ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01722.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01723.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01724.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground:The increasing numbers of cancer patients, the high costs of terminal care, and the development of palliative care services have led to a growing interest in patterns of terminal cancer care. These patterns are relevant to the formulation and evaluation of health services policy.Aims:To investigate trends in the place of death of South Australian cancer patients between 1981 and 1990, and to examine associations of socio‐demographic and clinical variables with the place of death.Methods:Data relating to 2715 deaths attributed to cancer in 1990 were extracted from the Central Cancer Registry. To assess trends, these data were directly standardised to the age‐sex distribution of cancer deaths in 1981 and 1985 which were investigated in a previous study. Unconditional logistic regression was used to investigate predictors of place of death.Results:The proportion of deaths which occurred in major metropolitan public hospitals decreased from 40% in 1981 to 28% in 1990. Conversely, the proportion which occurred in hospice units increased from 5% to 20% over the same period. There was a decline in the proportion of deaths which occurred in private hospitals, but there was no significant change in the proportion which occurred in country hospitals or nursing homes. The proportion of deaths at home remained around 14%. Associated with place of death were age, sex, type of malignancy, survival time from diagnosis to death, Aboriginality, and area of residence. Further research to assess the clinical appropriateness of terminal care patterns is suggested. (Aust NZ J Med 1993; 23: 245

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01725.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01726.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground:Dyslipoproteinaemia is an important risk factor for cardiovascular disease in uraemic patients on continuous ambulatory peritoneal dialysis (CAPD). Lovastatin is an HMG Coenzyme A reductase inhibitor which is useful in treating non‐uraemic patients with hypercholesterolaemia.Aims:We conducted a single blind cross‐over study versus placebo in 10 CAPD patients to examine the effect of lovastatin (20–40 mg) on the serum lipid profile and its safety in uraemic patients.Methods:Treatment phases were of eight weeks' duration. Each four weeks' measurements were made of serum total cholesterol (TC), triglyceride (TG), HDL‐cholesterol (HDL‐C), LDL‐cholesterol (LDL‐C), VLDL‐cholesterol (VLDL‐C), Apolipoprotein Al&B (Apo Al&Apo B) and Lipoprotein (a). After eight weeks, lovastatin significantly reduced TC by 29% from 6.7 ± 0.3 (mean±S.E.M.) to 4.8±0.1 mmol/L, LDL‐C by 41% from 4.6±0.3 to 2.7±0.1 mmol/L and Apo B by 32% from 116±7 to 78±3 mg/dl (p<0.01). HDL‐C increased by 8% froml.2±0.1 to 1.3 ±0.2 mmol/L after eight weeks' therapy (p<0.05). TG decreased by 18% from 1.9 ±0.4 to 1.6 ±0.3 mmol/L(p<0.05). There was no significant difference in changes of other lipid profiles between placebo and drug. No adverse effects of the drug were noted during treatment and the liver function and muscle enzymes were not significantly altered by either drug therapy or placebo.Results:Lovastatin appears to be a safe and useful drug in effectively treating dyslipoproteinaemia in CAPD patients. (

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01727.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground:The pathophysiology of cystinuria remains unclear. Decreased absorption of L‐cystine across brush border membranes of small intestinal and renal proximal tubular epithelial cells is likely but has not been directly demonstrated.Aims:To compare the rates of L‐cystine transport by isolated duodenal brush border membranes of normal individuals and patients with cystinuria.Methods:Distal duodenal biopsies were taken from normal individuals and patients with cystinuria. Brush border membrane vesicles (BBMV) were prepared using magnesium aggregation and differential centrifugation and the rates of L‐cystine transport into the vesicles measured using a rapid filtration technique.Results:Rates of L‐cystine transport by BBMV from patients with cystinuria were reduced at 5 minute(p =0.003) and 30 minute (/>= 0.053). Time points, indicating that L‐cystine absorption across brush border membranes is abnormal in cystinuria. (Aust NZ J Med 1993; 23:

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01728.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground:The accuracy of the assessment of patients with malignant disease and of their response to chemotherapy has been significantly improved with the routine availability of computerized tomography (CT) scanning. CT abnormalities, however, may be non‐specific, especially after chemotherapy. Rebound enlargement of the thymus gland after chemotherapy induced atrophy is one cause of an abnormal thoracic CT scan on re‐staging.Aims:This phenomenon has previously been reported mainly in relation to the treatment of lymphoma and germ cell cancers. This paper highlights the occurrence of thymic hyperplasia after chemotherapy in these and other tumour types.Methods:We discuss five cases including three patients with malignancies other than lymphoma in whom thymus enlargement occurred during or after intensive chemotherapy.Results:Clear identification of the nature of CT abnormalities after chemotherapy, particularly in the mediastinum, is required prior to embarking on further anti‐cancer treatments. (Aust NZ J Med 1993; 23: 264

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01729.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground:Traditional Chinese medicines often contain ‘chuanwu’ and ‘caowu’, the roots of certainAconitumspecies which are thought to have an anti‐inflammatory effect in many conditions. Excessive amounts of these materials, which contain diterpene alkaloids particularly aconitine, can produce toxic effects and occasional fatalities.Aims:This study was conducted to document the adverse effects related to these herbal medicines which resulted in hospital admission and to determine the outcome in these patients.Methods:A retrospective survey was conducted of patients admitted to the Prince of Wales Hospital, Hong Kong with suspected adverse effects from Chinese herbal medicines containing chuanwu or caowu over a two year period from 1989 to 1991.Results:Eight patients were identified with features of mild to moderate intoxication including nausea and vomiting, paraesthesiae or numbness in the mouth and extremities, hypotension and ventricular extrasystoles. The management of aconitine poisoning is essentially supportive and in‐hospital observation with ECG monitoring should be continued for at least 24 hours because of the risk of cardiovascular collapse and ventricular arrhythmias. The medical profession and general public should be alerted to the potential toxicity of these herbs and their usage should be controlled by legislation in Hong Kong as it is in some other countries. (Aust NZ J Med 1993; 2

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01730.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground:Yttrium synovectomy for chronic synovitis of the knee enjoys widespread usage in Australia with approximately 400 patients receiving yttrium‐90 in 1991. Despite abundant anecdotal evidence of its efficacy there is a paucity of controlled trials and those that have been done have produced conflicting results and have been of insufficient sample size.Aims:To critically and quantitatively evaluate the published English literature on comparative trials of yttrium‐90 therapy for chronic synovitis of the knee.Methods:The technique of meta‐analysis was utilised. The literature search was carried out using the MeSH terms of synovectomy and knee; and yttrium. This was augmented by referring to reviews, current textbooks and back‐references. Outcome measures varied between trials but could be grouped as treatment success. The Peto modification of Mantel and Haenszl was used for statistical pooling of data yielding a pooled odds ratio (OR).Results:The literature search revealed ten controlled trials of which two were excluded from further analysis. Yttrium was superior to placebo (OR 2.42, 95% CI 1.02–5.73) but this result should be interpreted with caution due to possible publication bias. Yttrium was not superior to triamcinolone (OR 1.89, 95% CI 0.81‐10.55) or other active modalities (OR 1.04, 95% CI 0.72‐1.52). Further research comparing yttrium with other modalities is necessary to properly determine its place in rheumatological practice. (Aust NZ J Med 1993;

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1993.tb01731.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY