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Biomedical subjects

H Jick

Publications and source records attributed to H Jick.

At least 145 records · Page 8Linked to original sources
PubMed1985

A followup study of ibuprofen users.

We followed up 13,230 members of the Group Health Cooperative of Puget Sound under the age of 65 years who were presumed to have taken ibuprofen as out patients. All hospitalizations that occurred within 3 months after a prescription for ibuprofen was filled were reviewed. We found no instances of serious uncommon illness which could be attributed to this drug with any reasonable degree of certainty. In particular, there were no cases of acute liver or kidney disease noted within 3 months of exposure to ibuprofen.

Adult↗
PubMed1984

Drug-induced blood disorders.

A case-history study of drug-induced blood disorders (pancytopenia, hemolytic anemia, thrombocytopenia, and granulocytopenia) was carried out at the Group Health Cooperative of Puget Sound, a health maintenance organization with more than 200,000 members, for the ten-year period from 1972 through 1981. During this time, only 26 instances of hospitalization for such disorders were thought to be definitely, probably, or possibly due to drugs other than antitumor agents. The rate was of the order of one per 100,000 person-years at risk. Only quinidine/quinine and sulfa-containing drugs were implicated in more than one case.

Adolescent↗
PubMed1984

Allopurinol and cataracts.

We conducted a two-part study to determine whether any positive association between the use of allopurinol and the development of cataracts could be demonstrated. Study 1 included 251 Boston-area patients hospitalized for cataract and 753 matched controls. Two cataract patients were regular allopurinol users as compared with six control patients. The relative risk for cataract comparing allopurinol users with nonusers was 1.0 (95% exact confidence interval 0.14, 4.7). Study 2 included 389 patients from the Puget Sound, Washington, area who were hospitalized for cataract surgery during a five-year period (551,543 person-years). The rate of hospitalization for cataract in patients 30 to 49 years old was 0/992 person-years for allopurinol users and 78/366,960 (2.1 per 10(4)) person-years for nonusers. The rate of hospitalization for cataract in patients 50 to 64 years old was 3/2,270 (13.2 per 10(4)) person-years for allopurinol users and 308/184,583 (16.7 per 10(4)) person-years for nonusers.

Allopurinol↗
PubMed1984

Nonsteroidal anti-inflammatory drugs and renal disease.

The relationship between nonsteroidal anti-inflammatory drugs (NSAIDs) and deterioration of renal function was examined in a large group of hospitalized patients carefully monitored for adverse drug effects and in a large group of outpatients whose discharge diagnoses after subsequent hospital admission were recorded. In the in-hospital study, no association between the use of NSAIDs and drug-attributed elevation of serum urea nitrogen levels diagnosed during hospitalization was present. In the outpatient study, none of the patients who used NSAIDs was hospitalized for acute renal disease. The majority of the available data related to indomethacin, ibuprofen, and phenylbutazone.

Anti-Inflammatory Agents↗
PubMed1984

Adverse drug reactions: the magnitude of the problem.

Much quantitative information on the clinical use and adverse effects of drugs has been accumulated in the past 15 years. These data provide a basis for substantial knowledge and perspective on the problem of drug toxicity, particularly for drugs that have been marketed for many years. We have also learned how to study adverse effects of newly marketed drugs in a cost-efficient and effective manner. Studies have shown that hospitalized adult patients in the United States receive on average about 10 drugs during hospitalization. Outpatient adults take on average about two drugs on a regular basis (i.e., at least once a week). Results from in-hospital studies indicate that some type of adverse reaction occurs about once in every 20 drug treatments. Most of these drug reactions are clinically minor and reversible, but about 10% of adverse reactions are regarded as life-threatening. Virtually all organ systems have been involved with adverse drug effects. Deaths in hospitalized patients that are attributable to drugs are rare and tend to occur in patients who are quite ill from their primary illness and receive potent drugs such as antitumor agents. However, some drug-induced illnesses appear to be preventable. Out-patient drug toxicity is the cause of about 3% of all hospitalizations. When considered with the enormous use of drugs in the outpatient population, however, this number of admissions secondary to drug toxicity seems to represent a small incidence.

Adrenal Cortex Hormones↗
PubMed1984

Pyloric stenosis and maternal Bendectin exposure.

As part of a long-term follow-up of structural disorders present at birth or shortly thereafter in infants born at Group Health Cooperative of Puget Sound, all infants with a diagnosis of pyloric stenosis born between July 1, 1977 and June 30, 1982, were identified. Automated pharmacy profiles were examined to determine whether an association between maternal Bendectin use in the first trimester and infantile hypertrophic pyloric stenosis existed. Among the 3,835 women exposed to Bendectin while pregnant, in this group of 13,346 births, 13 had infants who developed pyloric stenosis, and among the 9,511 women not exposed, 13 had infants who developed pyloric stenosis, resulting in a risk ratio estimate of 2.5 (95% confidence interval (CI) 1.2-5.2). When mothers were divided according to the number of prescriptions for Bendectin filled, the relative risk estimate increased from 1.2 (95% CI 0.4-4.4) in women who filled only one prescription to 7.6 (95% CI 4.9-11.6) in women who filled five or more prescriptions for Bendectin during their pregnancy.

Adult↗
PubMed1984

Drug toxicity and hospitalization among lithium users.

Among a cohort of 921 outpatients less than 65 years of age at Group Health Cooperative of Puget Sound who took lithium during a 5-year period, lithium-associated toxicity leading to hospitalization was rare. In only one case (muscle fasciculation) was lithium directly implicated as the cause of hospital admission. In five cases described in detail (one case each of hyperparathyroidism, vasculitis, edema, brain stem infarction, and subarachnoid hemorrhage), an etiologic connection with lithium exposure was considered unlikely but could not be ruled out.

Adult↗
PubMed1984

Cancer of the breast, colon, ovary, and testis in the United States: rates 1970-78 from a hospital reporting system.

We have explored the use of data from the Commission on Professional and Hospital Activities-Professional Activity Study ( CPHA -PAS) for ascertaining information on cancer incidence, with regional breakdowns. Extirpative surgical procedures were linked with discharge diagnoses to provide estimates of numbers of incident cases. We calculated incidence rates for four cancers: breast, colon, ovary, and testis. CPHA -PAS inferred rates corresponded closely to those of other reporting systems for breast cancer in most age groups, and for colonic and testicular cancer in some age groups. Ovarian cancer rates were consistently underestimated. We conclude that a cancer incidence reporting scheme based on hospital discharge data can work for certain cancers, and be very inexpensive and efficient. It must, however, be used with care.

Adult↗
PubMed1984

Antibiotic-associated colitis.

We determined the incidence of antibiotic-associated colitis among users of oral antibiotics or topical clindamycin in a large prepaid health plan. Exposure to antibiotics was determined using a system that automatically records outpatient prescriptions filled and hospital diagnoses were available from computer files. Four cases of acute colitis were judged likely to be causally linked with outpatient use of antibiotics. These findings provide substantial evidence that antibiotic-associated colitis requiring hospital treatment occurs very rarely.

Acute Disease↗