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Biomedical subjects

B Lewin

Publications and source records attributed to B Lewin.

11 recordsLinked to original sources

Effects of self-help post-myocardial-infarction rehabilitation on psychological adjustment and use of health services.

A home-based exercise programme has been found to be as useful as a hospital-based one in improving cardiovascular fitness after an acute myocardial infarction. To find out whether a comprehensive home-based programme would reduce psychological distress, 176 patients with an acute myocardial infarction were randomly allocated to a self-help rehabilitation programme based on a heart manual or to receive standard care plus a placebo package of information and informal counselling. Psychological adjustment, as assessed by the Hospital Anxiety and Depression Scale, was better in the rehabilitation group at 1 year. They also had significantly less contact with their general practitioners during the following year and significantly fewer were readmitted to hospital in the first 6 months. The improvement was greatest among patients who were clinically anxious or depressed at discharge from hospital. The cost-effectiveness of the home-based programme has yet to be compared with that of a hospital-based programme, but the findings of this study indicate that it might be worth offering such a package to all patients with acute myocardial infarction.

Adaptation, Psychological

Casual sex among Norwegian adolescents.

The issue of casual sex and amount of sexual experience was studied using data from a representative sample of 2997 Norwegians, 17-19 years old. Data were collected by anonymous self-administered questionnaires, and the response rate was 62.8%. Results showed that among adolescents, experience of casual sex to a large extent was a function of the time the individual had been coitally active. The amount of sexual experience was poorly related to social background and strongly related to life-style factors such as smoking and drinking of alcohol. A small minority of adolescents was found to have a sexual behavior deviating from that of the majority, and thus containing elements of potentially high risk for contracting HIV or other STDs. This minority of adolescents had the identifying characteristic of low self-reported intimacy with their first coital partner.

Adolescent

Use of birth control pills and condoms among 17-19-year-old adolescents in Norway: contraceptive versus protective behaviour?

This article addresses the relationship between sexual risk behaviour and contraceptive behaviour, and considers whether adolescents who use condoms are practising birth control or STD protective behaviour. The material comprised a representative sample of 3000 Norwegians aged 17-19 years. Data were collected by anonymous self-administered questionnaires. The response-rate was 63%. At the first sexual intercourse 51% of the adolescents used condoms and 7% birth control pills. At the most recent intercourse 31% used condoms and 38% the pill. Use of the pill was widespread among adolescents with high coital frequency and few coital partners. Use of condoms was not particularly widespread among adolescents who reported a relatively large number of coital partners. Irrespective of the number of years they had been coitally active there was no significant difference between those who intended to use condoms at the next sexual intercourse and those who did not as regards their beliefs about condoms as protection against STDs, HIV and unintended pregnancies. The results from this study indicate that the majority of adolescents who use contraception do this for protection against unintended pregnancy and not for protection against STDs. The preference for the pill may make teenagers less prepared to practise STD protective behaviour in specific situations.

Acquired Immunodeficiency Syndrome

3 regimens of topical metronidazole compared with subgingival scaling on periodontal pathology in adults.

This report presents the findings from an open randomized multicentre clinical trial designed to compare the clinical efficacy of scaling with application of 3 different preparations/dose frequencies of topical metronidazole in the treatment of adult periodontitis. The 4 treatments were: (A) metronidazole 25% dental gel administered 1 x a week for 2 weeks; (B) metronidazole 15% dental gel applied 1 x a week for 2 weeks; (C) metronidazole 15% dental gel applied 2 x a week for 2 weeks; (D) subgingival scaling, performed 1 x only. A split mouth design was used. Patients were included in the study if they had at least 1 tooth in each quadrant with a pocket depth > or = 5 mm in at least 1 of 4 sites. A total of 61 patients from 4 centres were entered into the study. The efficacy parameters were probing pocket depth and bleeding on probing. Follow-up visits for recording of clinical efficacy were made at 2, 4, 6 and 12 weeks after the end of metronidazole treatment. All 3 antibiotic treatments (A, B, C) reduced the symptoms of periodontal pathology and yielded results comparable to those seen after subgingival scaling (D). When using a topical drug therapy, it seems important to use a preparation that requires as few applications as possible. The best candidate for drug therapy would therefore be treatment (A) metronidazole 25% applied 1 x a week for 2 weeks.

Adult

Units of transcription and translation: sequence components of heterogeneous nuclear RNA and messenger RNA.

Defining the units in which the eucaryotic genome is transcribed and translated is central to any analysis of eucaryotic gene expression. The relationship between heterogeneous nuclear RNA and messenger RNA raises the question of whether the primary transcript may be more complex than the sequence which is translated; as I concluded last month in the first part of this review, kinetic analyses of these two RNA populations provide some suggestive indications but cannot prove whether the nuclear population includes messenger precursors that are much longer than mature cytoplasmic messengers (Lewin, 1975). Here I discuss recent analyses of the sequence components present in hnRNA and mRNA and how they may be related to each other and to the organization of the genome.

Animals

The effects of physical exercise training and cardiac education on levels of anxiety and depression in the rehabilitation of coronary artery bypass graft patients.

OBJECTIVE: to evaluate whether an exercise and education-based rehabilitation programme is sufficient treatment for individuals with clinically significant levels of anxiety or depression following coronary artery bypass graft (CABG) surgery. DESIGN: follow-up and repeated assessment after surgery. SETTING: outpatient cardiac rehabilitation programme. PATIENTS: all 88 attenders after CABG surgery. ASSESSMENTS: structured interview and Hospital Anxiety and Depression (HAD) scale (using 8 as the cut-off) administered by rehabilitation nurses at start of course and HAD repeated at 12 weeks and 6 and 12 months (by post after discharge). RESULTS: return rates of 76 and 80% at 6- and 12-month assessments, respectively; statistically significant reductions in levels of anxiety and depression found between first and all subsequent assessments; subdividing into groups revealed significant reduction in anxiety and depression in the anxious and depressed groups at 12 weeks and 6 months, respectively, but at 12 months there was no significant reduction. CONCLUSIONS: there is a need to address the problems of anxiety and depression directly by screening and treatment, and to provide more psychologically-orientated cardiac rehabilitation programmes.

Coronary Artery Bypass