Biomedical subjects
Publications and source records attributed to J Nacey.
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AIM: To review those cases of Schistosoma haematobium presenting in Wellington during 1993 and 1994. METHOD: All patients receiving praziquantel during 1993 and 1994 were traced through local pharmacy records. Their clinical records were reviewed and they were contacted by phone to ensure a complete set of information was obtained. This included timing of possible exposure to the parasite, symptoms, investigations and response to treatment. RESULTS: Nine patients were identified who had been treated with praziquantel during this period. The records of six patients were available for review, all of whom had recently travelled to Africa and had swum in water contaminated with the parasite. Four had presented to medical practitioners with irritative voiding symptoms and scant intermittent haematuria. One presented with haematospermia and one after becoming aware that a friend had contracted schistosomiasis. All were treated with a single dose of praziquantel. CONCLUSIONS: This paper has demonstrated an increased number of cases of Schistosoma haematobium being identified in Wellington. The prevalence of this condition is low, but has been seen to increase recently and relates to the increasing numbers of New Zealanders touring Africa. Patients present with relatively mild, nonspecific symptoms which require a high index of suspicion to ensure that appropriate investigations are ordered. The currently available treatment is efficacious and relatively well tolerated.
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AIMS: To assess the prevalence of urinary incontinence in New Zealand women of European, Maori and Pacific Island descent aged 18 years and over. METHODS: A questionnaire, designed to be self administered, was sent to a group of 1028 women selected at random from the electoral roll in central Wellington. Incontinence was defined as any involuntary loss of urine. If present, details were sought regarding the occurrence, type, and severity of the incontinence so that the prevalence and nature of the problem within ethnic groups could be determined. RESULTS: The prevalence for Maori women (46.8%) was significantly greater than for either Pacific Island (29.2%) or European women (31.2%) (chi 2 = 14.02, p = 0.001). Increasing age, and parity were associated with increasing prevalence of incontinence for all ethnic groups. Of the incontinent women, 9% were continually incontinent, 28% once or more daily, and 37% more than twice monthly. A further 26% were incontinent less than twice monthly. The most reported type of incontinence was stress incontinence (48% of incontinent women), with 27% reporting urge incontinence, and 21% a mixed picture of stress and urge. There was no significant difference in the frequency of these symptoms between the different ethnic groups. Fifty per cent of incontinent women reported wanting help for their urinary problems, but only one third had sought medical assistance, with many regarding incontinence as a normal occurrence. CONCLUSIONS: Urinary incontinence is common in New Zealand women irrespective of ethnic group. The low proportion of women seeking medical assistance emphasises the need for much greater awareness and public education of what is largely a treatable clinical problem. Urinary incontinence is estimated to affect more than one quarter of the female population. The prevalence varies according to different age groups, and although it is recognised that incontinence is more common in the elderly, a significant number are young with nearly 20% of female children experiencing episodes of urinary leakage. The medical, personal and social impact of urinary incontinence is substantial, but surprisingly it is largely ignored, both by women with the condition, and by those providing health services to them such that it has been described as 'the hidden epidemic'. In New Zealand, research has been carried out on the prevalence of urinary incontinence and reasons for not seeking treatment in the European community, but the other major ethnic groups in New Zealand (Maori and Pacific Island) have not been investigated. The aim of this study was to assess the prevalence of urinary incontinence in these ethnic groups and to determine any differences to the prevalence of incontinence in European women in a similar socioeconomic environment. In addition, it was hoped to obtain some understanding of the attitudes of the women in each group to incontinence and their perception of the currently available treatments and medical services.
Testicular cancer is the most common malignancy in young men and is frequently associated with delays in presentation. It has been postulated that ignorance and poor awareness of this type of cancer may contribute to such delays, which may result in high stage disease and subsequent treatment-related morbidity. This study was undertaken to assess the level of awareness of testicular cancer in a sample of 500 men from Wellington, New Zealand, and to specifically examine awareness related to the age, race, and socio-economic level of the respondents. Sixty-one per cent of men returned a satisfactorily completed questionnaire. Most (70%) were unaware that cancer of the testis could develop. Of those who correctly identified testis cancer as occurring, half recognized the most commonly affected age group, 40% understood testis cancer could be treated, and 14% believed testis cancer could be cured with treatment. The lowest awareness score (mean +/- s.d.) were found in the 18-30 age group. The score in this group (2.82 +/- 1.47) was significantly lower than that seen in the 31-40 (mean 3.66 +/- 1.81, P = 0.009) or 41-50 (mean 3.57 +/- 2.16, P = 0.036) age groups. Differences were also seen between ethnic groups, with Maori having significantly lower scores than non-Maori (Maori, mean 2.69 +/- 1.52; non-Maori, 3.45 +/- 1.83; P = 0.044). Higher scores were associated with higher socio-economic grouping. The overall poor awareness of men in this study supports the need for a public education programme aimed at encouraging men to seek early advice following the recognition of testicular masses.
The urinary catheter is one of the most frequently used medical devices and has a long and intriguing history of development. This paper describes the catheter from its simple beginnings through the subtle but important changes it has undergone paralleling the advances in plastics technology witnessed this century. The changes have not been without controversy and the recent association of catheters with tissue toxicity, which has forced the implementation of strict guidelines for their manufacture and use, is described.
A standard household 650 W microwave oven was used to sterilize polyethylene catheters of the type used for intermittent self-catheterization. The catheters were infected with Proteus sp. bacteria and microwaved at 650 W for periods of 2, 4, 6 and 8 minutes. The effect of microwaving was assessed by determining the resultant colony counts following catheter culture. It was determined that 6 minutes of microwaving were required to achieve sterility. It is suggested that use of a microwave oven is a reliable and cost-effective method of sterilizing polyethylene catheters for intermittent self-catheterization.
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We have measured the effects of Org 10172 (a mixture of naturally occurring glycosaminoglycans derived from hog intestinal mucosa) on blood loss after transurethral prostatectomy (TURP), using doses which are likely to prevent postoperative venous thrombosis (VT). 48 patients entered a double-blind randomised pilot study: 18 were given subcutaneous (sc) injections of a placebo and 30 received sc Org 10172 (750 anti-Xa units/day, 500 units twice daily (bid), or 750 units bid, starting just before TURP and continued until discharge; 10 patients per group). No Org 10172 regimen increased peroperative blood loss but all caused a similar trend towards increased urinary bleeding after surgery. Since there was no apparent dose effect gradient, it was decided to pool the data from all three dosing blocks: this analysis showed that Org 10172 increased geometric mean blood loss during the first 2 days after surgery from 10.4 gm hemoglobin (Hgb; range = 3.2-71) to 20.5 gm Hgb (range = 1.9-147) (p = .005), an effect which retained its significance after allowing for two other major determinants of postoperative bleeding, the weight of prostate resected and the length of surgery, and also when pooling was restricted to the twice daily Org 10172 injection groups and their corresponding controls. Bleeding was not severe, but our results indicate a need for caution when considering the use of Org 10172 in this setting.