Ultrasonography of pylorospasm: findings may simulate hypertrophic pyloric stenosis.

We compared sonographic images and measurements of patients diagnosed as having hypertrophic pyloric stenosis and pylorospasm among infants with projectile vomiting. Thirty-seven patients with hypertrophic pyloric stenosis had an unchanged pyloric length (mean, 22.5 mm) and muscle wall thickness (mean, 5.3 mm). Thirty-four pylorospasm patients had considerable variability in measurement or image appearance during their studies. Means of their longest or largest measurements were 14.4 mm for pylorus length and 3.8 mm for muscle wall thickness. Among these, 53% had muscle wall thickness of 4 mm or greater and 18% had pyloric length of 18 mm or greater during some portion of their study. We concluded (after clinical follow-up study confirmed our ultrasonographic diagnoses) that pylorospasm may mimic hypertrophic pyloric stenosis for at least a portion of a sonographic study. Muscle wall thickness or pyloric length measurements may overlap those accepted as positive for hypertrophic pyloric stenosis. Image or measurement variability is an important clue for diagnosing pylorospasm.

Illicit drug use by young people in sydney: results of a street intercept survey.

To complement existing institution-based drug use surveys, a street intercept survey of 581 young illicit drug users was conducted in Sydney, Australia. Patterns of use, reasons for use and awareness of the health risks associated with use were investigated. The most commonly used illicit drug type, after marijuana, was amphetamines. The least popular illicit drug was heroin. Most of the sample used occasionally, exhibiting a controlled pattern of use with a low prevalence of problems associated with use. Heroin users, in contrast, were often frequent users and reported a higher prevalence of associated problems. The majority of the sample reported excessive drinking patterns, indicating that the current policy of emphasis on alcohol misuse rather than illicit drug use amongst youth is appropriate.

The characteristics of cocaine users among young adults in Sydney.

OBJECTIVE: To describe the prevalence and pattern of cocaine use among young Sydney adults interviewed during a study of the "market position" of cocaine. DESIGN: A telephone survey of young Sydney adults. PARTICIPANTS: A total of 499 young Sydney men and women aged between 14 and 35 were selected to ensure a sample of 300 persons who used alcohol and tobacco at least weekly, and who had been offered or had tried at least one illicit drug. MAIN OUTCOME MEASURES: These were the prevalence of having ever used cocaine, the frequency of cocaine use, the prevalence of daily alcohol and tobacco use, and of ever having tried marijuana, sedatives, designer drugs, amphetamines and heroin. RESULTS: Thirteen per cent of the sample (95% confidence interval [CI], 10%-16%) had ever tried cocaine, of whom only 20% (CI, 15%-25%) were current users. Cocaine users were distinguished from non-users by being more likely to be daily users of tobacco (odds ratio, 2.1; CI, 1.3-3.6) and alcohol (odds ratio, 3.0; CI, 1.7-5.6), and to have tried marijuana (odds ratio, 7.1; CI, 3.2-15.9), sedatives (odds ratio, 11.4; CI, 6.4-20.7), designer drugs (odds ratio, 17.2; CI, 9.2-32.2), amphetamines (odds ratio, 27.1; CI, 14.3-51.3), and heroin (odds ratio, 36.5; CI, 14.0-94.9). The odds of having tried cocaine increased with the number of different types of illicit drugs that the person had tried. CONCLUSIONS: The prevalence of ever having tried cocaine was low among a sample of young adults selected to ensure an over-representation of illicit drug users. Cocaine users were more likely to have experimented with a variety of different types of illicit drugs. Only a minority of those who had ever tried cocaine were current users.

Pilot study: effective health and personal development. An experiment in school education.

This paper describes an experimental school-based health education and personal development programme conducted jointly by the Health Commission and Department of Education in northern Sydney, New South Wales. We evaluated the programme after it had been taught for five school terms, by adopting a control/experimental group design based on multiple choice questionnaires. We recorded large and significant gains in the health status of the secondary students from the experimental schools compared with the control students. Notable successes were in the areas of cigarette smoking (reductions as high as 13%), alcohol consumption (reductions of up to 12%) and exercise (increase of 17.5%). The long-term effectiveness of such programmes may depend on support from the medical profession.