The Australian Mesothelioma Surveillance Program 1979-1985

The Australian Mesothelioma Surveillance Program was planned in 1977 in order to improve diagnostic criteria, to monitor the incidence of the disease, to develop methods of counting lung fibres, and to explore occupational and other associations of mesothelioma. This paper presents a preliminary analysis of data that were collected between January 1, 1980 and December 31, 1985 on the pathological findings and the work and environmental history of 858 cases of mesothelioma. The annual incidence rate of mesothelioma in Australia was 15 per million population who were aged 20 years and over. This is more than the incidence rate of mesothelioma in any other country for which data are available. However, uncertainty over diagnostic criteria and the degree of ascertainment of cases places doubt on the validity of such comparisons. In 69% of cases, a history of work with or other exposure to asbestos was obtained. Due to the long interval between the first exposure to asbestos and the provisional diagnosis of a mesothelioma (up to 60 years), more than three-quarters of the 456 exposed cases first contacted asbestos in the years of its heavy use between 1930 and 1959. This article analyses cases by the industry and the occupation in which exposure to asbestos first occurred.     

Cutaneous lesions, not just skin deep!

Background  

Cutaneous metastatic disease is not unusual but it may mimic inflammatory lesions. The growth pattern of skin metastases is unpredictable and may differ from that of the primary tumour. Skin metastases may present as rapidly growing, solitary sessile or polypoid vascular nodules that ulcerate or bleed.     

Tourette syndrome: not just a tic disorder

Although tics are considered the hallmark of Tourette syndrome, arguably tics may not be the only or primary presenting symptom. For many children diagnosed with Tourette syndrome irritability, frustration intolerance, hyperactivity, inattention, ritual behavior or other difficulties may have been present a number of years before the appearance of tics. Children with Tourette syndrome are often highly co-morbid with attention deficit-hyperactivity disorder, obsessive compulsive symptoms, and other related behavioral problems that should be detected and treated effectively. Therefore tics should not be the sole indicator or receive over emphasis in the detection and treatment of Tourette syndrome.     

青少年需要性教育，而不只是禁欲的忠告

美国儿科学院在修改后的指南中，推荐青少年进行性咨询，以延迟性行为并掌握有关避孕的资讯和方法，包括获得紧急避孕的非处方药（Pediatrics 2005；115：281-6）。学院有60000名会员可为婴儿、儿童和18—21岁的青少年提供初级保健。