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PubMed1998

Chest radiography and tuberculosis case-finding in Western Australia.

A retrospective study to assess the role of chest radiography (CR) in the control of tuberculosis (TB) in Western Australia (WA) was carried out by reviewing the annual reports from 1948 to 1983 and analysing the records at the Perth Chest Clinic (PCC) for a 12-month period in 1992-93. Mass miniature radiography in WA was introduced in 1948 and was selective up to 1951, yielding 3.3 cases of active TB per 10(3) films and accounting for 18.3% of the total notifications. It became a compulsory statewide screening procedure from 1952 to 1972. During this period the average yield was 0.7 cases/10(3) films and they accounted for 19.6% of the notifications. Thereafter the examination was again selective, detecting 0.2 cases/10(3) films and accounting for 2.7% of the notifications for 1977-79. From 1 July 1992 to 30 June 1993, a total of 2456 asymptomatic persons had chest X-ray records at the PCC relating to contact tracing (456), positive Mantoux reaction (330), pre-employment clearance as child-care workers (616) and application for permanent residence (1054). Overall, their X-rays were reported as normal in 95.4%, abnormal and of clinical significance in 2.7% and abnormal but of no significance in 1.9%. Active TB was detected in 0.2%, giving a yield of 2.4 cases/10(3) films and accounting for 10% of the notifications for the 12-month period. This study shows that mass CR, when judiciously applied, can contribute significantly to TB case-finding even in low-prevalence countries where the goal is the elimination of the disease.

Adolescent↗
PubMedDate not supplied

Postcard and telephone reminders for unclaimed prescriptions: a comparative evaluation using survival analysis.

OBJECTIVE: This study investigated unclaimed prescription reminders with the goal of developing practical and useful recommendations for pharmacies interested in reminding patients to pick up unclaimed prescriptions. Based on the recipient and mode of the reminder notification, this study measured differences in unclaimed prescription pickup time. DESIGN: This study was conducted using a convenience sample of three independent pharmacies in a large Midwestern city. A total of 120 subjects with prescriptions remaining unclaimed after 3 or 4 working days were included in the study. Once identified as unclaimed, these prescriptions were randomly assigned into a control group or one of the following four intervention groups: (1) a telephone reminder to the patient, (2) telephone notification to the prescribing physician, (3) a postcard reminder to the patient, and (4) postcard notification to the prescribing physician. RESULTS: The results suggest that different methods of pharmacist-initiated reminder systems may affect time to prescription pickup in community pharmacy practice. Marginally significant differences were found among the five study groups and the time to prescription pickup (P = .09). Compared with the control group, neither telephone nor postcard reminders--to patients or physicians--significantly decreased the mean number of days to pickup of potentially abandoned prescriptions. CONCLUSION: The actual value of an unclaimed prescription reminder program may reside in improved relationships with customers and with the medical community. The effort and expense of implementing and maintaining an unclaimed prescription reminder system should be balanced against the opportunity to establish and improve pharmacist-patient and pharmacist-physician relationships. Further research in different pharmacy settings should investigate the effectiveness of (1) postcard versus telephone reminders, (2) physician versus patient notification, and (3) the effects of reminders on patient outcomes.

Community Pharmacy Services↗
PubMed2006

The seroepidemiology of pertussis in Australia during an epidemic period.

Studying the epidemiology of pertussis and impact of differing vaccine schedules is difficult because of differing methods of case ascertainment. The advent of internationally standardized serological diagnosis for recent infection has allowed comparison of age-specific pertussis infection among European countries and was applied in Australia at the time of a major national epidemic. In 1997 and 1998, a nationally representative serum bank using residual sera from diagnostic laboratories was established. Measurement of pertussis toxin (PT) IgG level was conducted by a reference laboratory using an enzyme-linked immunosorbent assay standardized for a number of European countries. A titre of 125 EU/ml was interpreted as indicative of recent pertussis infection. The serological data were correlated with age, gender, region and disease epidemiology in Australia. The highest prevalence of recent pertussis infection was in the 5-9 years age group, and the lowest in 1-4 and 25-64 years age groups. In the 5-14 years age group, 29.7% (5-9 years) and 14.6% (10-14 years) of the sample had serological evidence of recent infection, correlating with the pattern of epidemic notifications. The 15- to 24-year-olds had similar high titres but the same notification rate as 25- to 44-year-olds, suggesting ascertainment bias may result in under-notification in the former age group. The prevalence of high titres observed was up to 20-fold higher than some European countries during a similar time period. Although vaccination has reduced the transmission of pertussis in the youngest and most vulnerable age group, pertussis is still endemic in Australia, particularly in older children and the elderly. The Australian vaccination schedule has been changed in an attempt to address this problem, by spacing doses more widely, with the fifth dose at 15-17 years of age. Seroepidemiology for pertussis offers the potential to compare patterns of pertussis between countries and examine the impact of vaccine schedule changes independent of notification and diagnostic bias.

Adolescent↗
PubMedDate not supplied

EMTs' attitudes' toward death before and after a death education program.

OBJECTIVE: To test the hypothesis that emergency medical technicians' (EMTs') attitudes toward death will change after exposure to a death education program. METHODS: A convenience sample of 83 rural EMTs participated in this pretest-posttest study after exposure to an educational program related to death. Intact groups of EMTs were randomly assigned to one of three conditions. The short-intervention group received a two-hour class solely on making death notifications. The long-intervention group received a 16-hour, two-day workshop based on the Emergency Death Education and Crisis Training (EDECT(SM)) program. The control group received a program about toxicology. Each participant completed a questionnaire with items structured in a Likert five-point format with "strongly agree" and "strongly disagree" as the anchors. RESULTS: Before the training programs, most (77%) participants reported that an EMT's actions impact the family's grief. Less than half (43%) reported that an EMT's role should include making a death notification. The majority (84%) reported that their training was inadequate to make a death notification or to help the family with their grief. Most (84%) felt uncomfortable making a death notification. Those EMTs in the long-intervention group were significantly more likely (92%) to feel that their training was adequate after the intervention when compared with those EMTs in the short-intervention group (43%) or those in the control group (21%). CONCLUSION: The data showed that EMTs' attitudes toward death changed after exposure to a training program about death.

Attitude of Health Personnel↗
PubMed2002

Pediatric sentinel surveillance of vaccine-preventable diseases in Italy.

BACKGROUND: Planning and evaluating vaccination programs depend on reliable systems of monitoring disease incidence in the community. In Italy vaccine-preventable diseases are subject to statutory notification, but they are often unreported. In January, 2000, a pediatric sentinel network was launched, with the aim of monitoring in a timely and accurate way the geographic and temporal trends of vaccine-preventable diseases. METHODS: The network consists of National Health System primary care pediatricians; participation is voluntary. The diseases under surveillance include measles, mumps, rubella, pertussis and varicella. Case definitions are based on specific clinical criteria, and pediatricians report cases on a monthly basis. Incidence rates are estimated and compared with those obtained by statutory notifications. The proportion of vaccinated cases is also computed. RESULTS: In 2000 an average of 468 pediatricians participated each month of a total of 7276 pediatricians under contract for primary care by the National Health System. The population under surveillance consisted of 371 670 children younger than 15 years (of a national total of 8.347.804 children of the same age). The annual national incidence per 100.000 children was estimated at 5345 for varicella, 1972 for mumps, 279 for pertussis, 108 for rubella and 62 for measles, although wide variations were observed among geographic areas. The national estimates are 3 to 7 times higher than those obtained through statutory notifications. For all of the diseases the ratio between the two sources of data was significantly higher in southern Italy, compared with the rest of the country. The proportion of vaccinated cases was similar for measles and rubella (21 and 17%) but was approximately 3 times higher for mumps (59%). Most (74%) of the vaccinated mumps cases had received the Rubini vaccine strain. CONCLUSIONS: The sentinel surveillance system is considerably more sensitive than statutory notifications, particularly in southern Italy. The high percentage of mumps cases vaccinated with the Rubini strain indicates a reduced effectiveness of this vaccine. Although further improvements are needed, pediatrician-based sentinel surveillance is a useful tool for evaluating vaccine-preventable disease trends.

Adolescent↗
PubMed2004

Psychological impact of genetic testing for hereditary non-polyposis colorectal cancer.

The psychological impact of predictive genetic testing for hereditary non-polyposis colorectal cancer (HNPCC) was assessed in 114 individuals (32 carriers and 82 non-carriers) attending familial cancer clinics, using mailed self-administered questionnaires prior to, 2 weeks, 4 months and 12 months after carrier status disclosure. Compared to baseline, carriers showed a significant increase in mean scores for intrusive and avoidant thoughts about colorectal cancer 2 weeks (t = 2.49; p = 0.014) and a significant decrease in mean depression scores 2 weeks post-notification of result (t = -3.98; p < 0.001) and 4 months post-notification of result (t = -3.22; p = 0.002). For non-carriers, significant decreases in mean scores for intrusive and avoidant thoughts about colorectal cancer were observed at all follow-up assessment time points relative to baseline. Non-carriers also showed significant decreases from baseline in mean depression scores 2 weeks, 4 months and 12 months post-notification. Significant decreases from baseline for mean state anxiety scores were also observed for non-carriers 2 weeks post-notification (t = -3.99; p < 0.001). These data indicate that predictive genetic testing for HNPCC leads to psychological benefits amongst non-carriers, and no adverse psychological outcomes were observed amongst carriers.

Adult↗
PubMed2006

Epidemic infectious syphilis in inner Sydney--strengthening enhanced surveillance.

OBJECTIVE: To report the results of a 2001-04 enhanced syphilis surveillance program in south-eastern Sydney and a subset of cases from the Sydney Sexual Health Centre (SSHC). METHODS: For all laboratory syphilis notifications, a questionnaire was sent to the referring doctor requesting demographic data, clinical information about disease classification and the presence of symptoms. Sex of partner/s and HIV status were collected from a subset of cases seen at SSHC. RESULTS: During 2001-04, 1,275 syphilis notifications were received and 1,112 (87%) were able to be classified as 361 (28%) cases of infectious syphilis, 221 (17%) non-infectious syphilis and 530 (42%) treated syphilis. From mid 2002, an increase in the number of infectious syphilis notifications was noted. Of the 361 cases of infectious syphilis, most were in men (348, 97%). From a subset of 47 cases of infectious syphilis from SSHC, 43 (91%) were in gay men and nine (21%) had concurrent HIV infection. CONCLUSIONS: Inner Sydney has recently experienced a rapid increase in infectious syphilis affecting a defined population: men, aged 30-39, English speaking and Australian born. These results support recent reports of outbreaks among men who have sex with men, but without routine collection of additional risk factors control programs may be misguided. IMPLICATIONS: In light of the review of the NSW Public Health Act 1991, it is recommended that reducing barriers to the collection of HIV status and sex of sexual partners in de-identified syphilis notifications be explored as a matter of urgency.

Adolescent↗
PubMed2005

Variations among Institutional Review Board reviews in a multisite health services research study.

OBJECTIVE: To document the Institutional Review Board (IRB) review process and to explore the impact of different patient notification procedures. DATA SOURCES/STUDY SETTING: Review of IRB application and correspondence records prospectively collected during a multisite study of health care quality involving telephone interviews of 3,000 participants across 15 primary care sites. STUDY DESIGN: Records were reviewed to ascertain: (1) the type of IRB review conducted, (2) the number of days from submission to approval of the IRB application, (3) whether the IRB required patient notification and/or consent prior to the release of names, and (4) patient participation rates. DATA COLLECTION/EXTRACTION METHODS: The study coordinating center prepared a common study protocol for IRB submission and assisted sites with submission. The application, correspondence with the IRB, consent script, and patient letters were collected, reviewed, coded, and analyzed. PRINCIPAL FINDINGS: IRBs at the 15 sites and survey center varied in the type of IRB required and the number of days from submission to approval (range of 5-172 days). Four sites required patient notification in advance of the study; 2-11 percent of patients refused in opt-out sites and 37 percent in the single opt-in site. Participation among contacted patients did not appear to be related to patient notification procedures. CONCLUSIONS: Variations in IRB requirements can affect response rates and sample generalizability.

Adult↗
PubMed2003

Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges.

Current automated continuous-monitoring blood culture systems afford more rapid detection of bacteremia and fungemia than is possible with non-instrument-based manual methods. Use of these systems has not been studied objectively with respect to impact on patient outcomes, including hospital charges and length of hospitalization. We conducted a prospective, two-center study in which the time from the obtainment of the initial positive blood culture until the Gram stain was called was evaluated for 917 cases of bloodstream infection. Factors showing univariate associations with a shorter time to notification included higher body temperature and respiratory rate and higher percentage of immature neutrophils. Multiple linear regression models determined that the primary predictors of both increased microbiology laboratory and total hospital charges for patients with bloodstream infection were nonmicrobiologic and included length of stay and host factors such as the admitting service and underlying illness score. Significant microbiologic predictors of increased charges included the number of blood cultures obtained, nosocomial acquisition, and polymicrobial bloodstream infections. Accelerated failure time regression analysis demonstrated that microbiologic factors, including time until notification, organism group, and nosocomial acquisition, were independently associated with length of hospitalization after bacteremia, as were the factors of admitting service, gender, and age. Our data suggest that an increased time to notification of bloodstream infection is independently associated with increased length of stay. We conclude that the time to notification is an obvious target for efforts to shorten length of stay. The newest generation of automated continuous-monitoring blood culture systems, which shorten the time required to obtain a positive result, should impact length of hospitalization.

Adolescent↗
PubMed2005

Evaluation of the National Congenital Anomaly System in England and Wales.

OBJECTIVE: To evaluate the National Congenital Anomaly System (NCAS). METHODS: The NCAS in England and Wales based at the Office for National Statistics and the various regional registers that exchange data with it were examined, based on guidelines for evaluating public health surveillance systems, published by the Centres for Disease Control (CDC). Data relating to congenital anomaly notifications received from 1991 to 2002 were analysed. MAIN OUTCOME MEASURES: The main outcome measures were based on CDC standards and included the level of usefulness of the system, simplicity, flexibility, data quality, acceptability, sensitivity, representativeness, timeliness, and stability of the system. RESULTS: The NCAS has two main tiers: the "passive" system of voluntary notifications and the anomaly registers, but many reporting sources within these. It receives about 7000 notifications a year. It is inflexible and has variable data quality. The voluntary nature of reporting affects the system's acceptability. The sensitivity as compared with two regional registers (Trent and Wales) is about 33%. The congenital anomaly registers reporting to the NCAS achieve high levels of coverage and completeness. From 2003, they cover 42% of all births and account for the major proportion of the notifications. CONCLUSIONS: The NCAS serves the important function of monitoring birth defects in England and Wales, but is not currently operating in a timely or effective way. It should be adapted to meet its main objectives more effectively. More regional anomaly registers should be instituted and existing registers supported through central funds.

Congenital Abnormalities↗
PubMed1990

Prevalence of advanced renal failure in Northern Ireland.

OBJECTIVE: To determine the prevalence of advanced chronic renal failure in Northern Ireland as part of an assessment by the Renal Association of the level of service provision for treatment of such patients. DESIGN: Prospective notification of patients reaching a defined level of advanced chronic renal failure (serum creatinine concentration greater than or equal to 500 mumol/l or blood urea concentration greater than or equal to 25 mmol/l) within one year and follow up for at least three, and, at most, four years after notification. SETTING: Northern Ireland. PATIENTS: 122 Patients with a serum creatinine or blood urea concentration higher than the defined level newly detected from 1 March 1985 to 28 February 1986. MAIN OUTCOME MEASURE: Survival after notification. RESULTS: 77 Patients of all ages/million population/year had advanced chronic renal failure compared with 67/million/year between the ages of 5 and 80 found in an earlier study of the same population. 62% Of the patients were older than 50 years. Seventeen (14%) of the patients either required dialysis or died within one month of notification, 51 (42%) survived for at least three months, and 23 (19%) for one year or longer. Three patients, all of whom were attending a renal clinic, survived for periods of 43, 45, and 46 months respectively without renal replacement treatment. CONCLUSIONS: The increased number of new patients disclosed in this survey compared with the earlier survey is mainly owing to an increased number of older patients. Such patients often have disabilities other than renal failure, are less likely to be capable of self treatment, may develop complications more often and require more frequent hospital admissions, and may not be suitable for transplantation and consequently have considerable resource implications for the NHS.

Adolescent↗
PubMed2004

Potential impact of interventions to reduce times to thrombolysis.

OBJECTIVES: To estimate the lifesaving potential of interventions to accelerate the administration of intravenous thrombolysis for myocardial infarction. METHODS: Data were analysed from a prospective, observational study of all patients transported to hospital by ambulance, who subsequently received intravenous thrombolysis at 20 hospitals and two ambulance services in Victoria, Australia (n = 1147). Regression models estimated the association between predictor variables age, sex, route of referral, symptom onset to call time, ambulance pre-notification of the receiving hospital, emergency department thrombolysis, and the outcome, time to thrombolysis. Further modelling estimated the number needed to treat to save one life by several recommended interventions to reduce time delays. RESULTS: Presentation via a rural hospital or general practitioner was associated with an approximate doubling of the onset to call time (2.08 and 2.30 respectively). Ambulance-hospital pre-notification and emergency department thrombolysis reduced door to needle times by 21% and 27% respectively. Modelling showed that each of the following interventions would be expected to save one life: 1069 hospital pre-notifications, 714 cases of emergency department thrombolysis, 184 cases of prehospital thrombolysis, 340 cases to bypass their rural hospital, or 50 cases to bypass their general practitioner. CONCLUSIONS: Hospital pre-notification and emergency department thrombolysis reduce time delays, although the mortality impact seems to be modest. Prehospital thrombolysis has the potential to save lives, although validation in real practice is required. Advising patients to call directly for an ambulance, rather than the general practitioner, has the greatest potential to save lives.

Adult↗
PubMed1996

Increasing incidence of tuberculosis in the young and the elderly in Scotland.

BACKGROUND: Since 1987 there has been an arrest in the previously established decline of tuberculosis notifications in Scotland. A study was undertaken to determine whether age contributed to this phenomenon. METHODS: Notifications of tuberculosis in Scotland were quantified by year and age group for the years 1981-92 from national statistics supplied by the Information and Statistics Division. Population data were obtained from the 1981 and 1991 national censuses. RESULTS: Age group analysis of pulmonary tuberculosis notifications showed that, in the 0-14 age group, incidence (per 10(5) population) decreased from 7.4 in 1981 to 2.6 in 1987, rising by an estimated 12.6% per annum to 3.7 in 1992. In the 65+ age group incidence declined from 30.1 in 1981 to 17.3 in 1988, and rose by an estimated 4.1% per annum to 22.2 in 1992. In the age groups 15-44 and 45-64 a continuous decrease in notification rate was seen over the period of the study. CONCLUSIONS: The plateauing of the incidence of tuberculosis in Scotland is associated with significant increases since 1987 of tuberculosis in the young and elderly. Contributions from ethnic minorities and those infected with HIV are negligible. An ageing population over the decade, with the highest tuberculosis rates seen in the older age group, may explain these findings.

Adolescent↗
PubMed1996

Seasonality of tuberculosis: the reverse of other respiratory diseases in the UK.

BACKGROUND: In Western societies there is a winter peak in mortality, largely accounted for by respiratory and cardiovascular deaths. In view of the known seasonal variation in vitamin D, and of the postulated link between tuberculosis and vitamin D deficiency, a study was undertaken to examine whether the presentation of tuberculosis had the same seasonal rhythm as other pulmonary infections. METHODS: Using cosinor analysis the presence or absence of seasonality was determined for 57,313 tuberculosis notifications for England and Wales. OPCS data in four weekly notifications over a 10 year period (1983-92) were examined as two quinquential sets (1983-7 and 1988-92). These were compared with two groups of acute respiratory illness: 138,992 notifications to OPCS of pneumonia deaths for 1988-92 and all admissions to Scottish hospitals with respiratory disease (252,163 cases) during 1980-4. RESULTS: Analysis of notifications of tuberculosis revealed a summer peak with an amplitude of 10%. This pattern differs markedly from other respiratory disorders in which a winter peak and summer trough is observed. CONCLUSIONS: The unusual seasonality of tuberculosis is currently unexplained. One possibility is that low post-winter trough levels of vitamin D (which are known to affect macrophage function and cell mediated immunity) might result in impaired cellular immunity leading, after a latent period, to reactivation of dormant mycobacterial infection.

Humans↗
PubMed2007

Familial effects of BRCA1 genetic mutation testing: changes in perceived family functioning.

This study expands recent research that examines how the receipt of BRCA1 genetic test results affects family adaptability and cohesion 1 year after genetic risk notification. Study participants were members of a large Utah-based kindred with an identified mutation at the BRCA1 locus. The final sample, 90 men and 132 women, contributed information before genetic testing (baseline) and 4 months and/or 1 year after receipt of genetic test results. After controlling for other factors such as family coping resources (Family Crises-Oriented Personal Evaluation Scale) and strains (Family Strains Index) and the tested individual's anxiety levels before genetic testing (state anxiety subscale), men and women reported significant declines in family cohesion 1 year after genetic risk notification (P < 0.01). There is suggestive evidence that carrier men reported increasing adaptability 1 year after risk notification (+0.21 points per month; P < 0.10). Having a carrier sister had a positive influence on women's perceived family cohesion and adaptability levels, whereas a personal history of cancer, having a great deal of caregiving involvement for a female relative with cancer, anxiety, and some types of coping resources had a negative effect on men's perceived family cohesion and adaptability levels. Although results showed that tested parents are perceiving a decline in family functioning after genetic risk notification, there is no evidence to suggest that the decline is due to carrier status. In fact, it is other life circumstances that exist at the time of the genetic testing process that seem to influence the degree to which families adjust to the experience and test results.

Adaptation, Psychological↗
PubMed1998

Management of threats of violence under California's duty-to-protect statute.

OBJECTIVE: This is the first study to assess clinical practices under one of the new duty-to-protect statutes, some version of which has been passed in many states. In 1985, California enacted a statute enabling psychotherapists to limit their liability when a patient makes a serious threat of violence by 1) making reasonable efforts to warn the victim of the threat and 2) notifying local police. METHOD: The authors examined all duty-to-protect notifications over a 5-year period in San Francisco by reviewing police and court records. RESULTS: Police received only 337 notifications, typically made by nondoctoral staff members at public facilities such as psychiatric hospitals and crisis clinics. Patients most commonly directed their threats toward family members. Of the patients who made threats resulting in notifications, 51% had prior arrest records, and 14% had subsequent arrests. Only 52% of the patients who made threats were civilly committed. CONCLUSIONS: The findings suggest that 1) clinicians rarely discharge the duty to protect in the manner specified by the law, 2) many patients whose threats result in notifications have extensive involvement with the criminal justice system, and 3) family intervention may have clinical relevance in many duty-to-protect situations.

Adolescent↗
PubMed2005

Prehospital 12-lead electrocardiography impact on acute myocardial infarction treatment times and mortality: a systematic review.

OBJECTIVES: Prehospital 12-lead electrocardiogram (PHECG) interpretation and advance emergency department (ED) notification may improve time-to-treatment intervals for a variety of treatment strategies to improve outcome in acute myocardial infarction. Despite consensus guidelines recommending this intervention, few emergency medical services (EMS) employ this. The authors systematically reviewed the literature to report whether mortality or treatment time intervals improved when compared with standard care. METHODS: The authors used the Cochrane strategy to search MEDLINE, EMBASE, Current Contents, Dissertation Abstracts, Cochrane Library, and Index of Scientific and Technical Proceedings. Bibliographies and grant-agency Websites were reviewed, and primary investigators and industry were contacted for published and unpublished studies. Inclusion criteria included PHECG and advance ED notification versus standard EMS care; controlled trials; English only; and evaluation of treatment time intervals, all-cause mortality, or both. Study selection was hierarchical, blinded, and independent. Agreement at each level of review was evaluated by using a kappa statistic. Study quality was measured with a validated scale and was interpreted by two independent reviewers. RESULTS: A total of 1,283 citations were identified, and five studies met the inclusion criteria. The weighted kappa for selection was 0.61 (standard error [SE], 0.045) for titles, 0.63 (SE, 0.051) for abstracts, and 0.79 (SE, 0.146) for full articles. Mean study quality measures by two independent reviewers were 6.0/15 and 5.5/15 (correlation coefficient, 0.85; p = 0.06). PHECG and advance ED notification increased the weighted mean on-scene time by 1.2 minutes (95% confidence interval [95% CI] = -0.84 to 3.2). The weighted mean door-to-needle interval was shortened by 36.1 minutes (95% CI = 9.3 to 63.0: range of means, 22-48 minutes vs. 50-97 minutes). One study reported all-cause mortality, with a statistically nonsignificant reduction from 15.6% to 8.4%. CONCLUSIONS: For patients with AMI, the literature would suggest that PHECG and advanced ED notification reduces in hospital time to fibrinolysis. One controlled trial found no difference in mortality with this out-of-hospital intervention.

Electrocardiography↗
PubMed2006

Application of aldehyde dehydrogenase 2 (ALDH2) genetic diagnosis in support of decreasing alcohol intake.

Encouraging behavioral changes to decrease alcohol intake is not easy from the standpoint of health support. This study was conducted to examine whether the genetic diagnosis of ALDH2 polymorphism is useful in supporting those who want to decrease their alcohol intake. The participants in this study were 329 male employees who wanted to know the result of their ALDH2 genotype. We divided the 329 participants randomly into two groups. One was the "notified group" (n=157), and the other was the "non-notified group" (n=172). The subjects belonging to the "notified group" were informed of the results of the ALDH2 genotype diagnosis in April, 2003. Drinking habits and laboratory data were obtained before and after notification of the ALDH2 genotype. Among those with genotype ALDH2*1/*1, there was no significant change in drinking frequencies, nor was there any significant decline in liver function laboratory data in either of the groups before and after notification of the genotype. However, weekly alcohol intake tended to increase compared to that before notification. On the other hand, with regard to those with genotype ALDH2*1/*2, no significant changes in drinking frequencies or liver function laboratory data were evident in either group before and after notification of the genotype. However, the weekly alcohol intake tended to increase in the non-notified group, whereas it tended to decrease in the notified group. Although the result was not significant, it is suggested that, with further study and an increased sample size, the genetic diagnosis may be found to be useful.

Alcohol Drinking↗