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[Digestive diseases morbidity and need for medical care requirements. Prevalence study of declared symptoms and demand for medical care in a French "department" (author's transl)].

A survey on digestive morbidity and demand for medical care in a pilot area concerned 3504 persons, eighteen years old and over; 69.3 p. 100 of them reported that they had been affected by one or several digestive symptoms during the previous year. However, it concerns mostly just common symptoms, probably benign, observed in all age groups; only 9.4 p. 100 of those complaining (half of them being old persons) reported disorders which can be suspected as serious ones. Among the subjects presenting symptoms, there is a majority of women, of urban population, of higher educational levels and higher social classes. During this year 18.9 p. 100 of the total population sought medical advice for digestive symptoms, the average number of consultations being 0.7 for every subject. This demand is related to the age, the number and gravity of the complaints, and to the presence of a digestive history; 24.5 p. 100 of the subjects used self medication: this is related to the perception of benign disorders, to digestive history, sex and social class: factory workers, farm workers and self-operating farmers are using this least. Women complain of digestive disorders more often than men and practice self medication more frequently. They do not report serious symptoms or a history of digestive disease more often than men, nor do consult doctors more frequently.

Adult

FDA-approved drug repurposing in zebrafish identifies thyroid hormone and other compounds as potential antithrombotics.

Venous thromboembolism (VTE) is a highly prevalent medical condition with limited therapeutic options and an incomplete understanding of its acquired and inherited subtypes. The zebrafish is a model with the benefits of external development, fecundity, optical transparency, and hemostasis that demonstrates conservation with mammals. We utilized zebrafish as a phenotypic screening tool to identify novel therapeutic options for preventing VTE. A library of FDA-approved compounds was screened for suppression of acquired (elevated estrogen) and spontaneous (protein C deficiency) thrombosis. We found that thyroid hormone, receptor tyrosine kinase (RTK) inhibitors, and proton-pump inhibitors (PPIs) effectively modulated levels of thrombosis, particularly in the estrogen-induced model. These also showed a more favorable hemostatic profile than standard therapies, suggesting alternative mechanisms. Genome editing of thyroid hormone receptor proved that thyroid hormone action is on target. A retrospective electronic health record (EHR) analysis found that thyroid-hormone prescriptions in hormonal contraceptive users correlated with a higher VTE risk, potentially limiting direct repurposing but highlighting thyroid signaling as a pathway involved in estrogen-induced thrombosis. Together, these data identify several drug classes that can be tailored to specific subtypes of VTE and help elucidate distinct pathways driving thrombosis.

FDA-approved compounds

Skin disease in Lambeth. A community study of prevalence and use of medical care.

A community survey of skin disease was carried out in Lambeth, London. A postal questionnaire asking recipients to give details of the presence of skin disease was sent to a stratified sample of 2180 adults; a subsample of 614 persons were interviewed at home and an inspection was made of the exposed parts of their skin. Altogether 92 conditions were identified. These were graded for clinical severity and classified into 13 groups. The overall prevalence of skin disease thought to justify medical care was 22-5%. The most common important condition was eczema with a prevalence of 6-1%. Age, sex, and social class trends in prevalence were found in certain groups of skin disease. Of those with a skin disease thought to justify medical care, only 21% reported having attended their general practitioner in the past six months for a skin complaint. The reported use of medical care and self medication is discussed in relation to the presence of skin disease and other factors.

Acne Vulgaris

Geriatric medicine: model for computer-oriented research analysis.

It is important to have accurate information derived from basic data about geriatric patients, not only for clinical management but to anticipate changes in the demand for services and the taking of preventive action. A model is presented for computer-oriented analysis. The collection of data is designed to cover the specific physical, physiologic and social needs of the patients both in the hospital and in the community. It must also support effective action about these needs which involve not only usage of existing facilities but the planning of preventive measures and adjustment of the provision for care. In addition, it must support clinical research when necessary. Geriatric records have specific problems, not only those of the patient's identity and clinical data but also the maintenance of psychologic and social information so that the requirements for long-term care can be assessed. This type of record facilitates comparison between groups of patients and allows measurement of inter-hospital performance relating to medical care and the planning of social programs in the community. Such records furnish the background of a more detailed statistical analysis for indicating the direction of national policy. By this means the prevalence of medical, psychologic and social demand can be studied and various preventive actions taken, including the monitoring of geriatric facilities.

Computers

Medical students' orientation toward the chronically ill.

Medical students receive little training specifically directed toward care of chronically ill persons, and physicians, therefore, tend to have little knowledge of alternative long-term care arrangements. Moreover, the negative attitudes toward chronic patients which were observed by Becker in the 1950s still seem prevalent among medical students. Little interest is expressed by medical students in fields which focus on the chronically ill or aged. Restructuring of medical education is necessary in order to promote more concern among physicians with the needs of the chronically ill.

Attitude to Health

Alcoholism consultation and general hospital psychiatry.

The author explores the relationship between consultation-liaison psychiatry and alcoholism as it presents in the general hospital. He discusses cases that illustrate specific problems, reviews the studies of alcoholism prevalence in the medical and surgical services of general hospitals, and emphasizes the liaison and consultation roles of the general hospital psychiatrist around alcoholism diagnosis, management, and treatment referral.

Adult

Perinatal Diagnosis of Generalized Arterial Calcification of Infancy: First Genetically Confirmed ENPP1 Case in an Egyptian Fetus.

Generalized Arterial Calcification of Infancy (GACI) is a rare genetic vascular disease characterized by the early onset (between in utero and infancy) of extensive calcification and stenosis of the large and medium-sized arteries. Presentation is typically with respiratory distress, congestive heart failure, and systemic hypertension. With approximately 300 cases reported worldwide in the medical literature. The prevalence is unknown; however, based on the carrier frequency of the recognized pathogenic variants, a frequency of 1 in 200,000 has been suggested. The autosomal recessive form of GACI disorder is caused by mutations in the ENPP1 or ABCC6 genes. To the best of our knowledge, this study represents the first genetically confirmed case of GACI in an Egyptian fetus detected during the perinatal period. In this report, we describe a case of GACI in a fetus with a pathogenic ENPP1 gene mutation at 29 weeks of gestation. Ultrasound examination revealed aortic and pulmonary valve stenosis, biventricular hypertrophy, and a hypercalcified aorta and ductal arch. Genetic testing identified a homozygous pathogenic variant in the ENPP1 gene: c.749C>T (p.Pro250Leu). In conclusion, early diagnosis of GACI is vital due to its severe prognosis and early symptom onset. Expert fetal echocardiography plays a key role in detecting arterial calcification during pregnancy. Genetic testing enhances diagnostic accuracy, informs treatment strategies, and supports family counselling.

Arterial calcification

[Epidemiology of malignant neoplasms of the breast, uterine cervix, endometrium, and rectum of females in the G.D.R., 1962--1972 (author's transl)].

Based on a model described earlier, the time trend of incidence, mortality, prevalence, duration of medical care and 5-years survival rate is calculated for the following malignant neoplasms of female population in the G.D.R.: breast, uterine cervix , corpus uteri and chorionephithelioma (combined), and rectum (ICD 8th, revision Nos. 174, 180, 181/182, 154). Calculated rates agree quite well with published observations. The results support the assumption that care of cancer patients could be improved between 1962 and 1972. Some suggestions for further development of cancer control are discussed.

Adult

Prevalence of pharmacogenomically implicated prescriptions in multi-ethnic populations in Singapore.

AIM: To assess the potential impact of implementing pre-emptive pharmacogenomic (PGx) testing in Singapore, focusing on prevalence and genetic actionability of PGx prescriptions. METHODS: Electronic Health Records from 2014 to 2021 were obtained from the National University Hospital (NUH), a tertiary medical centre serving approximately 6% of Singapore's population, which were filtered for pharmacogenomically implicated medicines (CPIC Level A or A/B), defined as PGx medications. Coupling this with published data of whole-genome sequencing of 9051 Singaporeans, we estimated the proportion of patients whose prescriptions might have been modified based on pre-emptive PGx at population level. RESULTS: From 2014 to 2021, a total of 1 157 359 unique patients were seen at NUH, with 38.1% to 43.0% of patients with prescriptions receiving at least one PGx medication annually, exhibiting minimal variance over year of prescription, sex or race/ethnicity. The most frequently prescribed PGx medications were omeprazole, statins and tramadol, while the most implicated pharmacogenes were CYP2C19, CYP2D6 and SLCO1B1. The age-dependent increase in PGx medication exposure varied significantly by sex, with males prescribed these medications earlier in life than females. Similarly, Indians and Malays were more likely to be prescribed these medicines at a younger age than Chinese. Based on frequency of PGx variants in Singaporeans, we estimate that 18.4% of patients could have their prescriptions modified from pre-emptive PGx testing. DISCUSSION: Pharmacogenomically implicated medication prescriptions are common in Singapore and are particularly prevalent in elderly populations. Strategic investments in infrastructure and policy development will be pivotal to the successful integration of pre-emptive PGx into clinical practice.

Asian genomes

Prevalence of hepatitis B surface antigen in a dental school patient population.

A sample of 300 adult patients accepted for initial treatment between January 5th and 24th, 1977 at the Louisiana State University School of Dentistry had blood samples drawn and analyzed by radioimmunoassay+ for the presence of hepatitis B surface antigen (HBSAg). Two patients were positive for HBSAg (a prevalence of .67 percent. Medical questionnaire information obtained from each participant indicated that 11 patients had had hepatitis; seven were confirmed by the patients' private physicians. Both patients positive for HBSAg gave confirmed histories of having had hepatitis. The information gathered tends to indicate that dental patients who give a history of hepatitis should have a blood sample drawn and analyzed by radioimmunoassay for HBSAg to determine whether they are carriers of HBSAg. This analysis should precede any dental treatment. Further studies are planned to obtain information from another sample population.

Adolescent

Effects of monensin-feeding regimens on flock immunity to coccidiosis.

Feed medication with monensin caused delays in development of immunity in two floor-pen experiments which simulated commercial broiler production. Development of immunity was retarded with the higher level of monensin (120 p.p.m.) but was progressively less delayed as the monensin level was decreased (100, 60 or 0 p.p.m.). Delay was greatest with Eimeria tenella, but also occured with intestinal species including E. acervulina, E. brunetti, E. maxima, E. mivati, and E. necatrix. Drug withdrawal permitted earlier development of immunity. Plans involving use of monensin on layer replacements which later will be maintained on the floor without medication should consider: 1) prevalence of infective oocyst exposure in the area, 2) the lowest possible level of drug required for protection, and 3) its use for the shortest possible period of time.

Administration, Oral

William B. Castle and intrinsic factor.

Fifty years ago, William B. Castle described the properties of intrinsic factor. By so doing, he advanced the first acceptable theory of the pathogenesis and pathophysiology of pernicious anemia. Enveloping Castle's discovery were prevalent ideas in the medical community of the time, such as the importance of nutritional factors in the pathogenesis of disease, and the intriguing possibility that many disorders could be ameliorated or even cured by administration of a "missing" substance. When viewed in a contemporary perspective, Castle's observations of a half century ago are remarkable examples of ingenuity and single-minded dedication to uncovering the pathogenetic mechanism of a previously fatal disorder.

Anemia, Pernicious

Antibiotic Self-Medication and Public Awareness During the 2023 Gaza War: A Cross-Sectional Investigation.

BACKGROUND: Antimicrobial resistance is driven by inappropriate antibiotic use, particularly self-medication. The 2023 Gaza War disrupted healthcare services, increasing resistant infections and reliance on self-treatment practices. OBJECTIVES: To determine the prevalence of antibiotic self-medication and assess public awareness during the 2023 Gaza War. METHODS: A cross-sectional survey was conducted between May and October 2025 among adults residing in the Gaza Strip during the 2023 Gaza War. A multistage non-probability recruitment strategy, organized across predefined governorate and residential-setting strata, was used to recruit 422 participants from primary healthcare centers, community pharmacies, and displacement shelters. The questionnaire demonstrated good internal consistency (Cronbach's &#x3b1;&#x202f;=&#x202f;0.857). Ethical approval was obtained from the relevant institutional review board, and informed consent was secured from all participants. RESULTS: The overall KAP score was moderate (67.46%), with attitudes scoring highest (74.62%), followed by knowledge (66.23%) and practices (61.52%). Reported antibiotic self-medication increased from 60.4% before the war to 80.6% during the war (p < 0.001), with significant changes in reasons for self-medication and antibiotic procurement sources. The mean antimicrobial-resistance perception score was 82.19 &#xb1; 11.10%, and knowledge was strongly correlated with the total KAP score (r&#x202f;=&#x202f;0.836, p < 0.001). CONCLUSIONS: Reported antibiotic self-medication was markedly higher during the 2023 Gaza War despite moderate public awareness, highlighting the urgent need for education, antibiotic stewardship, and improved healthcare accessibility.

Gaza War 2023

Tuberculosis in Kenya: a second national sampling survey of drug resistance and other factors, and a comparison with the prevalence data from the first national sampling survey. An East African and British Medical Research Council Co-operative Investigation.

A survey was carried out in 1974 in the same random sample of 11 of 30 districts in Kenya that were surveyed in 1964, to obtain information on (a) the proportion of patients with pulmonary and with extra-pulmonary tuberculosis, (b) the prevalence of bacteriologically-positive pulmonary tuberculosis, (c) the prevalence of initial and acquired drug resistance, (d) the radiographic extent and type of pulmonary disease, and (e) the changes that had occurred in the 10-year period. Of 1490 patients, 88.5% had pulmonary tuberculosis only, 3.0% had both extra-pulmonary and pulmonary tuberculosis and 8.6% had extra-pulmonary tuberculosis only. Of the 172 patients with extra-pulmonary tuberculosis, 51% had lymph node involvement, 24% bone and joint disease and 9% a pleural effusion. Of the 1362 patients with pulmonary tuberculosis (with or without extra-pulmonary tuberculosis) 94% had no history of previous chemotherapy, fewer than 1% a history of possible and 6% a history of definite previous chemotherapy. (The proportions for the patients with extra-pulmonary tuberculosis only were 94%, 1% and 5% respectively.) A sputum specimen was produced by 1096 (80%) of the patients with pulmonary tuberculosis; 69% of smear results were positive, as were 74% of the culture results. In 2 (0.25%) of the 807 patients with a positive culture the strain was identified as being neither M. tuberculosis nor M. bovis. Of 702 patients with no history of previous chemotherapy and a sensitivity test result available, 10.1% had a strain resistant to isoniazid and/or streptomycin, 7.3% to isoniazid alone, 1.4% to streptomycin alone and 1.4% to both drugs. Of 1133 patients with chest radiographs available and a diagnosis in Kenya of pulmonary tuberculosis, a lung lesion or a pleural effusion was reported at independent assessment in London for 91%. Gross, extensive or moderate disease was present in 73% of the patients and cavitation was present in 72%. The radiographic disease was classified as acute in 31%, mixed-acute in 52%, mixed in 12% and chronic in 5%. The disease in children was usually less extensive, less often cavitated, and more acute than in adults. A comparison of the prevalence data in 1974 with that in 1964 suggested that there was a modest decline in the incidence of tuberculosis but that the characteristics of the registered patients and their disease were very similar in all respects; the disease was just as extensive radiographically and cavitation was, if anything, more common and more extensive in 1974 than in 1964.

Adolescent

An emergency medical system approach to disaster planning.

The increasing prevalence of terrorist attacks and natural disasters has mandated that more emphasis be placed on emergency disaster planning. The report focuses on the 1976 Courthouse bombing in Boston, which generated 20 casualties. Ambulance response by Boston's Emergency Medical Service system was made in 2.5 minutes and all victims were transported from the scene within 20 minutes. Successful management of this incident employed several important principles of disaster planning. These include the initial medical response, staging at the scene, and hospital notification. Additionally, the concept of triage as an integral part of disaster planning is explained with examples of the on-site medical stabilization and treatment of casualties. The importance of these concepts in practice and the necessity of close coordination of ambulance response and the responses of other emergency agencies, i.e., Police and Fire, were clearly demonstrated in the disaster which resulted from the Courthouse bombing.

Adult

Driving Under the Influence of Cannabis Among U.S. Young Adults Who Use Cannabis: Evidence From the 2021-2024 National Survey on Drug Use and Health.

PURPOSE: To estimate the prevalence of driving under the influence of cannabis (DUIC) and identify associated factors among U.S. young adult drivers reporting past-year cannabis use. METHODS: This cross-sectional study analyzed pooled 2021-2024 National Survey on Drug Use and Health. The analytic data were restricted to drivers aged 18-25 years who reported past-year cannabis use (N = unweighted 17,141; weighted N = 10,814,381). The outcome was self-reported past-year DUIC. Independent variables included demographics, substance use, mental health, cannabis-related perceptions, and driving behaviors. These relationships were assessed by modified Poisson regression. RESULTS: The weighted prevalence of DUIC was 28.0%, representing approximately over three million young adults. DUIC prevalence increased with cannabis use frequency, from 2.51 times higher among those using cannabis 12-49 days (adjusted prevalence ratio [APR]: 2.51; 95% confidence interval [CI]: 2.29-2.75) to 3.63 times higher among those reporting use on 300-365 days (APR: 3.63; 95% CI: 3.60-3.76), compared with those using cannabis 1-11 days. Cannabis use disorder (APR: 2.34; 95% CI: 2.06-2.65), simultaneous alcohol and cannabis use (APR: 1.29; 95% CI: 1.28-1.30), and perceived easy cannabis availability (APR: 2.36; 95% CI: 2.33-2.39) were also associated with higher prevalence of DUIC. Nonenrollment in school and living in a state with a medical cannabis law were associated with lower DUIC prevalence. DISCUSSION: DUIC is highly prevalent among U.S. young adults who use cannabis, with a clear graded association across categories of cannabis use frequency. Public health interventions should address frequent use, cannabis use disorder, alcohol-cannabis co-use, and perceived cannabis availability.

Humans

Recommendations for the screening of military personnel over 35 years of age for physical training programs.

Persons over 35 years old have an increased prevalence of risk factors. Careful medical examinations, even in a fit military population, are needed before initiating intensive physical training regimens. Risk factor profiling, which synthesizes major risk factors into a composite score, is a beneficial procedure by which to evaluate individuals. Training programs should be based on several considerations: (1) the individual's age and physical condition; (2) his body composition; (3) his risk factor profile; (4) his preference and physical ability for activity; and (5) the available facilities and climatic conditions. Exercise should enhance work capacity and serve as a preventive measure for coronary heart disease. The most efficient types of exercise to meet these ends are activities that involve the large muscles in continuous activity for 20 to 30 min daily, including warm-up and cool-down periods.

Adult

Latent thyroid carcinoma at autopsy: a study from Oporto, Portugal.

Thirty-nine (6.5%) latent thyroid carcinomas were found in 600 thyroid glands removed at autopsy in Oporto Medical School Laboratory of Pathology. The prevalence of latent thyroid carcinomas was significantly higher in women (sex ratio 4.3:1) and in elderly people (p less than 0.005) and appeared to be independent from the existence of another malignant neoplasm. The mean thyroid weight and the concurrent thyroid pathology of patients with thyroid carcinomas were not significantly different from those of patients without them. The study of cervical lymph nodes in the first 400 autopsies did not show any significant difference concerning histologic pattern, number of germinal centers and sinus histiocytosis between patients with thyroid carcinomas and those without them. Further investigation is required to evaluate the role of host factors on the peculiar characteristics of latent thyroid carcinomas.

Adolescent