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At least 1,567 records · Page 87Linked to original sources
PubMed2003

Use of hypnotic and tranquillising drugs in general practice. Determinants, satisfaction and motivation to stop: the patients' view.

OBJECTIVE: To know more about the characteristics of long-term users of hypnotic and tranquillising drugs in a primary health care area in The Netherlands. DESIGN: A questionnaire was applied to users of benzodiazepines and the computerised medical records were analysed. SETTING: Nine general practices affiliated to the Registration Network Family Practices (RNH) of the University of Maastricht (UM). SUBJECTS: A sample of 506 users, aged > or = 30 years, was divided into four categories: short-term (< 3 months) users (once-only and episodic) and long-term users (episodic and continuous). RESULTS: In 1992/93, 81% were long-term users and 42% of these took their drug continuously. All groups investigated had a preponderance of women. Health problems more so than social problems led to use of the drug. Long-term use was associated with older age, depressive behaviour in handling problems, a higher score on the medicine addiction index, problems with children or housing, and satisfaction with the effects of the drug. CONCLUSION: Most people taking benzodiazepines are long-term users. Age, depressive behaviour, addiction, satisfaction and problems with children or housing are risk factors for long-term use. Gender is not risk factor.

Benzodiazepines↗
PubMed2004

The disease that caused weight loss in King David the Great.

BACKGROUND: Older people have suffered from loss of weight since the dawn of history. This research is unique in character, as it combines contemporary medical knowledge with the presentation of a case taken from Ancient History. OBJECTIVE: To analyze from a modern perspective the biblical description of a geriatric patient who suffered from weight loss. METHODS: Biblical texts associated with the aged were examined and passages relating to geriatric patients who suffered from loss of weight were closely studied. This study is based on the evaluation of the biblical passages, and not on the interpretations of various rabbis and scholars. RESULTS: Passages such as: ". I forget to eat my bread" and "My knees are weak through fasting; and my flesh failed of fatness" and ". my bones cleave to my skin" indicate anorexia, fasting, extreme loss of weight, and subsequent cachexia. Among the numerous causes associated with weight loss, malignancy, social problems such as loneliness, social isolation and neglect by others, and psychological causes including depressed mood were most likely responsible. With regard to malignancy, it seems that the King was affected by primary carcinoma of the prostate or kidney with subsequent metastases to bones. CONCLUSION: This report demonstrates that the roots of geriatric medicine can be traced to biblical times.

Anorexia↗
PubMed1999

Genetic markers to predict polygenic disease: a new problem for social genetics.

Many genetic markers that relate to common multifactorial disease in adults have been identified during the past 15 years. Their use as adjuncts for the diagnosis, prognosis, prediction of disease or targeting therapy for these disorders has begun, good examples being the Factor V Leiden mutation for venous-thromboembolism, lipoprotein lipase mutations for hypertriglyceridaemia and the apolipoprotein E4 variant for Alzheimer's dementia. However, extensive gene-gene and gene-environment interactions make their use more complex than markers for the simpler monogenic disorders (such as cystic fibrosis, or Duchenne's muscular dystrophy). Possible misapplication of the genetic markers for multifactorial disease in the fields of risk prediction, direct sales to the public, life assurance, employment rights, and legislation for regulation of their use are discussed.

Adult↗
PubMedDate not supplied

The problem of Social Security disability determination for the burn patient. A report from the Committee on Rehabilitation of the American Burn Association (ABA).

The ABA Rehabilitation Committee has developed a form to be included in the hospital record at discharge that should facilitate the Social Security disability determination process for the burn patient. This form should aid in the disability determination process by guiding the Social Security disability examiner to the pertinent evidence of limitation and chronicity in the often cumbersome medical record and by emphasizing the multiple body system nature of the severe burn injury.

Burns↗
PubMed2004

Early childhood caries in children aged 6-19 months.

OBJECTIVES: To investigate the relationship between socioeconomic factors, behaviors and the severity of early childhood caries (ECC) in 6-19 month-old Thai children. The severity of ECC was estimated using the proportion of ECC teeth to erupted teeth. This was termed the 'Intensity of ECC' (I-ECC) index. METHODS: Cross-sectional questionnaire survey, dental examinations, and mutans streptococci counts were obtained from children and mothers/caregivers who participated in the ECC prevention program. RESULTS: The 520 children from rural areas were categorized into four age groups by the mean number of erupted teeth. In the 15-19-month-old children, the prevalence of ECC was 82.8% (cavitated caries, 40.8%; noncavitated caries, 42.0%) with a mean ECC teeth score of 4.18 +/- 3.19. The mean I-ECC severity score was 0.45 +/- 0.30 in these toddlers. Children from low-income families, those with low education, and mothers/caregivers with decayed teeth had higher I-ECC scores (P < 0.05). Children who were breast fed or had high counts of mutans streptococci also had higher I-ECC scores (P < 0.05). The logistic regression model revealed that only children's mutans streptococci level was a statistically significant predictor of ECC, with an odds ratio = 4.5 (95% CI = 1.8, 11.7). CONCLUSIONS: ECC is not only a public health problem but also a social problem in Thailand, because it relates to family income and education level. The community development approach to assisting disadvantaged Thai children should be combined with an effective preventive program at a very young age. Future longitudinal research should be performed to improve the I-ECC for measuring the severity of ECC.

Bottle Feeding↗
PubMed2004

Social and emotional adjustment of siblings of children with autism.

BACKGROUND: Social and emotional adjustment of siblings of children with autism was examined, to explore their risk or resilience to effects of genetic liability and environmental factors involved in having a sibling with autism. METHOD: Social-emotional adjustment, behavior problems, socialization skills, and siblings' relationships were compared among 30 siblings of children with autism, 28 siblings of children with mental retardation of unknown genetic etiology (MR), and 30 siblings of children with developmental language disorders (DLD). Groups were matched by probands' gender, siblings' chronological age, gender, IQ, and birth order, and by family size, ethnicity, and parental income, employment, and stress level. RESULTS: Four siblings of children with autism, three siblings of children with MR, and seven siblings of children with DLD received DSM-IV diagnoses. Nevertheless, most of the siblings were well adjusted. CONCLUSIONS: The adjustment of siblings of children with autism is in sharp contrast to the severe social and emotional disabilities characteristic of autism, and is noteworthy considering the stress involved in having a sibling with autism.

Adaptation, Psychological↗
PubMed1987

Early feeding problems in an affluent society. III. Follow-up at two years: natural course, health, behaviour and development.

The aim of this study was to investigate the natural course of later problems and their prevalence in children with early feeding difficulties. Forty-two children with feeding problems without any obvious medical reason during the first year of life were followed up prospectively to the age of two years. Comparisons were made with 42 age- and sex-matched controls. Information was obtained from parental interviews, medical records and assessments of psychomotor development. In 21 (50%) of the children with feeding problems the problems persisted at the age of two years. There were significantly higher frequencies of infections and behavioural problems among the children with early feeding problems than among the controls. No differences in psychomotor development were found. Recurrent infections, behaviour problems and psycho-social problems were significantly correlated with severe persistent feeding problems at the age of two years.

Child Behavior Disorders↗
PubMed1989

Randomisation by cluster and the problem of social class bias.

For randomised population trials the unit of randomisation is normally the individual person. In some situations, however, investigators take other groups as basic unit and one such design is cluster randomisation. Considerable attention has been given to this design recently in statistical and epidemiological literature. The Edinburgh randomised trial of breast cancer screening is an example which takes general practices as clusters of patients. The experience of this trial is reported here. Mortality from all causes, cardiovascular disease and lung cancer over the first 5 year period of follow up are examined. We found that spurious mortality differences were present in the analyses, which do not allow for socio-economic status. From examination of methods of adjusting for this, we conclude that allowance can be made at the analysis stage, and it is intended that this approach will be adopted when breast cancer mortality is analysed in the Edinburgh trial. Nevertheless, we recommend that for future studies with outcome related to socio-economic status, randomisations which use this design be stratified by socio-economic criteria where this is feasible.

Bias↗