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PubMed1999

Injury prevention: where do we go from here?

BACKGROUND: Most eye injuries are preventable. Military personnel, workers, athletes, and other spectacle wearers--especially children and the functionally one-eyed--who require protection from impact, should expect that safety eye-wear actually protects. PURPOSE: To present to eye care professionals the current state-of-the-art in eye injury prevention. METHODS: A review of the current eye protection standards, guidelines, and warnings for the activities of daily living, work, hobbies, education, and sports with emphasis on the importance of standards and the role of the recently organized Protective Eyewear Certification Council (PECC). CONCLUSIONS: The prescriber and dispenser are obliged to prescribe, fabricate, and dispense safe and effective eyewear. PECC will help the eye care professional fulfill this obligation.

Eye Injuries↗
PubMed1999

[Relationship between regular exercise and life style, social network, education and subjective symptoms in Japanese middle aged and elderly residents].

OBJECT AND METHODS: A community-based survey of 12,630 residents of Gunma Prefecture aged 40 to 69 years was conducted to investigate the relationship between the habit of regular exercise and life style, social network, and subjective physical and mental symptoms in particular. The subjective physical and mental symptoms were measured using the Todai Health Index (THI). The response rate was 91.6%. A total of 6,736 responses were analyzed after excluding respondents with chronic diseases from the analysis. On the question about the habit of regular exercise ("Do you exercise regularly?"), the responses were divided into three categories: 1. Often, 2. Sometimes, 3. Hardly ever or Never. RESULTS AND CONCLUSION: The results are summarized as follows: 1. The proportions of residents who exercise "often" were 14.2% and 11.1% for males and females, respectively, while those of "hardly ever or never" were 52.3% and 59.4% for males and females, respectively. More males than females had the habit of regular exercise. Respondents were divided into three age categories: 40-49, 50-59 and 60-69 years. Among the female respondents, it was shown that the older the age category the greater the habit of regular exercise. 2. Both male and female respondents who had regular exercise habits scored significantly lower on the THI scales for vague complaints, depression, and irregularity of life, while they scored higher on the aggression and lie (social desirability) scales. 3. Both male and female respondents who had regular exercise habits also tended to have be better perceived health and social networking, i.e. having close friends, having a hobby and involvement in community social activities, as well as taking care of pets. This group also had a higher average education level and less of a smoking habit. This study suggests that regular exercise habit correlates not only with physical health and fitness levels but with mental health status as well.

Adult↗
PubMed1999

[Three-years changes in disability and mortality associated with daily life patterns among the home frail elderly].

PURPOSE: The purpose of this study was to eximine 3-year changes in disability and mortality in relation to the daily life patterns among the frail elderly living at home. METHODS: Subjects were 50 frail elderly living at home who were interviewed at baseline, in July to September, 1995. By detailed time budgets, five daily life patterns were classified: Lying-rest, Sitting-rest, Hobby, Walking, and Housework. Information on ADL was obtained from visiting nurses or mailed questionnaires in June 1998 (3 years later). RESULTS: Within the 3-year period, 15 people (30%) died. At the follow up, 27 people (54%) were living at home, three (6%) were hospitalized, and four (8%) were institutionalized. In 31 analyzed samples, ADL scores significantly decreased during the 3-year period. As for the ability to perform each activity, it was found that only the elderly in Housework life pattern maintained their ADL. The elderly in Lying-rest life and Sitting-rest life patterns were more likely to die. CONCLUSION: Decline in ADL among home frail elderly was found for the 3 years. It was suggested that community health care for preventing disability progress among home frail elderly were important over a long time. Housework life patterns were seemed to be associated with physical performance.

Activities of Daily Living↗
PubMed1999

Tennis elbow, natural course and relationship with physical activities: an inquiry among physicians.

BACKGROUND: The main purposes of the study were to answer the following two questions: is a restrictive therapeutic management in case of tennis elbow (TE) better or worse than a regular therapeutic approach and do racket sports and other physical activities influence the risk to get TE and to what extent. METHODS DESIGN: Cross-sectional study by means of a postal questionnaire. The impression was verified that physicians are reserved about medical interventions when treating themselves for tennis elbow. The frequency of therapeutic measures and their results were compared with data reported in literature. Physical activities of physicians who had TE were compared with those of physicians who never had TE. SETTING: Physicians who attended postgraduate courses on diagnosis and treatment in orthopedic medicine from 1984 to 1992. PARTICIPANT: 72 physicians who had TE and 266 with no history of TE. MEASURE: The study is based on self-assessment of therapeutic approaches and their results, reported physical activities at the onset of TE and at the moment of the inquiry. By a team of experts the grade of grasping and/or dorsiflexion of the physical activities was classified. RESULTS: Compared with patients in general practice, physicians treating themselves for TE were more restrictive to use NSAID's, ointments or local steroid injections or to consult a specialist. No-one was treated with surgery and no-one interrupted her/his work because of TE. In all but two of the 72 cases the TE resolved within two years. The odds ratio for TE for playing racket sports versus not playing racket sports was 2.8 (95% confidence interval 1.64-4.82). The odds ratio for activities with low-grade grasping and/or dorsiflexion versus "no sports or hobbies" was 0.11 (0.02-0.50). CONCLUSIONS: Absence from work and therapeutic measures for TE are (in physicians) not necessary for a good result on the long term. Playing racket sports increases the risk to get TE by a factor of 2.8. Performing weekly activities with low grade grasping and/or dorsiflexion of the wrist may have a protective effect against developing tennis elbow.

Adult↗
PubMed2000

Central auditory processing disorders and reduced motivation: three case studies.

The central auditory test results for three normal-hearing children who were initially diagnosed as having a central auditory processing disorder and learning disability are presented. They were referred to the authors for second-opinion consultations. Central auditory processing retesting was performed by the authors under the condition of no reinforcement and then the condition of reinforcement with the child's favorite food, hobby, or toy. For all three cases, the central auditory test scores improved markedly bilaterally under the condition of reinforcement as compared with the condition of no reinforcement. We hypothesize that the improvement was related to increased motivation associated with the reinforcement and that these children represented false-positive results on the central auditory test battery. Large-sample studies are needed to investigate the effect of reinforcement on test performance in children with reduced central auditory test scores.

Child↗
PubMedDate not supplied

Hydro-therapy in CAPD training.

Exercise has been identified as being one of the five most important principles in renal rehabilitation (1). It is well recognised that physical exercise enhances the patients' ability to carry out normal daily activities such as walking, climbing stairs, pursuing gardening or other hobbies and holding employment (1).

Adult↗
PubMed2000

[Quality of life two years after myocardial infarction. 1. Examination questionnaires].

The purpose of the present study was to assess the quality of life (QOL) and factors influencing QOL in patients 2 years after myocardial infarction (MI). The study was performed in 100 pts (mean age 45.5) mean 2 years after MI. 50 pts of studied group (mean age 42.5) were resuscitated from ventricular fibrillation (VF) complicating acute phase of MI. The control group consisted of 100 healthy subjects persons (mean age 53.5). The QOL index was assessed with the use of 2 types questionnaires: "Quality of Well-Being Scale" (QWB) and questionnaires of QOL including 26 factors in terms of: pain, dyspnoea, anxiety, depression, energy, sleep, emotions, mobility, social isolation, sexual activity, hobby, subjective emotional, distress, functional and social state and return to work. The QOL index was assessed using mathematical Krefft method. The average value of QOL index in patients 2 years following MI was significantly lower when compared with control group. The mathematical method of Krefft showed, that out of 26 features the most important diagnostic power factor for the QOL index were: self estimation of physical performance, return to work, the lifestyle and presence of stenocardial pain and dyspnoea. The pts resuscitated from VF revealed the higher level of anxiety.

Adult↗
PubMedDate not supplied

Can you take your soul to work?

David White in The Heart Aroused: Poetry and the Preservation of Soul in Corporate America explores ways for professionals to take their souls to work, instead of checking them at the door. "We simply spend too much time and have too much psychic and emotional energy invested in the workplace for us to declare it a spiritual desert bereft of life-giving water." Several ideas are presented to help physician executives preserve their souls in an increasingly corporatized U.S. health care system: (1) Figure out what you are meant to do as your life's calling; (2) know what you think and want; (3) share some of what you think at work, while being careful to not lose your job unless you choose to; (4) be a trustworthy listener and find one; (5) get yourself outside; (6) pay attention to your physical space; and (7) develop some new hobbies or refresh old ones. "One of the disciplines of building a rich soul life seems to be the simple act, on a daily basis, of remembering what is most important to us."

Communication↗
PubMed2000

Upper extremity socket design options.

A careful evaluation of the amputee's physical situation is necessary to determine the best available prosthetic options. Evaluation of the psychologic and vocational needs are needed to determine the most appropriate designs. Other factors, such as hobby and sport activities, need to be determined to complete the prescription. Because the function of a prosthesis cannot restore all of the lost capability of the missing limb, every effort should be taken to provide the best available substitute by careful prescription, design, and construction.

Activities of Daily Living↗
PubMed2000

Lead toxicity in older adults.

Recent studies have shown that lead, even at relatively low levels of exposure, has the potential to harm not only the young and the occupationally-exposed, but also older people. Because they have been alive for a longer period of time, older adults have had more potential exposures to lead. They may have been exposed to lead while working in unregulated occupations, or they may have encountered more lead in the environment on a daily basis. Several large epidemiological studies have found that older people have higher blood and bone lead levels than younger adults. Additionally, sporadic clusters of acute lead exposure among older adults as a result of activities such as ceramic glaze hobby work and consumption of moonshine whiskey continue to be reported. After lead enters the body, it circulates in the blood reaching the soft tissues and bone. Researchers have learned that lead can hibernate within bone for decades. Although lead within bone is of uncertain toxicity to bone tissue, conditions of bone resorption, such as osteoporosis, can cause bone lead to reenter the bloodstream where it can then re-expose the soft tissue, and, potentially, exert delayed deleterious effects. Evidence is emerging that blood and bone lead levels, reflecting relatively modest exposures, are associated with hypertension, renal insufficiency, and cognitive impairment. Medical treatments that now exist to slow the rate of bone resorption may maintain lead within bones. On-going studies evaluating the relationship between body lead stores and both cognitive and renal impairment, as well as the potential modifying effect of bone resorption, will help determine whether bone resorption should be retarded specifically to preserve organ function. Physicians should be aware of potential past and present lead exposures among their older patients. Ongoing lead exposure should be prevented. In the future, treatment of osteoporosis may be undertaken not only to improve bone health but also to prevent mobilization of bone lead stores and subsequent toxicity.

Aged↗
PubMed2000

Quality of life issues for fibromyalgia patients.

OBJECTIVE: To collect information from patients with fibromyalgia syndrome (FMS) in regard to quality of life, impact of FMS, coping strategies, and what they want from their health care providers. METHODS: Two hundred seventy support group members in Washington, Illinois, and Pennsylvania completed an 85-item questionnaire. RESULTS: On a scale from 1 to 10 (10 being highest positive rating), patients ranked past quality of life as 8.6, present quality of life as 4.8, and future quality of life without FMS as 9.2. Respondents indicated that FMS has had a negative impact on personal relationships, career, and mental health. Many also reported a lack of social support. Most respondents reported a variety of coping responses including talking to friends, praying, exercise, hobbies, relaxation techniques, talking to a professional, and meditation. Patients reported needing more support, better educated health professionals, for people to believe that this disease exists, more funding for research, and better diagnostic tools. CONCLUSIONS: Health care workers need to be cognizant of the effect FMS has on quality of life. Treatment options should not be limited to prescription medication therapy. Patients are using a variety of methods to cope with their FMS symptoms, some positive, but others that are negative, and health care providers need to be alert to negative coping strategies such as alcohol and nonprescription medication abuse.

Activities of Daily Living↗
PubMed2000

[Cholinergic syndrome with unconsciousness in amanita poisoning].

HISTORY AND ADMISSION FINDINGS: A 41-year-old patient was found in his flat in a state of coma. After emergency treatment his vital signs were stable and he was transferred to an acute hospital with possible cannabis intoxication. The patient, a hobby gardener, was previously well and had an adversion to the use of any chemical substances. The main symptom showed a cholinergic syndrome with deep coma. We assumed plant ingestion because of the clinical picture and history. INVESTIGATIONS: The laboratory results were within normal limits apart from a slight rise of the serum creatinine kinase level. The electrocardiogram showed a bradycardia. A drug-screening could not be performed. TREATMENT AND COURSE: The differential diagnosis of plant alkaloids or mushroom toxins were considered due to possible plant ingestion and a cholinergic syndrome. Later the toadstool (Amanita muscaria) was found. After treatment oft the cholinergic syndrome with high doses of atropine primary poison elimination was performed. 24 hours later the patient awoke from his coma. Visual hallucinations persisted for a few days. No organic damage due to the intoxication was found. CONCLUSION: Toxic mushroom ingestion can produce a variety of clinical pictures. Most commonly an anticholinergic syndrome is found, but this was not the case in this patient. The effect of the poison depends on the amount and the preparation, so that no reliable outcome prediction can be made. The drug "poisonous mushroom" is legal and hallucinogenic substances are trendy. As a result clinical signs like those described here will have to be expected in the future.

Adult↗
PubMed2000

[How the lifestyle of families who care for home parenteral nutrition patients changes].

The role of families who care for home parenteral nutrition (HPN) patients is extremely important. They face many problems not only in caring for patients but also in their own lifestyle. We investigated by questionnaire the changes in the family of terminal stage cancer patients receiving HPN. Replies submitted to the questionnaire were obtained from 20 out of 32 families who underwent HPN in the Osaka Prefectural General Hospital. Ten out of 20 people answered that they changed their lifestyle during HPN. The changes were decreased opportunity to communicate with other people and decreased time for to spend on a hobby or other activity. The care of the HPN patients affects the wife, daughter-in-law and children more than the husband of the patient, because the former have to manage housekeeping as well as patient care. This result suggests that the quality of life of the family of terminal stage cancer patients at home with HPN declined because they had to change their own lifestyle in order to spare time to care for the patients.

Family↗
PubMedDate not supplied

[Frequency and intensity of behavioral and psychological symptoms in the course of Alzheimer's disease].

The aim of the study was: 1) to estimate the occurrence and intensity of some psychopathological symptoms in the course of Alzheimer's disease, and 2) to examine whether the occurrence of behavioral and psychological symptoms increases with the deepening of dementia process among persons with Alzheimer's disease living in their homes with outpatient treatment. The study was conducted among 94 persons (38 men and 56 women ageing from 52 to 86 years (x = 72.4 +/- 6.9), with education: from 2 to 17 years (x = 11.2 +/- 3.7). Three subgroups were selected for study with regard to the intensity of dementia process, estimated according to Clinical Dementia Rating (CDR): very mild (n = 16, x = 71.4 +/- 6.7), mild (n = 43, x = 72.6 +/- 7.9), moderate (n = 35, x = 72.5 +/- 6.9). Subjects in group II and III fulfill diagnostic criteria of dementia according to ICD-10, DSM IV and criteria of probable AD according to NINCDS-ADRDA. In the estimation of occurrence of behavioral and psychological disturbances: Alzheimer's Disease Assessment Scale--non-cognitive behavior (ADAS-non-cog) and subscale "Change in Personality, Interests, Drive" of Blessed Dementia Scale were used. The results have shown that with the progress of dementia process, the occurrence of the following psychopathological symptoms such as: hallucinations, intensive motor activity, purposeless hyperactivity, pacing, rigidity increases and there is a relinquishment of hobbies. In addition, regardless of the stage of dementia, such behaviors as: apathy, depression, tearfullness, impaired emotional control and disturbances of appetite were observed relatively frequently.

Age Distribution↗
PubMedDate not supplied

Association between canine malignant lymphoma, living in industrial areas, and use of chemicals by dog owners.

A case-control study was carried out to determine whether residential exposure to environmental pollutants increased risk for canine lymphoma in pet dogs. One hundred one cases with cytologically or histologically confirmed lymphoma diagnosed at a veterinary teaching hospital between the middle of 1996 and the middle of 1998 were examined. Controls were obtained by choosing twice the number of dogs without neoplastic disease, with overlapping distributions of province of residence, age, sex, and breed. Information regarding animal management, residence type, professional or hobby use of chemicals by owners, and treatment with herbicides or other pesticides in the area frequently visited by the dogs was obtained with a multiple-choice questionnaire by telephone interview. Two variables were positively and independently associated with the disease, namely residency in industrial areas (odds ratio [OR]; = 8.5; 95% confidence interval [CI], 2.3-30.9) and use of chemicals by owners, specifically paints or solvents (OR = 4.6; 95% CI, 1.7-12.6). A significantly lower value of the mean age of disease onset was found in the group of dogs at risk in comparison with the group of all other dogs (6.1 +/- 0.4 years, n = 36 versus 7.5 +/- 0.4 years, n = 65, respectively; P = .008). Variables describing animal care and pesticide use were either not associated with the disease or were uninformative. We suggest that canine lymphoma may be considered a sentinel of potentially hazardous situations for humans, because of the relatively short latency between exposure and disease onset.

Animals↗
PubMed2001

Refractive surgery in the new millennium.

As we stand at the threshold of a new millennium, perhaps nowhere else in the field of ophthalmology is there such a feeling of excitement, enthusiasm, and anticipation as in the subspecialty of refractive surgery. What was once considered an experimental hobby, dabbled in by a few rogue physicians, has now gained a level of respect among patients and ophthalmologists that has surprised even its most vocal critics.

Cornea↗
PubMed2001

Morbidity among airline pilots: the AMAS experience. Aviation Medicine Advisory Service.

BACKGROUND: Various cohort studies, military databases, and Federal Aviation Administration databases have characterized morbidity and disability in pilots. However, an overriding limitation of these studies is acquiring complete and accurate medical information from pilots with a profession, hobby, or aircraft investment to protect (6). The unique role of Aviation Medicine Advisory Service (AMAS) as pure pilot advocate with guaranteed patient confidentiality eliminates the aviator's need to conceal medical problems. Therefore, analyses of cases reported to AMAS might provide additional insight regarding the true prevalence of morbidity in airline pilots. METHODS: All AMAS cases of airline pilots and flight engineers from January 1996 through November 1999 were reviewed (n = 20,522). During that time, AMAS provided consultation to approximately 51 U.S. and Canadian airlines. Diagnoses were stratified by decades ranging from 20 to 69 yr of age. RESULTS: Notably, the five conditions most frequently inquired about at AMAS were similar to the major causes of long term disability found in a cohort of Air Canada pilots (5). Cardiovascular conditions accounted for almost 25% of the inquiries. However, the relative percentage especially in the older population was less than that reported previously. Interestingly, orthopedic and musculoskeletal cases (10-11%) rated second only to cardiovascular cases. CONCLUSIONS: These findings are limited by the inability to draw an exact reference population at risk, the use of proportional measures for description and the inherent difficulty in attempting to utilize an administrative index as an epidemiological tool. Further study addressing the impact of aviator nondisclosure of medical problems on the reported prevalence of disease among U.S. airline pilots may help target preventive efforts in the future.

Adult↗
PubMed1995

[Tuberculosis in Funen].

In the beginning of this century 20 percent of all deaths in the county of Funen, Denmark, was caused by tuberculosis. The sanatorium of Nakkebølle was opened in 1908. Dr. Otto Helms (1866-1942), who was a great personality with hobbies such as ornithology and writing textbooks for school children, became the first medical director from 1908 to 1940 of this famous sanatorium. His life and especially his fight against tuberculosis at the sanatorium is described. In general, today tuberculosis in Denmark is a minor problem. However, the incidence of tuberculosis in immigrants, especially from Somalia, has caused some difficulties. In the future the challenge of this field consist of AIDS and tuberculosis, and multiresistent tuberculosis. Tuberculosis hopefully may cause only limited problems if professionals are aware of early diagnosis and careful treatment of the populations at risk.

Communicable Disease Control↗