ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01517.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01518.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01519.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01520.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackgmund:The use of chelating agents to treat patients with petrol sniffing encephalopathy has been controversial, since alkyllead additives in petrol are not chelatable. A high mortality has also been reported in hospitalised petrol sniffers.Aims: (i) Evaluate the efficacy of chelating agents in mobilising lead for excretion and lowering blood lead; (ii) Review factors contributing to mortality in hospitalised petrol sniffers.Methods: All males chelated between 1992–1993 were studied (n = 20). Blood and urinary lead were measured daily before and during chelation then twice weekly until discharge. Parenteral calcium disodium edetate (EDTA) and dimercaprol (BAL) were administered together, every six hours for five days, seven patients subsequently received oral D‐penicillamine until discharge. Clinical details were reviewed for eight patients with petrol sniffing encephalopathy who died between 1990–1994.Results: Urinary lead excretion substantially increased during parenteral chelation (median excretion=I13 μM/L days, compared with pre‐chelation excretion =1.1 μM/day). Median blood lead concentration fell from 4.83 μM/L (pre‐chelation) to 1.91 μM/L (post‐chelation). D‐Penicillamine did not appear to increase urinary lead excretion appreciably. All eight deaths followed sepsis; five from complications of aspiration pneumonia.Conclusions: Airway maintenance and management are crucial for survival in these patients. In the short‐term, parenteral chelation was effective in mobilising lead for excretion and reducing blood lead in encephalopathic petrol sniffers and was comparable to cases of inorganic lead intoxication. However, as in the treatment of inorganic lead intoxication, the long‐term efficacy of chelation for petrol sniffers remains controversial. Prevention strategies against petrol sniffing at a community

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01521.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01522.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground: Trends in the incidence of acute myocardial infarction (MI) that are based on admissions to hospital would be misleading if the proportion of non‐fatal infarctions treated at home changed over time.Aim: To estimate trends in the management at home of cases of non‐fatal AM1 in Perth between 1984 and 1993 in order to determine if the number of such cases has remained consistently small and can be neglected in studies of the incidence of AMI.Methods: In 1989, 251 general practitioners in Perth responded to a postal questionnaire asking about management of cases of AM1 at home in the preceding 12 months. In 1993, 288 general practitioners and 174 physicians responded to the same questionnaire.Results: We estimate that 1.5% of all patients less than 65 years of age diagnosed with non‐fatal AM1 were managed at home in 1989. The corresponding figure for 1993 was 4.1%. A previous study in Perth in 1984 found that 3.9% of cases of non‐fatal AM1 in patients less than 65 years of age were managed at home.Conclusion: The management at home of cases of non‐fatal AM1 in people of working age in Perth has remained at a negligible level from 1984 to 1993. Thus a register based on admissions to hospital for AM1 will accurately reflect trends in AM1 in people of wo

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01523.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground: The need for liver biopsy is increasing with the increasing availability of treatments for liver disease, in particular interferon. For this reason the procedure must be efficient and economical, as well as safe.Aims: Firstly to assess the safety of outpatient liver biopsy when performed with ultrasound guidance and the 'Biopty™ gun. Secondly, to compare the cost of an outpatient and inpatient procedure.Methods: Two hundred and fifty consecutive liver biopsies performed over a two year period at St Vincent's Hospital, Melbourne were reviewed retrospectively. Indications, histological findings and complications were recorded.Results: Seventy per cent of the biopsies were performed as an outpatient procedure. There were no major complications. Four patients experienced prolonged pain post biopsy. The average cost for an outpatient biopsy was 351, the cost of an inpatient (overnight stay) was 690.Conclusion: Outpatient liver biopsy is safe and cost effective, with minor complications in 1.6%. The routine use of ultrasound guidance and the Biopty™ gun is likely to contribute to these favourable resu

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01524.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground: Until recently, new data on immune aspects of Alzheimer's disease (AD) have suggested that some facets of AD pathogenesis may be immune related. However, the effects of dementia itself on immune function have not been considered.Aim: To compare the distribution of peripheral blood lymphocyte subsets and their function in patients with AD and other dementias.Methods: Peripheral blood lymphocyte numbers, T cell subset distribution, proliferative responses to mitogens and suppressor cell assay were studied in a well characterised group of patients with AD, and compared to patients with other forms of dementia. Age and sex matched elderly controls were screened to exclude dementia, and young controls were medical, paramedical and laboratory staff. Analysis of variance (ANOVA) and student'sttest were used for statistical analysis.Results: The CD8 + lymphocyte population was reduced in AD and in other forms of dementia, when compared with non‐demented elderly and young controls. Concanavalin A induced lymphocyte transformation was reduced in all dementia groups and in elderly compared with young controls. The changes in T cell numbers and function were not specific for Alzheimer's disease, but were found also in other forms of dementi

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01525.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractMethods: Serum 25‐hydroxyvitamin D3, a marker of recent sun exposure and vitamin D status, was measured in 390 New Zealand residents (95 Pacific Islanders, 74 Maori and 221 others mostly of European descent), who were part of a larger cross‐sectional survey of a workforce (n= 5677) aged 40–64 years.Results: Serum 25‐hydroxyvitamin D3levels were significantly lower in Pacific Islanders (mean (SE) = 56 (3) nmol/L;p= 0.0001) and Maoris (68 (3) nmol/L;p=0.036) compared with Europeans (75 (2) nmol/L) after adjusting for age, sex and time of year. Also adjusting for ethnic group, 25‐hydroxyvitamin D, was higher in people doing vigorous (aerobic) leisure physical activities (71 (2) nmol/L; p=0.0066) and moderate (non‐aerobic) activities (68 (3) nmol/L; p = 0.12) compared with those who were inactive (63 (2) nmol/L). However, 25‐hydroxyvitamin D3was unrelated to body mass index, serum lipids, blood pressure or cigarette smoking.Background: Recent research suggests that body vitamin D levels are decreased in coronary heart disease and diabetes, but it is unclear which cardiovascular risk factors are related to vitamin D status.Aims: To examine the relation between vitamin D status and major cardiovascular risk factors.Conclusions: People with increased skin pigmentation, such as Polynesians, and people who are inactive, have decreased body levels of vitamin D; this might partly explain their increased risk of cardiovas

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1995.tb01526.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY