Hospital grand rounds in Australia.

Objective: To determine whether grand rounds are becoming less common in Australian hospitals.

Design And Participants: Between November 2003 and April 2004, we surveyed 88 clinicians with educational responsibilities in Australian hospitals. A written questionnaire evaluated whether grand rounds were held and how frequently; the structure and percentage of attendees; and the perceived value of grand rounds with regard to education, professional development and general characteristics.

Interstitial lung disease in recent onset rheumatoid arthritis.

Interstitial lung disease (ILD) is associated with rheumatoid arthritis (RA); however, the prevalence and natural history are undefined. Our aim was to determine the prevalence of ILD associated with RA using a number of sensitive techniques in patients with joint disease of less than 2-yr duration. Patients who met ARA criteria for RA were recruited from community-based and hospital rheumatologists and assessed using the following measures: clinical, lung physiology, radiology (chest X-ray, high resolution CT [HRCT]), bronchoalveolar lavage (BAL) and 99mTc-DTPA nuclear scan.

Respiratory insufficiency after abdominal surgery.

The objective of this study was to define the relationship between respiratory insufficiency (RI) and various putative risk factors for patients undergoing abdominal surgery. A review of 1332 adults undergoing abdominal surgery was undertaken. Information was collected in a unbiased, prospective and uniform manner with regard to baseline characteristics, perioperative events and adverse outcomes after surgery.

A case-control study of postoperative pulmonary complications after laparoscopic and open cholecystectomy.

Postoperative pulmonary complications (PPC) are common after upper abdominal surgery. The objective of this case-control study was to compare the incidence of PPC after laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) within a tertiary care center. Patients were accrued from two sequential clinical trials that evaluated the role of incentive spirometry in the prevention of PPC after abdominal surgery.

Prevention of respiratory complications after abdominal surgery: a randomised clinical trial.

Objective: To evaluate the prevention of respiratory complications after abdominal surgery by a comparison of a global policy of incentive spirometry with a regimen consisting of deep breathing exercises for low risk patients and incentive spirometry plus physiotherapy for high risk patients.

Design: Stratified randomised trial.

Setting: General surgical service of an urban teaching hospital.

The cost-efficiency of incentive spirometry after abdominal surgery.

This report gives the results of a cost-efficiency analysis of a prospective longitudinal study evaluating two forms of prophylaxis against postoperative pulmonary complications in 876 patients undergoing abdominal surgery. It cost $12.19 per patient for conventional chest physiotherapy, and equivalent costs accrue when incentive spirometers are recycled and used on average 2.

Pulmonary alveolar proteinosis in association with Fanconi's anemia and psoriasis. A possible common pathogenetic mechanism.

We report a case of PAP which proved to be fatal despite whole lung lavage. The need for early BAL and transbronchial biopsies in diffuse infiltrative lung disorders of unknown etiology is highlighted. The occurrence of PAP in association with Fanconi's anemia and psoriasis raises the possibility of a common pathogenetic defect which may be related to abnormal cytokine metabolism.

Incentive spirometry versus routine chest physiotherapy for prevention of pulmonary complications after abdominal surgery.

We entered 876 patients into a clinical trial aimed at preventing pulmonary complications after abdominal surgery. Patients either received conventional chest physiotherapy or were encouraged to perform maximal inspiratory manoeuvres for 5 min during each hour while awake, using an incentive spirometer. The incidence of pulmonary complications did not differ significantly between the groups: incentive spirometry 68 of 431 (15.

A multivariate analysis of the risk of pulmonary complications after laparotomy.

We evaluated the relationship between PPC and various putative risk factors in a prospective longitudinal study of 1,000 patients undergoing abdominal surgery. Transient subclinical events were excluded by defining PPC as positive clinical findings in combination with either positive sputum microbiology, unexplained pyrexia, or positive chest roentgenographic findings. The overall incidence of PPC was 23.

Multiple pneumatocoeles and bilateral tension pneumothoraces complicating pneumocystis pneumonia in AIDS.

Pneumatocoele and pneumothorax are uncommon complications of Pneumocystis carinii pneumonia. We report a patient with the Acquired Immune Deficiency Syndrome who developed multiple bilateral pneumatocoeles which we demonstrate to have ruptured leading to the subsequent bilateral tension pneumothoraces and to death. The computerised tomographic appearances, and histopathology of these unusual complications are presented.

Nebulized ipratropium in the treatment of acute asthma.

The efficacy of ipratropium and salbutamol was determined in 117 patients with acute asthma who presented to an emergency department to determine whether the order of administration of the two agents affects the improvement in peak flow rates. Patients were given two nebulized treatments at an interval of one hour in a randomized, double-blind design. They received either 5 mg nebulized salbutamol followed by 0.

Evaluation of ketotifen (HC20-511) in bronchial asthma.

Ketotifen 1 mg b.d. (oral) and sodium cromoglycate 20 mg q.

Effect of intravenous injection of rimiterol in asthma.

1 The effect of i.v. rimiterol was compared with aerosol rimiterol in twelve asthmatic patients.

Comparative efficacy of salbutamol by pressurized aerosol and wet nebulizer in acute asthma.

1 Cumulative dose-response curves (FEV1) to pressurized aerosol salbutamol were established in 17 patients admitted to hospital with acute severe asthma. After the maximal pressurized aerosol effect had been achieved, a further dose (5 mg) of salbutamol was given by wet nebulizer and any further increment recorded. 2 Baseline FEV1 was 1.

A hand-held calculator program for individualized dosage adjustment of intravenous theophylline in acute asthma.

Despite general development of drug assay services and increasing interest in pharmacokinetics, proper dosage regimen calculations are not often made in routine clinical practice. This could be due, in part, to unfamiliarity with pharmacokinetic theory, the consequent difficulty of collaboration and the inevitable delay while data are processed on a computer. The present program for a hand-held calculator (TI-59) was written to minimize these problems, and was designed for the use of intravenous theophylline in the management of acute asthma, where there is a need for individualisation of dosage.

Abuse of drugs "for kicks": a review of 252 admissions.

Abuse of drugs "for kicks" is becoming more common in Great Britain. This article reviews 252 consecutive cases of drug abuse admitted to the Regional Poisoning Treatment Centre, Royal Infirmary, Edinburgh, during 1971 and 1972. Of the 189 patients (146 males and 43 females; mean age 20 years) 72% of admissions occurred between 6 p.