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Biomedical subjects

M J Herz

Publications and source records attributed to M J Herz.

14 recordsLinked to original sources
PubMed1996

Constipation: a different entity for patients and doctors.

BACKGROUND: Medical definitions of constipation vary. Some are specific, based on the interval between defecations, with three days or twice weekly as the upper limit of normality. Others are vague. OBJECTIVE: This study investigates patients definitions, attitudes and management of 'constipation' and compares their definitions with physicians' criteria. METHODS: Survey of 1) 531 randomized patients of family clinics of the sick Fund of the General Federation of Labor of Israel, and 2) 100 randomized specialists and residents in family medicine. RESULTS: The present survey showed that constipation is more common in women and in the older (> 40 years) age group. The most important finding of this investigation was the wide discrepancy in the criteria used by doctors and patients to diagnose constipation. Fifty per cent of the patients defined constipation differently from accepted medical definitions--27% of the patients defined it as defecation every 2 days or less and 25% as hard stool alone. All 57 doctors who were asked the same question defined constipation as defecation every 3 or 4 days or less, sometimes in combination with hard stool. CONCLUSIONS: This study suggests that patients and doctors refer to different entities when they talk of 'constipation'. It is the doctor's responsibility to ensure that this misunderstanding is avoided so that unnecessary tests and treatment are not undertaken and, patient-doctor acrimony is avoided.

Adult↗
PubMed1991

The use of a self-report questionnaire to assess the frequency of sexual dysfunction in family practice clinics.

The epidemiology of sexual dysfunction has been investigated recently in various clinical and nonclinical conditions but, to date, little research has been conducted in the family practice setting. The authors have developed a brief self-report questionnaire addressing most of the common sexual problems, and assessed its usefulness as a screening device in two distinctly different family practice clinics. The proposed questionnaire has gained over 90% response rate in each practice, indicating an appropriate level of acceptability. The sex- and practice-specific prevalence ranged from 31% to 63%, and was found to be significantly higher among male patients than among female patients. Overall dissatisfaction with the present sexual life of either the respondent or his partner (as indicated by the former) was expressed by nearly 20% of the respondents, the majority of whom reported on both self and partner's dissatisfaction. Relatively few patients of those who reported on a sexual problem had ever sought any professional help, but approximately 50% of men and 25% of women indicated that the family physician was their preferred expert for this purpose. It is concluded that sexual dysfunction is highly prevalent in the family practice setting but is nevertheless under-reported. Anonymous screening in one's practice, as presented in this study, will provide the family physician with valuable information, and may contribute to further direct discussions of these delicate concerns.

Adolescent↗
PubMed1988

Antibiotics and the adult sore throat--an unnecessary ceremony.

Antibiotics are overprescribed for patients with sore throats for many reasons, including the difficulties in diagnosing the cause of the symptom, as well as the pharmacological and placebo strength of antibiotics. Two hundred adult patients presenting to one general practitioner were divided into two groups. One group was given an antibiotic, the efficacy of which was stressed, and the other group was given symptomatic treatment with an explanation that no antibiotic was needed. Six months after the initial consultation the patients' notes were checked for return visits with respiratory complaints. Significantly more patients who received an antibiotic returned to the doctor with respiratory problems, especially young men. During the study, few patients resisted either a high or low prescribing policy. It is concluded that antibiotic treatment for sore throats did not prevent complication for the patient. Furthermore, high antibiotic prescribing created more work for the doctor by increasing the repeat visit rate. Patients were equally compliant with a high or low antibiotic prescribing policy.

Adult↗
PubMed1971

Caudate nucleus stimulation retroactively impairs complex maze learning in the rat.

Rats, with permanent electrodes implanted bilaterally in the caudateputamen complex, were stimulated with single pulses after reinforcement of each maze learning trial or were stimulated with multiple pulses after each choice point or after reinforcement. Single pulses retarded the development of learning only when stringent learning criteria were required, whereas multiple pulses interfered with acquisition when the criteria for learning were less difficult.

Age Factors↗