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R A Bell

Publications and source records attributed to R A Bell.

194 records · Page 11Linked to original sources
PubMedDate not supplied

Direct-to-consumer prescription drug advertising: trends, impact, and implications.

We provide an overview of what is known about the impact of direct-to-consumer (DTC) advertising of prescription drugs. Specifically, we explore the historical trends that led to the industry's increasing use of this form of promotion. Then, using the published literature to date, we review the impact of DTC advertising on the consumer, the medical profession, and the health care system. We conclude by offering policy suggestions for how the pharmaceutical industry can promote its products more responsibly, how the Food and Drug Administration (FDA) can regulate DTC advertising more effectively, and how the medical and public health communities can educate the public about drug therapies more constructively.

Advertising↗
PubMedDate not supplied

Some epidemiologic aspects of psychosomatic medicine.

Both surveys of physicians' practices and community studies reveal that psychomatic disorders are very prevalent in our society. In a random sample of 1,645 adults, aged seventeen to ninety-two, we found that slightly more than 50% reported at least one psychosomatic symptom "regularly" during the preceding year; 17.3% reported two or more. A profile of the symptomatic shows that they tend to be widowed, separated, or divorced; many were unemployed, retired, or disabled. Examination of associations between certain sociocultural factors and the presence of psychosomatic symptomatology disclosed that, as a group, symptomatic respondents had been neither more nor less mobile than others. Most had relatives and friends nearby but few felt they could request help from either. Most attended church but few engaged in community activities. The symptomatic group appeared to lack meaningful social support systems. The discussion focuses on possible relationships between social change, support systems, and prevalence of psychosomatic symptomatology.

Adolescent↗
PubMedDate not supplied

Facial dysmorphologic and skeletal cephalometric findings associated with conotruncal cardiac anomalies. off.

Anomalous conotruncal cardiac morphology and facial dysmorphology have been associated with neural crest-pharyngeal arch abnormalities. To assess these associations, 20 patients 3 to 18 years old with tetralogy of Fallot (TOF) or persistent truncus arteriosus (PTA) were evaluated by cardiologic, facial dysmorphic, and cephalometric criteria. The average number of facial abnormalities of neural crest derivation was two, while pharyngeal arch derivative abnormalities were observed with an average of five defects per subject. The total group had many more facial malformations than normal populations (P less than .00001). The occurrence of defects was not significantly different between TOF and PTA patients. Thirteen TOF patients 8 years, 9 months to 18 years, 10 months old (x = 13 years, 4 months) had lateral cephalograms analyzed for skeletal relationships. The TOF patients exhibited higher than usual distribution of dolichofacial growth patterns (6 of 13), Class II skeletal relationships (6 of 13), mandibular retrusion (7 of 13), and maxillary protrusion (6 of 13). Trends were not absolute, since opposite patterns were individually expressed, and referencing by race tended to show more normal values for respective groups.

Adolescent↗
PubMedDate not supplied

Eruptive malpositioning of the mandibular permanent lateral incisors: three case reports.

Ectopic eruption of the mandibular permanent lateral incisors involving the loss of the adjacent primary canines is not uncommon, yet the extreme distalization and transposition of such teeth (partial or true) has been reported infrequently. Three cases that illustrate various anomalous eruption-exfoliation patterns are presented. Theories that attempt to explain the etiology of anomalous eruption positions are discussed. However, the multifactorial process of growth and development makes it difficult to identify specific primary etiological factors. Treatment options also are discussed and illustrated, with emphasis on early orthodontic intervention for optimal results.

Child↗
PubMedDate not supplied

Correlates of abnormal urinary albumin excretion rates among primary care patients with essential hypertension.

BACKGROUND: The excretion of small amounts of urinary protein, known as microalbuminuria, among patients with essential hypertension is associated with increased mortality from cardiovascular disease and, possibly, future renal decline. Correlates of microalbuminuria among primary care patients with essential hypertension, however, have not been well described. METHODS: One hundred forty patients enrolled in a large family practice ambulatory care center who had essential hypertension but not diabetes participated in a screening project to document cardiovascular and renal diseases in this population. Patients underwent a brief physical examination and submitted blood and urine samples for analysis. RESULTS: Twenty-five percent of patients had elevated urinary albumin excretion (UAE) rates, defined as greater than 30 micrograms/min. Patients with elevated UAE rates did not differ from patients without elevated UAE rates by age, race, sex, duration of hypertension, or type of antihypertensive medications used (if any). Although no patients had abnormally elevated glycosylated hemoglobin, after controlling for age and duration of hypertension, elevated UAE rates were significantly related to higher mean glycosylated hemoglobin levels (odds ratio [OR] = 3.06, 95 percent confidence interval [CI] = 1.11 to 8.41) and to current smoking (OR = 3.14, 95 percent CI = 1.09 to 9.04). CONCLUSIONS: These data are the first in a primary care population to show a threefold increase in risk for elevated UAE rates among patients with essential hypertension who currently smoke or who have above-average glycosylated hemoglobin levels. Although cross-sectional in nature, these data can also point toward subgroups of hypertensive patients who have a worse cardiovascular prognosis.

Albuminuria↗