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PubMed1993

Clinical results with Taleum in the treatment of extrinsic bronchial asthma.

Taleum inhalation aerosol, produced by EGIS Pharmaceuticals Works, was examined in an 8-week open cross-over self-controlled study in 50 patients suffering from extrinsic bronchial asthma. Intal powder capsule inhaled with the aid of a spinhaler was used as a reference drug. Changes in subjective complaints and symptoms were continuously recorded on a score scale in the patients' diary. The alterations in respiratory parameters were measured. Laboratory parameters were monitored. On the basis of the results Taleum spray was found to be effective in the prevention of bronchial asthma. It proved to be a well tolerated drug form of simple use.

Administration, Inhalation↗
PubMedDate not supplied

Coping in spouses of patients with acute myocardial infarction in Taiwan.

OBJECTIVE: The purpose of this study was to determine the usage and perceived effectiveness of coping strategies of spouses of patients with acute myocardial infarction in Taiwan, the Republic of China, during the acute phase of the illness. DESIGN: Survey. SETTING: Visitors room for a coronary care unit in Taiwan, the Republic of China. SUBJECTS: Twenty-one female and 10 male spouses of patients with acute myocardial infarction. OUTCOME MEASURES: The Revised Ways of Coping Scale was modified to assess both frequency of use and perceived effectiveness of coping strategies. It was also translated into Chinese. RESULTS: Seeking Social Support was the most frequently used coping strategy, whereas Confrontive Coping was used the least. There were significant positive relationships between the extent of usage of coping strategies and their perceived effectiveness. Men used Planful Problem-Solving more often and found it be more effective than did women; they also found the Self-Controlling and Accepting Responsibility strategies to be more effective than did women. Older spouses reported the Planful Problem-Solving strategy to be more effective than did younger subjects. The more family members living with a spouse, the less Accepting Responsibility was used as a coping strategy. CONCLUSIONS: Spouses of patients with acute myocardial infarction in Taiwan, the Republic of China, report using a variety of coping strategies. Those used most often are perceived to be the most effective.

Adaptation, Psychological↗
PubMed1994

[Results of 5-year activity in a program for pregnant diabetics in south-eastern Poland. I. Methodology of a unified program and evaluation of the degree of diabetes compensation in pregnant women].

A model of diabetic-obstetrical management in pregnant diabetics from the south-eastern Poland realized in Cracow has been described. It consists in education, intensive insulin therapy and self-control with borrowed glucose meters. The study included 102 pregnant women enrolled from 1987-1991. It was found that the patients in general with poorly normalized diabetes mellitus referred late to a special unit. It was shown that with experience normoglycemia was achieved with lower insulin doses in four injections. A characteristic feature was a very small number (4) of the patients who had thought of diabetes normalization before pregnancy. Coordinated care provides a possibility of reducing failures in pregnancy, nevertheless it is necessary to develop comprehensive care both before and during pregnancy in diabetic women.

Adult↗
PubMed1993

Gender differences in AIDS-relevant condom attitudes and condom use.

Two studies, conducted approximately one year apart, examined gender differences in AIDS-relevant condom attitudes, condom use behaviors, and relationships among attitudes and condom use behaviors. Subjects (N = 248, N = 528) were undergraduates, primarily heterosexual. Females reported more favorable attitudes, with the exception of greater inhibition about buying and possessing condoms. Men engaged in preliminary condom use behaviors (carrying and keeping condoms at home) substantially more often than did women. Preliminary condom use behaviors predicted past and intended condom use more consistently for men than for women. Relationships between condom attitudes and condom use behaviors were generally similar for both sexes, with poorer self-control explaining the most variance in past and intended condom use. These results, interpreted from the perspective of Eagly's (1987) gender role theory, suggest that although females may indirectly influence condom use decisions, providing condoms is the expected role of males, infusing them with greater control over the interpersonal process.

Acquired Immunodeficiency Syndrome↗
PubMed1993

The efficacy of intranasal DDAVP therapy in children with nocturnal enuresis.

This prospective self-controlled study was designed to evaluate the safety and efficacy of Desmopressin (DDAVP) in the treatment of childhood primary nocturnal enuresis (PNE) and the diurnal variation of ADH secretion and urine excretion/concentration in these children. Twenty-three children (15M,8F), aged 5-16 years, who wet their beds at least 3 nights per week were enrolled in the study. After a four-week observation period, they were hospitalized for one day to monitor intake, output, renal sonography, plasma ADH, urine and serum osmolality. Intranasal DDAVP treatment at a dose of 15-30 micrograms at bedtime was started with a 4-week titration period followed by a 3 to 6-month full dose treatment period. Subsequently the dose was tapered off for one to two months, and the patients were followed for at least two months to observe any recurrence. The results showed no diurnal difference of ADH level in these children (p > 0.05); serum osmolality decreased slightly during sleep (p < 0.01); urine production decreased, and urine osmolality increased, during sleep. Seventeen children (81%) responded with a more than 50% reduction in frequency of enuresis: 11 were excellent responders, 6 were partial responders, while 4 failed. After completion of therapy, four (19%) remained dry and were considered cured; the rest had much less frequent recurrence. There were no subjective complaints other than mild local discomfort; laboratory test results remained normal. It was concluded that intranasal DDAVP is a safe and effective treatment for PNE which usually works promptly. Given the spontaneous annual remission rate of 14%, the cure rate of 19% in this study was not satisfactory.

Administration, Intranasal↗
PubMed1994

Going through the motions.

The benefits of exercise to a person's health and self-esteem are well recognized. Yet, for the institutionalized elderly person, exercise can be a rarity. Unfortunately, too many gerontological nurses struggle to enhance their patients' quality of life and to reduce the risk of physical and mental deterioration while ignoring this basis nursing measure. Range-of-motion (ROM) exercise is one simple activity that can have unqualified results. It can strengthen an elderly person's quality of life by increasing self-control, self-functioning, independence and, thus, self-esteem.

Aged↗
PubMed1993

Management of abusive behaviour in a hemodialysis unit.

Occasionally in hemodialysis units there are situations where registered nurses are unable to assist an individual whose behaviour is abusive or escalating in that direction, and the person cannot re-establish self-control and appropriate behaviour. Such abusive behaviour may arouse concern for the physical and psychological safety or security of the nurse and that of other patients and visitors. Interdisciplinary conferences were held to develop a policy document and guidelines to aid caregivers should abusive situations occur. These were the result of collaboration between physicians, nurses, social workers, a dietician and the clinical nurse specialist from psychiatry. The policy statement and guidelines include nursing actions, physician interventions and recommendations for follow-up conferences.

Dangerous Behavior↗
PubMed1993

Coping with AIDS and AIDS-risk reduction efforts among gay men.

Because AIDS has been identified as a major source of stress among gay men, coping models may contribute to an understanding of factors related to changes in and failure to change sexual behavior. Gay men in Long Beach, California, were surveyed to determine whether appraisal and coping are factors in efforts to reduce transmission risk for the human immunodeficiency virus (HIV). Factor analysis of the appraisal and coping items yielded factor structures similar to those reported by earlier coping investigators and that were differentially associated with reported reductions in risk for HIV transmission and with reported intent to engage in high- and low-risk sexual behaviors. Risk-reduction efforts and intent were associated with health-threat (to self or to partner) primary appraisals, secondary appraisals that respondents could change or do something about AIDS, and the coping factors of self-control, seeking social support, and confrontive coping (expression of anger). In addition, intent to engage in relatively high-risk behavior was associated with passive coping (acceptance). These results are discussed in terms of their relevance for risk-reduction education programs and for future research.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Utilization of pacifiers: distribution, causes and sequelae].

UNLABELLED: A survey of 293 children in a pediatric practise showed that in 80% a pacifier was used. This spread is the result of a distribution in the hospital at birth on the one hand and appreciation of its tranquilizing effect by the parents on the other hand. According to the parents, the use of a pacifier is a habit. A sucking child can, thus, restore its emotional equilibrium. This self-control reappears in certain situations. With time the child learns to control its behavior by other means. Only few children have difficulties in giving up this habit. Children using an alternative to the pacifier have more dental and jaw deformations than those using a pacifier. Dental pacifiers cause far less deformations than the other types. CONCLUSIONS: 1. Children who suck their fingers should be given a pacifier. 2. One should give a pacifier to babies with emotional problems up to the age of 6 months. Later on, an object harmless to the teeth should be given. 3. A pacifier should only be used if really necessary.

Child Behavior↗
PubMed1993

[Diabetes and sports].

Through better understanding of the physiology of physical exercise in normal and diabetic subjects we can more closely define the significance of regular physical exercise in the treatment of diabetes. Although patients with type I and type II diabetes can obtain different advantages from regular physical exercise, this activity is in turn connected with different risks. The introduction of self-monitoring of blood glucose has though considerably eased management in relation to physical activity by type I diabetics. Essentially the risk to type I diabetics is that of developing hypoglycemia during or after exercise as well as the danger of a worsening of metabolic levels with the development of ketoacidosis. In type II diabetics the risk of hypoglycemia is less pronounced and in patients treated solely by dietary means the regulation of blood glucose presents no great problem. With these individuals regular physical activity can be implemented as a further therapeutic tool towards the normalisation of body weight and an improvement in insulin sensitivity. With appropriate training and self-control the potential hypoglycemia in type I diabetic patients can easily be avoided. For this reason regular physical exercise can be recommended as a cornerstone of therapy, both in the management of type I as well as type II diabetes. The positive effect of exercise is significantly better defined in regard to type II diabetics than with type I diabetics. In particular, regular physical exercise can be implemented as a supplement to caloric restriction for weight reduction and as a means to improve insulin sensitivity in the obese insulin-resistant individual.

Blood Glucose↗
PubMed1993

[Educating the diabetic patient as a basis for therapy].

Since the late 1970's, diabetes therapy has been revolutionized and, in fact, new treatment strategies have been initiated by patient education and the resulting self-monitoring of the patient. The modern management of the chronic lifelong disease diabetes mellitus not only requires the prescription of the appropriate nutritional and pharmacologic regimen by the physician, but also intensive education and counselling of the patient. It is the diabetic himself who ultimately has to secure the treatment as given by the physician in daily life and--in so doing--has to provide a great deal of self-care and self-control. Meeting the individual treatment goal is largely dependent upon the cooperation and motivation of the patient, with the physician as both the sympathetic and critical counterpart. Today, education is the indispensible prerequisite for the limited well-being and health of diabetics and, at this end, education is equal to therapy.

Combined Modality Therapy↗
PubMed1993

[Poor promotional practices in pharmaceutical communication: the anti- medical visit, International experience].

We start with a short introduction about the concept of "bad promotional practices" within the Pharmaceutical Industry's (PHI) communication, giving rise to the birth of so-called "un-representatives" (un'rep). Taking the self-control model from the "Association of the British Pharmaceutical Industry" (ABPI), based upon the "code of practice" as a paradigma, we comment about those who notify presumed code's breaches besides the assessment process and penalties that are usually imposed. We also considered the possibility that sometimes the physician instead of being a prosecutor is accused, by the PHI, of supposed "Medical Deonthological Code's" Infringement. The several modalities of malpraxis during the un-rep visit are classified into four categories: product un-information; unloyal competition; echonomical temptations addressed toward physicians; and disregarding stablished visit planning. We devote most of the text to exemplarize five common and very well documented situations; promotion of non-registered indications; influence of prescriptions through prebends to doctors; doubtful payments to compensate clinical trials and drug surveillance studies; the use of exagerated claims; and the abuse of the qualification "drug of choice". We end with a self-critism, from the phi's outlook on the prudence that a "good pharmaceutical communicator" must respect. As an excellent model of wisdom, we propose doctors, Because they follow the classical good-sense picture that illustrates the process of adoption of a new drug. We emphasize the fact that product over-estimation, creating false expectatives, is--together with the lak of informative liability--one of major reasons for a drug innovation to fail.

Advertising↗
PubMed1995

Drug development history, "overview," and what are GCPs?

History shows that regulation of the pharmaceutical industry came about as a result of unfortunate incidences in which self-control by the industry was insufficient. All facets of drug manufacturing and preclinical laboratory research and development are regulated by GMPs and GLPs. Only part of the GCPs, as proposed, have become regulations. The pharmaceutical industry has an attrition rate of NCEs, from discovery to product, of 10,000 : 2. Research and development to market a product consumes 12 years (approximately 71% of patent life) and costs more than +250 million. The industry will be well served to closely monitor itself through conformance to GCP guidelines and regulations to avoid further government regulation.

Clinical Trials as Topic↗
PubMed1995

[The correlations between psychological indices and cardiac variance].

Correlative links between psychologic and psychologic indicators were studied in subjects occupied either in airline transportation or in the chemical industry. Investigations covered three groups of persons: managers of airline traffic (57 subjects); workers at "Vratsa" Chemical plant (14 subjects); and operators at "Vratsa" Chemical plant (14 subjects). The psychologic parameters measured included indicators of cardiac variance: mean--mean value of successive cardiac intervals, SD--standard deviation of mean value of cardiac intervals (R-R), AMo--amplitude of the mode, HI--homeostatic index, Pt--spectral power of R-R related to thermoregulation, Pp--spectral power of R-R related to respiration, IBO--index of centralization; psychologic parameters included: extrovertiveness, introvertiveness, neuroticism, psychoticism, interpersonality conflicts, self-control, social support, self-confidence, work satisfaction, psychosomatic complaints. There was evidence of significant and highly significant correlative links between indicators of cardiac variance and psychologic indicators. There thus appeared to exist certain relationships between the psychologic and psychologic levels during lengthy stressful occupational exposure.

Adult↗
PubMed1995

[The cardiological progression under scrutiny of medicometrics. The case for cardiovascular prevention].

The utility of a new global approach to public health planning, "medicometry", is demonstrated using the example of cardiovascular prevention with its costs and benefits. Although cost-benefit analyses have become plethoric in recent years, they do not give the answers to the right questions asked by a society concerned by the explosion of investments in health care. Medicometry illustrates the complexity of the choices in cardiology and proposes alternative solutions different from simplistic proposals for short term budget cuts. For this demonstration several examples are used: the monetary gains of secondary and primary prevention; the impact of the geographical distribution of physicians on medical utilization; self-control of quality; and the impact of scientific and technologic developments on future costs. The impact of health care choices on the whole of society is stressed. The global feed-back of all medical branches, such as cardiology, is explained taking into account quality-of-life targets and economic, demographic and social constraints.

Cardiovascular Diseases↗
PubMed1995

[Prevention of smoking from the psychological medicine perspective].

Smoking is a complex socio-psycho-biological behavior with high prevalence and high risk for several diseases. Referring to a widely accepted concept of prevention, the review presents recent psychological and pharmacological strategies to cease smoking with respect to theory, application, and evaluation. Primary prevention, which includes appropriate settings in schools, families, and social groups, seems adequate in preventing people from health problems associated with tobacco-smoke. Although evaluations are rarely found, curricula starting at childhood and intensive training programs for adolescents can be presently recommended. These programs have to take into account specific group characteristics and should focus on active and self-controlled behavior without smoking. Additionally, negative short-term effects of smoking should be emphasized more clearly instead of longterm risks of smoking. The broad diversity of secondary prevention programs for smoking cessation and relapse prevention includes well established and efficient psychological and pharmacological treatments. Flexible combinations of psychotherapeutic and pharmacological strategies (e.g. behavioral skill training programs and nicotine replacement therapy), which also consider the strength of nicotine dependence and withdrawal symptoms, are most promising. For smokers, who continue to smoke despite of health damages (e.g. cardiovascular diseases, cancer), intensive psychotherapeutic regimens (tertiary prevention) are suggested. However, evaluation on this issue is almost missing. In summary, smoking prevention programs can be considered to be cost-effective. Nevertheless, 1 year abstinence rates range only between 20-30%. Furthermore, there is a strong need for psychobiological research on the development of smoking behavior, on long-term follow-up of prevention programs, and on outcome prediction.

Combined Modality Therapy↗
PubMed1995

Isokinetic cycle ergometer--application in sports medicine.

Paper deals with application of fully computerized isokinetic cycle ergometer with on-line registration of effective crank force in sports medicine, namely in functional diagnostic and rehabilitation. The system allows to carry out the time and position course analyses of effective pedal force and power produced at various revolution rates. Maximal or mean values of force and power produced by action of right and left leg may be used for the estimation of strength as well as for detection and quantitative assessment of lateral functional deficit for example due to injury. Short term bouts on isokinetic cycle ergometer may be applied as an effective means for the improvement of strength of lower extremities in patients as well as in competitive cyclists. The estimation of individual fluctuation of effective force (i.e. differences between maxima at horizontal and minima at vertical crank position) may be used for the evaluation of pedalling technique. Short term all-out efforts at various cadences allow to register not only peak and mean force and power at particular revolution rates, but also to estimate an optimal individual revolution rate, i.e. those allowing to produce highest power output. Such information can be employed for diagnostic assessment of anaerobic capabilities, namely in cyclists. Isokinetic cycling with self-controlled effort may be also used as a comfortable aerobic exercise. It may be concluded that isokinetic cycle ergometer represents a valuable diagnostic as well as therapeutic tool, which may be utilized in several areas of sports medicine.

Adult↗