Biomedical subjects

I Karp

Publications and source records attributed to I Karp.

3 recordsLinked to original sources

PubMed2006

Risk factors for tobacco dependence in adolescent smokers.

OBJECTIVE: To study the incidence of conversion to tobacco dependence (TD) and the prevalence of the TD state in relation to several potential determinants in a sample of adolescent smokers. METHODS: Questionnaires were administered every 3-4 months to document TD symptoms, amount of cigarette consumption, and depression symptoms in a prospective cohort of 1293 grade 7 students in a convenience sample of 10 schools. RESULTS: Over 54 months of follow-up, 113 of 344 novice smokers converted to TD. The referent series for the analysis of incidence comprised 823 person-surveys. The prevalence series included 1673 person-surveys, contributed by 429 smokers. Conversion to TD and TD status were associated with the intensity of recent (that is, past 3-month) cigarette consumption (adjusted incidence rate ratio (aIRR) 1.63 (95% confidence interval (CI) 1.36 to 1.97) and adjusted prevalence odds ratio (aPOR) 1.35 (95% CI 1.23 to 2.48) per 100 cigarettes per month), slowest CYP2A6 activity (aIRR 4.19 (95% CI 1.38 to 12.76) and aPOR 2.30 (95% CI 1.29 to 4.09)), depression score (aIRR 1.61 (95% CI 1.17 to 2.21) and aPOR 1.47 (95% CI 1.22, 1.75) per 1-unit change). Additional determinants included, for conversion to TD, time since onset of cigarette use (aIRR 0.76 (95% CI 0.58 to 1.00) per year) and, for the TD state, positive TD status six months ago (aPOR 3.53 (95% CI 2.41 to 5.19)). CONCLUSIONS: TD risk in adolescents is associated with intensity of recent cigarette consumption, while the role of more distant cigarette consumption appears small; subjects with slow nicotine metabolism and those with more depression symptoms are at increased risk of becoming tobacco dependent. The risk of being tobacco dependent is considerably higher in subjects who had previously developed the TD state.

Adolescent↗

PubMed2006

A comparison of damage accrual across different calendar periods in systemic lupus erythematosus patients.

Therapeutic approaches in systemic lupus erythematosus (SLE) have evolved over the last few decades, but their impact on prevention of organ damage is unknown. The objective of this study was to compare new cumulative damage in SLE patients across different calendar periods. Patients from a large SLE cohort were divided into two subcohorts; the first diagnosed and followed between 1978 and 1988 (cohort #1, n=100) and the second between 1989 and 1999 (cohort #2, n=51). Initial Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI) scores, and changes in scores over the observation intervals, were compared for the two groups. Logistic regression estimated adjusted odds ratios (OR) comparing damage accrual between the two cohorts. Medication exposures were noted. Baseline characteristics were similar between the two groups. At first assessment, the adjusted OR for a SLICC/ACR DI score > or =1 was 1.79 (95% CI 0.82, 3.88) for cohort #1 versus cohort #2. At the end of the observation interval, the adjusted OR for a SLICC/ACR DI score > or =1 was 1.22 (0.58, 2.55) for cohort #1 versus cohort #2. The adjusted OR for accruing damage over the observation interval in cohort #1 versus cohort #2 was 0.94 (0.39, 2.44). Increased medication exposure was evident for cohort #2 compared to cohort #1. Despite increased therapeutic measures used for patients in more recent periods, our data do not establish a clear difference in damage accrual. This emphasizes the need for strategies to effectively treat lupus-specific manifestations, while minimizing side effects and comorbidities.

Adrenal Cortex Hormones↗

PubMed1985

Deconstructing culture-bound syndromes.

Ethnopsychiatry comprises a large field of literature written from diverse perspectives, disciplines and orientations. Its status as an interdiscipLinary activity presents formidable obstacles to researchers interested in comparative problems and the development of generalizations. These difficulties can be demonstrated by even a cursory examination of the material written on what has come to be called 'culture-bound syndromes'. In spite of the considerable body of specific studies written about these 'ethnic psychoses', as Devereux termed them, debates continue to swirl over how to define them, whether they are manifestations of psychopathology, and, by implication, the degree to which the categories of Western psychiatric nosology are readily transferable to other cultural and historical settings. This paper does not attempt to play the role of broker between universalists and particularists. If anything I favor the particularist position with respect to the impossibility of directly applying diagnostic categories across cultural boundaries. On the other hand I would not deny that there are universal processes which take their form through complex interaction with particular cultural, historical and social settings. The goal of showing how general forms can only be realized in particular settings is a vital one for anthropology, and the literature on culture-bound syndromes illustrates the problems involved. The problems can be severe, but no more so than those facing any observer of an exotic cultural setting. Because I perceive parallels between problems of translation in social and anthropology in general and the issues that have emerged in discussions of culture-bound syndromes, I seek to return to basic issues in this essay to examine some aspects of culture-bound syndromes that should be examined before assertions about pathology are made.

Anthropology, Cultural↗