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PubMed2006

It is likely that the risk of cardiovascular events from pharmaceuticals as COX-2 inhibitors can be reduced significantly by standard pharmaceutical and lifestyle preventative measures.

Based on the principles of the altered homeostatic theory, a case will be made that the risk of cardiovascular (CV) events from pharmaceuticals as COX-2 inhibitors (coxibs) and sympatho-mimetic drugs can be reduced significantly by using standard pharmaceutical and lifestyle preventative measures as statins, exercise, a proper diet, and weight and stress reduction. The standard method of preventing CV events from coxibs, the prototypical pharmaceuticals which induce CV events, is not overly helpful; this method is based essentially on limitation of coxibs to low risk individuals, and to low dose and short term usage. Use of standard preventative measures apparently had not been considered because coxib-induced CV events are regarded as "special" as they are attributed to thromboxane. "Regular" CV events are attributed basically to dyslipidemia, and standard preventative measures are designed to improve dyslipidemia; therefore, it probably has been assumed that standard therapy for "regular" CV events would not be applicable to coxib-induced infarctions. In contrast, the altered homeostatic theory treats pharmaceuticals which induce CV events as "regular" risk factors which induce "regular" CV events. Therefore, "regular" preventative measures as exercise and statins should reduce the incidence of pharmaceutical-induced CV events. The critical issue is the mechanism of CV events. Thrombosis is the accepted and vasoconstriction (spasm of resistance vessels) is a proposed mechanism for CV events, and thrombosis and/or vasoconstriction (thrombosis/vasoconstriction) is regarded as the direct mechanism of CV events. Multiple and diverse "regular" risk factors express thrombosis/vasoconstriction, and multiple and diverse pharmaceutical and lifestyle preventative measures express anti-thrombosis/vasodilation. Risk and preventative factors are considered to operate in a dynamic balance; dominance of thrombosis/vasoconstriction favors development of CV events, and dominance of anti-thrombosis/vasodilation favors prevention of CV events. Thromboxane, and thus coxibs, and sympatho-mimetic drugs also express thrombosis/vasoconstriction; it is this expression which makes pharmaceuticals "regular" risk factors which induce "regular" CV events. It is assumed that all pharmaceuticals which induce CV events express thrombosis/vasoconstriction; thrombosis/vasoconstriction is the obvious mechanism for CV events from any source, and expression of thrombosis/vasoconstriction by multiple and diverse "regular" risk factors is supportive. Just as standard pharmaceutical and lifestyle preventative agent significantly reduce the risk of "regular" CV events, such measures should significantly reduce the risk of pharmaceuticals which favor CV events; protection is effected by shifting the overall balance between thrombosis/vasoconstriction and anti-thrombosis/vasodilation beneficially towards dominance of anti-thrombosis/vasodilation.

Cardiovascular Diseases↗
PubMed1983

Preventive measures in mite asthma. A controlled trial.

To evaluate the effect of preventive measures 46 patients, all allergic to house-dust mites (Dermatophagoides spp.), were randomly allocated to a study and a control group. According to the patients' subjective recordings of symptom score and use of medicine, compared with the control group, the study group had improved. There was, however, no improvement when comparing the objective recordings of morning and evening peak flow and use of medicine, and it is concluded that the preventive measures in this programme are not very effective for patients allergic to house-dust mites. The reduction in indoor humidity in the study group was limited and, as a high indoor humidity is the cause of huge populations of house-dust mites in homes, it is emphasized that future programmes of preventive measures should focus more on damp problems, particularly those related to bad housing construction.

Adolescent↗
PubMed1994

[Self application of preventive measures and opinion about applying them to the population at the health centers of Cantabria].

OBJECTIVE: To establish the degree of fulfillment of preventive measures and health promotion recommended by the Spanish Society of Family and Community Medicine for medical staff; to determine the opinion for medical staff about the application to these preventive measures in the general population and to analyse the relationship between the self application and the recommendation to the population. DESIGN: Cross-sectional observational through questionnaire. SETTING: Health Centers in Cantabria. PARTICIPANTS: Medical staff of Health Centers. MEASUREMENTS AND MAIN RESULTS: A response of 67.9% (146 out of 215) was obtained. The results of the self application had been: smokers, 35.6%; know their TA, 89.5%; know their weight, 99.3%; know their cholesterol, 81.5%; tetanus vaccinated, 41.4%; influence vaccinated, 33.6%; hepatitis B vaccinated, 38.6%; consume alcohol in excess, 5.6%; make breasts annual exploration, 44.4%; mammography, 33.0%; cervical cytology, 73.1% protected against german measles, 87.2%. The opinion of the medical staff about the application of the preventive measures in the general population of was positive in more of 90% the respondent. We found a significant relation (p < 0.01) between self application and recommendations to the population; and the population recommendation also showed an inverse relationship with the number of years of experience in First Aid (p < 0.01). However, the statistical was low for these variables (0.2). CONCLUSION: The self application of the preventive measures in the Health Centers of Cantabria is in general better than in other Spanish regions and although, we found relations between self application and recommendation to the population the statistics potency was low for this variable.

Adult↗
PubMed1995

[Decrease of nosocomial bacteremia and nosocomial pneumonia after introduction of preventive measures of hospital infection].

In the early 1980's methicillin-resistant staphylococcus aureus (MRSA) was reported as a major pathogenic organism of geriatric hospital infection in Japan. At the same time in the A geriatric hospital MRSA infection was prevalent. To decrease nosocomial infections some active preventive measures against hospital infection were taken since Oct. 1991. About a year before introduction of prevention of hospital infection in the geriatric ward (190 beds) of A hospital 193 episodes of nosocomial bacteremia were observed. However a year after introduction of preventive measures episodes of nosocomial bacteremia were decreased to less than a half (45.6%) in comparison to the number before introduction of prevention. As a causative organism gram-positive bacteria including MRSA were markedly decreased. Major portals of entry of bacteremia (74.9%) were urinary-tract system, intravenous hyperalimentation (IVH) catheter, and pressure sores. MRSA-positive pressure sores were decreased to 20.4% of those before prevention. On the other hand 87 episodes of nosocomial pneumonia were observed before prevention. However a year after introduction of preventive measures episodes of nosocomial pneumonia were decreased to less than a half (44.8%) in comparison to the number before introduction of prevention. After prevention MRSA and mixed infection of P. aeruginosa and MRSA were markedly decreased. The decrease of bacteremia and nosocomial pneumonia were caused by cleaning hands, the preventive measures for decrease and improvement of pressure sores, cleaning the upper respiratory tract for prevention of lower respiratory-tract infection cleaning floors and education of the staff, etc.

Adult↗
PubMed2000

The effect of preventive measures on the incidence of ankle sprains.

OBJECTIVE: To critically review the current data concerning the efficacy of preventive measures described in the literature, on the incidence of lateral ankle ligament injuries. DATA SOURCES: MEDLINE, Sportdiscus, and EMBASE were searched for papers published between 1980 and December 1998. Keywords used in the search were "prevention" in combination with "ankle," "ankle taping," "ankle bracing," "orthosis," "shoes," and "proprioception." Additional references were reviewed from the bibliographies of the retrieved articles. STUDY SELECTION: A study was included if: 1) the study contained research questions regarding the prevention of lateral ankle ligament injuries; 2) the study was a randomized controlled trial, a controlled trail, or a time intervention; 3) the results of the study contained incidence rates of lateral ankle ligament injuries as study outcome; and 4) the study met the cut-off score set for quality. DATA EXTRACTION AND SYNTHESIS: Two reviewers reviewed relevant studies for strengths and weaknesses in design and methodology, according to a standardized set of predefined criteria. Eight relevant studies met the criteria for inclusion and were analyzed. MAIN RESULTS: Overall, all studies reported a significant decrease in incidence of ankle sprains using the studied preventive measure. There was a great variety in methodology and study design between the eight analyzed studies, and every study had one or more drawbacks. Therefore, between studies only general results could be compared. CONCLUSIONS: The use of either tape or braces reduces the incidence of ankle sprains. Next to this preventive effect, the use of tape or braces results in less severe ankle sprains. However, braces seem to be more effective in preventing ankle sprains than tape. It is not clear which athletes are to benefit more from the use of preventive measures: those with or those without previous ankle sprains. The efficacy of shoes in preventing ankle sprains is unclear. It is likely the newness of the footwear plays a more important role than shoe height in preventing ankle sprains. Proprioceptive training reduces the incidence of ankle sprains in athletes with recurrent ankle sprains to the same level as subjects without any history of ankle sprains.

Ankle Injuries↗
PubMed1991

On the economic analysis of response to preventive measures.

There are many circumstances in which the effectiveness of preventive measures depends to a large extent on the compliance of the patient in changing his or her behavior or lifestyle. It is shown how economic techniques can be used (i) to describe the rationale of individuals and predict their behavior (Section 2); and (ii) to assess preventive measures that, by requiring a change of conduct, imply "costs" to the individual due to a decline in the quality of life (Appendix). Cigarette smoking and coronary heart disease are used as an illustration. While the analysis of Section 2 uses graphical techniques, a simple textbook-type of lifetime utility model with a mathematical emphasis is used in the Appendix. It is also shown that techniques often used to assess health care programs such as the QALYs (Quality-Adjusted Life Years) are inappropriate to the evaluation of preventive programs aiming at behavioral changes. Finally, topics that call for further research are indicated.

Attitude to Health↗
PubMed2005

Suicide in Japan: present condition and prevention measures.

This article introduces the reader to present conditions and suicide prevention measures in Japan. The suicide rate has increased gradually since the early 1990s, reaching a postwar peak in 1998. The number of suicides has remained at about 30,000 every year since 1998. Middle-aged (55-59 years) and elderly men have especially high suicide rates. In 2002, The Council of Learned People on Measures Against Suicides (organized by the Japanese Ministry of Health, Labor, and Welfare) released its report on national suicide prevention strategies. Although national suicide prevention strategies have just begun to be established, some prefectures or regions have undertaken unique suicide prevention measures.

Adolescent↗
PubMed1993

[Reduction of the number of falls in hospitalized patients using a risk index and through preventive measures].

OBJECTIVE: To investigate the effect of early identification of hospitalised patients with an increased risk of falling and of preventive measures on the frequency of falling. SETTING: Ten medical units (two neurology, five internal medicine, three surgery; 276 beds) in the St. Radboud Hospital in Nijmegen. METHODS: In a first case control study (5 months), a slightly modified falling risk index of Innes and Turman was validated. In a following (5.5 months) study period the index was computed for every hospitalised patient. Preventive measures were used in patients with a high score. The numbers of falls in both study periods were compared. All falls were carefully documented. RESULTS: High scores on the index were significantly associated with falls (p < 0.001). In both study periods (1 and 2) sensitivity (87% and 89%) and specificity (82% and 74%) of the index were high. A significant reduction in fall rate, 86 falls in period 1 versus 66 in period 2, was achieved, (corrected for number of patients and patient days). CONCLUSION: The modified index is a useful instrument for early identification of patients with a substantial risk of falling in the hospital. Early risk identification and preventive measures were successful in reducing the number of falls.

Accidental Falls↗
PubMed2005

Outbreak of vancomycin-resistant enterococci (VRE) in a hematological oncology ward and hygienic preventive measures. A long-term study.

BACKGROUND: We report on two endemic outbreaks of VRE (vancomycin-resistant enterococci, vanA type Enterococcus faecium) on a hematological oncology ward in a university hospital and a new strategic concept to fight against spread of VRE. PATIENTS AND METHODS: During management of the outbreak, a total of 1,124 patients and 1,700 specimens were investigated from June 1999 to December 2001. Protective measures were instituted. Intensive prophylactic infection control was practiced until December 2003. RESULTS: Of the 1,124 patients, 44 were VRE-positive. From 1,700 environment specimens, 110 VRE isolates were obtained from the inanimate environment, 5 from the living environment. Molecular biological typing identified 5 different clones which had spread on the ward in different locations. CONCLUSION: The study shows the need for prophylactic microbiological screening investigations in the risk group of hematological oncology patients and consistent implementation of protective hygiene measures to prevent the spread of multiresistant infectious pathogens on risk wards. It is also shown that intervention can to control such an endemic outbreak.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Imported myiasis. Report of a case and prevention measures].

Myiasis is the invasion of tissue by larvae of flies. They parasitize living tissues (specific myiasis) or cavity of warm blood animals compulsorily, optional (hemispecific myiasis) or accidentally (accident myiasis). It is frequent in sub-saharian Africa, while in European countries only imported cases are described. A case personally observed and some measures for prevention are described.

Adult↗
PubMed1991

Iatrogenic injury to the pulp in dental procedures: aspects of pathogenesis, management and preventive measures.

This review calls attention to the fact that iatrogenic ('dentistogenic') injury to the dental pulp is not an insignificant problem in clinical dentistry. On a short-term basis pulpal inflammatory lesions and hypersensitive teeth are frequently associated with procedures that involve removal of the dental hard tissue structures. Although the pulp is likely to recover, reparative processes induced by the insult may impair pulpal function on a long-term basis. In this paper current concepts regarding pathogenic mechanisms associated with injuries induced in the pulp by restorative and periodontal treatment procedures are reviewed. Aspects of the management of accidental pulp exposures are also described as well as measures to prevent or reduce iatrogenic injuries to the pulp.

Dental Materials↗
PubMed2001

[A study on the epidemiological characteristics and the preventive measures of rabies in Shanghai].

OBJECTIVE: To analyze the epidemiological characteristics and the preventive measures of rabies in Shanghai from 1950 to 2000. METHODS: Suspected cases of rabies were investigated epidemiologically and collection of samples to isolate the virus. RESULTS: The most highest morbidity of rabies was 1.98/100,000 in 1950. There had been neither case of rabies, nor the rabies virus positive identified in dogs between 1958 and 1988. The morbidity of rabies was 0 - 0.03/100,000 from 1989 to 2000. According to the data of 20 reported cases from 1985 to Sept. 2000, the mean incubation was 66.37 days, except one case of 14 years. The mean course of diseases was 4.55 days. Seventy percent of the cases did not receive any preventive measure. A hundred and ninety-four persons who were bitten by rabies virus positive dogs were timely treated and all of them survived. In recent years, there has been more than 50,000 persons bitten by dogs every year in Shanghai. The rate of rabies vaccine immunization was over 95%. The rate of anti-rabies serum immunization was over 20%. CONCLUSION: Rabies is a preventable disease even when persons were bitten by dogs with rabies virus positive. The important measure is to treat the wound timely, giving vaccine and anti-rabies serum injection. According to the regulation of dog control in Shanghai, the number of dogs be kept at the lowest level, immunizing all the registration dogs, and destroying the none-registration dogs are the most essential measures to be taken.

Animals↗
PubMed1997

[A clinical study of skin flora in patients with MRSA colonization after introduction of preventive measures of hospital infection in a geriatric ward].

In early 1980's methicillin-resistant Staphylococcus aureus (MRSA) was reported as a major pathogenic organism of geriatric hospital infection in Japan. At the same time in the geriatric hospital MRSA infection was prevalent. To decrease nosocomial infections some active preventive measures against hospital infection were taken since Oct. 1991. After introduction of preventive measures of hospital infection in the geriatric ward (190 beds) nosocomial bacteremia and pneumonia were markedly decreased in comparison of episode number before introduction of prevention. However several patients with MRSA colonization were observed every month. The aim of this clinical study was to clear how frequent MRSA was isolated from skin. Consequently 3 strains (3.4%) of MRSA were observed in 86 cultured skin. In conclusion we considered frequency of MRSA colonization frequency of MRSA colonization on skin was not so high but rather very low under the preventive measures.

Aged↗
PubMed1983

Psychological influence of preventive measures in the realization of the program of ischaemic heart disease prevention.

In carrying out the programme of ischaemic heart disease prevention among the male population of Kaunas aged 45 to 59 years, in the course of two years the possible adverse influence of certain preventive measures (information about the given disease) on the attitude of the examined subjects to their state of health was investigated. A certain influence was found only in IHD patients, whereas no such influence was observed in healthy persons and in subjects with borderline values of HD risk factors.

Attitude to Health↗
PubMed2004

[Perioperative nosocomial infection preventive measures].

For the prevention of perioperative nosocomial infection, 1) topical mupirocin treatment, 2) tight perioperative glycemic control and 3) immunonutrition are described. A large, prospective, randomized trial showed that the nasal application of mupirocin may effectively reduce postoperative Staphylococcus aureus nosocomial infection in the subgroup of patients who had S. aureus in their nares. Tight glycemic control after surgery, especially in the early period after operation, may also be effective in decreasing postoperative infection. In septic ICU patients, strict glycemic control even reduces ICU and hospital mortality rates. Several specific nutritional substrates such as arginine, omega-3 fatty acids, glutamine, and RNA have been shown to modulate host immune function. Some enteral formulas enriched with such immunonutrients have been commercially available in the USA and in Europe and are now available in Japan. Recent meta-analyses of randomized, controlled trials have shown that the administration of these formulas to elective surgical patients results in a significant reduction in the risk of developing infectious complications by approximately 50% and shortens the overall hospital stay.

Administration, Intranasal↗