ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137619.x

出版商:Wiley    

年代:1993

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137620.x

出版商:Wiley    

年代:1993

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137621.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo estimate the potential increase in renal donation rates if elderly donors (those over 60 years of age) were considered.DesignPatients dying from acute brain damage resulting from stroke were identified using the Royal Melbourne Hospital (RMH) Stroke Service Register. Their records were retrospectively analysed to assess their eligibility as potential renal donors.SettingOne hundred and ninety‐eight patients dying from acute brain damage caused by stroke at a large metropolitan teaching hospital (RMH), from May 1987 to December 1990 inclusive.Patient assessmentPatients were considered “eligible”, “ineligible” or “possibly eligible” (requiring further assessment) as donors according to existing strict criteria (see methods) but irrespective of age.ResultsOf 198 stroke patients dying of brain damage, 92 satisfied the criteria of eligibility for renal donation; 51 of these were over 60 years old, yet only one became a renal donor.ConclusionThere is good evidence that elderly donors are acceptable for renal transplantation, yet they are not being referred. The consideration of elderly stroke victims as renal donors could have a dramatic effect on decreasing transplant waiting lists, increasing recipient patient well‐being, and reducing hospital costs.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137622.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo review the various clinical manifestations of Murray Valley encephalitis (MVE) or Kunjin virus encephalitis in patients in Western Australia.DesignReview of clinical records, 1978 to 1991.PatientsOf 26 reported cases of Australian encephalitis, four were excluded from study because the patient's symptoms were not definitely associated with MVE virus or Kunjin virus infection. Two further cases of MVE were not reviewed as case records were not available. Of the remaining 20 patients, 18 had MVE and two had Kunjin virus encephalitis.ResultsSixteen cases were in the Kimberley, a tropical region where the viruses are endemic. Four were in the subtropical Pilbara and Gascoyne regions. Thirteen of the 20 cases were in Aborigines, of whom 11 were children. The seven non‐Aboriginal patients were adults. Seventeen of 20 cases were in males. The range of neurological disease and outcome was similar to that in previously reported cases, with convulsions, brainstem disease or respiratory failure in severe and fatal cases, and involvement of the spinal cord, cranial nerve or cerebellum in the moderate cases. One mild case without neurological involvement was caused by Kunjin virus.ConclusionsThe poor outcome in young Aboriginal children indicated that disease resulting from exposure early in life was more likely to be severe. The disease in adults, irrespective of racial background, was similar to that in cases reported previously from south‐eastern Australia, but generally milder.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137623.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo estimate the frequency of cholestatic hepatitis of uncertain origin occurring among persons who had recently received flucloxacillin, a drug which has recently been reported as causing cholestatic hepatitis, and to compare this frequency with that related to oxytetracycline, a drug which has seldom been reported as causing this disorder.DesignA retrospective cohort study using data automatically recorded on general practitioners' office computers.SettingSome 600 general practices in the United Kingdom.Subjects132 087 people who received flucloxacillin and 145 844 people who received oxytetracycline.Main outcome measureClinically documented cholestatic hepatitis of uncertain origin diagnosed 1–45 days after a prescription for flucloxacillin, 46–90 days after a prescription for flucloxacillin and, for comparison, 1–45 days after a prescription for oxytetracycline.ResultsThere were 10 cases of cholestatic hepatitis of uncertain origin diagnosed within 45 days of receiving flucloxacillin that were either characteristic of or consistent with a syndrome recently described as being associated with this drug; there was one such case 46–90 days after a prescription for flucloxacillin; there were three such cases 1–45 days after a prescription for oxytetracycline.ConclusionFlucloxacillin is a likely cause of cholestatic hepatitis. The risk is estimated to be in the range of 7.6 per 100 000 users (95% confidence interval, 3.6–13.9).

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137624.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo estimate the risk of cholestatic hepatitis of uncertain origin in patients who had recently received erythromycin, a drug which is known to cause this disorder.DesignA retrospective cohort study using data automatically recorded on general practitioners' office computers.SettingSome 600 general practices in the United Kingdom.Subjects366 064 people who received erythromycin.Main outcome measureClinically documented cholestatic hepatitis of uncertain origin diagnosed 1‐45 days after a prescription for erythromycin.ResultsThere were 13 cases of cholestatic hepatitis of uncertain origin diagnosed within 45 days of receiving erythromycin which were either characteristic of or consistent with a syndrome previously described as being associated with this drug.ConclusionThe risk of cholestatic jaundice associated with erythromycin is estimated to be in the range of 3.6 per 100 000 users (95% confidence interval, 1.9–6.1).

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137625.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectiveTo determine the pattern of seropositivity to the three species ofChlamydiain women and children from a single community.DesignTesting of blood samples obtained during a prospective study of mothers and infants. For each individual, the sample giving the highest titre of antichlamydial antibody was included in the analysis.SettingThe only health centre for a small rural community in the Top End of the Northern Territory. This served all 1200 or so residents, almost 95% of whom were Aboriginal.ParticipantsSixty‐one pregnant Aboriginal women at routine antenatal clinic visits, and 114 of their children aged between one and six years at the time of sampling.Main outcome measureSpecific IgG or IgM antibody to any of the three species ofChlamydiaat titres ≥32, as determined by micro‐immunofluorescence.ResultsIgG antibody to one or more chlamydial species was found in 83.6% of mothers and 42.1% of their children. IgM antibody was found in five mothers and four children, in each case against only one chlamydial species. IgG antibody toC. trachomatiswas found in 55.7% of mothers and 28.9% of children, toC. pneumoniaein 59.0% of mothers and 19.3% of children, and toC. psittaciin 29.5% of mothers and 17.5% of children. Log linear modelling gave positive correlations between seropositivity forC. trachomatisandC. pneumoniae(χ2= 9,P<0.01), and forC. trachomatisandC. psittaci(χ2= 15,P<0.001). Cross‐reactivity was more evident in children than in mothers.ConclusionsThis is the first Australian report providing serological evidence of exposure to the three chlamydial species in one community. The seropositivity patterns suggest complex interactions when all species are present.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137626.x

出版商:Wiley    

年代:1993

数据来源: WILEY

摘要:

ObjectivesTo study the changes in admission rates for hip fracture in New South Wales in the last decade; and to compare the age‐adjusted rates with those from Europe, America and Asia.MethodsHospital discharge data for the years 1981, 1986 and 1989–1990 for New South Wales were used. The number of patients discharged with hip fracture (International Classification of Diseases code 820) as one of the diagnoses was calculated. Age‐specific rates were calculated using the census population for 1981, 1986 and 1991. These rates were then directly standardised to the 1985 United States population and then presented with similarly adjusted rates from countries in Europe, America and Asia.ResultsFor New South Wales men, the incidence rates of hip fracture (directly standardised to the 1985 United States population) for 1981, 1986 and 1989–1990 were 148 per 100 000, 181 per 100 000 and 182 per 100 000 respectively. In women, the rates for these three years were 437 per 100 000, 537 per 100 000 and 500 per 100 000 respectively. The age‐adjusted rates for both men and women were high and were comparable to the rates in the United States and New Zealand.ConclusionsThe incidence of hip fracture in NSW in the last decade was very high by world standards. The prevention of hip fracture is essential as the Australian population ages.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137627.x

出版商:Wiley    

年代:1993

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1993.tb137628.x

出版商:Wiley    

年代:1993

数据来源: WILEY