How to incorporate health promotion into national health insurance.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to S Jonas.
Explore the source record for details and available documents.
Sixteen acceptably randomized studies of anticoagulant therapy after cerebral or retinal ischemia or infarction are reviewed and the results among 1,046 anticoagulated patients and 1,071 controls are analyzed. The following conclusions are derived. 1) Anticoagulant therapy has not been shown to be better than control management after transient ischemia or nonprogressing ischemic stroke; this is true whether the control management was deliberately ineffectual treatment (generally studies completed in 1974 or earlier) or platelet antiaggregant therapy (pooled results of three recent studies). 2) Although a study done 30 years ago demonstrated no benefit, a recent study showed benefit from anticoagulant therapy in patients who had had cerebral emboli of cardiac origin; additional controlled data are needed. 3) There is evidence that patients with thrombosis in evolution might benefit from anticoagulant therapy; additional controlled data are needed.
A significant portion of the deaths in the United States could have been prevented or postponed using known interventions. One reason this did not occur is because medical science and medical education are disease, not health, oriented. Since physicians are at the center of the health care delivery system, their disease orientation pervades the industry. Historically, there have been calls for physicians to focus more on disease prevention; however, medical education does not teach disease prevention/health promotion. There are several reasons for this: 1) medical school faculty conceptual discordance between "certainty" of curative disease vs. the "probability" of risk factor reduction; 2) gaps in the knowledge of effective interventions; 3) the concept that health promotion/disease prevention are outside the province of physicians; 4) the significant role of biomedical research grants on medical school funding; 5) the close association of medical education and the acute care hospital; and 6) the use of rote memory/lecture based teaching methods of traditional medicine vs. the problem-based learning necessary to teach disease prevention/health promotion. Some medical schools have begun to use problem based learning and to introduce health promotion concepts. Widespread and long-lasting change requires support of the leadership in medical schools and the preventive medicine/public health community, and grant funding from state and federal sources to support research on medical education research and change.
In neutral solutions, desferrioxamine (Desferal) can react with the superoxide free radical, O2.- (possibly through its protonated form HO2.), to form a relatively stable nitroxide free radical, which can have a half-life of approx. 10 min at room temperature. The formation of the radical can be largely prevented by the presence of superoxide dismutase. The radical reacts rapidly with cysteine, methionine, glutathione, vitamin C and a water-soluble derivative of vitamin E. It also reacts rapidly with alcohol dehydrogenase, causing a loss of enzyme activity. The implications of these findings for mechanistic free-radical biochemistry and iron-chelation therapy could be considerable.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Idiopathic scoliosis was treated by an automated portable posture-training device that incorporated precise behavioral principles and enabled therapeutic training to be given in the patients' normal environment throughout the entire day. Twenty-one patient-years of training were completed with a group of 12 adolescent girls selected as being imminently likely to require a brace because of the way their spinal curves had been progressing. As an alternative to conventional brace therapy, patients found the posture-training device considerably less physically restraining and more cosmetically acceptable. Most patients wore it 23 hr per day for at least 1 year and adapted well to the constant physical and psychological presence of the instrument. For 10 patients, the outcome was entirely successful; they were discharged from this pilot study as satisfactorily corrected. Progression of the scoliotic curve was arrested; in fact, there was an average slight improvement in the Cobb angle (a measure of spinal curvature) as measured by x-ray radiography.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This study examines the clinical setting, characteristics, and follow-up of 173 patients who had slow paroxysmal atrial tachycardia (SPAT) (greater than 4 beats, rate less than 150 bpm) during 24-hour Holter monitoring. These episodes were classified by probable mechanism according to recognized ECG criteria and included AV nodal reentry (AVNR), sinoatrial nodal reentry (SANR), and automatic (A). There were 76 males (44%) with a mean age of 72 years and 97 females (56%) with a mean age of 73 years. The indications for Holter recording revealed that the SANR and A subgroups had a higher frequency of cerebral symptoms compared to AVNR (p less than 0.01). Chest pain was more common in the SANR group as compared to the other two groups (p less than 0.01). There was no difference in the frequency of palpitation in the three subgroups. The mean rate of SPAT for the entire group was 115.2 +/- 14 and these episodes had a mean duration of 5.58 +/- 3.07 seconds. The SANR subgroup had a significantly slower rate (107.1 +/- 9.2) as compared to the AVNR subgroup (p less than 0.01). One hundred fourteen patients were available for follow-up. The average period of follow-up was similar for all three groups. At follow-up the frequency of sick sinus syndrome as determined clinically and permanent pacemaker insertion was significantly greater in the SANR subgroup (p less than 0.01) as compared to the other subgroups which did not differ from each other.