Required research a disservice?
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Curriculum↗
Biomedical subjects
R Fahrenwald
Publications and source records attributed to R Fahrenwald.
Health outcomes of women exposed to household alcohol abuse: a Family Practice Training Site Research Network (FPTSRN) study.
BACKGROUND: There is a paucity of knowledge about the effects of exposure to alcohol abuse in the household on women who do not abuse alcohol. The purpose of this study was to determine whether women who did not abuse alcohol demonstrated any health-related adverse effects because they lived with family members who did abuse alcohol. METHODS: This study was a historical prospective survey of female patients at five primary care practices. Survey instruments included the CAGE questionnaire, a five-item screening test for exposure to alcoholism, and the Medical Outcomes Study 36-item Short Form Health Survey (MOS SF-36). Patient records were examined for specific diagnoses. RESULTS: A total of 267 patients completed the questionnaires and had complete medical records available for analysis. Forty-two (15.7%) potential alcohol abusers were excluded from the sample leaving a working total of 225; 70 (31.1%) were potentially exposed to alcoholism in the household. Women exposed to alcohol abuse in the home did not experience an increased risk for the medical diagnoses studied, but they did demonstrate decreased health-related quality of life as measured by the MOS-SF-36 for the following scales: role physical (P = .025), role emotional (P = .038), social functioning (P = .001), bodily pain (P = .016), and mental health (P = .040). CONCLUSIONS: Women exposed to alcohol abuse in the household are more likely to perceive themselves as less healthy. Although they may not have received a clinical diagnosis of depression, they are more likely to feel depressed. The extent to which subjects' health-related quality of life is influenced by exposure to alcohol abuse suggests that the medical diagnosis may be insensitive as a description of health status in this population.
Adolescent↗
Selections from current literature: the traveller to high altitude.
AMS is a preventable disease about which travellers are frequently uninformed and one which physicians may wrongfully assume is limited to the population of ultra high altitude adventurers. These studies on incidence, while not without flaws, point out the frequency of AMS, as well as its significant incidence at moderate and commonly frequented altitudes. The current literature does not fully answer questions about incidence at moderate altitudes, nor about the full effects of altitude on children. Certainly AMS is not a rare complication of travel to altitudes and may indeed be under-recognized and under-treated. Both acetazolamide and dexamethasone provide adequate prophylaxis, and the choice of medications can be to some extent based on experience and patient profile. The best prophylaxis is a slow stepwise ascent, and the best treatment descent. The availability of medications for the amelioration or prevention of symptoms, and succinct advice on prevention by travel planning will make many of our patients' holidays more enjoyable and business trips more productive.
Acetazolamide↗
In situ detection of PCR-amplified HIV-1 nucleic acids and tumor necrosis factor cDNA in cervical tissues.
This study determined the histological distribution of polymerase chain reaction-amplified human immunodeficiency virus 1 (HIV-1) DNA and RNA in cervical tissues. Amplified HIV-1 DNA and complementary DNA were detected in each of 21 cervical biopsies from women with acquired immunodeficiency syndrome. The viral nucleic acids were most abundant in the endocervical aspect of the transformation zone at the interface of the glandular epithelium and the submucosa and in the deep submucosa around microvessels. Many virally infected cells colabeled with leukocyte common antigen, Mac387, and polymerase chain reaction-amplified tumor necrosis factor complementary DNA, demonstrating that they were activated macrophages. Virally amplified nucleic acids were not detected in 10 controls and in only one of eight cervical tissues from children less than 3 years of age who died due to immunodeficiency syndrome acquired in utero. Determining whether the HIV-1-infected macrophages consistently present in the cervix of adult seropositive women may represent primary infection and, if so, whether they can transport the virus to regional lymph nodes and thus initiate systemic infection requires further study.
Adult↗