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PubMed1990

Otolaryngic examination of the sport scuba diver.

Diving is a sport presenting unique environmental and physiological hazards to its participants. Despite this, scuba diving is an enjoyable and safe hobby, with an estimated rate of 250,000 new divers certified each year. The ears, nose, and paranasal sinuses are the source of the most common problems in divers. Proper otorhinolaryngic medical examination is vital in the certifying of diving candidates and in routine examinations of active scuba divers. Most authorities agree on major guidelines applicable in ENT examination, although some points are a matter of controversy. Based on the major sources on the subject and our own experience, we have listed disqualifying disorders and relative or temporary contraindications for sport scuba diving. Although there are no regulations specifying medical standards for sport divers in the United States, we have tried to provide guidelines for the general practitioner and ENT specialist engaging in an otolaryngic medical examination of a sport scuba diver.

Clinical Protocols↗
PubMed1989

[Backache--risk of disability?].

Low back pain and lumbo-ischialgia are symptoms of degeneration of the intervertebral disc with protrusion. The possible invalidity in these patients is difficult to assess. Several factors do influence the outcome of conservative and/or neurosurgical treatment: Some patients are treated as out-patients only instead of the necessary in-patient treatment. Only in case of a paresis or disturbances of the urine bladder function, operation must be done without pretreatment. The quality of the postoperative treatment decides on the later result! The clinical assessment of a patient is not possible without examination and intensive questions about the circumstances of daily life, holiday activities, hobbies and so on. Discrepancies between the result of examination and the answers to these questions give a signal to a very critical evaluation of this patient.

Back Pain↗
PubMedDate not supplied

[Orthopedic diseases in children and adolescents--indications for prohibiting sports participation].

School sports is not only a compensation for inactivity but also training and basic experience in many kinds of sports. The stress exercised by school sports is similar to that of hobby sports. The dimension of errors in respect of excessive stress in orthopaedic diseases and the biological development--acceleration/retardation--is important for prohibiting school sports in some diseases. The indication for prohibiting school sports either completely or incompletely in the most important orthopaedic diseases in childhood, is discussed. The special importance of part prohibition or participation without any giving marks, is emphasised.

Adolescent↗
PubMed1989

[Computers and contact dermatitis].

A computerized database with the complete composition of pharmaceutical products and some cosmetics helps the patient with an allergic contact dermatitis reaction to avoid his specific allergens. Together with a database with patient information (12000 cases) this product, file serves as the basis for an expert system that assists the dermatologist during his every day clinical practice. The use of the computer in the field of contact dermatitis has gained much interest in the course of the last decade. In fact, the computer can be a particularly helpful tool in: 1. The storage of large amounts of data that can help to identify the patient's allergen microenvironment: --literature: articles related to contact dermatitis problems; --product information such as, for example, the composition of pharmaceutical, cosmetics, and industrial materials; --the dermatologist: the filling in of a standardized anamnesis from also helps to assure that relevant clinical data is not overlooked. 2. The diagnosis of allergic contact dermatitis: on the basis of all these data stored, an expert system can be developed to provide targeted information to assist the physician with the anamnesis of a new patient. Depending on the profile of the patient, several factors that could be at the source of the contact dermatitis, such as the patient's profession, hobbies, and use of pharmaceutical products and cosmetics, can be considered, thus increasing the efficiency of the allergological examination considerably. 3. Research in contact dermatitis: --The data can be used for epidemiological analyses in behalf of the patients, the medical profession, the industry, and the authorities.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗
PubMed1989

Quality of life in patients with advanced bladder cancer. A randomized study comparing cystectomy and irradiation--the Danish Bladder Cancer Study Group (DAVECA protocol 8201).

The "quality of life" after treatment for advanced bladder cancer was investigated. The study was part of a randomized trial comparing the effect of preoperative irradiation (40 Gy) and cystectomy with radical radiation therapy (60 Gy) and salvage cystectomy. Patients answered a mailed questionnaire on psycho-social aspects. The first was filled in 6 months after treatment and was answered by 107 patients. The second was sent out 12-18 months later and was answered by 68 patients. From a general point of view, there were no consistent differences between the two treatment groups. In the first questionnaire, patients treated with radical irradiation and salvage cystectomy expressed a slightly more pessimistic outlook than patients treated with pre-operative irradiation and cystectomy. There was not such difference in the second questionnaire, but the latter group reported the largest reduction of social (sports, hobbies, etc.) and sexual activities. In conclusion, pre-operative information about treatment and post-operative life is an important but often neglected issue.

Combined Modality Therapy↗
PubMed1986

The prevalence of locomotor disability and handicap in the Cape Peninsula. Part I. The coloured population of Bishop Lavis.

A door-to-door survey to identify the locomotor disabled was carried out on 33.35% of the so-called coloured population in a low socio-economic area of the Cape Peninsula (9112 people). The prevalence rate of locomotor disability was 11.2/1000. The main causes of disability were illness (44.1%) and trauma (41.2%); the former resulted mostly from cerebrovascular accidents (15.7%) and poliomyelitis (15.7%). Of the disabled persons 11.8% were 15 years of age or less, 57.8% between the ages of 16 and 59 years and 30.4% were more than 60 years. Of those in the working-age group 15% were employed. Few of the unemployed had hobbies or interests or had any contact with health or social services.

Activities of Daily Living↗
PubMed1988

[Special treatment measures in patients with a stoma].

Psychological, social and technical problems in the management of patients with stomata are discussed. The success of treatment depends on the skill of the doctors and nurses to handle personal problems of the patient, to help him to find his way into the community, to his work, to his hobbies. Problems such as love, sexual life and death have also to be taken into consideration. Each such patient should get detailed and written information in order to have enough time to prepare himself for his new situation. Doctors and nurses must offer time for sufficient discussions with the patient.

Adaptation, Psychological↗
PubMed1988

[Characteristics of insulin and glucose regulation in short-term physical exertion and recovery in type I diabetic patients].

It is a recognized fact that diabetics stand greater risk of developing diseases of the heart and circulation system. Active sport participation, however, can reduce this risk and is therefore of particular importance for diabetics. In order to give the juvenile type diabetics the best possible advice on a 15 minute physical training program, we examined 6 insulin-dependent diabetics and compared their insulin and glucose regulation during physical activity and recovery with that of 6 healthy hobby-sportsmen of the same age. During the phase of recovery a highly significant difference in the blood sugar levels was observed (p less than 0.01). Whereas the blood sugar levels of the healthy group increased quickly in the first 5 minutes immediately following the course of activity, it was seen to decrease during the phase of recovery in 4 diabetics and 2 diabetics showed mostly a very slight increase. The insulin levels of the healthy group remained constant both during activity and recovery. Widely differing, but nevertheless constant values were also shown in the diabetics insulin levels during the course of activity. In the recovery phase however divergent courses were observed. The insulin levels of 4 diabetics increased and of the other 2 they decreased slightly. Juvenile type diabetics therefore show no special characteristics compared to their healthy counterparts during a 15 minute physical activity. In the recovery phase however their blood glucose increase reaction is lacking. This reaction is in fact impeded by the slight increase of the insulin level. Thus, juvenile type diabetics are potentially prone to hypoglycemia immediately following physical activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

A new class mutation of low density lipoprotein receptor with altered carbohydrate chains.

In a monensin-resistant mutant (Monr-31) of Chinese hamster ovary cells, the O-linked sugar chains of the low density lipoprotein (LDL) receptor are altered, suggesting a mutation at a Golgi apparatus gene. In a compactin-resistant mutant (MF-2) of Chinese hamster V79 cells, the mature LDL receptor is apparently 5000 daltons smaller; the difference is due to altered glycosylation of O-linked sugar chains. Hybrids between MF-2 and Monr-31 still produced LDL receptor molecules with aberrant sugar chains; thus both mutants are in the same complementation group. Krieger and his colleagues (Krieger, M., Kingsley, D., Sege, R., Hobbie, L., and Kozarsky, K. (1985) Trends. Biochem. Sci. 10, 447-452) have classified Chinese hamster ovary cell mutants with altered LDL receptor structure into four groups: ldlA, ldlB, ldlC, and ldlD. Cell-cell hybrids between their ldl mutants and Monr-31 produced wild type mature LDL receptors with normal molecular sizes, suggesting that these compactin- and monensin-resistant mutants define a new class of LDL receptor mutant. Since both of our mutants are defective in internalization of LDL, we assign them as int mutants. This may imply a further etiology for hypercholesterolemia, and cases can now be examined for such a class.

Animals↗
PubMed1988

Who benefits from tricyclic antidepressants: a survey.

To determine what patients are likely to benefit from treatment with a tricyclic antidepressant, the authors surveyed American researchers, teachers of psychiatry, general psychiatric practitioners, and foreign researchers. Areas of agreement were appreciable and can serve as an index of accepted community practice and as guidelines for teaching. Responses indicated that patients most likely to benefit from a tricyclic antidepressant are those with primary depression; early morning awakening; motor retardation; loss of appetite; weight loss; prior positive response to a tricyclic antidepressant; loss of interest in work or hobbies; sad, blue, or depressed feelings; improved mood in evening; and loss of interest in sex. Amitriptyline was preferred for agitated depressions, and imipramine was preferred for retarded depressions.

Amitriptyline↗
PubMed1988

Anabolic androgenic steroids and a stroke in an athlete: case report.

Use of anabolic androgenic steroids among athletes has grown at an alarming rate in recent years, despite the knowledge that their use has resulted in such side effects as severe depression of high-density lipoprotein levels, increased low-density lipoprotein/cholesterol levels, and hepatocellular carcinoma. We report here the case of a 34-year-old man whose hobby was body building, in the course of which he had been taking various anabolic androgenic agents for four years. Seventeen days before a scheduled body physique contest, he developed an acute right hemiparesis and experienced difficulty in speaking. In the emergency room he developed a simple partial seizure activity; an electroencephalogram showed abnormal slowing suggestive of left hemispheric structural lesion. After rehabilitation, he was able to ambulate independently; he had mild motor weakness in the right upper extremity with no sensory changes at discharge. Physicians working with athletes who use anabolic androgenic steroids should warn them of the risk of stroke.

Adult↗
PubMed1987

The needs and wants of the aged in East London. A preliminary survey.

A pilot survey was conducted among elderly white and black people in East London. The purpose was: to determine whether the facilities available to the white group in this area met their requirements or not; and in view of the scanty facilities for elderly blacks to make a pilot survey of areas of need before undertaking a comprehensive survey of current and future social and medical requirements. The results reveal some fundamental differences; 90% of whites v. 58% of blacks experienced problems with ageing. Loneliness was not a major feature in either group, but about 80% of both white and black single subjects were lonely. Threequarters of the whites but less than one-third of the blacks had a hobby and considered that they were fully occupied. Eighty-one per cent of whites and 40% of blacks saw a doctor regularly, and 88% and 47% respectively took medicine regularly. The white population was not abusing the medical services, but the reasons for the low figures for blacks are not clear. Both groups had a significant demand for spiritual help, emphasising the important role of the clergy in geriatric care. Accommodation was acceptable to 93% of whites but only 25% of blacks. Both groups resisted going to an old-age home, yet 93% of those in a home were happy. This pilot study has confirmed that the services rendered for the white population in East London are adequate, but there is an urgent need for an extensive study of the medical and social expectations and requirements of the black geriatric population.

Black or African American↗
PubMed1987

[Endangered domestic animal breeds in German-speaking countries. III. Sheep].

Sheep are mainly kept extensively. They therefore have to tolerate the local climatic conditions. By these conditions many traditional breeds still exist, those are hardy and modest enough to find an ecological niche. Because of the local occurrence the number of individuals of many breeds is rather small, so that these breeds are endangered. The hope lies on hobby-breeders, who do not exclusively follow economical reasons and present breeding aims. In the care of the countryside and landscape and in using natural grassland the importance of sheep is growing.

Animals↗
PubMed1987

Psychological, social, and somatic prognostic indicators in old patients undergoing long-term dialysis.

We prospectively studied the influence of 29 demographic, social, psychological, and somatic factors on survival of 78 patients over age 70 years receiving long-term dialysis. Three years after the prospective evaluation, 54% of the patients had died. Only four factors, all psychosocial, were prognostically important. The patients who survived rated higher on the Karnofsky scale (85 vs 78 points), gained less weight between dialyses (1.5 vs 1.9 kg), more often underwent home dialysis (44% vs 21%), and less often wished for transplantation (28% vs 57%). In stepwise and multiple regression analysis, home dialysis and Karnofsky scale resulted in best fit. No somatic variable predicted outcome. Thirty-one patients were reinterviewed three years later. At that time, more patients were depressed and had a lower income, fewer wanted a transplant, and five had lost their living companion. There was a decrease in the number of patients who cooked their own meals, spent time outdoors, went to church, or had hobbies. Activity on the Karnofsky scale decreased from 87 to 84 points. The home dialysis patients' perceived health decreased from 3.9 to 3.4 points. Our study shows that psychosocial, but not somatic variables, are prognostically important in survival of older patients undergoing dialysis, and there is a measurable decline in these variables during a three-year follow-up period.

Age Factors↗
PubMed1987

Smoking as a risk factor in noise-induced hearing loss.

We studied the relationship between cigarette smoking and hearing loss among 2,348 noise-exposed white male participants in a hearing conservation program at an aerospace company. Comparisons of risk factors were based on two definitions of hearing loss. In the first, cases were defined as those subjects in the top third of the hearing loss distribution (at 3, 4, and 6 kHz) for their age category, and controls were those subjects in the lowest third of the distribution. The crude relative risks for smokers were significantly elevated (ever smoker: odds ratio = 1.27, p = .02; present smoker: odd ratio = 1.39, P = .002) compared with never smokers. Simultaneous evaluation of several risk factors using multiple logistic regression methods indicated that the effects of smoking, having a noisy hobby, and years worked at the plant were independent factors for hearing loss. Statistically significant trends in risk were observed for the number of pack-years of smoking (P = .007) and current packs per day consumption in present smokers (P = .009). In the second definition, hearing loss cases were defined according to National Institute for Occupational Safety and Health criteria for beginning impairment. By using multiple logistic regression, present smoking was a statistically significant independent predictor of impairment. These results suggest that smokers are at increased risk of noise-induced hearing loss.

Adolescent↗
PubMedDate not supplied

[Social motives in visitors of a senior center].

This study dealt with senior citizens' motivation to participate in educational activities offered by non-institutional services for the aged. For this purpose 90 visitors of a senior citizens centre in Hamburg participating in several hobby and learning groups were interviewed in detail. As to the results, subjects primarily came to the centre because they were interested in special programmes. Also social motives turned out to be relevant for two-thirds of the sample as maximum value. Among those with social interests there were significantly more subjects living alone or living in unfavourable socio-economic conditions. The results indicate that continuous learning groups can be recommended as part of gerontological education. These groups should care for people's interests in special activities as well as for their social needs.

Aged↗
PubMed1985

[Psychosocial adaptation with an artificial intestinal outlet].

A total of 1625 patients with colostomy, ileostomy or urostomy, including all members of the Swiss ILCO Association, received a questionnaire concerning their medical, social, family and personal situation. 948 questionnaires were analyzed. The mean age was 64 and the time since operation 6 years. 60% regarded their postoperative instruction in stoma care as adequate, but 32% were unhappy with the preoperative information. The transstomal colonic irrigation technique was still unknown to 21% of the colostomy patients and was utilized by only 32%. One year after the operation 69% of the patients with colostomy, 83% with ileostomy and 59% with urostomy in the under-62 age group were fully reintegrated in their professions. Acceptance of the stoma by family and friends was good and there were no major difficulties in practising sports and other hobbies. Sexuality proved to be the most seriously affected aspect of their personal lives, as 33% male and 13% female patients reported major problems.

Adaptation, Psychological↗
PubMed1985

Social and school competencies in children with short stature: longitudinal patterns.

Longitudinal evaluation of 47 children with short stature secondary to growth hormone deficiency (GHD), constitutional delay (CD), and Turner's syndrome (TS) was undertaken approximately 3 years after initial assessment. Parent ratings of social and school competence indicated a developmental trend of poorer adjustment during early adolescence (ages 12 and 14), which was preceded (age 9) and followed (age 17) by age-appropriate functioning. Evaluation of social competence scores suggested that large organized group activities were avoided, although children had close friends with whom they interacted regularly. Children with short stature obtained age-expected scores for their involvement in solitary activities (i.e., hobbies and household chores) and tended to participate in individual sports (i.e., fishing, swimming), consistent with a pattern of withdrawal from large groups. Younger children with CD evidenced academic functioning at least 1 SD higher than children from all other groups, and this age-related effect may explain performance inconsistencies reported previously with other groups of CD children. Of the children studied, girls with TS experienced the greatest academic difficulty.

Achievement↗