Medical treatment of 145 cases of gastric dilatation in rabbits.

Gastric dilatation is an acute and life-threatening condition in pet rabbits commonly caused by an intestinal obstruction with pellets of compressed hair. Surgery is normally considered to be the treatment of choice to alleviate the obstruction. However, for various reasons such as restrictions by the owner, a high anaesthetic risk due to the critical condition of the patient or concurrent diseases, surgical treatment may be impossible. In a three-year period, 145 cases of gastric dilatation were treated medically with a combination of metoclopramide, metamizole, balanced fluid electrolyte solution with glucose and syringe feeding. No gender or breed predisposition could be noted. Four animals were euthanased, three of them directly after diagnosis. Eleven animals died, eight of them on the day of presentation. The medical treatment was successful in 130 cases (89 per cent) with a mean treatment time of three days. The animals were released from hospital when eating and defecating normally. Although the use of medical treatment of gastric dilatation has to be thoroughly considered, especially regarding the severity of obstruction, the painfulness and the animal's welfare, the good survival rate observed with these animals makes it a good option for all cases where surgical treatment is contraindicated.

Obstetrics and gynaecology in Australia, 1914-1994.

The last 80 years have seen enormous advances in the area of women's health. Perhaps the most important have been the efforts to improve medical standards after the First World War and the development of hormone therapy--specifically, the contraceptive pill, which has had far-reaching effects on women's ability to control their bodies, their fertility and their place in society.

Performance indicators--their place in health care evaluation.

OBJECTIVE: To report on some of the more important performance indicators used at St Vincent's Private Hospital, Sydney. METHOD: Clinical data collected using DRG technology is reviewed by the Clinical Review Committee and its subcommittees. Administrative data and consumer satisfaction sampling by questionnaire are used to provide other performance indices. Performance indicators are reviewed on a quarterly basis to assess quality of care. The importance of definitions and subset analysis is emphasised and the cost effectiveness of using DRG technology to retrieve data is presented. CONCLUSION: Performance indicators are a cost-effective, sensitive tool to assist in the evaluation of the quality of health care.

Multifocal endometrial type carcinoma involving 5 primary sites in the pelvis.

A case of widespread endometrioid carcinoma is reported. The concept of multifocal carcinoma in the pelvis is discussed.

The diagnosis, treatment and complications of cervical intraepithelial neoplasia--experience at the Royal Hospital for Women, Sydney, during the years 1972-1982.

During the 11 years 1972-1982, 770 patients with cervical intraepithelial neoplasia III (carcinoma in situ/severe dysplasia) were treated at The Royal Hospital for Women, Sydney. Of these, 592 had primary conization (Group I) and 153 had colposcopically directed biopsy and diathermy (Group II). Carcinoma in situ was diagnosed in the remaining 25 following hysterectomy for other gynaecological indications. The recurrence rates were similar in the 2 groups, but the conization group had a complication rate of 9.6% while none of the patients in group II had any significant complications. The presenting symptoms, gravidity, cytology and histopathological diagnosis were similar in the 2 groups. The conization and subsequent hysterectomy rates have decreased over the years. However, 50% of patients are still treated in this institution by cone biopsy. More conservative treatment (biopsy and diathermy) is being performed in increasing numbers of younger patients.

Smoking and pregnancy.

Smoking is associated with decreased fertility in both males and females, an increased abortion rate, lowered birth weight, an increased still birth rate and probably an increased neonatal death rate. There is also a reduced incidence of maternal hypertension (although the babies are at even greater risk), an increased incidence of ante-partum haemorrhage, impaired brain development and possible teratogenic effects. These effects can be reversed if the mother gives up smoking in pregnancy.