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Biomedical subjects

R R Frerichs

Publications and source records attributed to R R Frerichs.

At least 19 recordsLinked to original sources

Randomised, controlled trial of effectiveness of ampicillin in mild acute respiratory infections in Indonesian children.

The recommended treatment for mild acute respiratory infections (ARI) in children is supportive care only, but many physicians, especially in developing countries, continue to prescribe antibiotic treatment because they believe it prevents progression to more severe ARI. To find out whether ampicillin treatment conferred any benefit over supportive care alone, a randomised, controlled trial was carried out among 889 children (under 5 years) with mild ARI in Indonesia. 447 were randomly allocated ampicillin (25-30 mg/kg body weight three times daily for 5 days) plus supportive care (continued breastfeeding, clearing of the nose, and paracetamol to control fever); 442 were allocated supportive care only. The treatment groups were almost identical after randomisation in terms of age, sex, level of parental education, history of measles immunisation, and fever. After 1 week the percentages cured were nearly identical (204 [46%] ampicillin; 209 [47%] control), as were the percentages of cases progressing to moderate ARI (56 [13%] vs 53 [12%]). The effect of treatment was not modified by age, sex, measles immunisation status, or the educational level of the parents. At the 2-week follow-up, the percentages cured were 62% (277) in the ampicillin group and 58% (256) in the control group; 14% of both groups had progressed to moderate ARI; and 24% (107) and 28% (123), respectively, still had mild ARI. None of the differences in outcome between the ampicillin and control groups was statistically significant. Thus, ampicillin plus supportive care offers no benefit over supportive care alone for treatment of mild ARI in young Indonesian children.

Acute Disease

Personal health habits and symptoms of depression at the community level.

This investigation examined the relationship between lifestyle, as defined by common health habits, and symptoms of depression in a general community sample. The study was conducted using data from a longitudinal survey involving four interviews of 1,003 Los Angeles County adults. The survey focused on the epidemiology of depression and help-seeking behavior, which included questions about seven health habits identified in the Alameda County Study as predictive of health status. The group used for this analysis comprised 752 adults who participated in and had usable depression scores (as measured with the 20-item CES-D scale) at all interviews. Depression prevalence rates were higher for six of the seven "poor" health habits examined compared with the "good" health habit. Prevalence odds ratios were greater than 2.0 for poor sleeping and drinking habits (both sexes) and equaled 1.8, among women only, for poor physical activity and smoking habits. Multivariate regression analyses showed a simple sum of the total number of good habits to be a significant independent predictor of depression after controlling for prior depression and various sociodemographic factors. The finding of an independent contribution of health habits to depression status emphasizes that lifestyle may influence mental as well as physical health.

Adult

On measures and models for the effectiveness of vaccines and vaccination programmes.

Smith, Rodrigues and Fine have discussed and linked different measures, models, and study designs for the assessment of vaccines. The present paper responds to a number of issues implicitly raised by these authors. In particular, it is argued that measures and models need to be considered independently, with choice of measure depending on evaluation objectives, and choice of model depending on consideration of both mechanism of administration and mechanism of action. Models in which a particular measure remains constant tend to be unrealistic for evaluating field effectiveness. Some technical issues arising in the design and analysis of case-control studies of vaccines are also addressed.

Humans

Epidemiology of urinary tract infection: I. Diaphragm use and sexual intercourse.

In the present case-control study of college-aged women, we examined the associations of sexual intercourse and diaphragm use with primary and secondary urinary tract infection (UTI), and measured the treatment and functional costs of primary, secondary, and recurrent UTI. All of the cases but only half of the controls had engaged in sexual intercourse during the past four weeks. When compared to using oral contraceptives, diaphragm use was associated with both first attack UTI (when compared with controls) and second attack UTI (when compared to women with primary UTI) even after controlling for frequency of sexual intercourse (Primary UTI: RRMH = 3.5; 95% CI: 0.9, 13.0; Secondary UTI: RRMH = 2.2; 95% CI: 0.3, 15.4). Women with all types of UTI reported 6.1 symptom days, 2.4 restricted-activity days, 1.6 office visits and laboratory tests, and spent $62 for treatment of UTI, based on prices of a subsidized student health service.

Adolescent

Epidemiology of urinary tract infection: II. Diet, clothing, and urination habits.

Although several health habits and behaviors are commonly cited in medical and nursing textbooks as potential causes of urinary tract infection (UTI) in women, few have been studied in a systematic fashion. In a case-control study, we evaluated the associations between UTI and the most commonly mentioned risk factors: urination habits, diet, clothing, and soaps. Because sexual intercourse and diaphragm use increase the risk of UTI, we assessed the effect of health habits and behaviors controlling for these two risk factors. Women with initial UTI were compared with controls with no UTI history; women with a second UTI were compared to those with initial UTI. For the 25 initial cases, 19 secondary cases, and 181 controls enrolled in the study from a university health service, we found using tampons and drinking soft drinks to be moderately associated (RR greater than or equal to 1.4) with both initial and recurrent UTI. Although several other individual habits had only small associations with UTI, several of these behaviors together might substantially increase risk of initial or recurring UTI.

Adolescent

Serum high density lipoprotein and its relationship to cardiovascular disease risk factor variables in children--the Bogalusa heart study.

Serum high density lipoprotein is increasingly recognized as a negative risk for cardiovascular disease. The distribution and interrelationship of serum lipids, lipoproteins, anthropometric measurements and blood pressures were determined in some 5,000 children. Children had mean +/- S.D. alpha-lipoprotein cholesterol levels (mg/100 ml) of 36 +/- 15 at birth, 51 +/- 22 at 6 mo, 53 +/- 18 at 1 yr, 60 +/- 19 at preschool age (2 1/2-5 1/2 yr) and 68 +/- 22 at school age (5-14 yr), reflecting a sharp increase in alpha-lipoprotein between birth and school-age years, when these levels remained relatively stable through age 14. Although white children tended to have higher levels of total cholesterol and alpha-lipoprotein at birth than black children, during childhood this trend was reversed and the differences were pronounced in school-age children (p less than 0.0001). Unlike in adulthood, boys had slightly higher levels of alpha-lipoprotein than girls. The alpha-lipoprotein was negatively correlated with pre-beta-lipoprotein and to a lesser extent with beta-lipoprotein classes. There was an inverse relationship between alpha-lipoprotein and obesity with a consistently significant relationship (p less than 0.01) in older children (10-14 yr). Children with higher levels of alpha-lipoprotein have lower levels of blood pressure, beta-lipoprotein and a lower obesity index.

Adolescent

Path analysis of environmental and genetic influences on blood pressure.

Familial aggregation of a trait (determined by the intraclass correlation coefficient) may result from genetic influence or from environment common to a household. The authors used path analysis to separate aggregation into the proportion of population variability due to genetic influence (h2 = heritability) and the proportion due to environment common to a household (c2). They used data from full siblings and maternal half siblings, aged two to 18 years, from Bogalusa, Louisiana, a biracial community. The statistically significant aggregation they found could be explained by either h2 or c2 except for two cases: systolic measurement in the pooled (black and white) sample requires h2; diastolic measurement in the white sample requires c2. The authors present a simplified explanation of the techniques they used.

Adolescent

Equations for estimating percentage of body fat in children 10--14 years old.

Measurements of the percentage of body fat (derived by underwater weighing), height, weight, and triceps skinfold thickness were determined for a volunteer sample of 214 children, 10--14 years old. The bivariate correlations, by sex, of percentage of body fat with five obesity indices are highest with the triceps skinfold and least with weight-height. Five sets of equations are presented for predicting percentage of body fat based on measurements of either height and weight, triceps skinfold, or height, weight, and triceps skinfold. Cumulative frequency distributions of the percentage of body fat (based on height, weight, and triceps skinfold) are shown by race and sex for a total community of 10- to 14-year olds.

Adipose Tissue

Childhood sibling aggregation of coronary artery disease risk factor variables in a biracial community.

To analyze aggregation of risk factors for coronary artery disease (CAD), the authors studied 4538 children from the biracial community of Bogalusa, Louisiana. Of these children ranging in age from two to 18 years, 2535 had at least one sibling, permitting the calculation of F-ratios and intraclass correlation coefficients. Those calculations revealed statistically signigicant F-ratios for all anthropometric, blood pressure and lipid variables studied. Of the lipoprotein variables studied only alpha-lipoprotein showed no statistically significant aggregation (for black children). The analysis failed to reveal any significant differences in intraclass correlations between black and white children.

Adolescent

Relation of serum lipids and lipoproteins to obesity and sexual maturity in white and black children.

The interrelationships of serum lipids and lipoproteins with measures of body habitus and maturation stages were analyzed in a biracial population of 3151 children, ages 5--14 years. In general, triglycerides, pre-beta-lipoprotein, and beta-lipoprotein were positively correlated with body habitus and maturation while alpha-lipoprotein was negatively correlated. The relationships in most instances were more apparent in whites than in blacks, with the highest correlations observed in white boys. No significant correlations were observed between serum cholesterol and the anthropometric variables except in white boys. The most obese children tended to have higher levels of triglycerides, pre-beta-lipoprotein, and beta-lipoprotein, and lower levels of alpha-lipoprotein than the remaining population. In the total population, the multiple correlation coefficients with the children's age, race, sex weight-height index, triceps skinfold and maturation stage as the independent variables and the concentrations of the different serum variables as the dependent variables ranged from 0.04 to 0.11.

Adolescent