PubMed Health⌕ Search

Biomedical subjects

J Worm

Publications and source records attributed to J Worm.

14 recordsLinked to original sources
PubMed1992

Drug related admissions to medical wards: a population based survey.

1. In total 1999 consecutive admissions to six medical wards were subjected to a prospective high-intensity drug event monitoring scheme to assess the extent and pattern of admissions caused by adverse drug reactions (ADRs) or dose related therapeutic failures (TF), in a population-based design. The wards were sub-specialised in general medicine, geriatrics, endocrinology, cardiology, respiratory medicine and gastroenterology. 2. Considering definite, probable and possible drug events, the prevalence of drug related hospital admissions was 11.4% of which 8.4% were caused by ADRs and 3.0% by TFs. There were large inter-department differences. 3. The six classes of drugs most frequently involved in admissions caused by ADRs were anti-rheumatics and analgesics (27%), cardiovascular drugs (23%), psychotropic drugs (14%), anti-diabetics (12%), antibiotics (7%), and corticosteroids (5%). Noncompliance accounted for 66% of the TFs with diuretics and anti-asthmatics most frequently involved. 4. The pattern of drugs involved in ADRs was compared with the regional drug sales statistics. Drugs with a particularly high rate of ADR related admissions per unit dispensed were nitrofurantoin and insulin (617 and 182 admissions per 1,000,000 defined daily doses), while low rates were seen for diuretics and benzodiazepines (10 and 7 admissions per 1,000,000 defined daily doses). Confidence intervals were wide. 5. Patients who had their therapy prescribed by a hospital doctor had a slightly higher prevalence of drug events than those who were treated by a general practitioner (12.6% vs 11.8%). The reverse applied for drug events assessed as avoidable (3.3% vs 4.6%). Although these differences were not statistically significant, it may suggest general practitioners as the appropriate target for interventive measures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Causes of death during the first 5 years of a randomized trial of mass screening for colorectal cancer with fecal occult blood test.

The main purpose of population screening for colorectal cancer is to reduce mortality from the disease. The criteria of death from colorectal cancer are defined in the present randomized trial of 61,938 persons between 45 and 74 years old, and the need for an impartial death review committee was demonstrated. Causes of death within the first 5 years are described within subgroups of the test group and compared with those in the control group. Death rates were higher among non-responders to screening than among controls and among those in whom Hemoccult-II had been performed at least once. Persons with negative Hemoccult-II had a lower death rate than controls. The overall autopsy rate was 32%. Lethal complications from treatment of colorectal neoplasia were evaluated per se. Death from colorectal cancer occurred in 74 persons in the total screening group and in 91 among controls. Sources of bias are discussed. A method of evaluating possible benefit to those being screened is suggested. Final results cannot be expected before 1996.

Aged↗
PubMed1991

Drug related events and drug utilization in patients admitted to a geriatric hospital department.

Two hundred ninety-four consecutive admissions to a geriatric department were evaluated for drug events as cause of admission. The drug events considered were adverse drug reactions (ADRs) and dose-related therapeutic failures. In 39 cases (13.3%), a definite, probable or possible drug event was a dominant or contributing cause of the admission (11.2% ADRs and 2.0% dose-related therapeutic failures). Five of these cases (1.7%) were judged to be due to errors in prescription and a further seven (2.4%) were found to have been avoidable by efforts exceeding the obligatory. There were no statistically significant differences between drug-related and non-drug related admissions in terms of age, sex, number of drugs taken at the admission or duration of hospitalization. ADRs in the geriatric patients are difficult to recognize and may be interpreted as senile loss of function. Sixty-seven percent of the patients took drugs with a sedative action, 68% took drugs with a hypotensive action, 67% took drugs with a potential for confusional states, 15% took drugs with a potential for depression, and 64% took drugs with a potential for constipation. A reduction of the number of drug-related hospital admissions by means of a large-scale intervention would be a difficult task for several reasons: no particular class of drugs caused the drug events, no particular mechanism dominated, no particular group of doctors were responsible for the drug events, and only a part of the drug events were judged to be avoidable.

Aged↗
PubMed1978

Relationship between haemoglobin and serum testosterone in normal children and adolescents and in boys with delayed puberty.

The concentrations of haemoglobin and of serum testosterone were measured in 215 normal children and adolescents aged 7--20 years, and in 8 boys with constitutional delayed puberty. From the age of 14 years onward haemoglobin and testosterone rose in normal boys and differed significantly from the stable levels observed in prepubertal children and pubertal girls. In the entire series of normal boys (n = 118, age 7--20 years) concentrations of haemoglobin and testosterone were found to be closely correlated (r = 0.73, p less than 0.001). These results provide further evidence for a major role of testosterone in the control of erythropoiesis. Therefore, this correlation suggests the use of serum testosterone determination for the proper selection of haemoglobin reference ranges in boys. The respective reference ranges of haemoglobin corresponding to testosterone levels at 0 and 30 nmol/l were 120.5--148.5 and 143.5--171.5 g/l (95% confidence limits). Boys with delayed puberty were found to have significantly reduced median values of haemoglobin and testosterone for their chronological age, and 6 of the 8 boys investigated were truly anaemic on this background. Nevertheless, their haemoglobin concentration did appear appropriate as judged from their testosterone levels. This observation supports the idea that the selection of the relevant reference range for haemoglobin in boys should depend on the state of physical development as expressed by serum testosterone.

Adolescent↗