Health bulletin
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(1) To review the pattern of published world age-standardised registration rates for myeloma (ICD8 and ICD9 203) for the five Scottish regional cancer registries between 1973-77 and 1983-87. (2) To review the patterns of world age-standardised incidence and survival for myeloma in Grampian region over the time period 1960-89. ⋯ The increase in myeloma incidence may be due to a combination of improved ascertainment, especially in the elderly and a possible true increase in incidence in females, suggestive of increased exposure to an aetiological agent in the past. A formal year birth cohort analysis is required to confirm this finding. The overall prognosis for myeloma remains poor, especially for elderly patients and efforts to elucidate the aetiology must continue.
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(a) To assess the practice of junior doctors who administer thrombolytic therapy in acute myocardial infarction. (b) To assess whether wider implementation of current guidelines is indicated. ⋯ There is wide variation in clinical practice among junior doctors who administer thrombolytic therapy for acute myocardial infarction. Wider implementation and firmer current national guidelines would ensure that patients presenting with suspected acute myocardial infarction receive optimal therapy.
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A postal survey of all Consultant Anaesthetists working within Scotland was conducted to establish the current state of epidural analgesia and the level of post-operative care for patients after epidural opioid administration. Of those consultants using epidurals for post-operative analgesia, 89% use extradural opioids, and the lipid soluble opioids diamorphine and fentanyl by an infusion technique were the most popular. For analgesia in labour the use of extradural opioids drops to 41% with fentanyl by bolus the commonest drug and method of administration. ⋯ Sixty-nine per cent of consultants frequently send their patients to a high dependency unit following epidural opioid administration. Additional administration of opioids on an ordinary ward setting is considered inappropriate by over half of the consultants replying. There is considerable variability amongst anaesthetists as to how patients receiving epidural opioids should be monitored and National Recommendations are required to stop the present confusion.
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The study takes a three stage approach to review Scottish unit policies, staff views and parents experiences of visiting and involvement with their low birthweight infant (1,750 gm or less) in a sample of Scottish neonatal intensive care units (NICUs). The study indicated that while most units had 'liberal' views regarding parental and family visiting some staff views were not in line with their unit policy and retained reservations about family visiting. Many parents reported visiting daily despite considerable 'social' and real costs. Unit differences emerged regarding the degree of parental involvement as measured by tasks carried out.