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[The spine and horseback riding].

115 horseback riders have undergone clinical and radiologic examinations of the spine. A minimum of 10 years' riding was required. Depending on intensity of training and number of riding hours, the subjects were divided into three groups: roughriders, sport riders and hobby riders. It was striking that of the bare half of cases (51) suffering from lower back, only 8 (about 15%) had had medical treatment and actually been disabled. Moreover, 47% of the riders with lower back pain were painfree in the saddle, i.e. when riding. No causal connection was found between riding and a higher incidence of osteochondrosis in some parts of the vertebral column. In roughriders and partly in sports riders an increased stress on the spine due to prolonged intensive training cannot be ruled out if the higher incidence of pathologic X-ray findings and low back pain in this group is taken into consideration. On the other hand, other factors such as deficiencies and hard work in the past may, especially in roughriders with a rural background, also be responsible. A higher incidence of spondylolisthesis than in the normal population was not found. It is important that riders should possess a strong back and gluteal muscular system in order to avoid early painful spinal decompensation, especially in cases with degenerative alteration and static form anomalies of the spinal column.

Adult↗

[Rickettsiosis: state of the art at the turn of the 21st century].

Information about changes in the modern taxonomy of intracellular bacteria conditionally united within the nomination of "Rickettsioses" is presented in the paper. Due to a total hobby related with keeping home animals (pets), cats and dogs, apart from the cattle, joined the natural ecological cycles of rickettsioses stimulation. The morbidity of rickettsioses of the acaroid group has been persistently growing; like in case with other pathologies (Lyme's disease) involving the acaroid transfer factor, its obvious "urbanization" is pronounced. Absolute and relative morbidity indices in respect to rickettsioses, which are epidemiologically important for Russia, are presented. The modern knowledge database concerning the rickettsioses makes it possible to control the epidemic process for this infection category. It is noteworthy, that Prowazek's rickettsiosis of its both forms (i.e. the epidemic and relapsing ones), which does not have an independent cycle of circulation of its stimulator in wild nature, and unlike the acaroid group rickettsioses, turned into a socially controllable infection. It will be totally eliminated, during 10-15 years, both in Russia and the CIS countries. The practitioners are well supplied with a variety of drugs of tetracycline and fluorine-quinol groups, which makes it possible to arrest the infection process in patients rapidly and effectively and to prevent the lethal cases. A low incidence rate of rickettsioses, including Q fever, within the general infection morbidity, and taking into consideration the availability of methods for effective therapy and prevention, makes one consider a comprehensive vaccination against the discussed group of infections to be irrational. Obviously, such vaccination must be still applied in respect to a limited number of persons from among high-risk groups and for two or three varieties of rickettsioses only (i.e. Prowazek's rickettsioses, Rocky Mountain spotted fever and Q fever). Live vaccines, obtained on the basis of attenuated and recombined strains (which have a full-scale set of specific antigens), are recommended.

Animals↗

[Asthma, alveolitis, aspergillosis, berylliosis. What to do when there is allergic reaction of the lung?].

Among the major allergic pulmonary disorders are bronchial asthma, extrinsic allergic alveolitis, allergic aspergillosis and berylliosis. Asthma is diagnosed on the basis of clinical symptoms (wheezing, respiratory distress, tight chest, coughing) and lung function tests possibly supplemented by allergic and provocative testing. Asthma treatment is differentiated into long-term medication and as-required medication. Specific immunotherapy is considered the sole causal therapy. Extrinsic allergic alveolitis is work- or hobby-related (farmer's/cheese worker's/bird-fancier's lung) and manifests as diffuse pneumonitis with dyspnea, coughing and fever. For the diagnosis, the antigen provocative test in particular plays a major role. In the main, treatment comprises strict avoidance of allergens. The diagnosis of allergic pulmonary aspergillosis is based on the history, clinical findings, skin tests, serology and radiography. Treatment is stage-related by means of immunosuppressive agents. In terms of radiographic and pulmonary function findings, berylliosis is similar to sarcoidosis. Here, too, immunosuppressive agents are to the fore.

Adrenal Cortex Hormones↗

[Lifestyle differences between conjugal bereaved women and non-bereaved women in later life].

PURPOSES: In Japan, there has been limited research regarding lifestyle of elderly bereaved. The present study was conducted to clarify lifestyle characteristics in conjugal bereaved women compared to non-bereaved women. METHODS: Subjects consisted of 872 bereaved and 643 non-bereaved elderly women aged 65 or over in T prefecture. Bereaved subjects experienced the death of a spouse in 1994 and their family structure remained unchanged after the bereavement. Non-bereaved subjects were randomly selected from community registration lists in 1995 and matched for age and area of residence. Lifestyle characteristics were obtained by home visit and interview. For the analysis, we divided the subjects into 4 groups by age and family structure. Multiple logistic regression analysis was performed to identify lifestyle characteristics of bereaved elderly women, after adjustment for physical ability and disease, as confounding factors. RESULTS: Bereaved elderly women were significantly associated with no roles at home, no hobbies, lack of contact with friends, physical inactivity, sleeplessness and irregular meal patterns compared to the non-bereaved. Analysis of the 4 groups revealed bereaved women living with family members have more unfavorable lifestyle characteristics than bereaved women living alone. Bereaved women living with family members had no roll at home and sleeplessness. CONCLUSION: Bereaved women have unfavorable lifestyle characteristics. Those living with family members had more unfavorable lifestyle than bereaved women living alone. From the preventive point of view, interventions for bereaved women are needed. This is particularly the case for bereaved women living with family members. Not only health services but also social welfare services are needed to reconstruct favorable lifestyles and maintain health and well-being.

Aged↗

[Jaroslav Hladik--a Czech pharmaceutical historian on his jubilee].

Jaroslav Hladík, who on 12. April 2003 would reach the age of 100 years, started his professional career as a pharmacist in different pharmacies, but after certain period of interim activities he became a university teacher Associate Professor for Pharmaceutical History, founded a pharmaceutical museum, published papers on pharmaceutical history, laid the foundations of a centralized pharmaceutical book collections, etc. He was successfully active in several pharmaceutical university institutions in Prague, Brno, and Bratislava. Pharmaceutical history remained his hobby until his death on 1. August 1975. He is remembered as a great positive personality of Czech pharmacy.

Czech Republic↗

Health and economic impact of the premenstrual syndrome.

OBJECTIVE: To explore the effect of the premenstrual syndrome (PMS) on health-related quality of life, health care utilization and occupational functioning. STUDY DESIGN: A cross-sectional cohort study of women prospectively diagnosed with PMS. RESULTS: Among women completing the survey, 28.7% were diagnosed with PMS. Women with PMS had significantly lower scores on the Mental Component Summary (MCS) and Physical Component Summary (PCS) scale scores of the Medical Outcomes Study Short Form-36 as compared to women without PMS (MCS = 42.8 vs. 49.5, P < .001, and PCS = 51.1 vs. 53.0, P = .04). Women with PMS reported reduced work productivity, interference with hobbies and greater number of work days missed for health reasons (P < .001). In addition, women with PMS experienced an increased frequency of ambulatory health care provider visits (P = .04) and were more likely to accrue > $500 in visit costs over 2 years (P < .006). CONCLUSION: Findings from this study suggest that premenstrual symptoms significantly affect health-related quality of life and may result in increased health care utilization and decreased occupational productivity.

Absenteeism↗

Nonverbal treatment of neurosis; techniques for general practice.

"Psychosomatic medicine" does not demand that the general practitioner function as a psychiatrist; rather, it is a psychiatric orientation that can increase the effectiveness of purely medical treatment for such conditions as neuroses. The general practitioner to whom the patient turns may achieve permanent results with nonverbal techniques where formal psychotherapy would be impracticable or unacceptable. The first aim is to relieve pressure so that the patient can regain his mental balance and thereby his self-confidence. Arts, hobbies, sports, and the like can be prescribed rather specifically according to the patient's personality and needs. Nutrition can be improved simply at first by prescribing needed additions to diet rather than imposing restrictions. Vitamin deficiency may by itself be the cause of neurosis or more serious mental disease, whereas psychic stress by itself may create a need for additional vitamin intake. Hormone therapy may be extremely helpful but must be based on clear indication and limited to specific purposes. Since lack of sleep and rest quickly impairs mental function, it is important for neurotic persons to learn relaxation as a necessity for sleep. Sedatives may be used in a crisis but should be abandoned as soon as possible. With all drugs there are problems of excess and habituation. The least, the mildest, the shortest dosage is the ideal. THE INITIAL STEPS OF PSYCHOTHERAPY ARE AVAILABLE TO ANY PHYSICIAN: Establishing rapport, noting how complaints are stated, encouraging ventilation, winning confidence rather than immediate results.

Diet↗

[Study on physical and mental health status and influencing factors of middle-aged intellectuals].

OBJECTIVE: To understand physical and mental health status of middle-aged intellectuals and related risk factors on mental health under the present social conditions. METHODS: Stratified-cluster sampling and questionnaire survey were used. One thousand five hundred and three middle-aged intellectuals were investigated by SCL-90 test and influential reasons, using general relative risk model. Effects and interaction modes of risk factors were analyzed. RESULTS: The prevalence rate of middle-aged intellectuals was 241.5 per thousand per two weeks, while the prevalence rate of chronic disease was 306.7 per thousand. 6.9% of the middle-aged intellectuals (male 6.1%, female 7.8%) had mental health problems. Results suggested that the major risk factors were, as listed in a order of their effects on mental health disorders: divorced or losing spouse, exposure to poison and noisiness, lack of hobbies, long working hours, having chronic diseases. CONCLUSION: Physical and mental health status of middle-aged intellectuals were under by many kinds of pressures. Multiple measures should be taken to improve the health status of the middle-aged intellectuals.

Adult↗

Psychological problems of aging.

The increasing number of older persons in the United States is having far-reaching economic, social, political and psychological effects. Patients over 60 make up more than a fourth of current admissions to California's state mental hospitals. Biological, personal, cultural and economic problems are present in each elderly person and must be considered in the treatment of such individuals. Neurotic reactions are much more frequent that the psychoses, and these may be treated by the same therapeutic tools utilized with younger persons. Not all the psychoses in the aged group are such as to necessitate mental hospital care. Many of the patients could be cared for in suitable nursing homes. An adequate mental hygiene program, maintenance of physical health, opportunities for work, and the development of hobby and recreation centers may help ward off many of the difficult problems that the aged now present.

Aged↗

[A study of psychiatric patients perceived effect and expectancy of activity therapy].

The intent of this descriptive study is to investigate the patients perceived effect and expectance of activity therapy. The subjects for this study were 56 patients from the psychiatric ward in Severance Hospital. The data were collected during the period from June 1, 1991 to January 18, 1992. The effect and expectance of the activity therapy was measured using a questionnaire developed by this study's investigators. The date were analyzed by descriptive statistics, t-test and one-way ANOVA, using the SPSS program. The results of this study can be summarized as following; 1. For motivation for the activity therapy, the response range was from 64.3% to 89.3%, that is, it showed a relatively positive response. 2. For the degree of improvement according to the nurse's method in the activity therapy, it was shown that the nurses need professional skill and meeting after activity therapy. 3. For the relevance of the nurse in the activity therapy, 90% of the subjects had a positive answer for all of the activity therapy except the painting therapy. 4. For the perceived effect of the activity therapy, the following results were obtained. 1) 92% of the subjects had a positive response to the dance therapy, that is-I am vigorous physically. 2) 90% of the subjects had a positive response to the reading therapy, that is-I acquire good ideas and instruction. 3) 98.1% of the subjects had a positive response to the recreation therapy, that is-I am joyful. 4) 88.9% of the subjects had a positive response to the writing therapy, that is-I am interested and become acquainted with other patients. 5) 86.8% of the subjects had a positive response to the occupation therapy, that is-I am happy when I work. 6) 92.6% of the subjects had a positive response to the painting therapy, that is-I can express myself in painting. 7) 87.3% of the subjects had a positive response to the music therapy, that is-I am comforted. 5. For the expectance related to the activity therapy, 97.1% of the subjects had the most positive response to the music therapy which is a pleasant comfortable time. From the above-mentioned findings, it is suggested that psychiatric nurses need to development systematic and professional group activity therapy, and know the patient premorbid hobbies, interests and occupations.

Analysis of Variance↗

Health-related quality of life and physical ability among pregnant women with and without back pain in late pregnancy.

BACKGROUND: Back pain during late pregnancy is a frequent clinical problem. Very little is known about the impact of this symptom on the quality of life among pregnant women with back pain. OBJECTIVES: To study the influence of back pain and physical ability on quality of life in late pregnancy. METHODS: One hundred and sixty women in the 34th-37th week of pregnancy and attending two different midwife receptions, were asked to fill out questionnaires including: general questions about background factors, the Disability Rating Index (DRI) to score the physical ability, and The Nottingham Health Profile (NHP) for assessing health-related quality of life. Two groups were defined, with and without back pain. RESULTS: One hundred and thirty-six (85%) out of 160 screened women returned the questionnaire for evaluation. The 69 (51%) women with back pain rated significantly (p < 0.05) higher on the DRI; on NHP part I, sub scales sleep, energy, pain, physical functioning and total score; and on NHP part II, aspects occupation, ability to perform jobs around the house, social life and hobbies compared with women without back pain. CONCLUSIONS: Irrespective of back pain the pregnant women studied featured lower quality of life (QOL) compared with published data on healthy women. Among the women with back problems, who had the most impaired QOL, the factors affecting QOL were mostly related to physical ability.

Adult↗

Open globe injuries: epidemiological study of two eye clinics in Germany, 1981-1999.

AIM: To analyze the epidemiology of open eye globe injuries and their treatment outcomes in patients treated at two university eye clinics in Germany in the past two decades. METHODS: Retrospective analysis was performed of medical records of 1,026 patients with open globe injuries primarily treated at the Universities of Freiburg and Wurzburg between January 1981 and December 1999. Final visual function was determined as a parameter of age, extent of injury, sex, cause of injury, and activity at the time of injury. Relative risk was calculated. RESULTS: After correction for the demographic distribution, the risk for open globe injury was 1.7 times the average for young adults and 0.6 for seniors. In the recent years, the risk for severe eye injury has been more equally distributed and is increasing for old people. The proportion of injuries at work decreased over the studied period from 42% to 32% for all open globe injuries, and the proportion of injuries in traffic accidents decreased from 30% to 4%. The number of eye injuries related to hobby activities increased. The proportion of enucleations and blindness decreased. Social life and income was moderately or severely impaired in 27% of patients after severe unilateral eye trauma. The median follow up of patients was 7 months. CONCLUSION: The prevalence and types of open globe injuries changed over the years, especially in relation to the law requiring seat belt use in traffic. The progress in surgical techniques led to a significant reduction in the number of blind eyes after injury. The proportion of enucleations and blindness decreased partly due to better surgical techniques, but mostly due to the decrease in injuries with usually poor outcome, such as gunshots, ruptures, and windscreen injuries.

Academic Medical Centers↗

[Animal welfare aspects in raising sheep].

Basing on experience in sheep herd health service light is thrown on sheep keeping in Germany concerning protection of sheep against cruelty. Despite there is at the moment no legislative regulation especially on keeping sheep, there exist a number of local and european recommendations. Cruelty and undesirable or avoidable disorders and loads occur in small sheep flocks often due to unawareness of the owner who keeps his sheep as a hobby. In large herds the increasing flock size and the more and more extensive husbandry clash increasingly with the requirements of the sheep.

Animal Husbandry↗

[Clinical reasoning and decision-making in practice. A man with jaundice, renal function disorder, thrombocytopenia, muscular pain and confusion].

A 51-year-old man became jaundiced, after experiencing flu-like symptoms for a week. On admission anaemia, thrombocytopenia, and hepatic and renal function disorders were present. One month previously he had had sinusitis. Thrombotic thrombocytopenic purpura (TTP)/haemolitic-uraemic syndrome (HUS) was suspected, but the thrombocyte count rose spontaneously. The leukocytosis indicated an infectious cause of the symptoms and the jaundice appeared to originate from intrahepatic cholestasis. All symptoms could be traced to leptospirosis icterohaemorrhagica (known as 'Weil's disease'). The source was possibly the patient's fishpond. He recovered spontaneously and was also treated with antibiotics. Leptospirosis, a multi-organ disease is seen ever more infrequently as an occupational disease in stock farmers and increasingly frequently in people whose hobbies involved animals.

Anti-Bacterial Agents↗

Naja Kaouthia envenomation in the midwest.

Exotic pet ownership and distribution continues to grow in popularity in the United States. In light of this dangerous hobby and trade, emergency physicians may be confronted with caring for a patient injured by animals not indigenous to our country. We report a patient with significant neurotoxicity resulting from being envenomated by his pet Suphan cobra.

Adult↗

Comparison of planning and using free time among students of the Faculty of Pharmacy and the Faculty of Nursing and Health Sciences.

The work presents a research of the group of third year students from two faculties of the Medical University in Lublin. The aim of the research was find out the correlation and differences in the ways of managing and using the so-called 'leisure time'; in relation to stable factors, as well as the system and the direction of studies and environmental factors, dependent on the influences of the psychosociological surrounding. 114 students of the Faculty of Pharmacy and also 55 daily and 51 extramural students of the Faculty of Nursing and Health Education were examined. It has been stated that students of the Faculty of Nursing and Health Education devoted most of their time to house work, reading books and magazines and watching TV, which differentiated them from pharmacy students. Daily students of both faculties in comparison with extramural students spent more time on listening to the radio, going to the cinema or taking part in social meetings. Daily students of the Faculty of Nursing and Health Education devoted more time to sport, walking, reading books and magazines, hobbies and going to the theatre, opera, museum, concerts and exhibitions, not only in comparison with the extramural students, but also with the pharmacy students. A few students showed interest in part-time work during the academic year, although their number rose during the period of holidays, especially among daily students of the Faculty of Nursing and Health Sciences. On the basis of the research it was stated that the way of managing and actual spending of leisure time was influenced by the direction of studies, family situation and sex of the examined students.

Adult↗

[Quality of life in women after mastectomy].

The aim of the study was evaluation of quality of life of women after radical mastectomy. It was assumed that cancer of the breast, treatment and results could cause the decrease of quality of life. 107 women aged from 40 to 75 years after radical mastectomy were examined. Questionnaire made by G. Hansen at Norwegian University of Sport and Physical Education was used in all women. Questionnaire consists of 4 parts and contains 87 questions concerning general and medical data, quality of life and physical activity. Examined women had not any problems in daily activity. Most of them (about 70%) had difficulty in physical effort, particularly using upper extremities. 60% of women did not work, but they had a hobby (about 70%). Housework and daily activity were less efficient in 80% women after radical mastectomy. We observed a change in psychical status of examined women. They had some problems with concentration, irritation, irritability and sleep. These problems did not influence the family relationships and contacts with other people. Instead we noticed change in self-rating of women after radical mastectomy. Removal of breast--attribute of femininity--changed sexuality, consciousness of femininity and appearance of an image. We observed "half woman complex" in examined women. Women evaluated status of their body and quality of life from 3 to 5 in 7-gradual scale.

Activities of Daily Living↗

[Individual background factors for "cannot go out alone to distant places" among medium elderly persons living alone in a metropolitan suburb].

OBJECTIVE: To verify whether the statement "cannot go out alone to distant places" should be considered a risk factor for disability among medium elderly persons living alone autonomously in a metropolitan suburban environment, the present cross-sectional study was performed. METHODS: Self-rated mobility levels in elderly persons living alone were surveyed by questionnaire in 1,216 elderly people (209 male, 1007 female) aged 65 to 74 years, living in a metropolitan suburb, who had autonomy and ambulation competence. Two categories were used for evaluation of the self-rated mobility level: the A group were those who were able to go out alone to distant places and the B group were those who were able to do so in the locality, but not to distant places without help (cannot go out alone to distant places). Factors such as everyday lifestyle, self-rated health, and psychological, functional, physical and social items were investigated. RESULTS: Although the frequency of going out was nearly the same between the A and B groups, the B group showed the lower hobby and association activity in social communities. Individual factors such as self-rated health, instrumental activities of daily living (Tokyo Metropolitan Institute of Gerontology), eyesight, masticatory ability, 1 km continuous walking, pedestrian crossing walking on a green light, and fracture history, medicine intake, cerebrovascular disorder related subjective symptoms, intermittent claudication related subjective symptoms, physical pain, symptoms of depression, daytime sleep, number of meals, and no regular walking and light gymnastic exercises demonstrated significant differences in levels between the A and B groups. The B group had characteristics of lower social activities in social communities, deterioration of physical functions, subjective symptoms of sickness and depression, and a worse self-rated level of health. On stepwise multiple logistic regression analysis, individual frailty-risk factors related to "cannot go out alone to distant places", were "inability to continuously walk a distance of 1 km", "lower masticatory ability", "having depressive symptoms", and "having symptoms of intermittent claudication". CONCLUSIONS: The findings from this study show that with autonomous medium elderly persons, those who "cannot go out alone to distant places" have risk factors for a trend toward disability.

Activities of Daily Living↗