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Biomedical subjects

D M Huse

Publications and source records attributed to D M Huse.

33 records · Page 2Linked to original sources
PubMed1990

Benzodiazepine tranquilizers and the risk of accidental injury.

To determine whether benzodiazepine tranquilizers increase the risk of accidental injury requiring medical attention, we used pharmacy claims submitted to a large third-party payer to identify 4,554 persons who had been prescribed these agents and a matched control group of 13,662 persons who had been prescribed drugs other than benzodiazepines. We then used diagnoses recorded on claims submitted by medical care providers to identify all accident-related care received by these persons during three months before their first-observed prescription for a benzodiazepine or nonbenzodiazepine agent, respectively, and six months subsequently. We found accident-related care was more likely among persons who had been prescribed benzodiazepines; among these persons, the probability of an accident-related medical encounter was higher during months in which a prescription for a benzodiazepine had recently been filled compared to other months; and persons who had filled three or more prescriptions for these agents in the six months following initiation of therapy had a significantly higher risk of an accident-related medical event than those who had filled only one such prescription. Approximately two-fold risks of accident-related care were found, after controlling for age, sex, and prior utilization.

Accidents↗
PubMed1989

The economic costs of non-insulin-dependent diabetes mellitus.

Persons with diabetes experience elevated risks of a variety of other illnesses-- including circulatory, visual, neurological, renal, and skin disorders--relative to their nondiabetic peers. Previous estimates of the economic burden of diabetes, however, have not taken full account of this related morbidity and mortality and have therefore understated the cost to the nation due to this disease. Accordingly, we estimated the economic costs of type II, or non-insulin-dependent, diabetes mellitus, reflecting its contribution to the total burden of disease in the United States. In 1986, non-insulin-dependent diabetes mellitus was responsible for $11.6 billion in health care expenditures, including $6.8 billion for diabetic care and $4.8 billion attributable to an excess prevalence of related (principally cardiovascular) conditions. The human toll of non-insulin-dependent diabetes mellitus included 144,000 deaths -- about 6.8% of total US mortality -- and the total disability of 951,000 persons. The total economic burden of non-insulin-dependent diabetes mellitus in 1986, including health care expenditures and productivity forgone due to disability and premature mortality, was $19.8 billion.

Aged↗
PubMed1989

Cimetidine and adverse reactions: a meta-analysis of randomized clinical trials of short-term therapy.

PURPOSE: We pooled data from randomized, double-blind, placebo-controlled trials to determine the frequency of adverse reactions among patients treated with cimetidine for acute acid-peptic disorders. METHODS: Meta-analysis was used to analyze data obtained from a search of English language reports of trials of cimetidine in the ambulatory treatment of acute acid-peptic disorders that were published between January 1982 and April 1987. RESULTS: Of 161 trials of cimetidine that we identified, 84 provided complete reporting of data on adverse reactions and, of these, 24 employed a randomized, double-blind, placebo-controlled design. Across these 24 trials, the overall rate of reported adverse reactions among 622 patients randomly assigned to receive cimetidine was 10.9%; the corresponding rate among 516 patients randomly assigned to receive placebo was 10.1%. This difference was not statistically significant (p greater than 0.10), nor were any significant differences noted in the frequencies of reported central nervous system or gastrointestinal adverse reactions (p greater than 0.10). Rates of adverse reactions also did not differ by dosage or trial duration. The overall rate of adverse reactions reported in the 60 trials that did not utilize a randomized, double-blind, placebo-controlled design was similar to the rate reported in those that did. CONCLUSIONS: Our findings suggest that the frequency of adverse reactions among patients receiving cimetidine for acute acid-peptic disorders is not significantly different from that of patients receiving placebo.

Acute Disease↗
PubMed1987

Accident- and injury-related health-care utilization among benzodiazepine users and nonusers.

Benzodiazepine tranquilizers have been found to cause psychomotor and cognitive impairment, and there is evidence of an increased rate of automobile accidents among users of these drugs. To determine whether benzodiazepine users are more likely than nonusers to experience accidental injury requiring medical attention, we examined health-care utilization among 7,271 such users and an age- and sex-matched sample of 65,439 nonusers, all of whom were enrolled in an "HMO-like" health insurance plan. Benzodiazepine users and nonusers were identified through a review of 4 months' prescription drug claims. Six months' health-care claims for each user and nonuser subsequent to the first observed claim for a benzodiazepine or nonbenzodiazepine agent, respectively, were compiled. Claims related to accidents were identified on the basis of physician-recorded diagnoses. Our results indicate that benzodiazepine users were significantly (p less than .01) more likely than nonusers to experience (1) at least one accident-related episode of care; (2) a greater number of accident-related hospital admissions; and (3) a greater number of accident-related inpatient days. Accident-related utilization was also significantly higher when users had recently filled a prescription for a benzodiazepine agent. Benzodiazepine users, however, also utilized significantly more non-accident-related health-care services than nonusers. The nature of the association between benzodiazepine use and a higher accident-related utilization is thus unclear. A pretest-posttest study is now being undertaken to ascertain the significance of these findings.

Accidents↗
PubMed1987

Cost effectiveness of labetalol and propranolol in the treatment of hypertension among blacks.

The cost effectiveness of labetalol and propranolol in the treatment of black adults with mild to moderate hypertension was assessed using published reports from US clinical trials of these agents among such patients. Data from these studies suggest that labetalol and propranolol lower diastolic blood pressure among black hypertensive adults by 11.2 mmHg and 8.4 mmHg, respectively. Results indicate that, for a hypothetical cohort of 1,000 patients on monotherapy, patients treated with labetalol would experience two to seven fewer strokes over a ten-year period, depending upon age and sex, and annual drug costs would be reduced by $190. For stepped care, annual costs would be $205 and $212 lower for those treated initially with labetalol. Labetalol therefore may be more cost effective than propranolol among black adults with mild to moderate hypertension.

Aged↗
PubMed1986

Cost-effectiveness of nicotine gum as an adjunct to physician's advice against cigarette smoking.

A nicotine chewing gum has recently become available for use as an aid in giving up cigarette smoking. Although its efficacy has been demonstrated in clinic-based smoking cessation programs, its value in a primary care setting is uncertain. We examined the cost-effectiveness of nicotine gum as an adjunct to physician's advice and counseling against smoking during routine office visits. Our findings indicate that the cost per year of life saved with this intervention ranges from $4113 to $6465 for men and from $6880 to $9473 for women, depending on age. This compares favorably with other widely accepted medical practices, eg, treatment of hypertension or hyperlipidemia. Our study, therefore, suggests that nicotine gum is a cost-effective adjunct to physician's advice against cigarette smoking in a primary care setting.

Adult↗
PubMed1984

Dietary patterns in anorexia nervosa.

This study characterized the dietary patterns of 96 patients with anorexia nervosa who were seen for diet history. The mean age of the patients was 16.6 yr, and mean loss from preillness weight was 28%. Twenty-five patients ate high-quality meals regularly but simply restricted calories. Eleven maintained a high-quality diet but ate at irregular intervals; of these, six had episodes of binge-eating and vomiting or fasting. Among patients whose diets were qualitatively poor, 19 consumed regular meals and 41 ate irregularly; 31 of the latter had episodes of binge-eating and vomiting or fasting. No typical profile of dietary manipulations by these patients was found. Beyond the generalization that there was caloric restriction that resulted in weight loss, there was great variability in the diet patterns.

Adolescent↗
PubMed1982

The challenge of obesity in childhood. I. Incidence, prevalence, and staging.

The incidence and prevalence of obesity in a school-age cohort and the effect of two different weight-reduction treatment programs were studied over 5 years. The study group received diet instruction and met individually with a dietitian weekly for 16 months, and the control group received only the diet instruction. After 5 years, the students were evaluated by triceps skinfold measurements, a parents' questionnaire, and a structured interview. The incidence of obesity over the 5-year period was 7.8%, or 1.6% per year. The prevalence of obesity increased considerably as students entered adolescence. The overall prevalence of obesity for grades 4, 5, and 6 versus grades 9, 10, and 11 was 9.1% and 14.8%, respectively; the greatest increase occurred between grades 10 and 11. There was no significant change in mean weight index in either the study or the control group at 16 months or at 5 years of follow-up. Individuals in both groups did make successful changes in behavior, and these changes resulted in seemingly permanent reductions in weight. The interviews and questionnaires indicated that family environment and interaction played a role in obesity and its treatment. It was found that obese individuals were easily categorized on the basis of attitudes expressed during interviews and that these " stages" correlated highly with 5-year changes in weight index and triceps skinfold measurements.

Adolescent↗
PubMed1982

The challenge of obesity in childhood. II. Treatment guidelines by stage.

A treatment model for obesity is proposed which uses the attitudinal staging technique previously described from our studies of obesity in school-age children. The model utilizes an assessment of attitude as a measure of the progress in effective weight reduction and as a measure of problems that need to be met and corrected during the treatment program. Illustrative examples are provided which include the possible role of the weight counselor in the treatment of obesity.

Adolescent↗
PubMed1975

Infants with congenital heart disease. Food intake, body weight, and energy metabolism.

Growth failure in infants with congenital heart disease was investigated by studies of food intake, change in body weight, oxygen consumption, carbon dioxide production, and lean body mass. Infants with congenital heart disease weighed less initially and gained less weight during observation than normal infants. The daily intake of calories per kilogram body weight was inadequate for some infants and considered generally adequate for others. Lean body mass was normal, and the quantity of oxygen used for metabolism was similar in both groups. Infants with congenital heart disease were not found to be hypermetabolic when oxygen consumption was related to lean body mass. The growth failure seen in these infants appears to be most appropriately related to inadequate calorie intake rather than to any other factor studied.

Body Composition↗