Trial evidence to date suggests that any type of heparin thromboprophylaxis decreases deep vein thrombosis and pulmonary embolism in medical-surgical critically ill patients, and low-molecular-weight heparin compared with bid unfractionated heparin decreases pulmonary embolism and symptomatic pulmonary embolism. Major bleeding and mortality rates do not appear to be significantly influenced by heparin thromboprophylaxis in the ICU setting. Trial methodology, indirectness, and the heterogeneity and imprecision of some results temper inferences from this literature.

When John Cade was born in 1912, in the small Victorian country town of Murtoa, his future professional field was also in its infancy, if indeed it had been truly born at all. There were of course larg e lunatic asylums occupying prime real estate in Melbourne and grand sites in the country, but these functioned primarily as custodial institutions rather than as hospitals offering treatment, for in general there was no effective therapy for the major mental illnesses. But living many of his younger years within the grounds of these impressive institutions, since his father was for many years medical superintendent at several of these hospitals (Beechworth, Sunbury, Mont Park), was to have a major bearing on his later deep understanding of the needs of the mentally ill.John Cade was still a small boy when his father, David, left for World War I, for Gallipoli and later France, returning in 1919 a Colonel with a DSO (Distinguished Service Order) but with severe physical and mental exhaustion referred to at the time as 'war weariness'. During the war, the family (John's mother, Ellen, John himself, and his two younger brothers, David and Frank) had lived in the peaceful Dandenongs, and the main memory of that time was that his mother bought from a door-to-door salesman a block of land at St Leonards which turned out to be underwater. After the war, the family returned to Murtoa, but his war-weary father became increasingly exhausted treating the large number of his patients in the influenza pandemic of the time. He, therefore, sold his general practice and gratefully accepted a position with the Mental Hygiene Department, in which he worked in three of the major mental hospitals over the next 25 years.

No abstract

No abstract

No abstract