ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138539.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138540.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138541.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138542.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138543.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo examine the management of haemophilia A in Australia and to compare it with international trends.MethodsSix haemophilia centres treating most patients in Victoria, New South Wales and South Australia were surveyed in 1993 by means of a written questionnaire followed by an “on site” interview.ResultsThe centres were treating 739 patients; 234 (32%) had severe haemophilia. Factor VIII inhibitors were present in 5.9% of all patients and in 19% of those with severe disease. Twenty‐three per cent were human immunodeficiency virus (HIV) antibody‐positive and 74% were hepatitis C virus (HCV) antibody‐positive. The main treatment was “on demand” therapy for acute bleeds (average use of factor VIII: 1350 IU/kg per year for children; and 780 IU/kg per year for adults). Prophylactic therapy was used in only 17 patients, with doses of 3000–4500 IU/kg per year. One million IU was used for three patients with high litre inhibitors who had “tolerising” therapy. While most developed countries have a factor VIII supply of 2–5 IU per capita, the total supplied to the States represented 1.46 IU per capita, while use at the centres represented 1.1 IU per capita.ConclusionBecause supply of factor VIII is limited, use was less than half that recommended internationally. Shortage of factor VIII has compromised prophylactic therapy and virtually prevented “tolerising” therapy.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138544.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo determine how current hospital practice for transfusions of red cells, platelets and fresh frozen plasma conformed with published criteria.DesignElaboration of criteria for transfusion from a review of the current literature; and analysis of the medical records of patients receiving transfusions of red cells (200), platelets (215), and fresh frozen plasma (260) during defined time periods in 1993.SettingA large tertiary care teaching hospital.Outcome measuresIn appropriateness rates for transfusion episodes and numbers of individual units of blood products administered.ResultsInappropriateness rates for transfusion episodes and numbers of individual units administered were 16% and 10% for red cells, 13% and 11% for platelets, and 24% and 16% for fresh frozen plasma (31% and 21% when transfusions for thrombotic thrombocytopenic purpura were excluded). Red cells and fresh frozen plasma were used inappropriately most frequently in association with a surgical procedure; for platelets, it was their use for bleeding. In many of the transfusions deemed inappropriate, deficiencies of red cells, platelets and/or coagulation factors were documented, but the degree of deficiency did not meet the stringent appropriateness criteria. Twenty‐six transfusions were deemed inappropriate because the indication was not documented in the medical record.ConclusionsSpecific problem areas in which blood product use was inappropriate were identified. Guidelines for transfusion appropriateness, education of hospital staff, and a monitoring system to ensure adherence to the guidelines, are required.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138545.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo examine, in the light of a current national inquiry into taxation for wine, claims that wine drinkers rarely misuse alcohol and that cask wine is more likely to be misused than bottled wine.Methods1272 persons aged 16 years and over and resident in metropolitan Perth were interviewed in their homes regarding their use of alcohol.ResultsThe alcohol consumption of 524 (373 women, 151 men) who had drunk at least one glass of wine on one or more of their last four drinking days was examined in relation to National Health and Medical Research Council guidelines. While only 2.9% of women and 2.6% of men had an average daily intake of wine above low risk levels, 6.9% of women and 13.2% of men had exceeded these levels when considering all alcoholic beverages. When wine intake was examined for the day of highest consumption of the last four drinking days recalled by each respondent, 42.3% of women and 16.6% of men had exceeded low risk levels. There was no significant difference in the amounts of cask and bottled wine consumed in 180 wine drinkers for whom the distinction between cask and bottled varieties could be made and who drank wine on their last drinking occasion.ConclusionsPast estimates of the contribution of wine consumption to excessive alcohol intake are underestimates. Raising the tax on wine should be considered as a public health measure and taxes should be levied in direct relation to alcohol content to encourage the consumption of lower alcohol varieties.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138546.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo examine the effect of specific firearm control legislation on firearm and overall suicide rates.DesignRetrospective survey of data from the Register of the Suicide Research and Prevention Program, Queensland Department of Health. The hypothesis was tested that the legislation would reduce firearm and overall suicides more in metropolitan and provincial city areas than in rural areas, where firearm ownership is higher.SettingState of Queensland, 1990–1993.Outcome measuresSuicide rates by age, sex and method for metropolitan, provincial city and rural areas in the two years before (1990–1991) and after (1992–1993) legislation.ResultsMean annual firearm suicide rates declined significantly (P<0.05) in metropolitan and provincial city areas after legislation (from 3.6 to 2.3 per 100 000, and from 5.2 to 3.1 per 100 000, respectively), with significant declines among men and in the 15–29 years age group. Rates increased slightly in rural areas (from 7.2 to 8.2 per 100000). Overall suicide rates declined in provincial areas only, with minimal change in metropolitan areas and a slight rise in rural areas.ConclusionThese results provide preliminary evidence that firearm control legislation, including a 28‐day “cooling‐off” period before firearm purchase, reduces suicide rates, especially among younger adult men.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138547.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138548.x

出版商:Wiley    

年代:1995

数据来源: WILEY