ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121167.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121168.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121169.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121170.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectiveTo evaluate the currently perceived status of thermography in the diagnosis of musculoskeletal disorders.Data sourcesMedical and legal journals published from 1956 onwards; report of the United States Office of Health Technology Assessment and personal communication with the author of that report.Study selectionConfined to application of thermography to musculoskeletal and neurological medicine.Data extraction and synthesisWeighted towards prospective and controlled studies.ConclusionLittle evidence exists of any application of thermography in which it is unequivocally superior to conventional diagnostic imaging methods.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121171.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectiveTo review the current medical and legal status and future directions of thermography.Data sourcesMedical and legal journals published from 1956 onwards; report of the United States Office of Health Technology Assessment and personal communication with the author of that report; report of Australian Institute of Health and personal communication with the author; personal communication with members of the Therapeutics and Technology Assessment Subcommittee, American College of Neurology and with the Chairperson of the Commission of Technology Assessment and Efficacy Studies, American College of Radiology.Study selectionReports and position statements of statutory bodies and specialist colleges in the United States and Australia; legal judgments in both these countries.ConclusionAcceptance of thermography is largely confined to those who use it and profit by its use.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121172.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectiveTo determine whether a blood alcohol concentration (SAC) of 0.15 or more identifies accurately problem drinking in an apprehended drinking driver.DesignCross‐sectional analytic study of 86 drink drivers (“diagnostic test study”).SettingSt Vincent's Hospital, Melbourne, drink‐driver education programme.SubjectsMen aged between 18‐25 years, applying for relicensing after disqualification, who were participants at 10 consecutive drink‐driver education courses conducted in early 1987.Outcome measuresSelf‐reports of the amount of alcohol consumed and the amount of money spent on alcohol per week, the standard Michigan Alcoholism Screening Test (MAST) score and the blood alcohol level at apprehension. The first three measures were used as reference standards for alcohol related problems, against which the blood alcohol level was compared.Major resultsScatter plots of SAC against amount consumed, amount spent and the MAST scores showed that a large proportion of the heaviest drinkers were not identified by the SAC. Log‐transformed correlation coefficients were: for amount spent v. amount consumed, r= 0.73; for MAST score v. amount consumed, r=0.52, and for MAST score v. amount spent r=0.53. Correlating the SAC with the log of the MAST score gave r = 0.21, SAC with log of the amount consumed, r=0.20, and SAC with log of the amount spent, r=0.15. Comparing a SAC of 0.15 or more with a MAST score of>5, we obtained a sensitivity of 0.36, a specificity of 0.76, a positive predictive value of 0.86, and a negative predictive value of 0.23. The prevalence of heavy drinking as measured by the MAST score was 0.80.ConclusionA blood alcohol concentration of 0.15 or more identifies only a third of the problem drinkers in this sample of drink drivers. Although it selected a group of drinkers with alcohol‐related problems, it missed most of the problem drinkers and did not reliably identify the heaviest drinkers.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121173.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectiveTo determine whether there are any secular trends in the incidence of childhood cancer in Queensland.DesignA retrospective epidemiological study of the incidence of cancer in children, aged 0‐12 years, in Queensland during the 16‐year period 1973‐1988 inclusive.SettingCases were found from the records of the Queensland Childhood Malignancy Registry. Ascertainment is believed to be virtually complete for children aged 0‐12 years.ParticipantsAll children who were resident in Queensland and less than 13 years of age at the time of diagnosis of cancer. The cases included all malignant neoplasms and also all intracranial neoplasms in children but excluded Langerhans' cell histiocytosis.Main outcome measurementsThe incidence by year of diagnosis was calculated for each of a number of standard diagnostic groups of neoplasms. These data were analysed by the x2for trend test.ResultsCancer incidence was found to be increasing at a rate of about 0.9% per year. The rise was almost entirely accounted for by a rise in incidence among boys, whereas there was virtually no change in the incidence in girls. Statistically significant increases in incidence were found in acute nonlymphocytic leukaemia and also in nonHodgkin's lymphoma in boys; Hodgkin's disease was found to be decreasing in incidence.ConclusionsThe results of this study emphasise the importance of childhood cancer incidence surveillance in Australia to determine whether these trends will continue in the future. The findings also indicate a need for continuing research in childhood cancer epidemiology.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121174.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

ObjectiveTo assess the effectiveness and safety of parietal pleurectomy in establishing a tissue diagnosis and controlling pleural fluid accumulation in patients with pleural mesothelioma, and to assess the success of this procedure In effecting palliation.Design and settingFifty consecutive patients with pleural mesothelioma who underwent thoracotomy at the cardiothoracic units at Concord and Royal Prince Alfred Hospital were reviewed retrospectively. The male:female ratio was 4:1 and the mean age was 63 years. In only 11 of the 50 patients was a tissue diagnosis of mesothelioma made before surgery.InterventionsAt thoracotomy, subtotal parietal pleurectomy was performed In 45 of the 50 patients. In two patients biopsy alone was performed and three patients were treated by a chemical pleurodesis only, as pleurectomy was not technically possible. Pulmonary decortication was required in 28 patients to allow full expansion of the underlying lung for effective pleurodesis.ResultsThere was one postoperative death. The morbidity rate was 16%. Excluding the patient who died In the postoperative period, the median survival was 16 months, and ranged from three to 54 months, with 21% of patients surviving for more than two years. Only one patient developed a reaccumulation of pleural fluid.ConclusionsPleurectomy, with decortication when required, provides both a tissue diagnosis and effective control of pleural fluid accumulation and therefore excellent palliation in patients with pleural mesothelioma. We advocate early thoracotomy in these patients.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121175.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Few medical schools appear aware of modern developments in general practice and of its educational potential in helping provide balance to a predominantly teaching hospital approach to the diagnosis and treatment of disease. Contributing to the problem are a lack of clarity about the term“ undifferentiated doctor ”, failure to understand the different purposes of undergraduate and vocational training and the erroneous view that general practice is not a “ proper” university discipline because it lacks an intellectual basisis.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb121176.x

出版商:Wiley    

年代:1991

数据来源: WILEY