Hysterectomy trends in australia between--2000/01 and 2004/05

Background: Hysterectomy is a major and common surgical procedure that has the potential to provide relief from ongoing gynaecological problems, but is often associated with negative impacts on health and wellbeing. Research indicates that hysterectomy rates and trends vary widely between and within countries; yet little is known about patterns in Australia.

Aims: This research aimed to describe hysterectomy rates and trends in Australia between 2000/01 and 2004/05.

Methods: This repeat cross-sectional study used routinely collected data from all hospitals in Australia. Data on all women admitted to hospital for a hysterectomy were obtained from the National Hospital Morbidity Database (2000/01–2004/05). Data were analysed by calculating population rates for each type of hysterectomy. Incidence rate ratios were calculated to assess changes over time.

Results: Hysterectomy rates in Australia declined from 34.8 per 10 000 women in 2000/01 to 31.2 per 10 000 women in 2004/05. A decline in the incidence rate for abdominal hysterectomy (from 18.7 to 15.1 per 10 000 women) and the incidence rate for concurrent oophorectomy (from 12.4 to 11.3 per 10 000 women) were also observed during this time period. At each point in time, the highest incidence rates for hysterectomy were for women aged 45–54 years.

Conclusions: Hysterectomy rates in Australia are declining over time and currently appear to be lower than most other countries. More hysterectomies are performed vaginally than in Canada, the USA, the UK and Finland and the rate of concurrent oophorectomy is less than that reported in the USA and the UK.

Allelujah short 05

Allelujah Short 05 is a cinematic and New Age piece that also fits well with projects of a religious or spiritual theme; Christmas and Easter included. It centers on a female vocal singing Alleluia, with violin, cello harp and 2 synths.

Interleukin-6 and tumor necrosis factor-α are not increased in patients with type 2 diabetes: Evidence that plasma interleukin-6 is related to fat mass and not insulin responsiveness

Aims/hypothesis. Our aim was to examine the possible direct relationship of interleukin-6 and TNFα with insulin sensitivity in humans. Methods. We carried out two series of euglycaemic-hyperinsulinaemic clamp experiments. In the first (CLAMP1), skeletal muscle mRNA expression and plasma concentrations of IL-6 and TNFα were examined in patients with Type 2 diabetes (n=6), subjects matched for age (n=6), and young healthy (n=11) control subjects during a 120-min supra-physiological hyperinsulinaemic (40 mU·m -2·min-1) euglycaemic clamp. In the second series of experiments (CLAMP2), patients with Type 2 diabetes (n=6) and subjects matched for age (n=7) were studied during a 240-min high-physiological hyperinsulinaemic (7 mU·m-2·min-1) euglycaemic clamp, during which arterial and venous (femoral and subclavian) blood samples were measured for IL-6 and TNFα flux. Results. In both experiments the glucose infusion rate in the patients was markedly lower than that in the other groups. In CLAMP1, basal skeletal muscle IL-6 and TNFα mRNA were the same in all groups. They were not affected by insulin and they were not related to the glucose infusion rate. In CLAMP2, neither cytokine was released from the arm or leg during insulin stimulation in either group. In both experiments plasma concentrations of these cytokines were similar in the patients and in the control subjects, although in CLAMP1 the young healthy control group had lower (p<0.05) plasma IL-6 concentrations. Using data from all subjects, a strong positive correlation (r=0.85; p<0.00001) was observed between basal plasma IL-6 and BMI. Conversely, a negative relationship (r=-0.345; p<0.05) was found between basal plasma TNFα and BMI, although this was not significant when corrected for BMI. When corrected for BMI, no relationship was observed between either basal plasma IL-6 or TNFα and GIR. Conclusions/interpretation. These data show that the increased circulating IL-6 concentrations seen in patients with Type 2 diabetes are strongly related to fat mass and not insulin responsiveness, and suggest that neither IL-6 nor TNFα are indicative of insulin resistance.

Screening for diabetic retinopathy using a non-mydriatic retinal camera in rural Victoria

PURPOSE: To develop a screening programme for the early detection of diabetic retinopathy using non-mydriatic retinal photography. METHODS: A community based screening service was offered to all people with known diabetes mellitus in selected townships in the LaTrobe and Goulburn Valleys in Victoria. At the local examination centre, basic sociodemographic information was collected as well as details of previous use of eye care services for the early detection of diabetic retinopathy. The examination included visual acuity (VA), glycosylated haemoglobin level and Polaroid photographs of each fundus using a Canon CR5-45NM non-mydriatic retinal camera (Canon, Tochigiken, Japan). Dilating drops were not used. Photographs were subsequently reviewed and letters were sent to all participants (with copies to their general practitioners) with recommendations for appropriate follow up. RESULTS: A total of 1177 people with diabetes attended the screening service, which is estimated to be 40% of the total population with known diabetes in the study area. The mean age was 65 years (range 20-94 years); 559 (48%) people reported not having a dilated fundus examination within the past 2 years; 345 (29%) people had never had a dilated fundus examination. Of the 2354 eyes, 2126 (90%) of the photographs were gradable. A total of 704 people (60%) had normal VA and no evidence of diabetic retinopathy, 209 people (18%) had diabetic retinopathy, 101 people (9%) had evidence of other fundus pathology, 42 people (3%) had reduced acuity (< 6/18) in one or both eyes (with no fundus pathology evident) and 121 people (10%) had ungradable photographs in one or both eyes. CONCLUSIONS: The present study demonstrates the usefulness of a screening programme with non-mydriatic retinal photography as an adjunct to current eye care services for the early detection of diabetic retinopathy.