Number Of Medical Consultations Research Articles

Number of bodily symptoms predicts outcome more accurately than health anxiety in patients attending neurology, cardiology, and gastroenterology clinics

Background In consecutive new outpatients, we aimed to assess whether somatization and health anxiety predicted health care use and quality of life 6 months later in all patients or in those without demonstrable abnormalities. Method On the first clinic visit, participants completed the Illness Perception Questionnaire (IPQ), the Health Anxiety Questionnaire (HAQ), and the Hospital Anxiety and Depression Scale (HADS). Outcome was assessed as: (a) the number of medical consultations over the subsequent 6 months, extracted from medical records, and (b) Short-Form Health Survey 36 (SF36) physical component score 6 months after index clinic visit. Results A total of 295 patients were recruited (77% response rate), and medical consultation data were available for 275. The number of bodily symptoms was associated with both outcomes in linear fashion ( P<.001), and this was independent of anxiety and depression. Similar associations were found in people with or without symptoms due to demonstrable structural abnormalities. Health anxiety was associated only with health-related quality of life in patients with symptoms explained by demonstrable abnormalities. Conclusion The number of bodily symptoms and degree of health anxiety have different patterns of association with outcome, and these need to be considered in revising the diagnoses of somatization and hypochondriasis.

Can we predict the health of teenagers 2 years in advance?: A preliminary study

Objective : A two year follow-up study of a cohort of adolescents on 9 health parameters. Method : 325 adolescents were enrolled in April 1999. In addition to answering a general social-demographic questionnaire, they answered Wallston's Multidimensional Locus of Control scale (MHLC) and Olson's questionnaire on family dynamics (FACES III). 10 health indicators were recorded : two analogical visual assessments (VAS) (general coping and feelings of well-being), their concern for their health on a five level Likert scale., Zung's Depression Scale, and having had to repeat a school year as an indirect indicator of self esteem. Two years later, the sample (n = 86) were re-evaluated through the same questionnaires, and answered a supplementary questionnaire addressing (1) additional medication taken since their initial evaluation, (2) the number of medical consultations they have been through since the baseline, and/or (3) hospitalisations they underwent. They also answered a VAS about their level of concern over their body. Results : Numerous variables belonging to Wallston's MHLC scale as well as to Olson's FACES III questionnaire were found to correlate with health indicators two years later. It proved to also be the case for both several > values such as general coping and feelings of well-being, and being concerned with one's health, and with more > parameters such as subjects' scores on the Subjective Depression Feelings form, or their intake of additional medications. Conclusion : It appears that it is may possible to predict two years in advance at-risk adolescents for whom preventive medicine is particularly necessary.

Conséquences des accidents de la circulation chez les enfants : suivi pendant un an dans le département du Rhône

Children aged 6 to 11 who have been injured in a traffic accident were observed over a one year period, in parallel with a control group of children. More than one-third of the injured children had been hospitalized (for periods ranging anywhere between 1 and 47 days). One year later, one injured child out of ten was still suffering from pain, and/or still being treated for injuries resulting from the accident. Many other factors were linked to the initial overall level of severity of the injuries, contrary to that of pain, such as the rate and duration of hospitalization, the duration of care provided, the number of medical consultations, and absenteeism from school. Children who had been injured in a road traffic accident were found to be more anxious and nervous, in general, as well as having a high prevalence of sleeping disorders in comparison to the children in the control group.

Effects of Long‐term Consumption of a Fermented Infant Formula (with Bifidobacterium breve c50 and Streptococcus thermophilus 065) on Acute Diarrhea in Healthy Infants

ABSTRACTObjective:To determine whether long‐term consumption of a fermented infant formula could influence the incidence of acute diarrhea and its severity in healthy infants.Method:Nine hundred seventy‐one infants, ranging in age from 4 to 6 months, were included in a randomized, double‐blind, placebo‐controlled trial during a period of 5 months. They consumed daily either a fermented infant formula (FF) (fermentation with Bifidobacterium breve C50 and Streptococcus thermophilus 065) or a standard infant formula (SF) of the same nutritional composition.Evaluation Criteria:Number and duration of acute diarrhea episodes were evaluated. Severity of the episodes was determined by the number of hospital admissions, incidence of dehydration, number of medical consultations, number of oral rehydration solution prescriptions, and number of formula switches.Results:Growth of the infants and acceptability of the formulas were identical in the two groups. Incidence, duration of diarrhea episodes, and number of hospital admissions did not differ significantly between groups. Episodes were less severe in the FF (fermented formula) group. There were fewer cases of dehydration 2.5%versus 6.1% (P = 0.01), fewer medical consultations (46%v 56.6%, P = 0.003), fewer ORS prescriptions 41.9%v 51.9% (P = 0.003) and fewer switches to other formulas (59.5%v 74.9%, P = 0.0001) in FF infants compared to SF.Conclusion:A fermented formula may reduce the severity of acute diarrhea among healthy young infants. This outcome may be linked to the bifidogenic effects of fermentation products and their interactions with the intestinal immune system.

EFFECTS OF LONG-TERM CONSUMPTION OF A FERMENTED INFANT FORMULA ON ACUTE DIARRHOEA IN HEALTHY INFANTS

ST01 STARTERS AND FERMENTED DAIRY PRODUCTS: IMPACT ON THE IMMUNE SYSTEM OF THE INFANT AND THE CHILD Satellite Symposium organized by DANONE Objective: to determine whether long-term consumption of a fermented infant formula could influence the incidence of acute diarrhoea and its severity in healthy infants. Method: 971 infants aged from 4 to 6 months were included in a randomised double-blind placebo controlled trial over a period of 5 months. They consumed daily either a fermented infant formula (FF) (fermentation with Bifidobacterium breve C50 and Streptococcus thermophilus 065) or a standard infant formula (SF) of the same nutritional composition. Evaluation criteria: Number and duration of acute diarrhoea episodes (DE); severity of the episodes, evaluated by number of hospital admissions, incidence of dehydration, number of medical consultations, number of oral re-hydration solution (ORS) prescriptions and number of formula switches. Results: Growth of the infants and acceptability of the formulas were identical in the 2 groups. Incidence, duration of diarrhoea episodes and number of hospital admissions did not differ significantly between groups. However, episodes were less severe in FF (fermented formula) group, as there were fewer cases of dehydration 2.5% versus 6.1% (p = 0.01), fewer medical consultations (46% vs 56.6%, p = 0.003), fewer ORS prescriptions 41.9% vs 51.9% (p = 0.003) and fewer switches to other formulas (59.5% vs 74.9%, p = 0.0001). Conclusion: These results provide some evidence that a fermented formula could reduce the severity of acute diarrhoea among healthy young infants. This outcome, could be linked to the bifidogenic effects of fermentation products, and their interactions with the intestinal immune system.

The dependent patient in a psychiatric inpatient setting: relationship of interpersonal dependency to consultation and medication frequencies.

To examine the relationship between interpersonal dependency and medical service use in a hospital setting, the number of medical consultations and psychotropic medication prescriptions were compared in matched, mixed-sex samples of 40 dependent and 40 nondependent psychiatric inpatients. Results indicated that dependent patients received more medical consultations and a greater number of medications than did nondependent patients with similar demographic and diagnostic profiles. Implications of these results for theoretical models of interpersonal dependency and for previous research on the dependency-help-seeking relationship are discussed. Practical implications of these findings for work with dependent patients are summarized.

Analyzing Prior Clinical Events at Presentation in 102 Women With Vulvar Carcinoma: Evidence of Diagnostic Delays

To investigate the conditions leading to development of vulvar carcinoma, the authors prospectively studied 102 patients with squamous cell carcinoma of the vulva who were seen in the gynecologic oncology clinic at National Women’s Hospital in Auckland, New Zealand. They were all evaluated by a single investigator, who obtained a detailed patient history and reviewed all previous medical records. Two of the 102 women, both >90 years old, were unable to give a reliable history and were not included in the study. Of the remaining 100 patients, 43 had stage I disease, 27 had stage II, 22 had stage III, and none had stage IV carcinoma (classified according to International Federation of Gynaecological and Obstetrics criteria). Twenty women were <50 years old, 43 were between 50 and 75 years of age, and 43 were >73 years old. Eighty-eight percent of the women reported experiencing vulvar symptoms for at least 6 months; these symptoms had been present for >5 years in 28 percent of the patients. Almost all (94 percent) of the patients reported a history of intermittent or constant vulvar irritation. Abnormal skin adjacent to the tumor was seen in 85 percent of the women. Thirty-one women had sought medical treatment for their vulvar symptoms at least three times >6 months before the cancer was diagnosed. Twenty-seven had been treated with topical estrogen or corticosteroids, and 25 had previously undergone biopsy. The patients who had undergone biopsy were significantly more likely to present with stage I disease (17 of 27, 68 percent) than those who had never undergone biopsy (26 of 73, 33 percent) (P < .01). Patient age was not associated with the duration of symptoms, length of clinical history, or number of medical consultations before diagnosis. J Reprod Med 1999;44:766–768

Economic evaluation of influenza vaccination and economic modelling. Can results be pooled?

Scientific reviewing methods were applied to economic studies of influenza vaccination, and an economic model of influenza vaccination was developed from these primary sources. Issues arising from the secondary literature review include the quality of evidence on the effectiveness of the vaccines, the absence of a traditional population-based approach to reviewing economic data, confusion in terminology, and how to generalise from resource data contained in primary evaluations. Data from the literature review were summarised in terms of resource units used in the prevention and treatment of influenza. An economic model was constructed using local unit costs (from the Emilia region of Italy) and applying the data to a notional population. The model was sensitive to length of stay in hospital but not to variation in incidence of influenza, days off work or number of medical consultations. The model was predicated on and is sensitive to an estimate of 80% vaccine effectiveness. The approach is constrained by the available data, but could be more generally useful in that it allows variations in the quantity of inputs to be considered separately from variations in their values. The model may be used locally as a decision-making tool, although the method needs further development.

Characteristics of Women Reporting Cervical Screening

The characteristics of women reporting cervical cytology screening has been evaluated using data from control subjects collected in the framework of a case-control study on invasive cervical cancer conducted since 1981 in the greater Milan area. A total of 515 women admitted for nonneoplastic, nongynecologic, nonendocrine-related acute conditions to a network of general and university hospitals were interviewed. The frequency of cervical screening utilization decreased with age: regular screening (greater than or equal to 3 lifetime Pap smears) was reported by 46% of women aged 44 years or less, but only 11% of those aged 65 or more. Married women reported about 50% more frequently occasional (1 or 2) and about three times regular (greater than or equal to 3) cervical screening than unmarried ones. Parous women were more frequently screened, but no trend emerged with number of births. Similarly number of medical consultations in the year before the interview was associated with an increased number of Pap smears. There was no consistent association between number or recency of Pap smears and smoking, sexual habits or education, but women in low social classes tended to be less frequently screened. Ever contraceptive users (oral contraceptives or barrier methods) reported an increased probability to be screened regularly and within two years before the interview.

The measurement of cultural distance and its relationship to medical consultations, symptomatology and examination performance of overseas students at Edinburgh University

The paper describes the development of an instrument to measure the distance between two cultures based on their social and physical attributes. The instrument was used to investigate the possible associations between cultural distance and medical consultations, symptoms and examination performance in a sample of overseas students at Edinburgh University. Anxiety during the Easter term and the number of medical consultations during the year were significantly related to cultural distance, but no relationship was found between the latter and examination performance. It is concluded that cultural distance per se is no handicap to overseas students. The use of the instrument and implications for transcultural research are discussed.

Sports accidents: 1963-1973 statistics

Every year, the Swiss Accident Insurance Administration is paying a considerable amount of money for sports accidents. From 1963 to 1973 the number of these accidents has increased more markedly than other types of accidents. Different tendencies can be observed in the different types of sports: skiing accidents have, after a long period of retrogression until 1973, shown a noticeable augmentation again. Football accidents and accidents in other types of sports have on the other hand increased year by year. Mountaineering and aquatic sports often result in fatal accidents. The numerous preventive measures in skiing accidents have obviously been successful. Not only the fractures have decreased, but also the average number of days where sickness benefit was paid. Next to the traffic accidents, the skiing accidents are the most expensive ones. The nature of the healing cost in sports accidents has changed during the period from 1967 to 1972, depending on the different types of sports. In particular, hospital costs have changed considerably. The number of medical consultations per accident has decreased. Payment of sickness benefit has followed the development of the salaries on the one hand and the modifications of the number of lost days on the other. Finally, the costs of the annuities show more or less the same tendency as the ones for sickness benefit. A very gross estimation on the economical losses through sports accidents in Switzerland makes us believe that the direct and indirect costs actually amount to more than one thousand millions of Swiss Francs per year.