1,721,061 research outputs found
Attention deficit disorder: not just for children
No full textAttention deficit/hyperactivity disorder (ADHD) has long been described in children who demonstrate developmentally inappropriate symptoms of inattention, impulsivity and motor restlessness. In adults, symptoms are known to persist and the validity of adult ADHD as an entity is now recognized. There is an associated high proportion of other serious psychiatric comorbidities, especially substance abuse, mood and anxiety disorders. Advances have been made into the aetiology and management of ADHD. Many of these focus on the dopamine and noradrenaline pathways
Pituitary apoplexy presenting as aseptic meningitis without visual loss or ophthalmoplegia
No full textClinical and spinal fluid evidence of aseptic meningitis were the sole features at presentation in a patient with pituitary apoplexy. Visual impairment and bitemporal field defects developed later. Necrosis within a chromophobe adenoma was found at surgical decompression of the sella
Statistical inference is overemphasised in cluster investigations: The case of the cluster of breast cancers at the Australian Broadcasting Corporation studios in Brisbane, Australia
No full textThe aim of statistical analyses in cluster investigations is to estimate the probability that the aggregation of cases could be due to chance. As a result of several statistical problems – including the post-hoc nature of the analysis and the subjective nature of implied multiple comparisons – this cannot be carried out with any certainty. In cluster investigations, expert opinion should carry much more weight than P-values, which are exceedingly difficult to interpret
The Role of Inflammatory Markers in Assessment of Disease Activity in Systemic Sclerosis
No full textPatient Reported Outcomes (PROS) in Patients with Rheumatic Diseases: Using the OPAL Registry to Link PROS with Clinical Outcome
No full textThey just don’t get enough! Variable intern experience in bedside procedural skills
No full textBackground: Medical school and resident training programmes offer different learning opportunities and outcomes. The aim of the study was to assess medical student and intern experience in common clinical procedures. Methods: Interns employed in a metropolitan teaching hospital from 2000 to 2004 completed a survey of experience and confidence in clinical procedures at the beginning and end of their intern year. Attendance at and the contribution to procedural confidence of a voluntary procedural skill-training programme were examined. Results: For the 314 interns, clinical experience before and during internship varied for each procedure and between year cohorts as did training programme attendance (44–84%). Student procedural confidence was predicted by pre-intern experience either on patients or by simulation (b = 0.17, 95% confidence interval (CI) 0.02–0.21, P = 0.03) and age >30 years on commencing internship (b = 8.44, 95%CI 3.03–14.06, P = 0.003. Adjusted R2 = 0.08, P = 0.002). Intern procedural confidence by year’s end was predicted by attendance at the training programme (b = 0.48, 95%CI 0.34–0.62, P < 0.001), intern experience with patient procedures (b = 0.34, 95%CI 0.21–0.47, P < 0.001) and a clear decision to enter a postgraduate training programme (b = 0.13, 95%CI 0.04–0.22, P = 0.007, Adjusted R2 = 0.50, P < 0.001). Conclusion: Interns and students receive variable experience to carry out procedural skills on patients. This makes designing training programmes difficult as training needs vary each year. Both mandatory supervision of key skills and opportunities to supplement limited experience are needed during the intern year to ensure a uniform experience
Should future health-care costs be discounted? The case of diabetes in Australia [Editorial]
No full textNo Abstrac
Reversible posterior leukoencephalopathy syndrome: Diagnosis and management in the setting of lung transplantation
No full textReversible posterior leukoencephalopathy syndrome (RPLS) is a potentially devastating early complication of calcineurin inhibitor (CNI) therapy in solid organ transplantation. Management centres on cessation of CNI therapy; however, this strategy is complicated in lung transplantation because of the threat of allograft rejection, or, if CNI is replaced with mammalian target of rapamycin-based immunosuppression, poor wound healing and bronchial dehiscence. We describe four cases of RPLS after lung transplantation, emphasizing the diagnostic and management approach required to maintain a healthy allograft and ensure that RPLS is, as the name suggests, reversible
Decreasing mortality from non-Hodgkin lymphoma in Australia
No full textBased on the number of new cases (incidence), non-Hodgkin lymphoma is an increasingly common cancer in Australia and many developed countries. Until recently, mortality trends have been stable or slightly increasing. However, since the year 2000, mortality has decreased every year by an average of 5.1% per year (95% confidence interval (CI) −7.1 to −3.1%), whereas incidence has continued to increase at 0.9% per year (95%CI 0.6 to 1.2%). It was not possible with the population-based registry data available to us to untangle the causes of the decrease in mortality. The stable mortality rates during the 1990s (in the face of increasing incidence) might have been because of introduction of novel therapies such as autologous stem cell transplant for relapsed diffuse large cell lymphoma or the purine analogue-based therapy for indolent lymphomas. A plausible explanation for the large decrease in mortality since 2000 is the introduction of the monoclonal antibody rituximab
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