relative efficacy and morbidity are clarified, it would be inappropriate for local professional bodies to recommend a preferred mode of ECT administration.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116367.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective: To describe the prevalence and pattern of cocaine use among young Sydney adults interviewed during a study of the “market position” of cocaine.Design: A telephone survey of young Sydney adults.Participants: A total of 499 young Sydney men and women aged between 14 and 35 were selected to ensure a sample of 300 persons who used alcohol and tobacco at least weekly, and who had been offered or had tried at least one illicit drug.Main outcome measures: These were the prevalence of having ever used cocaine, the frequency of cocaine use, the prevalence of daily alcohol and tobacco use, and of ever having tried marijuana, sedatives, designer drugs, amphetamines and heroin.Results: Thirteen per cent of the sample (95% confidence interval [CI], 10%‐‐16%) had ever tried cocaine, of whom only 20% (CI, 15%‐‐25%) were current users. Cocaine users were distinguished from non‐users by being more likely to be daily users of tobacco (odds ratio, 2.1; CI, 1.3‐‐3.6) and alcohol (odds ratio, 3.0; CI, 1.7‐‐5.6), and to have tried marijuana (odds ratio, 7.1; CI, 3.2‐‐15.9), sedatives (odds ratio, 11.4; CI, 6.4‐‐20.7), designer drugs (odds ratio, 17.2; CI, 9.2‐‐32.2), amphetamines (odds ratio, 27.1; CI, 14.3‐51.3), and heroin (odds ratio, 36.5; CI, 14.0‐94.9). The odds of having tried cocaine increased with the number of different types of illicit drugs that the person had tried.Conclusions: The prevalence of ever having tried cocaine was low among a sample of young adults selected to ensure an over‐representation of illicit drug users. Cocaine users were more likely to have experimented with a variety of different types of illicit drugs. Only a minority of those who had ever tried cocaine were current users.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116368.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective: To examine the presentation, investigative findings, treatment and outcome in patients with spinal epidural abscess.Design and setting: The study was a retrospective analysis of all patients with this condition presenting to the Neurosurgical Units at the Royal Prince Alfred Hospital and Westmead Hospital, Sydney, during the period September 1984 to September 1987.Patients: There was a total of 21 patients with an age range from 7‐‐87 years (mean 47 years). Eleven cases were acute and ten chronic. The causative organism wasStaphylococcus aureusin 15 of the 21 cases, the other organisms involved wereMycobacterium tuberculosis, Escherichia coli, StreptococcusandPseudomonas aeruginosa.Interventions: All patients were treated with a combination of surgery (decompression with or without fusion) and prolonged antibiotic administration.Results: Of the 21 patients 11 had a good to excellent outcome while 10 had a poor outcome.Conclusion: The main determinant of outcome was the neurological state at presentation emphasising the importance of early diagnosis and prompt treatment.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116369.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116370.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective: This study was undertaken to see if patients who had a radiological diagnosis of arachnoiditis attributed to methylprednisolone acetate (Depo‐Medrol, Upjohn Pty Limited) had the clinical syndrome of arachnoiditis.Design: An attempt was made to review all patients, reported by Roche in 1984 with a radiological diagnosis of corticosteroid‐induced arachnoiditis, by taking a detailed history and performing a physical examination.Setting: The Department of Orthopaedics and Traumatic Surgery, The University of Sydney, The Royal North Shore Hospital, Sydney.Results: Of the 18 patients reported by Roche 15 were located and participated in this study. The clinical syndrome of arachnoiditis was defined as a constant burning pain in the back and legs, impotence, marked limitation of spinal motion, alteration of sensation and power in the legs, and a need for regular analgesia. Three of the 15 patients had the clinical syndrome of arachnoiditis. The grade of radiological change was unrelated to the severity of symptoms. The details of doses and precise sites of administration were unavailable for the severely affected individuals.Conclusions: The absence of any other apparent cause for their symptoms implies that Depo‐Medrol should not be used in or about the thecal sac.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116371.x

出版商:Wiley    

年代:1991

数据来源: WILEY