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Biomedical subjects

Kenneth C Hyams

Publications and source records attributed to Kenneth C Hyams.

10 recordsLinked to original sources
PubMed2003

The investigation of chronic fatigue syndrome: a case-study of the limitations of inductive inferences and non-falsifiable hypotheses in medical research.

Karl Popper's argument that deductive logic and falsifiable hypotheses are necessary for the growth of scientific knowledge has been controversial. One approach to assess the relevance of his ideas to medical science has been to evaluate examples of successful research. Another approach is to analyze an unsuccessful investigation. The inconclusive search for a unique 'chronic fatigue syndrome' offers a well-documented case-study for this analysis. Over the past 130 years, numerous studies have provided clinical and epidemiological data, which have supported competing hypotheses about the etiology of chronic fatigue. However, few hypotheses have been refuted because it has not been possible to establish objective standards of inquiry for a subjective symptom like fatigue. As a result, intensive research efforts have not converged on correct explanations by eliminating erroneous ideas. This unsuccessful investigation illustrates how non-falsifiable hypotheses are insufficient to advance medical knowledge, even when there is an abundance of empirical data.

Biomedical Research↗
PubMed2003

Risk factors for hepatitis C virus infection among patients receiving health care in a Department of Veterans Affairs hospital.

A cross-sectional, seroepidemiological study was conducted to determine the prevalence and risk factors for hepatitis C virus (HCV) infection among veterans receiving health care from the VA. Among 274 evaluated outpatients, anti-HCV was found in 27 (9.9%). The prevalence of anti-HCV was 3.7% among 190 individuals who reported no illicit drug use compared to 24.7% among 81 subjects who had used drugs (P < 0.001). The prevalence of anti-HCV was 4.8% among 208 veterans who had never been incarcerated compared to 27.9% among 61 veterans who had been incarcerated (P < 0.001). A multivariate model found the following factors to be independently associated with anti-HCV; having used illicit drugs [odds ratio (OR) = 3.7, 95% CI 1.3-11.8; P = 0.001), having been incarcerated (OR = 4.4, 95% CI 1.7-10.9; P = 0.001), and a yearly income less than 10,000 US dollars (OR = 3.5, 95% CI 1.3-9.4; P = 0.002). Because HCV infection was most strongly associated with illicit drug use, incarceration, and low income, these risk factors should be utilized to develop screening strategies among VA patients.

Adult↗
PubMed2002

Endemic infectious diseases of Afghanistan.

The current crisis in Afghanistan has resulted in an influx of Western military personnel, peacekeepers, humanitarian workers, and journalists. At the same time, unprecedented numbers of internally displaced persons and refugees have overwhelmed much of the already fragile infrastructure, setting the stage for outbreaks of infectious diseases among both foreigners and local populations. This review surveys the literature concerning the infectious diseases of Afghanistan and south-central Asia, with particular emphasis on diseases not typically seen in the Western world.

Afghanistan↗
PubMed2002

Protecting the health of United States military forces in Afghanistan: applying lessons learned since the Gulf War.

Four weeks after the terrorist attacks on the World Trade Center and the Pentagon, US combat troops began bombing missions over Afghanistan in Operation Enduring Freedom. Additional Reserve and National Guard personnel were called to active duty to support the war effort and to ensure security throughout the United States. All of these troops will require health care and assistance during and after this war on terrorism. They will benefit from recent federal legislation that has increased access to health care and from the changes implemented by the Departments of Defense and Veterans Affairs since the Gulf War. An innovative Defense Department "Force Health Protection" strategy places greater emphasis on helping service members and families stay healthy and fit and on preventing injury and illness. The two agencies also have developed new post-deployment clinical practice guidelines, established deployment research centers, and made further improvements in preventive medicine, health surveillance, and risk communication and are thus better prepared for this newest generation of war veterans.

Afghanistan↗
PubMed2002

New perspectives on hepatitis E.

The infectious agent causing epidemic non-A, non-B hepatitis was identified in 1983 from a human challenge experiment. The novel hepatitis E virus (HEV) subsequently was cloned in 1990 and the genome sequenced. HEV transmission is highly endemic in Asia, the Middle East, and Africa. Fecal contamination of drinking water is the most common mode of spread. Although usually asymptomatic, HEV infection can cause fulminant hepatitis. Recent studies indicate that hepatitis E may be a zoonotic disease, with pigs and possibly rats serving as reservoirs for human infection. A recombinant HEV vaccine is currently in phase III clinical trials. The characterization of the major types of viral hepatitis during the last 20 years illustrates how modern genetic technology has revolutionized research in infectious diseases. Within less than two decades of the discovery of HEV, its epidemiology has been described, serologic tests have been developed, and a candidate vaccine has been evaluated in clinical trials.

Africa↗
PubMed2002

Responding to chemical, biological, or nuclear terrorism: the indirect and long-term health effects may present the greatest challenge.

The possibility of terrorists employing chemical, biological, or nuclear/ radiological (CBN) materials has been a concern since 1995 when sarin gas was dispersed in a Tokyo subway. Contingency planning almost exclusively involved detection. containment, and emergency health care for mass casualties. However, it is clear that even small-scale CBN incidents--like the recent spread of anthrax spores through the mail--can cause widespread confusion, fear, and psychological stress that have lasting effects on the health of affected communities and on a nation's sense of well-being. More emphasis therefore needs to be placed on indirect effects and on the medical, social, economic, and legal consequences that follow months to years afterward. To respond effectively to CBN attacks, a comprehensive strategy needs to be developed that includes not only emergency response, but also long-term health care, risk communication, research, and economic assistance. Organizing an effective response challenges government institutions because the issues involved--eligibility for health care, the effects of low-level exposure to toxic agents. stress-related illnesses, unlicensed therapeutics. financial compensation--are complex and controversial.

Bioterrorism↗
PubMed2002

The Recruit assessment Program: a program to collect comprehensive baseline health data from U.S. military personnel.

Pilot testing has begun on the Recruit Assessment Program (RAP). The RAP is a proposed Department of Defense (DoD) program for the routine collection of baseline demographic, medical, psychosocial, occupational, and health risk factor data from all U.S. military personnel at entry into the armed forces. The RAP currently uses an optically scannable paper questionnaire, which will provide data for the first building block of an electronic medical record within the DoD and the Department of Veterans Affairs. The RAP will serve several important functions, including automating enrollment into the military health care system, improving patient care and preventive medicine efforts, and providing critical data for investigations of health problems among military personnel and veterans. If the feasibility of the RAP is demonstrated and the program is fully implemented throughout the DoD, it could provide a substantial improvement in health care delivery. For the first time, DoD and Department of Veterans Affairs physicians, public health officers, and researchers will have access to comprehensive baseline health status data.

Feasibility Studies↗
PubMed2002

Force health protection: 10 years of lessons learned by the Department of Defense.

The Department of Defense has applied lessons learned since the Persian Gulf War to develop the force health protection (FHP) strategy. The goal of this new, unified strategy is to protect the health of military members from medical and environmental hazards associated with military service to the maximum extent possible. FHP is an evolving strategy that seeks to balance the military health system's responsibilities to promote and sustain health and wellness throughout each person's military service; prevent acute and chronic illnesses and injuries during training and deployment; and rapidly stabilize, treat, and evacuate casualties. In addition, FHP demands a continuous assessment of the current and future health of military members through medical surveillance, longitudinal health studies, adequate medical record documentation, and clinical follow-up. Effective communication with military members, leaders, veterans, families, and the public regarding military members' health status and the health risks of military service is a key element of the FHP strategy.

Emergency Treatment↗
PubMed2002

Self-reported health of Persian Gulf War veterans: a comparison of help-seeking and randomly ascertained cases.

The objective of this study was to compare self-selected Persian Gulf War veterans attending a health assessment program with veterans ascertained in an epidemiological study to determine why Gulf War veterans do, or do not, present for clinical assessment. A postal survey was sent to randomly selected United Kingdom Armed Forces personnel who served in the Persian Gulf conflict. Outcome measures included a symptom checklist, health perception, physical functioning, psychological distress, post-traumatic stress symptoms, and health attributions. A total of 173 survey respondents had also attended the Medical Assessment Program (MAP). MAP attendees were more likely to be female, older, and working part time or not working at all. They had poorer health perception and reported higher levels of illness, and they differed in terms of their health attributions. The belief that one had Gulf War syndrome and attributing health problems to Gulf War service were the most powerful predictors of MAP attendance, even when controlling for the level of physical functioning. The findings suggest that health beliefs rather than symptoms are more important predictors of attendance of an assessment program and that Gulf War veterans who attended the MAP have different characteristics than those who did not. This suggests that MAP patients are unrepresentative of the wider deployment to the Persian Gulf.

Adult↗