ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127410.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127377.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127378.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo describe the characteristics of cutaneous malignant melanoma in Australians in 1989.Design and dataDescriptive analysis of all invasive melanomas reported to State or Territory cancer registries in 1989.Main outcome measuresThe age, sex and State or Territory of residence of affected individuals, and the topography, morphology and thickness of the melanoma.ResultsThe age‐standardised incidence rates of melanoma were 30.2 and 23.9 per 100000 males and females respectively; the highest rates were observed for the male trunk (11.7 per 100000) and female lower limbs (8.8 per 100 000); the most commonly specified morphology was superficial spreading melanoma, followed by nodular melanoma and lentigo malignant melanoma. Fifty‐two per cent of melanomas of known thickness were thinner than 0.76 mm, with females having proportionally more thin melanomas than males, and males having twice the rate of melanomas thicker than 3 mm. Melanoma rates in northern latitudes were approxi‐mately double those further south.ConclusionsDistinct patterns of melanoma incidence by latitude and body site confirm the role of sunlight exposure in melanoma aetiology. Females often have thinner melanomas than males, which is reflected in their better prognosis. People living closer to the equator more often have level 1(in situ) and thin invasive melanoma, probably related to increased awareness of melanoma risk with decreasing latitude. The collection of melanoma data would be improved if patholo‐gists' reports routinely included melanoma site, morphology, level and thickness. All registries should collect data on level 1 melanomas to help evaluate early melanoma detection programs and to continue surveillance of the Australian skin cancer epidemic.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127379.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo determine the current knowledge, perceptions and practices of general practitioners (GPs) in Victoria in the diagnosis and management of skin cancer.MethodA stratified random sample of 666 Victorian GPs was surveyed by postal questionnaire (a colour photographic quiz on 12 examples of benign and malignant skin tumours).ResultsGPs were better at recognising the 12 skin tumours as suspicious or benign than they were at providing the correct diagnosis. They were better at providing the correct diagnosis for benign lesions (75%) than for skin cancers (61%) or dys‐plastic lesions (61%). They had more difficulty in recognising early melanoma than late melanoma and were more likely to manage benign lesions (85%) and dysplastic lesions (34%) than skin cancers (4%). Knowledge of appropriate management was high for GPs who correctly identified tumours. Most perceived skin cancer as an important public and individual health concern.ConclusionsOverall, GPs had a good knowledge of diagnosis and management of skin cancer and related benign tumours. Several gaps in knowledge and practice were apparent and need specific targeting for educational programs.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127380.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo describe the response of general practitioners (GPs) and patients during the 1991 National Skin Cancer Awareness Week media campaign.DesignSkin examinations in general practices in three representative regional towns in Queensland were monitored for five weeks around the time of the campaign and participating GPs were personally interviewed.Outcome measuresNumber and type of consultations in which the skin was examined for cancer before, during and after the campaign, and GPs' attitudes and beliefs about skin checks.ResultsThe 46 GPs (47%) who participated, representing 60% of the practices, conducted 1805 consultations in which the skin was examined for cancer. The number of consultations in which skin examinations were conducted by each GP increased by 56% during the campaign. Skin checks were nearly always initiated by the patient (90%), and in only half of all cases was the examination given as the primary reason for the consultation. Sixty‐two per cent of lesions were considered to be clinically benign.ConclusionPublic education programs may have an impact on the level of skin examinations requested in general practice consultations. Currently, patients are the principal initiators of such examinations during consultations —there is potential to increase the active role played by GPs in support of patient requests for the early detection of skin cancer.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127381.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo replicate overseas experience with clozapine, a new antipsychotic drug reputed to be effective in producing major improvement in a high proportion of patients with treatment‐resistant schizophrenia.Design and settingA prospective clinical trial at Kenmore Psychiatric Hospital, Goulburn, NSW. This paper is a preliminary communication covering 14 to 18 weeks after commencement of clozapine.PatientsTwelve patients with treatment‐refractory chronic schizo‐phrenia, chosen on the basis of the severity of their disability.InterventionAfter existing medication was changed to be compatible with clozapine, it was reduced to the minimum level acceptable for staff and patient safety. Clozapine was then introduced gradually while other medication was withdrawn.Outcome measuresProgress was monitored in terms of clinical presentation, side effects, use of supplementary medication and assessments by means of three standardised scaling systems.ResultsNone of the patients deteriorated. Of six patients aged 35 years or less, three showed dramatic improvement and three showed clinically significant improvement. None of the six older patients showed major improvement, except that extrapyramidal symptoms were reduced in all cases. Drowsiness and hypersalivation were the only common side effects.ConclusionsThese preliminary findings are consistent with results reported overseas.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127382.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectivesTo determine the range of sleep behaviour of normal children to age 38 months and to ascertain the level of parents' problems associated with their child's sleep behaviour.Design and settingA crosssectional survey by questionnaire of parents presenting with their children for routine well‐child checks at child health centres, mobile clinics, flying doctor clinics and home visits throughout Queensland. Of 3383 questionnaires distributed 3269 (96.5%) were returned.Main outcome measures1. Sleep frequency and duration, settling procedures, time taken to setde at night, age when child first slept through the night and number of night‐time wakenings requiring parental intervention. 2. Parents' problems with their child's sleep behaviour.ResultsThere is a wide range of normal childhood sleep behaviour. Circadian rhythm is not well established until four months of age. Daytime sleep becomes less regular with increasing age. Frequent nighttime wakening is common from four to 12 months. Night‐time settling requires more parental input from 18 months. A large proportion of parents (28.6%) have a problem with their child's sleep behaviour.ConclusionsParents require information from health care providers about the wide range of normal childhood sleep patterns. This information can help prevent misdiagnosis, inappropriate medication use, child abuse and parental depression when children's sleep patterns are a problem.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127383.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo report three cases of cardiotoxicity related to the administration of 5‐fluorouracil (5‐FU) in patients with cancer.Clinical featuresThree patients with gastrointestinal malignancies were being treated with combined radiotherapy and chemotherapy regimens. Two patients developed myocardial ischaemia and the other a ventricular arrhythmia in association with 5‐FU administration.Intervention and outcomeAll patients survived the cardiac event. No patient was rechallenged with 5‐FU. Radiotherapy was continued, achieving a good tumour response.ConclusionCardiotoxicity is rarely reported with 5‐FU. The cardiac events can be life threatening. It is difficult to predict which patients will be affected. Clinicians need to be aware of this potential toxicity and monitor patients appropriately.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127384.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb127411.x

出版商:Wiley    

年代:1994

数据来源: WILEY