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Biomedical subjects

L Cowan

Publications and source records attributed to L Cowan.

27 records · Page 2Linked to original sources

Residential mobility and long-term treatment of hypertension.

Maintenance of long-term care of populations with high mobility patterns poses problems for programs designed to prevent and treat cardiovascular and other chronic diseases. The Hypertension Detection and Follow-up Program (HDFP)--a community-based screening and treatment program implemented in 1973--provided an opportunity to examine residential mobility among adults under long-term treatment in 13 communities. Whereas 11% of hypertensives included in the HDFP changed residence in the first two years of the study, only 4% moved outside the service areas of the programs. Although a higher proportion of blacks (to whites) moved within the service areas, a similar proportion moved outside the service areas. This low residential mobility, especially the low rate of movement outside the service areas of the treatment centers, suggests that mobility of cohorts under long-term treatment and observation may present lesser problems to continuous, long-term community health care programs than do other factors affecting adherence.

Community Health Services↗

Interaction of antibiotics and warfarin in pediatric cardiology patients.

Antibiotics are known to alter the anticoagulation induced by warfarin in adults, but little is known about this interaction in children. In a retrospective review of patients under the age of 21 years, we found that antibiotic therapy (89 courses of antibiotics in 23 patients) was associated with an increase in the mean international normalized ratio (INR) from 2.7 to 3.6. The change in INR correlated inversely with patient age. These data suggest that more intensive monitoring of the INR after starting antibiotics may help to mitigate excessive anticoagulation in children receiving warfarin.

Adolescent↗

An emergency department-based domestic violence intervention program: findings after one year.

This article reports findings from the first year of operation of an emergency department-based domestic violence intervention program in one of Canada's major metropolitan areas. The program has established methods for identifying, treating, and following up battered women. Information on several key variables is now available for the group of 279 individuals who were the program's first patients. Two out of three (68%) of the patients seen were assaulted by their current spouse. Nine percent (9%) were abused by former spouses from whom they were separated or divorced. Twelve percent (12%) were assaulted by someone they were dating. Women in the program who were abused by a former or current spouse experienced severe violence, with 81% being kicked, bitten, or hit; 60% being pushed, grabbed, or shoved; 55% being threatened; and 30% being choked. Follow-up connection could only be made with 140 women (50%), highlighting the need for focused interventions during the emergency department visit. The findings confirm that women are being injured, often seriously, by those with whom they have close relationships. We present a program for addressing the needs of battered women seen in emergency departments.

British Columbia↗