ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138503.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138504.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138505.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138506.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo investigate the hypothesis that HIV can be transmitted via contamination of multidose vials of local anaesthetic solution through reuse of needles and syringes.Design and settingLaboratory study. (1) By experiments with multidose vials and disposable needles and syringes, we identified a sequence of events in which HIV could contaminate the anaesthetic solution. (2) Three anaesthetic solutions were contaminated with a laboratory strain of HIV and tested by viral culture and p24 enzyme immunoassay one, two and four hours later to see how long the virus remained active.Results(1) Needles and syringes retained small volumes of fluid after use (mean, 25 μL; in syringe alone, mean 16 μL) which could be transferred to multidose vials of local anaesthetic. (2) 10 mL of anaesthetic solution contaminated with 8 μL of HIV‐infected solution (equivalent to 1% infected lymphocytesin vivo) contained active virus one hour later. In some settings, HIV could be isolated four hours after exposure.ConclusionWhen inadvertently contaminated with HIV, multidose solutions represent a potential source of transmissible virus.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138507.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectivesTo identify factors associated with a high risk of diabetic retinopathy in order to rank patients for urgency of examination by fundal photography.DesignRetrospective case survey.PatientsEight hundred and eighty‐eight consecutive diabetic patients who were routinely referred for mydriatic fundal photography to the Queen Elizabeth Hospital, Adelaide, between August 1987 and May 1992.Outcome measuresThe prevalence of non‐proliferative and proliferative diabetic retinopathy, and patient biochemical and demographic characteristics and urinary albumin excretion rate.ResultsThe prevalences of nonproliferative and proliferative diabetic retinopathy were 18.1% and 2.4%, respectively. Multiple logistic regression analysis established that treatment with insulin or oral hypoglycaemic drugs was associated with the highest risk of diabetic retinopathy (odds ratio [OR], 14.7; 95% confidence interval [CI], 3.4‐63.2), while duration of diabetes ⩾7 years (OR, 3.6; 95% CI, 1.9‐6.8), age 50‐66 years (OR, 2.1; 95% CI, 1.1‐4.0) and albumin excretion rate ⩾ 21 μg/min (OR, 2.2; 95% CI, 1.1‐4.5) were also significant risk factors. Non‐significant variables were hypertension, obesity and sex.ConclusionsDiabetic patients may be ranked for urgency of retinal photographic screening based on mode of treatment and duration of diabetes, thereby facilitating examination of patients at highest risk of asymptomatic diabetic retinopathy and increasing the efficiency of the screening program.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138508.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo investigate trends in recorded incidence and mortality rates for prostate cancer in South Australia.DesignA multiple Poisson regression analysis of recorded incidence (by diagnostic period) and mortality (by year of death), after adjusting for age at diagnosis and residential location.Subjects and setting8073 patients with prostate cancer and 2659 who died of prostate cancer as notified to the South Australian Cancer Registry for 1977‐1993.Main outcome measuresThe relative risk of a recorded diagnosis of prostate cancer (by period of diagnosis), and of a death from prostate cancer (by year of death).ResultsDuring 1977‐1989, the recorded age‐standardised incidence of prostate cancer was stable, but it increased markedly thereafter. The relative risk (95% confidence limits) of diagnosed prostate cancer was 1.36 (1.29, 1.43) in 1990‐1992, and 2.26 (2.12, 2.42) in 1993, when compared with 1977‐1989. There was a smaller and less certain increase in prostate cancer mortality.ConclusionsThe large increase in recorded incidence of prostate cancer in South Australia is thought to be due mostly to increased disclosure of latent cases from increased clinical investigations. Until there is experimental evidence of health benefits from screening and related investigations for prostate cancer in asymptomatic men, it will be difficult to reconcile benefits with costs.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138509.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo compare the efficacy of three types of diet and lifestyle interventions for lowering plasma lipid levels.DesignRandomised parallelgroup trial.Subjects and settingAdults with plasma cholesterol levels of 5.5‐8.0 mmol/L attending two Sydney community health screening clinics were asked to participate: 179 agreed and 131 completed the study.InterventionsA pamphlet with brief advice; group dietary counselling; or individual counselling. Counselling included three sessions with a dietitian/nutritionist over six months.Main outcome measuresPlasma total cholesterol levels measured by Reflotron analyser; fasting serum lipid levels measured by standard laboratory methods; and calculated low‐density lipoprotein cholesterol levels.ResultsSignificantly lower plasma total cholesterol levels (Reflotron) were observed at two months and at six months with each of the three interventions. Additionally, both types of dietitian‐based counselling resulted in small but significant decreases in plasma low‐density lipoprotein cholesterol levels at six months in a subset of subjects.ConclusionAlthough there were no statistically significant differences in efficacy between the three types of intervention, dietitians have a role to play in setting up such counselling programs.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138510.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138511.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138512.x

出版商:Wiley    

年代:1995

数据来源: WILEY