ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126591.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126592.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126593.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126594.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126595.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectivesTo determine the clinical features, response to treatment and outcome of petrol sniffers presenting to Perth's teaching hospitals.DesignRetrospective study of all admissions to Perth's tertiary referral hospitals that were related to petrol sniffing from 1 January 1984 to 31 December 1991.ResultsTwenty‐five patients (22 male and 3 female) were admitted with a diagnosis of intentional petrol sniffing. Five presented with acute petrol intoxication as the result of an isolated action. The remaining 20 patients were “chronic petrol sniffers”. The mean age was 17.7 years (range, 5‐27 years). Twenty patients were Australian Aborigines, including 18 of 20 chronic petrol sniffers and the three females. In the chronic petrol sniffers, a high prevalence of seizures and an alarmingly high case fatality ratio (8 of 20), usually by sudden death, were found. An altered mental state was universal, manifesting as drowsiness, delirium or stupor. Generalised tonic‐clonic seizures occurred in 14, three with status epilepticus. Myoclonus (9), chorea (8) and cerebellar ataxia (appendicular and truncal) (13) were common. High blood lead levels on presentation were associated with a poor prognosis (survivors v. deaths,P=0.002). Eighteen of the 20 patients were treated with specific agents to reduce the lead load, but the results were extremely disappointing.ConclusionPetrol sniffing is an important cause of sickness and death in young people from some rural Aboriginal communities. It can cause sudden death or irreversible encephalopathy. Those severely affected have a poor prognosis, despite treatment. Effective strategies for prevention are needed.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126596.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectivesTo examine the upper gastrointestinal endoscopic findings in Australian Aborigines in central Australia; to determine if peptic ulceration occurs in this group; and to discover whether this population sharesHelicobacter pylorias a risk factor for peptic ulceration.MethodsA retrospective analysis of the records of all Aboriginal patients undergoing endoscopy at a general hospital over a two‐year period.ResultsEighty‐five endoscopies were performed in 64 patients. Haema‐temesis and melaena was the indication for 24 patients (more commonly in men) and a cause was identified in 83% of these patients; varices were the cause in 17%. Pain was an indication for 25 patients (more commonly in females) and abnormalities were detected in 64%. Peptic ulceration was found in nine patients and a further 23 had gastritis or duodenitis. Cases of oesophageal, gastric and duodenal malignancy were seen, as well as late complications of simple diseases, including gastric outlet obstruction, oesophageal stricture and cholecysto‐duodenal fistula formation. Of 17 gastric biopsies with evidence of inflammation,H. pyloriwas found in 15 (88%).ConclusionThis, the first study of upper gastrointestinal endoscopy in Aborigines, shows its usefulness in the investigation of their gastrointestinal complaints. Oesophageal varices were found to be an important cause of bleeding. Peptic ulceration associated withH. pyloriwas found to be common.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126597.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126598.x

出版商:Wiley    

年代:1994

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126599.x

出版商:Wiley    

年代:1994

数据来源: WILEY

摘要:

ObjectivesTo assess the relative clinical toxicity of pheniramine compared with other antihistamines taken in overdose and its relative use for self‐poisoning.DesignA prospective follow‐up cohort study of antihistamine self‐poisonings. Local pharmacists were surveyed to ascertain the approximate market share of pheniramine.SettingNewcastle, Australia.Subjects102 patients giving rise to 118 consecutive admissions to hospital for antihistamine self‐poisoning after ingestion of pheniramine (43) or other antihistamines (75).Main outcome measuresGeneralised seizures, delirium/psychosis, sedation,QRSwidth, mean blood pressure.ResultsPheniramine accounted for only 3.0% of antihistamine items dispensed, 5.5% of defined daily doses (DDDs) dispensed, but 33.9% of antihistamine self‐poisonings. Fourteen admissions were complicated by seizures and 43 by delirium/psychosis. Patients admitted after ingestion of pheniramine were more likely to have generalised seizures (13 of 43) than those ingesting other antihistamines (one of 75). Other complications (sedation, need for ventilation, prolongation ofQRSInterval, change in blood pressure) were comparable. A very high proportion of the pheniramine group had a history of drug or alcohol abuse (79.9%). This included 60.5% with a history of antihistamine abuse. The figures for those who ingested other antihistamines were 46.7% and 6.7% respectively.ConclusionsPheniramine is taken in overdose more frequently than other antihistamines relative to its market share. It Is also more likely to be abused than other antihistamines. In overdose, It appears to be more pro‐convulsant than other antihistamines. Consideration should be given to the use of alternative antihistamines in patients at risk of seizures. In the light of these findings, regulatory authorities should review the over‐the‐counter availability of pheniramine.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1994.tb126600.x

出版商:Wiley    

年代:1994

数据来源: WILEY