ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137662.x

出版商:Wiley    

年代:1993

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137663.x

出版商:Wiley    

年代:1993

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137664.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo determine the likelihood of pregnancy for couples entering the New Reproductive Technology (NRT) programs in Australia and New Zealand, by combining the data from nearly all the practising units.DesignAll units practising in‐vitro fertilisation (IVF) and/or gamete intrafallopian transfer (GIFT) were contacted and asked to provide data on patients treated and pregnancy rates. These figures were then combined to produce life tables to determine the likelihood of pregnancy with repeated attempts.SettingIVF/GIFT units in five States of Australia, the Australian Capital Territory and New Zealand. Eighteen of the 22 units provided data to be analysed.PatientsData were available for analysis on 18 089 cycles of IVF resulting in 3034 clinical pregnancies, and 6308 cycles of GIFT resulting in 1724 clinical pregnancies.Main outcome measuresThis was either “clinical pregnancy” (the presence of products of conception on ultrasound examination), or “viable pregnancy” (a pregnancy developing to at least 20 weeks of gestation).ResultsAfter four attempts at IVF, half the couples achieved a pregnancy, whereas four attempts at GIFT resulted in two‐thirds of the couples achieving pregnancy.ConclusionBoth IVF and GIFT are effective and successful options for infertile or subfertiie couples. New Reproductive Technology should be readily available in every advanced clinic dealing with subfertile couples in the 1990s.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137665.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo ascertain the prevalence of hysterectomy in the South Australian community.Design and settingData were collected as part of the South Australian Health Omnibus Survey which involved a self‐weighting, multistage, systematic, representative area cluster sample of 4608 households in metropolitan and country South Australia. One thousand and forty‐seven women over the age of 40 were personally interviewed by trained data collectors.Outcome measuresDemographic characteristics, selected medical descriptive variables and the prevalence of hysterectomy.Results27.9% of the respondents over 40 had undergone a hysterectomy. The prevalence rose from 18.9% in the 40–44 age group to 31.4% in women aged between 55 and 64 years. There were no statistically significant associations with country of birth, educational attainment or income. Significantly more women who had undergone a hysterectomy were current or past users of oestrogen replacement therapy and they also visited their general practitioner more frequently. Elevated body mass index and the prevalence of diabetes also approached statistical significance.ConclusionAt current rates nearly a third of South Australian women will have a hysterectomy during their lifetime.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137666.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo prospectively study occupational exposures to human immunodeficiency virus (HIV) and other blood‐borne pathogens.Design and settingDetailed clinical information was collected and follow‐up was performed on all health care workers with occupational exposures to potentially infected substances at Fairfield Infectious Diseases Hospital during the period January 1985 to September 1991.ResultsThere were 230 occupational exposures reported. One hundred and forty‐one were considered “significant” or “potentially significant”; these involved exposure (or the potential for exposure) to blood or body fluids by the parenteral route or contamination of non‐intact skin or mucous membranes. Needle/syringe assemblies accounted for 59% of the “significant” injuries, “butterfly” needles for 21% and lancets for 8%. “Butterfly” needles were over‐represented relative to their degree of use. Seventy‐seven of the 230 exposures were HIV‐related and 27 of these were considered “significant”. The number of HIV positive patients attending the hospital increased progressively over the survey period but the rate of HIV‐related exposures fell during that time. After 1988, 13 individuals with “significant” exposure to HIV received a six‐week prophylactic course of zidovudine. No health care workers seroconverted for HIV, hepatitis B or hepatitis C during the survey period.ConclusionsThe risk of acquiring HIV (and other blood‐borne diseases) through occupational exposure is very low and this risk can be further reduced by adopting safe work practices.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137667.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo characterise the molecular abnormalities present in a cohort of patients with the Angelman syndrome.MethodsDNA samples from 10 patients with the Angelman syndrome were investigated with molecular probes. Family studies were performed by means of DNA polymorphism analysis and densitometric estimation of allele copy number to determine the underlying mutation and its parental origin.ResultsNine probands were shown to have molecular (DNA) deletions involving chromosome 15q11‐q13. Polymorphism analyses demonstrated that all deletions were maternal in origin. Five of the nine had normal karyotypes, with deletions only detected after DNA study. One patient had inherited both chromosomes 15 from her father. This represented an example of paternal uniparental disomy of chromosome 15.ConclusionsDevelopment of the Angelman syndrome can result from either deletion of the maternally‐derived copy of chromosome 15q11‐q13 or the presence of two paternally derived copies of chromosome 15, that is, uniparental disomy. DNA testing allows the identification of deletions that are not seen on cytogenetic analysis and can provide additional information regarding the parental origin of the deletion. Uniparental disomy is most readily established by DNA studies.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137668.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectivesTo compare the causes of deaths recorded on death certificates with findings at autopsy and to identify other deficiencies in the completion of death certificates.Design and settingThe causes of death (Part I and II) recorded on the death certificates of all patients undergoing autopsy at St Vincent's Hospital, Melbourne, in 1992 were compared with the autopsy findings. Additional clinical information about previous medical and surgical history and antemortem investigations was obtained from the clinical summary in the autopsy reports, and from hospital charts in some cases.PatientsIn 1992, 132 hospital autopsies were performed (autopsy rate of 24.2%). Of these patients, 68% were aged 65 years or over, and 30% were aged 75 years or over.ResultsMajor discrepancies between the cause of death listed on the certificates and autopsy findings were found in 16 cases (12%). Other deficiencies of death certification included listing the mode of death (e.g., cardiac failure) without an underlying cause in 14 cases (11%); failure to cite recent major surgery in 17 of 20 cases (85%); failure to specify site or organism in 33 of 40 cases (82.5%) of infection or sepsis.ConclusionsThis study confirmed findings of previous studies with respect to missed major diagnoses, but identified other deficiencies in certification of causes of death, which could compromise accuracy of statistics obtained from death certificates. Mechanisms by which these deficiencies can be prevented or corrected are discussed.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137669.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo examine weight change among patients attending a smoking cessation program administered by general practitioners.DesignBody weight and smoking level were measured at the initial assessment and at a six‐month follow‐up visit. Pretreatment measures of demographic, attitudinal and smoking‐related variables were examined for relationship to weight gain.ParticipantsA total of 235 patients who were part of a smoking cessation study in Sydney.Main outcome measureChange in weight over six months.ResultsAbstainers (n= 52) gained an average of 4.0 kg, significantly more than continuing smokers who gained an average of 1.2 kg. Among abstainers, only self‐ratings of good health predicted weight gain.ConclusionsResults indicate that weight gain among general practice patients following smoking cessation is similar to that in other research settings.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137670.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

Recent advances in diagnostic techniques for parasitic diseases, such as improved serological and molecular techniques, have been accompanied by improvements in the traditional methods involving staining and microscopy. Timing of tests and background information about where the patient has been are important factors. Detailed information is given of the appropriate specimens for diagnosis of protozoan and helminthic infections and of the sensitivity and specificity of the various tests.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137671.x

出版商:Wiley    

年代:1993

数据来源: WILEY