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At least 19 recordsLinked to original sources
PubMed1989

The implications for Australia of the New Zealand report of the cervical cancer inquiry: no cause for complacency.

The New Zealand Cervical Cancer Inquiry established that patients with carcinoma-in-situ were left untreated in order to observe the natural history of their disease. Many patients developed invasive carcinoma unnecessarily and some died. The Inquiry found the research to have been unethical in that: the risk of progression to invasive carcinoma was known; the subjects had not consented to such study; and the study was designed and conducted poorly. The Inquiry was critical of the lack of proper review and the failure of responsible doctors and administrators to intervene in the interests of the patients. This article considers reasons for this failure and background issues of ethics and law. It is concluded that there is no cause for complacency in Australia in that provisions that are designed to protect patients may be ineffective. The NZ recommendations for changes in communication with patients, in the treatment of patients, in reviews of research, and in the training of doctors should be examined for their possible adoption in Australia.

Attitude of Health Personnel↗
PubMed1989

The New Zealand Report of the cervical cancer inquiry: significance for medical education.

The New Zealand Cervical Cancer Inquiry has elicited considerable interest in Australia as well as in New Zealand. However, relatively little attention has been paid to the future practice of medicine with regard to the relevance of the Inquiry's findings for medical education, although it did recommend the incorporation of ethics teaching into all stages of the medical curriculum, and also urged that attention be paid to communication skills within the curriculum. In this article, I argue that medical ethics teaching should be seen as an essential part of the medical curriculum, with the teaching being integrated closely with the other disciplines that comprise the medical course. To illustrate one possible approach, I have outlined elements of current ethics teaching at the University of Otago. I also have raised what I regard as wider issues for the medical curriculum. These include the need for students to develop a critical facility and an ability to handle conflicting data and attitudes (fostered principally by an understanding of research methods), to appreciate the importance of accountability (fostered in part through group learning activities) and to be aware of the impact of community concerns on the practice of medicine. Another issue which I consider is raised indirectly by the Inquiry concerns the procedures that are used for the selection of students into medical courses.

Attitude of Health Personnel↗
PubMedDate not supplied

Rapid in vivo destruction of Yt(a+) erythrocytes in a recipient with anti-Yta.

A patient with anti-Cartwright (anti-Yta) is reported. Immunohematologic studies showed this antibody to be an IgG immunoglobulin that does not bind complement. A 51Cr red blood cell survival study resulted in a greatly reduced half-life of less than six hours of Yt(a+) cells. The antibody titer increased threefold after the red blood cell survival study. Determination of red cell survival is indicated when crossmatch-incompatible blood transfusion is considered.

Antibodies↗
PubMed1991

The extent of cervical screening in New Zealand women.

To estimate the extent of cervical screening coverage of New Zealand women, a national survey of 1000 randomly selected women with a supplement of 200 Maori women was carried out by the National Research Bureau in August 1990 for the Department of Health. The results indicate a high level of screening in women aged 20-64 and improvements in coverage over the last three years, probably in response to the Cartwright inquiry. Overall, 77% of women reported having had a smear test within the previous three years and after adjustment for hysterectomy, this proportion increased to 82%. Screening coverage, however, was unevenly spread according to ethnic group, age and household income. Only 15% of European women reported no smear test in the last three years compared with 27% of Maori and Pacific Island women. The likelihood of having had a smear test in the last three years increased with increasing income. The survey confirms a high level of very frequent screening throughout New Zealand (2.4 smear tests per woman in the previous three years); the most frequent screening occurred in women 20-24 years of age (2.9 smears). Because an organised national screening programme has the potential to maintain and extend screening coverage to all age and ethnic groups, as well as reduce the number of unnecessary smears, it is likely to be more cost effective than the current screening practice.

Adolescent↗
PubMed1988

Comparison of the effects of carboxyl terminal truncation and point mutations on pp60c-src activities.

pp60c-src kinase and transforming activities are negatively regulated by phosphorylation of Tyr 527, a residue 6 amino acids from its carboxyl terminus. Tyr 527 to Phe mutation has been shown to activate pp60c-src, yet pp60c-src(F527) is still less active than pp60v-src. To see if additional carboxyl terminal mutation can stimulate pp60c-src transforming activity to pp60v-src levels, we compared the properties of pp60c-src(Am517), a pp60c-src mutant in which the 17 carboxyl terminal amino acids were deleted, with those of pp60c-src(F527) and pp60c-src(F519), a protein in which the Tyr nearest to Tyr 527 was changed to Phe. Tyr 519 to Phe mutation did not affect pp60c-src activities while the Am517 mutation activated focus formation, growth in soft agarose, in vivo tumorigenicity and in vitro specific kinase activity to levels between those of pp60c-src and pp60c-src(F527). This contrasts with a previous study [Cartwright et al. (1987) Cell 49, 83-91] which reported that Am517 mutation enhances biological activities without enhanced kinase activity. These data support the hypotheses that (1) complete transformation by pp60c-src requires activation of its protein tyrosine kinase activity and (2) that downregulation by the pp60c-src carboxyl terminus is governed by phosphorylation of Tyr 527; additional changes beyond that needed to prevent this phosphorylation do not further enhance activity.

Animals↗
PubMed1991

Porokeratosis of Mibelli and immunosuppression.

Immunosuppression is recognized to predispose to the development of disseminated superficial actinic porokeratosis and to cause the spread of pre-existing lesions. Porokeratosis of Mibelli has been less frequently described following immunosuppression and we report a further case.

Humans↗
PubMed1992

Oculocardiac reflex in the anophthalmic socket.

The oculocardiac reflex occurred in a patient with an anophthalmic socket undergoing surgery for inferior fornix shortening and laxity of the lower lid. This reflex occurs only rarely in anophthalmia; it has not been previously reported during socket surgery.

Aged↗