The Medical journal of Australia
-
Sixteen persons with a wide range of disabilities were subjected to a formal scuba-diver training course, after passing a medical and psychological assessment specific for divers. Subjects with brain damage and with impaired bladder and bowel control were included. ⋯ The study supports the argument that scuba-diving may improve the physical self-concept of selected disabled persons. It is stressed that specialized diving supervision is essential for such people.
-
Seventy-five episodes of bacteraemia or fungaemia related to indwelling temporary intravenous devices were assessed by the Infectious Diseases Unit of The Westmead Centre, to determine the quality of care of these devices. The estimated incidence of systemic sepsis was 1% for all central venous catheters inserted and 0.1% for all peripheral venous catheters inserted. ⋯ Staphylococcus aureus was the most common isolate (41%); antibiotic resistant Gram-negative rods were also common (38%). It is concluded that continued education of resident and nursing staff is essential to minimize the risk of intravenous catheter-related sepsis.
-
Occupational asthma is a hypersensitivity syndrome, and must be distinguished from non-specific aggravation of existing asthma. Probably only a minority of the causal agents produce sensitization by allergic mechanisms. The important clinical features of occupational asthma are the latent period before the onset of symptoms, the characteristic periodicity of symptoms, and the progressive increase in the severity of symptoms with continuing exposure. ⋯ Identification of the agent responsible is desirable but not essential to the diagnosis, and specific bronchial challenge with the causal agent should be reserved for atypical cases. Symptomatic or prophylactic drug treatment should never be more than a short-term measure. The most effective treatment is for the patient to change his job.