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Biomedical subjects

E Segest

Publications and source records attributed to E Segest.

At least 37 records · Page 2Linked to original sources

The influence of prolonged stable methadone maintenance treatment on mortality and employment: an 8-year follow-up.

A cohort of 169 opiate drug addicts was followed for 8 years. The mortality rate was 3.3 per year. The average lethality per observation year was found to be higher than in other studies. The treatment with methadone was unstable and only 11% had received stable prolonged maintenance treatment. It is not possible to reject a model that described increasing mortality rates neither as a function of falling methadone maintenance treatment nor as a function of socially unstable addicts contra stable addicts. Unemployment was high in the cohort (87%), and no relationship could be demonstrated between methadone maintenance treatment and employment.

Adult

Prevention of AIDS: free condoms to drug abusers in the Municipality of Copenhagen.

The slogan "safer sex" was presented in a questionnaire investigation carried out over an interval of 6 months among intravenous drug addicts (N = 116) attending three different outpatient clinics in Copenhagen. Despite this, many of the patients, who were mainly heterosexual and many of whom were HIV positive, continued to practice sexual and injection behaviors which exposed both them and others to HIV infection. Free condoms and advice have been offered as a part of the campaign against AIDS. The initiative was well accepted by the drug addicts and within a period of 6 months there was an increase of 19% in the group which employed condoms. It is concluded that there is still a need for initiatives and research to support the changes achieved in the behavioral pattern of the population.

Acquired Immunodeficiency Syndrome

[The problem of proof in the processing of complaints about alleged medical errors].

The processing of patients complaints of alleged medical errors comprises two main elements: the definition of the medical standard and general legal aspects, particularly the submission of evidence. On the basis of laws, chiefly the Health Act, several judicial theories are presented together with empirical studies and usage pertinent to the problem of evidence. It is concluded that there are very few empirical studies but that the instruments of law give wide scope for judgement on issues of alleged medical error.

Adult

Free condoms in the schools of Copenhagen, Denmark.

Attitudes of ninth grade students and their classroom teachers toward using condoms as a preventive measure against contracting AIDS were studied. Students (N = 438) and their teachers (N = 28) in the council schools of the Municipality of Copenhagen were surveyed using a structured questionnaire. Overall, results demonstrated that the message regarding "safe sex" had been well understood. However, 42% of pupils reported not using a condom during their last sexual intercourse. Many pupils indicated difficulty in using condoms. A continuing need exists for advice to the young. An information campaign, with distribution of free condoms, was well accepted by pupils and teachers. Almost all (94%) pupils indicated they will use condoms more frequently in the future. This campaign differed from other efforts that focused more on general information. The importance of other strategies designed to alter behavior to reduce the risk of contracting AIDS is discussed.

Acquired Immunodeficiency Syndrome

The allocation of drug addicts to different types of treatment. An evaluation and a two-year follow-up.

In Denmark the official aim has been to reduce methadone treatment, even though no effort is made to directly forbid this therapy. A multiprofessional committee was established to regulate and limit methadone treatment. There were no specific guidelines for what type of drug addict should be treated with methadone. We found that allocation for the Regional Narcotic Committee of the Municipality of Copenhagen during 1982-1984 did not serve the desires of the addicts because only 41% followed it. Allocation also did not follow the principles of research in this field. In a 2-year follow-up investigation we found that drug addicts had a mortality rate of 6.3/year, rising criminality (significant), and falling availability to the labor market (nonsignificant). We therefore came to the conclusion that the efforts of the committee did not improve the conditions of drug addicts. Only those drug addicts who had been under almost constant methadone treatment had a low lethality and a falling number of criminal convictions (significant). Finally, it is concluded that limited research within this field prevents more specific treatment and improved use of financial resources.

Adult

Poisoning with dextropropoxyphene in Denmark.

The sale of dextropropoxyphene is rising in Denmark, and the number of both fatal and non-fatal cases of poisoning with dextropropoxyphene is similarly rising. A total of 124 fatal and 297 non-fatal hospitalized cases of poisoning caused by dextropropoxyphene were reported to the National Board of Health in 1984. These figures are judged to be minimum figures. There is an accumulation of cases in the municipality of Copenhagen as compared to the remainder of the country. Cases of poisoning with dextropropoxyphene occur more frequently in socially and mentally encumbered groups. It is often difficult to determine with certainty the method of poisoning, but it is considered that the distribution is roughly one-third suicide or attempted suicide, about the same from accidental or simple over-dosage, while the remainder are uncertain. It is judged that the number of suicides or attempted suicides in normal persons is small, while the numbers in persons not entirely normal or carried out as an impulsive act are considerably higher. Other intoxicants, most frequently alcohol, have in more than one half of the cases been consumed together with dextropropoxyphene. The mortality rate for those cases reaching medical aid has been found to be 3.6% which is lower than the figure reported in other investigations. Very many of the cases of poisoning, however, are fatal at the time of discovery. Serious sequelae after non-fatal cases of poisoning are extremely rare. The steps being taken by the National Board of Health to reduce the number of cases of poisoning are mentioned, and the possibilities of reducing the number of cases are also discussed.

Adolescent

Police custody: deaths and medical attention.

Information was obtained from all the county constabularies regarding deaths and medical attention given to those in police custody. It was presumed that this information covered all deaths in custody in Denmark during the period 1981 through 1985. There is no apparent increase in the absolute number of deaths during detention during the period 1969 through 1985. The number of deaths occurring in custody in relation to the annual number of persons incarcerated has fallen during the period 1955 through 1985. Simultaneously, a marked rise has occurred in the number of persons held in police custody. During the period 1981 through 1985, 7.9 persons were incarcerated per 1000 population per year. One homicide and nineteen other deaths occurred. The most frequent cause of death was asphyxiation as a result of aspiration of gastric contents during alcohol intoxication, drug poisoning, and intracranial hemorrhage. A physician had been consulted but had not diagnosed the seriousness of the condition in 42% of the deaths. All the deceased were men, and all suffered from the effects of social, psychiatric, and physical diseases. The lethality evaluated from hospitalized clients with the same type of life-threatening conditions was found to be 25%. A discussion is presented of the costs which will be incurred if a large group of those kept in police custody were admitted to hospital. Similarly, changes in the present arrangements are suggested that could ensure a greater certainty of avoiding deaths in detention.

Adult