A randomized double-blind trial of glypressin in the management of acute epistaxis.

This is the first randomised double-blind trial of glypressin in the treatment of acute epistaxis, where no localized bleeding point was found and where the patient would normally be treated with a form of nasal packing. It shows a statistically significant benefit with the intravenous drug compared to placebo. In addition, the dose of glypressin used to achieve control appears to be free of major side effects.

Patients infected with human immunodeficiency virus type 1 have low levels of virus in saliva even in the presence of periodontal disease.

In two consecutive studies, 80 subjects human immunodeficiency virus (HIV)-1-seropositive (21 asymptomatic, 6 persistent generalized lymphadenopathy, 13 AIDS-related complex, and 40 AIDS) were examined for oral lesions. Paired serum and saliva specimens were tested for HIV isolation, DNA, and antigen. HIV antigen was detected in sera from 31 patients, but not in saliva.

Bullous impetigo in homosexual men--a risk marker for HIV-1 infection?

Objective: To determine the incidence of bullous impetigo in a group of homosexual men at high risk of HIV-1 infection.

Design: A longitudinal descriptive study (1984-9).

Setting: A private primary care and STD clinic in Sydney, Australia.

Clinical and molecular aspects of molluscum contagiosum infection in HIV-1 positive patients.

Molluscum contagiosum virus (MCV) lesions from 31 human immunodeficiency type 1 (HIV-1) positive patients and 54 HIV-1 negative adult control patients were examined for the presence and type of MCV DNA by high stringency Southern hybridization using 32P-labelled or digoxigenin-labelled MCV DNA probes. Of the 83 patients whose lesions contained detectable MCV DNA, 77 were infected with a single type of MCV (16 with MCV 1; 29 with MCV 1v; 30 with MCV 2; and 2 with MCV 2v). Five patients had apparent double infections, with hybridization results indicating the presence of various combinations of MCV 1 or 1v and MCV 2 or 2v.

Prolonged bleeding time as a marker of venous clot lysis during streptokinase therapy.

Despite their expense and inconvenience, serial ultrasound or venographic examinations are currently the only available methods to assess the efficacy of thrombolysis for deep venous thrombosis (DVT). We therefore tested whether the bleeding time (BT), a simple and inexpensive test, is useful in assessing lytic efficacy and might thus be a valuable adjunct in guiding the dose and duration of the thrombolytic agent. Serial BTs were obtained daily in 16 patients (eight men and eight women, average age 45.

Frequency of deep venous thrombosis in asymptomatic patients with coronary artery bypass grafts.

The frequency of deep vein thrombosis (DVT) in patients undergoing coronary artery bypass graft (CABG) surgery has not been established. Therefore to estimate the frequency of clinically silent DVT, we performed ultrasound examinations of the leg veins in 29 asymptomatic CABG patients before hospital discharge. We used high-resolution B-mode ultrasonography with color Doppler imaging.

The influence of human immunodeficiency virus type 1 infection on the development of the hepatitis B virus carrier state.

To assess the influence of human immunodeficiency virus type 1 (HIV-1) infection on the natural history of acute hepatitis B virus (HBV) infection, a study was undertaken of the clinical records of all 77 homosexual men with documented seroconversion to anti-hepatitis B core antibody (anti-HBc) between visits to either of two Sydney clinics between 1985 and 1989. HIV-1-seropositive subjects developed chronic HBV infection (positive for hepatitis B surface antigen [HBsAg] greater than 6 months) more frequently (7/31, 23%) than HIV-1-seronegative ones (2/46, 4%; P = .026).

Heterosexual gonorrhoea in central Sydney: implications for HIV control.

Gonorrhoea is a sexually transmissible disease (STD) characteristic of a core group of individuals and their contacts. From the experience of a Sydney STD clinic, as well as local and national population-based reports, trends in heterosexually acquired gonorrhoea in Australia over a decade were examined. An overall decline of 90% in case numbers between 1981 and 1989 was found, with an average yearly decline of 30%.

A study of the relationship between tensile testing of condoms and breakage in use.

The ability of the condom wall to maintain its integrity throughout sexual intercourse is critical to its role in halting the spread of major sexually transmissible pathogens including the human immunodeficiency virus. There are three principal in vitro performance tests applied to condoms: a test for freedom from holes, an inflation test, and tensile testing. In this study we subjected condoms that had broken in use to tensile tests in order to determine any correlation between their in vivo and in vitro performance.

Relationship of perceived maternal acceptance-rejection in childhood and social support networks of pregnant adolescents.

In a sample of 53 at-risk pregnant adolescents, the relationship between their perceptions of maternal acceptance-rejection in childhood and the nature of their social supports was examined. Perception of acceptance-rejection was significantly correlated with both frequency of interaction with social network members and expectations of their future support. Implications for public health strategies are discussed.

Program for the prevention of venous thromboembolism in high-risk orthopaedic patients.

Postoperative orthopaedic patients remain at risk for venous thromboembolism (VTE) after hospital discharge. Therefore, the authors designed and implemented a program for prevention of VTE that included outpatient adjusted-dose warfarin using twice-weekly prothrombin time (PT) determinations, a dedicated telephone line for PT results, and vigilant nurse-physician supervision to administer prophylaxis to 125 postoperative orthopaedic patients against VTE for an average of 31.4 days after discharge.

Recombinant tissue-type plasminogen activator versus urokinase in peripheral arterial and graft occlusions: a randomized trial.

A randomized prospective trial was undertaken to compare intraarterial administration of recombinant human tissue-type plasminogen activator (rt-PA) with urokinase (UK) in 32 patients with peripheral arterial or bypass graft occlusions. Sixteen patients were randomized to receive rt-PA and 16 to receive UK. The rt-PA dose was administered as a 10-mg bolus into the thrombus, followed by 5 mg/h for up to 24 hours.