ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02785.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02786.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:Notifications of 485 patients with culture‐positive tuberculosis (TB) in Western Australia from 1980 to 1989 inclusive have been analysed. In 478 (98.6%) the disease was caused byMycobacterium tuberculosis hominisand in seven (1.4%)M. bovis. Most (78.5%) of the disease was pulmonary with 4.3% pleural and 17.2% extrapulmonary. The annual incidence decreased from 4.6 per 100 000 in 1980 to 2.5 in 1985 steadying thereafter around 3.3. The Aborigines had over four times the average incidence of the non‐Aboriginal Australians but less than a quarter that of the Asians. In a total 297 migrants, 51% of 253 with data available had been in Australia for over five years. Initial drug resistance was found in 48 patients giving an overall rate of 9.9%. In 32 (66.7%), resistance was against a single drug, mainly isoniazid and in 11 (22.9%) against two drugs, predominantly isoniazid and streptomycin. The most disturbing finding was the occurrence of multiple‐drug resistance including both isoniazid and rifampicin in five immigrants (10.4%). This study has provided useful baseline TB data, raised important issues such as chemoprophylaxis and drug resistance, and clearly indicates that the campaign against TB is far from over. Continual surveillance, monitoring and regular evaluation of existing policies should be maintained. (Aust NZ J Med 1992; 22: 109

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02787.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:Official records show that the rates of mortality from ischaemic heart disease (IHD) in Tasmania have been the highest of all the Australian states for most of the past decade. This study assesses the accuracy of the official Tasmanian mortality data for IHD in 1987 and 1988 for males aged 25 to 74 years using routinely available clinical and pathological data supplemented by information from the attending doctor. Our findings show that a death officially coded to ICD 9 rubrics 410–414 (IHD) in Tasmania has 94% sensitivity and a positive predictive value of 90% for fatal definite acute myocardial infarction or possible coronary death as defined by the WHO. Comparison of our results with those of two earlier studies undertaken in Australian mainland centres indicates that differences in the official statistics for coronary mortality between Tasmania and the mainland states reflect true differences in the risk of coronary death. While the results from three Australian studies suggest that the routine system of death certification is reasonably accurate, careful monitoring of death certification and coding practices need to be undertaken regularly in all states of Australia if secular changes in regional patterns of coronary mortality are to be regarded as credible. (Aust NZ J Med 1992; 22: 114–1

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02788.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:Thirty‐one patients with malignancy, anticoagulated for the treatment of venous thromboembolism (VTE) are reported. Complications of treatment included major bleeding (35%), redevelopment of VTE whilst on therapeutic levels of anticoagulants (13%) and recurrent VTE following cessation of anticoagulant (42%). Forty‐two per cent of patients died within three months of initiating anticoagulant therapy. The cause of death was progressive malignancy, except in one patient who died of anticoagulant‐related bleeding. The high incidence of bleeding is frequently associated with over‐anticoagulation and indicates the need for improved monitoring. The frequent recurrence of VTE is associated with chronic disseminated intravascular coagulation, for which warfarin is ineffective and heparin is indicated. (Aust NZ J Med 1992; 22: 1

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02789.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:In an attempt to improve response and survival rates in patients with non‐Hodgkin's lymphoma, a relatively intense six drug regimen MATCOP was developed comprising four‐weekly cycles of methotrexate (100mg/m2, IVYday 8), Adriamycin (30mg/m2, IVYdays 1,2), teniposide (75 mg/rn2, IV, day 1), cyclophophamide (300 mg/m2, po, days one to five), Oncovin (1.4 mg/m2, IV: maximum 2 mg, days 8,15) and prednisolone (100 mg, po, days one to five). A randomised trial was conducted comparing MATCOP with the standard CHOP regimen, comprising three‐weekly cycles of cyclophosphamide (750 mg/m2, IV, day 1), Adriamycin (50 mg/m2, IV, day 1), Oncovin (1.4 mg/m2IV: maximum 2 mg, day 1) and prednisolone (100 mg, PO, days two to six). Eighty patients with large cell lymphoma, diffuse mixed small cleaved and large cell lymphoma or diffuse small cleaved cell lymphoma were randomised, 47 to MATCOP and 33 to CHOP. MATCOP patients experienced increased granulocytopenia, thrombocytopenia (p0.0001), mucositis (p= 0.002) and infections (p= 0.01) compared to CHOP patients. Complete response rates were similar: 66% for MATCOP patients and 61% for CHOP patients. There were no apparent differences in the time to relapse for patients achieving CR, the time to treatment failure or the overall survival time. Thus despite an increase in toxicity, the more intense regimen MATCOP failed to confer any therapeutic benefit compared with the standard CHOP regimen.Survival was not influenced but toxicity was increased by dose intensification. (Aust NZ J Med 1992; 22: 123

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02790.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:Streptokinase is the thrombolytic agent most commonly used for the treatment of acute myocardial infarction. We report eight patients who developed late uncommon adverse reactions to streptokinase probably due to immune complex disease. The clinical manifestations included vasculitic rashes, abnormal renal and liver function tests and a syndrome resembling adult respiratory distress syndrome, Major adverse events with streptokinase such as stroke, bleeding and othet allergic reactions, have been previously documented but the morbidity related to delayed reactions has not been widely recognised. These reactions produced significant morbidity resulting in prolonged hospital stay and may need to be considered in the decision to use streptokinase. (Aust NZ J Med 1992; 22: 129–133

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02791.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:One‐hundred‐and‐three patients underwent surgery for paroxysmal supraventricular tachycardia (PSVT). In eighty‐three patients (81%), PSVT was due to an accessory atrioventricular pathway (Group I) and in 20 (19%) to Atrioventricular Junctional (AV nodal) Reentrant Tachycardia (AVJRT:Group II). Initial surgery successfully divided 77 of 83 accessory pathways, including 58 of 60 left free wall pathways, 12 of 15 posteroseptal pathways, six of seven right free wall pathways and one anteroseptal pathway. Twenty patients had successful surgery for AVJRT. Surgery was performed with low morbidity and no early or late mortality in either group. One patient in each group required permanent pacemaker implantation. Immediate (within one week) postoperative electrophysiological study using epicardial wires was performed in 96% of patients and repeat electrophysiological study six months later was possible in 65/103 (63%) patients. Patients with surgery for accessory pathways were followed‐up for a mean 34 ± 23 months, while those with surgery for AVJRT for a mean of 13 ± seven months. No patient with successful surgery has had a clinical recurrence of PSVT. Thus the results indicate that surery is a safe and curative therapy for patients with PSVT. (Aust NZ J Med 1992; 2

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02792.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:Involvement of the thyroid gland by plasma cell neoplasms is a rare occurrence. Two modes of presentation are described; firstly as part of disseminated myeloma and secondly, as an isolated plasma cell neoplasm of the thyroid as the only evidence of disease. We wish to describe two cases of thyroid involvement as part of disseminated disease. (Aust NZ J Med 1992; 22: 139–141

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02793.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1992.tb02794.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY