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At least 937 records · Page 52Linked to original sources
PubMed1994

Acute hepatitis associated with the Chinese herbal product jin bu huan.

OBJECTIVE: To describe the hepatotoxicity associated with ingestion of the Chinese herbal product Jin Bu Huan Anodyne Tablets (Lycopodium, serratum) and to propose possible mechanisms of injury. DESIGN: Retrospective analysis. SETTING: Academic hepatology units and private practice facilities. PATIENTS: Seven previously healthy patients. MEASUREMENTS: Clinical, laboratory, radiologic, and histologic studies. RESULTS: Acute hepatitis occurred after a mean of 20 weeks (range, 7 to 52 weeks) of Jin Bu Huan ingestion and resolved in six patients within a mean of 8 weeks (range, 2 to 30 weeks); another patient is currently improving. Hepatitis was associated with symptoms of fever, fatigue, nausea, pruritus, and abdominal pain and with signs of jaundice and hepatomegaly. Biopsy specimens showed that one patient had hepatitis with eosinophils (consistent with a drug reaction) and the other had mild hepatitis, moderate fibrosis, and microvesicular steatosis. Decreasing the Jin Bu Huan dose in one patient improved liver test results. Reusing Jin Bu Huan in two other patients caused abrupt recrudescence of hepatitis. CONCLUSION: Jin Bu Huan can cause liver injury. Although the hepatotoxic mechanisms are not defined, they may include hypersensitive or idiosyncratic reactions or direct toxicity to active metabolites. Hepatotoxicity caused by herbal products underscores the toxicity caused by herbal products underscores the importance of national surveillance programs and quality control of the manufacture of these products.

Acute Disease↗
PubMed2000

ACOG educational bulletin. Primary and preventive health care for female adolescents. Number 254, November 1999. American College of Obstetricians and Gynecologists.

Although most adolescents enjoy good health, many of their behaviors put them at risk for negative health outcomes. Consequently, a fundamental change in the provision of health care services is required. Increasingly, services must be directed at primary and secondary prevention. As such, physicians should respond by making preventive services a greater component of their clinical practice. The approach outlined previously can help in this transition and can ensure that adolescents receive the services their health status demands.

Adolescent↗
PubMed1997

Epidemiology and clinical characteristics of HIV-infected patients in Kuala Lumpur.

Between 1987 to 1995, a total of 334 patients infected with HIV were treated at the Hospital Kuala Lumpur. There were 159 Malays, 108 Chinese, 64 Indians, and 3 from other ethnic groups. Three hundred and twenty-one (96.1%) of these individuals were males and 262 (65.9%) were between the ages of 26-45 years. Intravenous drug users made up 77% (256) of the attributable risk behaviour from the group although many of them also had added risk behaviours like heterosexual activity with multiple partners (50 patients), tattoos (7 patients), homosexual practice (4 patients) and previous transfusions (3 patients). The others acquired their infection through heterosexual promiscuity (59 patients), homo/bisexual activity (7 patients), previous transfusion (5 patients) and tattoos (1 patient). Sixty-six patients (all males) had since progressed to full blown AIDS and 10 have died. The two commonest AIDS-defining events were tuberculosis infection and Pneumocystic carinii pneumonia occurring in 37 (56%) and 15 (22.7%) of patients respectively. Forty-one patients with AIDS presented for the first time with their AIDS-defining infections. The mean CD4 count of the patients when they progressed to AIDS was 130/mm3. The mean time for progression from "known" seropositivity to AIDS was 2.42 years. These results suggest that Malaysians infected with HIV are not coming forward for treatment until they are in the advanced stage of the disease.

AIDS-Related Opportunistic Infections↗
PubMed2000

[Physical pain and suffering in the child].

Since about ten years ago there has been a great interest in the treatment of pediatric pain, previously neglected in medical practice. A review of procedures of pain assessment is made: self-assessment, behavioural analysis and biological measurements. The main therapeutic procedures are also reviewed (drugs, physical agents and psychological treatment), emphasizing the interest of prophylaxis and parental participation in children's pain treatment.

Analgesia↗
PubMed1997

Fever nurses' perceptions of their fever nurse training 1921-1971.

This paper is based on evidence from 118 ex-fever nurses. The method used, postal questionnaires, is rarely mentioned by oral historians, yet it proved invaluable in such a scattered target population. It shows the importance of collecting evidence before it is too late. This study gave the respondents a welcome opportunity to recall, analyse and reflect on their fever nursing practice. It complements the previous paper, 'The rise and demise of fever nursing' and confirms its findings.

Communicable Diseases↗
PubMed2003

Apoptosis caused by chemotherapeutic inhibition of nuclear factor-kappaB activation.

Both the protein kinase C (alpha/beta) inhibitor Go6976 and expression of dominant-negative nuclear factor (NF)-kappaB inhibitor kinase mutants: (a) blocked the growth and caused regression of a mammary tumor insyngeneic mice; (b) inhibited epidermal growth factor (EGF)-induced activation, nuclear translocation, and DNA-binding activity of NF-kappaB; and (c) caused apoptosis of EGF-stimulated cultured mammary tumor cells. cDNA microarray analysis revealed that these treatments reversed the expression changes of a subset of genes altered by EGF treatment. These included: up-regulation of proapoptotic genes of the tumor necrosis factor (TNF) pathway, death-associated protein (DAP) kinase, p53, and p21/Waf1; and down-regulation of inhibitors of apoptosis: inhibitor of apoptosis(IAP)-1 and X-IAP, TNF receptor-associated factor (TRAF)-2, and factors OX40 and 4-1BB. These results and our previous studies suggest the practicality of a target-directed chemotherapy for EGF-responsive breast cancers, by blocking NF-kappaB activation and thereby reinstating apoptosis.

Adenocarcinoma↗
PubMed2000

Respiratory morbidity in primary care. A population based study, using practices from the Scottish Continuous Morbidity Recording Research Database.

OBJECTIVE: To elucidate the patterns and period prevalences of respiratory disease with special reference to asthma (including wheezing) in view of its increasing reported prevalence. DESIGN: Observational study based on prospectively entered data. SETTING/SUBJECTS: Fifty five Continuous Morbidity Recording (CMR) practices with 290,000 patients located throughout Scotland. RESULTS: Respiratory problems accounted for a large proportion (17%) of total general practice workload. Upper respiratory tract infections were the commonest presentation in pre-school children, followed by asthma but with an ever increasing proportion of consultations for bronchitis and lower respiratory tract infections with advancing adult age. There was no significant correlation between deprivation and the incidence of asthma. CONCLUSIONS: Observed rates and patterns of disease for CMR practices, were similar to previously reported studies. The large number of presentations by patients in early childhood with minor respiratory illnesses and in particular upper respiratory tract infections are likely to reflect a heightened level of parental anxiety where interpretation of clinical signs and separation of simple and significant illness can be difficult. CMR has also been shown to be of use in helping to investigate links between deprivation and disease incidence or severity. Potential uses for CMR include the study of whole population morbidity and utilisation of primary care services.

Database Management Systems↗
PubMed1992

The care of people over 75 years old after discharge from hospital: an evaluation of timetabled visiting by Health Visitor Assistants.

The objective of this study was to evaluate a programme of timetabled visiting by Health Visitor Assistants (HVAs) to patients over 75 years old who were recently discharged from hospital. An outcome evaluation examined whether patients benefited in measured health status and use of services over the year of the programme. A randomly selected group of patients (the intervention group) who were allocated to the programme of visiting were compared with an equal-sized randomly selected group of patients (the control group) who had no timetabled visiting. A process evaluation examined the actions taken by HVAs during their visits and related the actions taken to patients' measured health status and other characteristics. No overall benefit from the programme of visiting was found in the outcome evaluation. There was wide variation in the numbers of actions recorded for different patients. Numbers of HVAs' actions were related to patient's health status and sex, with more actions being initiated for those in poorer health and women. Neither age nor whether the patient lived alone were found to be related to numbers of HVAs' actions. It was concluded that the lack of demonstrated overall benefit and the wide variation in actions taken on patients' behalf suggest that this type of service cannot be recommended for all discharged patients over 75 years. Poor health at the time of discharge is recommended as a first choice of measure for need of support. Exchange of information between general practice and hospital about previous dependency may aid the identification of patients who need post-discharge support.

Activities of Daily Living↗
PubMed1992

Natural history of phobic anxiety.

The characteristics of those with phobic anxiety--anxiety with or without avoidance of specific fear-provoking situations--seen in family practice have not been previously described. However, patients with agoraphobia--extreme avoidance of fear-provoking situations--are frequently seen in the general health sector. In addition, panic attacks, which are spontaneous episodes of intense anxiety associated with at least four autonomic symptoms that build rapidly in intensity, are believed to be antecedent to phobic anxiety. This secondary analysis used 29 patients with panic attacks. During a structured interview, these patients completed a phobic anxiety questionnaire and the Health Locus of Control questionnaire. Of the 21 patients with phobic anxiety, 16 (76%) reported that they avoided at least one situation. Although patients frequently left home during the week (mean = 10.8 times), 11 (58%) felt that their fears controlled their lives. Patients' responses generally supported the model of fear causing anticipatory anxiety that in turn causes avoidance; however, panic attacks frequently began after phobic anxiety but before the fear was reported by patients to control their lives. Recognition and early intervention with those with phobic anxiety may minimize its severity and pervasiveness.

Adult↗
PubMed1992

Impact of hepatitis B virus infection on women and children.

HBV infection acquired during infancy and early childhood has a high likelihood of progressing to chronic infection, which can lead to chronic hepatitis, cirrhosis, and primary hepatocellular carcinoma. In areas of the world where HBV infection occurs predominantly in infants and young children, routine infant immunization with hepatitis B vaccine is the most appropriate vaccination strategy. In the United States, the majority of HBV infections occur in adults with behaviors or occupations that put them at risk for HBV infection. Nevertheless, infection acquired during infancy and early childhood contributes significantly to the burden of chronic liver disease in the United States. Until recently, the vaccination strategy in the United States has included HBsAg screening of pregnant women and vaccination of infants born to infected women and vaccination of people in groups at high risk for HBV infection. Because of the difficulties in accessing and vaccinating persons from high-risk groups and the recent findings that HBV infection occurs more commonly among children in some groups in the United States than previously appreciated, the Immunization Practices Advisory Committee of the US Public Health Service and the American Academy of Pediatrics in 1991 endorsed a strategy of universal immunization of infants for hepatitis B. This strategy has the advantages of accessing infants in the United States through preexisting vaccine delivery systems and vaccinating individuals prior to their engaging in high-risk behavior. Continued screening of pregnant women for HBsAg is necessary to prevent perinatal HBV transmission and to identify for vaccination those household and sexual contacts of HBV carriers, a group that is also at high risk of HBV infection.

Acute Disease↗
PubMed2004

Looking inside the 2003 CDC dental infection control guidelines.

On Dec. 19, 2003, the Centers for Disease Control and Prevention published updated infection control guidelines for dentistry. The guidelines provide comprehensive information on all aspects of dental infection control. The recommendations are designed to prevent or reduce the potential for disease transmission from patient to dental health care personnel, from dental health care personnel to patient, and from patient to patient. Most recommendations will be familiar and are already practiced routinely. This article highlights major updates and additions in the CDC guidelines and provides additional information to assist readers in applying the latest guidelines. Almost a year ago, the CDC and Prevention published updated dental infection control guidelines in a supplement to the Morbidity and Mortality Weekly Report. The Guidelines for Infection Control in Dental Health Care Settings--2003 represent a collaborative effort between leading experts in infection control from other federal agencies, public health, and hospital epidemiology and infection control. Unlike regulatory agencies such as the Occupational Safety and Health Administration, the U.S. Food and Drug Administration, or the U.S. Environmental Protection Agency, the CDC cannot mandate certain practices; it can only recommend. However, the CDC is recognized as the nation's disease prevention agency and develops a broad range of guidelines intended to improve health care and to inform clinicians and the public. As a result, many dental licensing boards adopt CDC's recommendations, or variations of them, as the infection control standard for dental practice in their states. In contrast to the 1986 and 1993 CDC dental infection control recommendations, the 2003 CDC publication includes more background information and the scientific rationale for the recommendations. Also, readers will notice that each recommendation has a rank assigned to it categorizing the recommendation on the basis of existing scientific data, theoretical rationale, and applicability (Table 1). Most recommendations will be familiar and already are practiced routinely. As with previous CDC recommendations, the guidelines are designed to prevent or reduce the potential for disease transmission from patient to dental health care personnel; from dental health care personnel to patient, and from patient to patient. The following is an overview highlighting major updates and additions in the 2003 CDC guidelines. It is not intended to be a comprehensive review. Readers can access the complete document (Figure 1) by visiting www.cdc.gov/oralhealth/ infectioncontrol.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

A third study on predicting NCLEX success with the HESI exit Exam.

This was the third annual validity study designed to assess the accuracy of the HESI Exit Exam (E2) in predicting NCLEX success for graduating registered and practical nursing students. As in year I (N = 2,725) and year II (N = 3,752), in year III (N = 6,277), the E2 was highly predictive of NCLEX success for associate degree nursing, bachelor of science nursing, diploma, and practical nursing students. Unlike previous years, in year IIl, monitoring was not a significant factor in the predictive accuracy of the E2. NCLEX success of low-scoring E2 students, first examined in year II, was also examined in year Ill. As in year II, low-scoring E2 students were significantly more (P = .001) likely to fail the licensure examination than high-scoring E2 students, in year Ill, unlike year II, there was no significant difference in the pass rate of low-scoring E2 students who participated in a remediation program and those who did not. The authors recommended that a more definitive definition of remediation be used in future studies and that such studies focus on E2 implementation strategies and their relationship to NCLEX success.

Journal Article↗
PubMed1991

Barriers to cholesterol testing in a rural community.

BACKGROUND: The purpose of this study was to investigate the factors that determine whether residents in a rural community have their cholesterol tested. METHODS: A population-based survey was conducted in 1987 as part of a community-oriented primary care project that sought to define and address the causes of and burden caused by increased cardiovascular disease in an economically depressed agricultural region of New York. All of the residents living in two towns in the region who were over 16 years of age and who lived in their homes year-round were surveyed. Demographic information was obtained from the participants, as well as information about previous cholesterol testing and their cardiovascular-risk knowledge and behaviors. The serum cholesterol of each participant was measured. RESULTS: Of the 557 households contacted, 508 (91%) households participated. A total of 1063 persons over 16 years of age were surveyed, and 973 (92%) were screened for cholesterol. Overall, 24% reported prior cholesterol testing. Logistic regression analysis identified several independent factors that were associated with a reduced likelihood of ever having had a cholesterol test. These factors included: (1) age under 45 years, (2) having less than 12 years of education, (3) having an income of less than $10,000, (4) not having health insurance, (5) not having visited a physician within the previous year, and (6) practicing three or more high-risk cardiovascular behaviors. The participants' cardiovascular knowledge made no independent contribution to having had their cholesterol levels tested. CONCLUSIONS: Many of the factors that prevent cholesterol testing are socially determined. The results of this study suggest that financial and social barriers are two of the major obstacles to residents of rural communities having their cholesterol levels tested.

Adolescent↗
PubMed1990

Lactate dehydrogenase and creatine phosphokinase isoenzymes in tissues of laboratory animals.

The lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) isoenzyme distributions in tissues of the ICR mouse, Wistar rat, guinea pig and golden hamster were analyzed by histoelectrophoresis. Tissues obtained were as follows: liver, pancreas, stomach, small intestine, heart, femoral muscle, uterus, kidney, spleen, lymph node, cerebrum, spinal cord and erythrocyte. Histoelectrophoresis was for the direct analysis of LDH and CPK isoenzymes in the tissues and had high practical value compared with previous tissue-extraction methods. In tissues of the mouse, guinea pig and golden hamster, LDH isoenzymes showed five bands. In the rat, LDH isoenzyme was separated into four fractions. CPK isoenzyme showed three bands; BB, MB and MM. In some tissues, the MM band was separated into two sub fractions.

Animals↗
PubMed1989

Choosing and using a microcomputer for tropical epidemiology. II. Study implementation.

Continuing from the previous paper (Byass 1989), practical considerations in setting up a computer system to assist in the collection of data from an epidemiological project are discussed. Organizing field work so as to facilitate computer processing is considered, together with establishing data entry and checking procedures. The use of the hypothetical example in the first paper is continued here.

Data Collection↗
PubMedDate not supplied

Primary care physicians' assessment and prevention of HIV infection.

The degree and depth to which primary care physicians counsel patients at risk for human immunodeficiency virus (HIV) infection is a major concern. To determine which factors influence whether physicians counsel patients at risk for HIV, primary care physicians's clinical experience, knowledge, attitudes, and preventive counseling advice in hypothetical case scenarios were assessed. Ninety-nine adult primary care physicians in the Washington, D.C., metropolitan area were interviewed by telephone from May through November 1987. Ninety-one physicians had tested or referred patients for HIV antibody tests. However, 58% could not name the ELISA or Western blot as the tests. The most frequent HIV prevention recommendations were using condoms (67.7%), abstaining from sexual activity (36.4%), getting tested for HIV (30.3%), and safe sex (23.2%). Naming the HIV antibody tests was the most significant predictor of preventive counseling advice; other significant predictors included physicians' personal comfort with counseling homosexual patients and various physician practice and demographic characteristics. Previous studies showed that homophobia was the main inhibitor of effective AIDS counseling. These results suggest that physicians' lack of knowledge and general discomfort in counseling patients about sexual risk factors, rather than homophobia alone, are important barriers to preventive counseling about HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Perimortem cesarean delivery.

Postmortem cesarean delivery is an operation that has been practiced since antiquity. In previous centuries low infant survival rates led to negative opinions regarding the operation's usefulness. A review of the past centuries' cases and a review of fetal physiology suggest that to obtain optimum infant survival, cesarean delivery should be initiated within four minutes of maternal cardiac arrest. The physiology of cardiopulmonary resuscitation during pregnancy is analyzed, and recent cases of maternal cardiac arrest with successful maternal resuscitation are reviewed. This data suggests that perimortem cesarean delivery initiated within four minutes of maternal cardiac arrest will yield the highest rates of maternal survival. Legal liability from the operation is minimal.

Cesarean Section↗
PubMed1987

[Spontaneous fetal mortality. Role of maternal age, parity and previous abortions].

Analysing the reproductive biographies of samples of women has made it possible to clarify the role of various factors in bringing about a risk of spontaneous fetal death during the reproductive life of the mother. However, attention must be paid to the difficulties in observing the cases and measuring parameters. To make the various features comparable it is necessary to distinguish between apparent intra-uterine mortality (the pregnancy being diagnosed by the woman), recognisable (the pregnancy is diagnosable clinically) and total (from the time of fertilisation). The effect of maternal age is definite and quite independent of parity. Apparent intra-uterine mortality rises from about 120 per 1,000 pregnancies at the age of 20-24 to 200 per 1,000 at 35-39 and 270 per 1,000 at 40-44. If there has been no previous abortion the risks generally are less than 150 per 1,000, but if there has been even one previous abortion they become practically double. This discontinuity can be interpreted as showing the existence of marked changes between women as far as this risk is concerned.

Abortion, Habitual↗