The Medical journal of Australia
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To review current and potential analgesic techniques in day surgery, with particular regard to their pharmacology. ⋯ Combination analgesia therapy is the best approach for postoperative analgesia for day surgery. The usefulness of preoperative blockade of the pain sensation which limits activation of the central pain pathway and decreases analgesic requirements, is also emphasised. Examples of measures for relief of mild, moderate and severe pain are given.
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To identify reliable predictors of envenomation in suspected snake bite and to examine the current standard of treatment in envenomed patients. ⋯ Headache, abdominal pain, nausea or vomiting, or abnormal coagulation tests accurately predict envenomation by snakes in southern mainland Australia. More or better education on first aid and clinical management of snake bite is needed.
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To report a case of progressive disease caused by Mycobacterium bovis after BCG vaccination in a patient asymptomatically infected with the human immunodeficiency virus (HIV). ⋯ BCG vaccination of asymptomatic HIV-positive patients is not recommended. The detection of those at risk for HIV infection before vaccination administration is essential. Self-exclusion based on information supplied to all potential recipients is likely to be the most effective method.
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To describe a method for accurate excision and exact histopathological diagnosis of impalpable breast lesions, considered suspicious of carcinoma, and detected on mammographic examination alone. ⋯ The use of an acrylic compression-grid specimen-evaluation device in the diagnosis of suspicious mammographic breast lesions facilitates confirmation of excision by specimen radiology, and expedites accurate histological examination of suspicious radiological lesions.