KNOWLEDGE OF COLORECTAL CANCER AND ATTITUDE TO OCCULT BLOOD TESTING AMONG RECENT MEDICAL GRADUATES IN NEW SOUTH WALES

The extent to which new information on colorectal cancer (C.C.) is being transmitted to medical undergraduates was assessed in a repeated survey of new interns' knowledge of and attitudes on C.C. A probability sample of 214 graduates of the two Sydney medical schools was drawn as they commenced their internships in 1978. A comparable sample of 186 was drawn in 1980. Interns in each sub-sample completed a questionnaire of 54 pre-coded items of knowledge of C.C. epidemiology, early diagnosis, and followup, and on their attitudes towards C.C. On most topics knowledge was not well developed, and 1980 graduates were not significantly better informed than those of 1978. Almost three-quarters of 1980 interns intend using faecal occult blood testing.     

Sudden Pacemaker Failure

Two cases of sudden pacemaker failure due to fractured wires supplying power to the generator are described. Both devices were Kappa KD703 (Medtronic Inc., Minneapolis, MN, USA) implanted in a prepectoral subcutaneous pocket. In 2002, Medtronic issued an advisory regarding Kappa 700/600 devices. A number of these devices, all subpectoral implants, had presented with intermittent or no output due to fractured wires supplying power to the devices, leading to recommendations to replace susceptible devices in pacemaker-dependent patients. These two cases may warrant extension of this advisory to include all these devices, regardless of implant location.     

Comparison of Vitreous Carbon and Elgiloy Transvenous Ventricular Pacing Leads

In a randomized prospective study of 150 patients, we compared two porous-tipped, finned leads, one with a vitreous carbon tip (surface area = 12 mm2) and the other with an Elgiloy tip (surface area = 8 mm2). We assessed the acute and chronic stimulation thresholds and the ease of implantation of the two leads. The acute current thresholds for the vitreous carbon and Elgiloy-tipped leads were 1.7 +/- 0.5 (+/- SD) mA vs. 1.1 +/- 0.4 mA (0.25 ms pulse width), 1.3 +/- 0.5 mA vs. 0.9 +/- 0.3 mA (0.5 ms), and 1.0 +/- 0.3 mA vs. 0.8 +/- 0.3 mA (0.75 ms), respectively (P less than 0.0005). Impedance at implantation was 473 +/- 121 ohms and 716 +/- 285 ohms (P less than 0.0005) for the carbon-tipped and Elgiloy-tipped leads, respectively. The R-wave amplitudes were 10.2 +/- 5.1 volts and 6.8 +/- 3.0 volts, respectively (P less than 0.0005). Both leads were easy to implant and showed low stable chronic thresholds from 3 weeks after implantation, at which time the stimulation threshold was 1.9 +/- 1.0 volts vs. 1.5 +/- 0.6 volts with the implanted voltage-variable generators and 1.8 +/- 0.8 mA vs. 1.6 +/- 0.6 mA with the implanted current-variable generators. Reoperation for displacement was required for two of the 87 (2.3%) carbon-tipped and 2 of the 67 (3.2%) Elgiloy-tipped leads. There was no exit block nor any other lead-related complication. We conclude that both leads have similar and satisfactory performance.