Relationship between shunt-dependent hydrocephalus after subarachnoid haemorrhage and duration of cerebrospinal fluid drainage.

Subarachnoid haemorrhage (SAH) patients in Fisher group 3 have a high risk of vasospasm and chronic hydrocephalus. We have provided cisternal irrigation combined with a head-shaking method for preventing vasospasm in SAH patients. We investigated 76 SAH patients in Fisher group 3 who received cisternal irrigation with head-shaking to evaluate the relationship between the occurrence of hydrocephalus and various clinical factors, including duration of cerebrospinal fluid (CSF) drainage.

Psychosomatic status affects the relationship between subjective hearing difficulties and the results of audiometry.

Objective: Subjective hearing difficulties are often used as a surrogate to audiometry in health check-up, although its effectiveness has not been tested in healthy workers. We conducted a study to test the usefulness of self-reported hearing difficulties for screening hearing impairment among healthy workers by comparing the results with those of audiometry.

Study Design And Setting: This was a cross-sectional observational study.

Primary care practice and facility quality orientation: influence on breast and cervical cancer screening rates.

Background: Despite the importance of early cancer detection, variation in screening rates among physicians is high. Insights into factors influencing variation can guide efforts to decrease variation and increase screening rates.

Objectives: To explore the association of primary care practice features and a facility's quality orientation with breast and cervical cancer screening rates.

Blood pressure management in acute intracerebral hemorrhage: relationship between elevated blood pressure and hematoma enlargement.

Background And Purpose: The association between elevated blood pressure (BP) and hematoma enlargement in acute intracerebral hemorrhage (ICH) has not been clarified. We investigated the association between maximum systolic BP (SBP) and hematoma enlargement, measuring SBP between a baseline and a second CT scan in patients with hypertensive ICH.

Methods: We assessed 76 consecutive patients with hypertensive ICH retrospectively.

Effects of working and residential location areas on air pollution related respiratory symptoms in policemen and their wives in Bangkok, Thailand.

Factors, including air pollution, influencing the prevalence of respiratory symptoms were investigated in a cross-sectional study in policemen and their wives (530 couples) in Bangkok. Information on respiratory symptoms was obtained using the American Thoracic Society Division of Lung Diseases (ATS-DLD) questionnaire. Effects of working and residential locations were evaluated using a multiple logistic model adjusted for several potential confounding factors.

Lipid screening in HIV-infected veterans.

Background: Lipid screening is recommended for patients taking protease inhibitors (PIs).

Methods: We examined data from the Veterans Administration Immunology Case Registry to assess lipid screening among HIV-infected veterans who received PIs for at least 6 consecutive months during 1999 and 2001. We estimated crude and adjusted associations between lipid screening and patient characteristics (age, gender, HIV exposure, and race/ethnicity), comorbidities (AIDS, cardiovascular disease, diabetes, hypertension, smoking, and hyperlipidemia), and facility characteristics (urban location, case management, guidelines, and quality improvement programs).

Smoking cessation care received by veterans with chronic obstructive pulmonary disease.

Smoking is the main cause of chronic obstructive pulmonary disease (COPD), and smoking cessation is the only effective intervention to slow its progression. We examined whether smokers with COPD received more cessation services than smokers without COPD. Current smokers from 18 Veterans Health Administration primary care clinics completed baseline and 12 month follow-up surveys (baseline n = 1,941; 12 month n = 1,080), composed of validated questions on smoking habits, history, and attitudes; health/functional status; and sociodemographics.

Particulate air pollution and chronic respiratory symptoms among traffic policemen in Bangkok.

In this cross-sectional study, the authors examined the relationship between traffic-based air pollution and chronic, nonspecific respiratory symptoms among traffic policemen in Bangkok, Thailand. A total of 1,603 policemen who lived and worked in areas that had 3 different levels of airborne particulates were evaluated. The authors used a modified standardized questionnaire to identify nonspecific respiratory disease (NSRD) in participants.

Adverse environmental health effects of ultra-low relative humidity indoor air.

In Japan, relative humidity (RH) shows the lowest achievement rate among the various general air quality standards for work environment. It has been mainly contributed by airtight design of modern buildings and occurrence of dry outdoor air in winter. Furthermore, an ultra-dry air environment of nearly 0% RH is often required in sophisticated industries.

Oral health of patients with Parkinson's disease: factors related to their better dental status.

Contrary to intuitive preconceptions, patients with Parkinson's disease (PD) have been reported to have less carious teeth. The present study was undertaken to seek responsible factors for this unexpected finding. The PD patients consisted of 31 consecutive university hospital outpatients who were 60 years old or over, and the controls of 104 comparable outpatients at a dental clinic.

[The short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8): its reliability and validity].

The Zarit Burden Interview (ZBI) is the instrument most widely used in North America and Europe for assessing the burden experienced by family caregivers who look after the community-residing impaired elderly. The Japanese version of the ZBI (J-ZBI) is the most widely used in Japan for the same purpose. We used data from 691 caregivers in relation to their caregiver burden with the 22-item J-ZBI.

Reporting of somatic symptoms as a screening marker for detecting major depression in a population of Japanese white-collar workers.

Objective: The objective of this study was to assess screening practices for detecting major depression in workers complaining of somatic symptoms.

Methods: A total of 1443 Japanese white-collar workers (991 men and 452 women, mean age 34 years) completed a medical symptom checklist (major 12 somatic symptoms) and were diagnosed using the structured clinical interviews of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).

Results: There were 42 cases (2.

The organization and delivery of women's health care in Department of Veterans Affairs Medical Center.

Congressional eligibility reforms have profoundly changed the array of services to be made available to women veterans in Department of Veterans Affairs (VA) health care facilities. These include access not only to primary and specialty care services already afforded VA users, but also to a full spectrum of gender-specific services, including prenatal, obstetric, and infertility services never before provided in VA settings. The implications of this legislative mandate for delivering care to women veterans are poorly understood, as little or no information has been available about how care for women veterans is organized.

Availability of comprehensive women's health care through Department of Veterans Affairs Medical Center.

Despite increased numbers of women veterans, little is known about health services delivery to women across the Department of Veterans Affairs (VA). To assess VA availability of women's health services, we surveyed the senior clinician at each VA site serving 400 or more women veterans. We found that virtually all sites have developed arrangements, either directly or through off-site contracts, to ensure availability of comprehensive women's health care.

Reactive oxygen metabolite production induced by asbestos and glass fibers: effect of fiber milling.

Particle stimulated chemiluminescence (CL) production by human polymorphonuclear leucocytes (PMN) has been utilized to evaluate the pathogenicity of mineral and glass fibers with the understanding that reactive oxygen metabolites (ROM) production as measured by CL is etiopathogenically related to fiber toxicity. In the present study to investigate the specific pathogenic role of fiber number and dimensions, CL production from PMN exposed to anthophyllite asbestos mineral and glass fiber samples milled for different time periods was measured. Almost all the fibrous particles in the glass fiber sample were destroyed after milling for 30 minutes.

Blood pressure-lowering effects of biofeedback treatment in hypertension: a meta-analysis of randomized controlled trials.

To examine the blood pressure-lowering effects of biofeedback treatment in patients with essential hypertension, a meta-analysis was conducted on studies published between 1966 and 2001. A total of 22 randomized controlled studies with 905 essential hypertensive patients were selected for review. Compared with clinical visits or self-monitoring of blood pressure (non-intervention controls), biofeedback intervention resulted in systolic and diastolic blood pressure reductions that were greater by 7.

Ultraviolet B exposure and type of lens opacity in ophthalmic patients in Japan.

Over the course of an individual's lifetime, lens fiber cells proliferate and differentiate to form various parts of the lens. The specific pathogenic effects of ultraviolet B radiation (UVB), one of the major causes of cataracts, may differ depending upon the particular part of the lens. In this study, the association of UVB exposure with specific types of lens opacity was investigated in relation to lifetime cumulative exposure, and was confirmed by subjects' ages at exposure.

Roadside particulate air pollution in Bangkok.

Airborne fine particles of PM(2.5-10) and PM2.5 in Bangkok, Nonthaburi, and Ayutthaya were measured from December 22, 1998, to March 26, 1999, and from November 30, 1999, to December 2, 1999.

What patient population does visit-based sampling in primary care settings represent?

Background: Evaluations of outpatient interventions often rely on consecutive sampling of clinic visitors, and assume that study results generalize to the population of patients cared for.

Objective: The representativeness of such visit-based sampling compared with the population of patients seen during the same year, in terms of sociodemographic and clinical characteristics of the user groups that visit-based sampling yielded were assessed.

Methods: One thousand five hundred forty-six continuing patients visiting the primary care firms in an urban VA medical center were consecutively sampled, and visit frequencies were compared for these patients with subsets of the patient population.

Use of home health services covered by new public long-term care insurance in Japan: impact of the presence and kinship of family caregivers.

Objective: In April 2000, the system for caring for the elderly in Japan was changed drastically with the launch of new long-term care insurance. Unlike the previous system, the maximum monthly amount of insured services is now decided solely by an applicant's physical condition, regardless of family support. We investigated whether the presence and kinship of a family caregiver still affect service use under the new system.

Primary care practice management in rural and urban Veterans Health Administration settings.

Limited access to specialty care in rural settings may result in more expectations of primary care providers and a higher demand for primary care. The authors used survey and administrative data from 1999 from the Veterans Health Administration (VHA) to compare primary care practice management and performance in 19 rural to 103 urban VHA hospitals nationally. Rural VHA hospitals were smaller, less likely to be academically affiliated, and had fewer integrated specialty care services.

Use of general medical services by VA patients with psychiatric disorders.

Objective: Patients with psychiatric disorders, particularly those with severe mental illnesses, have high rates of undetected and untreated medical problems and substantially elevated mortality rates due to medical illness. The authors sought to develop a better understanding of the demographic, medical, and psychiatric characteristics of this population to inform efforts to improve the medical care of these persons.

Methods: Using Department of Veterans Affairs (VA) databases, the authors examined use of medical services by 175,653 patients who were treated in Southern California and Nevada during fiscal year 2000.

Chemiluminescent detection of induced reactive oxygen metabolite production of human polymorphonuclear leucocytes by anthophyllite asbestos.

Incidences of lung cancer and pleural plaque have been reported in relation to exposure to anthophyllite asbestos. To investigate the pathogenic mechanisms of anthophyllite, chemiluminescence (CL) detection of reactive oxygen metabolite (ROM) generation of human polymorphonuclear leucocytes (PMN) stimulated by anthophyllite asbestos was determined and compared with that of other asbestos and mineral fiber samples. When anthophyllite fiber sample was mixed with the luminol-primed PMN, high levels of CL which exhibited a specific time course characterized by two separate peaks were induced.

Individual income, income distribution, and self rated health in Japan: cross sectional analysis of nationally representative sample.

Objective: To assess the effects on self rated health of individual income and income distribution in Japan.

Design: Cross sectional analysis. Data collected on household income, self rated health, and other sociodemographic characteristics at the individual level from comprehensive survey of the living conditions of people on health and welfare in a nationally representative sample from each prefecture.

Respiratory symptoms and pulmonary function among traffic police in Bangkok, Thailand.

The authors undertook a cross-sectional study of the potential adverse health effects of air pollution in Bangkok, Thailand. During 1998 and 1999, the authors administered lung function spirometry tests and a Thai version of the American Thoracic Society's Division of Lung Diseases (ATS-DLD) respiratory questionnaire to 78 male traffic police and 60 male nontraffic police in Bangkok, as well as to 68 male general police in Ayutthaya province, a rural area in Thailand. No consistent trend of decreased pulmonary function was observed in traffic police.