Adolescents' knowledge of medical terminology and family health history.

Compared 309 youths (aged 10.4–15.7 yrs) and their parents with respect to comprehension of terms for 7 common medical disorders: heart attack, stroke, atherosclerosis, ulcer, hypertension, diabetes, and cancer. For two-thirds of the adolescents, accuracy of reporting of these disorders among the parents and grandparents was assessed. Results indicate considerable variation among disorders with respect to both comprehension of terms and accuracy of family health history. Adolescents' age was a major predictor of knowledge of medical terms. Age was not related to accuracy of family health information. Adolescents' level of accuracy regarding family health history was generally similar to that of previous adult samples, suggesting that family health information is acquired and retained at an early age. Adolescents were more accurate concerning parents' compared with grandparents' history of hypertension. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Type A behavior, family history of hypertension, and cardiovascular responsivity among Black women.

Determined the effects of Type A (coronary-prone) behavior and family history of hypertension on cardiovascular reactivity to mental stress in 50 26–63 yr old employed Black women. Results indicated that Type A behavior was associated with systolic and diastolic blood pressure hyperresponsivity during a structured interview (SI) but not during mental arithmetic. Certain speech components of the Type A pattern, as well as features of the potential-for-hostility component, were also related to cardiovascular responses during the SI. Family history of hypertension did not influence the cardiovascular parameters. Results suggest that many of the cardiovascular response characteristics of the Type A pattern that have been observed in predominately White samples also hold true for Blacks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biobehavioral research on cardiovascular disorders.

Discusses several major research issues, needs, and opportunities related to the role of behavior in cardiovascular disorders. Cardiovascular disorders, especially coronary heart disease and essential hypertension, have been among the most well-developed topics in health psychology. There are many physiological, environmental, sociocultural, and behavioral variables that interact in etiology, prevention, and treatment of these disorders. The standard risk factors for coronary disease are all variables with significant behavioral components. A broadened search for mechanisms and influences contributing to heart disorders has led to an examination of psychosocial risk factors. Research issues that are currently under study or that in need of further attention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between prophylactic effect of lithium therapy and family history of affective disorders

Lithium therapy response and age of onset (AOO) were studied in 98 patients with bipolar affective disorder (BPAD) who were divided into subgroups depending on type of family history of affective disorders. The highest (33.0 years) and lowest (25.5 years) age of onset were found in nonfamilial patients and in familial patients with a first-degree relative of BPAD, respectively. Nonfamilial patients showed the best response to lithium. There were 0.9 episodes/year off lithium compared to 0.3 episodes/year on lithium (an 88% decrease). A poorer response (a 71% decrease; a reduction from 1.39 episodes per year off lithium to 0.65 on lithium) was found in familial patients with a first-degree relative of BPAD. Differences in serum lithium values between the groups could not explain the observed differences. Thus, familial patients showed a more severe manifestation of the disease with an earlier AOO and a lower prophylactic effect of lithium.     

Dependence of marital problems on parental family history.

Examined the relation of marital complaints to family history in 1,624 psychiatric outpatients. Marital complaints were recognized to be an aspect of a broader "depressive spectrum disorder" with distinctive age, gender, alcohol, and neurotic depressive symptom characteristics. However, holding constant the depressive spectrum characteristics, a specific independent relation of marital complaints to family history of parental marital discord was verified. It is concluded that marital problems have 2 primary etiologies in the psychiatric population, one as part of a broader depressive spectrum disorder and the other a more specific familial behavior patterning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic family history assessment

The purpose of this article is to familiarize nurses with why, how, when, and where a genetic family history assessment should be used in clinical practice. Pedigrees are diagrams that display the relationship among family members by using a combination of symbols and lines. They are used to record concisely a complete family history to identify the risk of transmitting inherited condition, to identify people at risk for development of adult-onset conditions, to aid in clinical diagnosis, and to serve as a reference for social and biologic relationships. A detailed explanation of the standardized pedigree nomenclature that was recommended by the Pedigree Standardization Task Force in 1995 is included. Step-by-step guidelines on taking a genetic family history and drawing pedigrees are provided. A case study is also included to illustrate pedigree construction.     

Accuracy of confidence ratings associated with general knowledge and eyewitness memory.

The confidence–accuracy (C–A) relation for general knowledge (GK) and eyewitness memory (EM) was compared in both within- and between-Ss analyses. Researchers in the cognitive tradition tend to use within-Ss designs and to find moderately positive C–A relations, whereas those in the forensic tradition tend to use between-Ss designs and to find no relations. 80 Ss took part in 1 of 2 conditions, EM or GK. No difference between conditions was found on the within-Ss measure of the C–A relation, but there was differentiation with a between-Ss measure. There was a strong positive C–A correlation (r?=?.58, p?r?=?–.11, ns). One source of this difference may be the differing opportunities for calibration offered by the 2 kinds of memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety and depressive disorders in cardiovascular diseases

Cardiovascular diseases are often associated with anxiety and depression. The literature gives different interpretations of this comorbidity. Psychopathological factors have been successively studied as risk factors, comorbid disorders and factors influencing the prognostic. The authors describe the incidence and the prevalence of anxiety and depression, first in coronary heart disease and secondly before cardiac surgery. The prognostic significance of these psychological factors is also reviewed. Physiopathological hypothesis and practical application in clinical practice are proposed.     

Trandolapril. An update of its pharmacology and therapeutic use in cardiovascular disorders

Trandolapril is an orally administered angiotensin converting enzyme (ACE) inhibitor that has been used in the treatment of patients with hypertension and congestive heart failure (CHF), and after myocardial infarction (MI). Trandolapril is a nonsulfhydryl prodrug that is hydrolysed to the active diacid trandolaprilat. Trandolapril 2 mg once daily provides effective control of blood pressure (BP) over 24 hours in patients with mild to moderate hypertension, with a trough/peak ratio of BP reduction (as determined by 24-hour ambulatory monitoring) consistently > or = 50%. Trandolapril has similar antihypertensive efficacy to enalapril as indicated by several clinical trials. Combined therapy with trandolapril and sustained-release verapamil has a significantly greater antihypertensive effect than either agent alone. Only limited data are available on the use of trandolapril in patients with CHF, although ACE inhibitors as a class are recommended as first line therapy in such patients. In the Trandolapril Cardiac Evaluation (TRACE) study, trandolapril 1 to 4 mg once daily resulted in an early and long term reduction in all-cause mortality, including cardiovascular mortality, in patients with left ventricular (LV) dysfunction after an MI. Trandolapril therapy was commenced a mean 4.5 days after acute MI and continued for 24 to 50 months. At study end, the relative risk of death from any cause with trandolapril versus placebo was 0.78 (p = 0.001). The tolerability profile of trandolapril is similar to that of other ACE inhibitors. Most adverse events are mild and transient in nature, and include cough, asthenia, dizziness, headache and nausea. Trandolapril has no adverse effect on lipid or carbohydrate metabolism. Conclusions: trandolapril has a favourable pharmacological profile and an antihypertensive efficacy at least comparable to that of other ACE inhibitors. The pharmacological characteristics of trandolapril allow it to provide good 24-hour control of BP with once-daily administration. Trandolapril has also demonstrated some efficacy in a small number of patients with CHF. In addition, trandolapril provides long term protection against all-cause mortality in patients with LV dysfunction after MI. The results of the Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) study will determine its potential as a cardioprotective agent in patients with coronary artery disease and preserved LV function. Thus, trandolapril represents an effective, well-tolerated and convenient treatment option for patients with mild to moderate hypertension or LV systolic dysfunction after MI.     

A review of instruments for assessing family history

The influence of family history on one's development has long been a focus of psychological theory, research, and practice. In recent years, however, conceptualizations of family influences on development have evolved considerably, and there has also been increased concern about the reliability of individuals' memory for their childhoods in general. Current knowledge regarding these and other issues are applied to reviewing the instruments that have been developed to assess aspects of family history. The complexity of this type of assessment is emphasized, and a variety of problems with the reliability and validity of the currently available instruments are discussed. Suggestions for future research are also offered.     

Incorporation of family history in logistic regression models

For diseases with a genetic component, logistic regression models are presented that incorporate family history in a quantitative way. In the largest model, every type of relative has their own regression coefficient. The other two models are submodels, which incorporate family history either by the number of cases in the family minus its expectation or by a weighted number of cases in the family minus its expectation. For various genetic effects, namely polygenic and autosomal dominant effects, the performance of these simple logistic models is studied. First, the predictive values of the logistic and true genetic models are computed and compared. Secondly, a simulation study is carried out to investigate the effects of estimation of the parameters in a small data set. Thirdly, the logistic models are fitted to a data set of Von Willebrand Factor responses of target individuals and their families; in these models, family history has a significant effect. The conclusion is that for the genetic effects considered the logistic models perform well.     

Self-awareness theory, family history of alcoholism, and adolescent alcohol involvement.

A recent psychological theory (Hull, 1981) suggests that alcohol use may be motivated by a desire to avoid painful states of self-awareness. Highly self-aware individuals who are receiving failure feedback are hypothesized to use alcohol to reduce their awareness of negative self-relevant information. However, data in support of this theory are derived largely from laboratory studies of adult populations. Two studies were conducted to evaluate the theory in predicting adolescent drinking behavior in the natural environment. The studies also examined the ability of the model to account for phenomena of clinical importance, namely, indicators of adolescent problem drinking and drinking among high-risk adolescents (offspring of problem drinkers). Results showed that adolescent drinking was predictable as a function of demographic variables, self-awareness, failure feedback, and a family history of alcohol abuse. However, the predictions of self-awareness theory were not supported. The results are interpreted with regard to describing boundary conditions within which self-awareness theory is useful in explaining alcohol consumption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Carvedilol. A reappraisal of its pharmacological properties and therapeutic use in cardiovascular disorders

Carvedilol competitively blocks beta 1, beta 2 and alpha 1 receptors. The drug lacks sympathomimetic activity and has vasodilating properties that are exerted primarily through alpha 1-blockade. Animal models indicate that carvedilol confers protection against myocardial necrosis, arrhythmia and cell damage caused by oxidising free radicals, and the drug has no adverse effects on plasma lipid profiles. Recent data have confirmed the antihypertensive efficacy of carvedilol in patients with mild to moderate essential hypertension. Carvedilol has similar efficacy to other beta-blocking agents, calcium antagonists, ACE inhibitors and hydrochlorothiazide. Carvedilol also improves exercise tolerance and ischaemic symptoms in patients with stable angina pectoris. Significant reductions in serious cardiac events after acute myocardial infarction and in frequency and severity of ischaemic events in patients with unstable angina have also been demonstrated. Interest in the use of carvedilol in patients with congestive heart failure (CHF) has culminated in the publication of a cumulative analysis of data from 1094 patients with mild to severe CHF who participated in the US Carvedilol Heart Failure Study Program (4 trials). After a median follow-up of 6.5 months, a significant overall reduction in mortality relative to placebo (3.2 vs 7.8%) was revealed in patients who had received carvedilol 6.25 to 50 mg twice daily (plus diuretics and ACE inhibitors). All-cause mortality, risk of hospitalisation for cardiovascular reasons and hospitalisation costs were also reduced significantly (by 65, 28% and 62%, respectively) in these trials. In addition, the Australia and New Zealand Heart Failure Research Collaborative Group showed a 26% reduction in the combined risk of death or hospitalisation with carvedilol 12.5 to 50 mg/day relative to placebo after a mean 19-month follow-up period in 415 patients with CHF (relative risk 0.74). Adverse events with carvedilol appear to be less frequent than with other beta-blocking agents, are dosage-related and are usually seen early in therapy. Events most commonly reported are related to the vasodilating (postural hypotension, dizziness and headaches) and the beta-blocking (dyspnoea, bronchospasm, bradycardia, malaise and asthenia) properties of the drug. Carvedilol appears to date to have little effect on the incidence of worsening heart failure. Concomitant administration of carvedilol with some medications requires monitoring. Carvedilol is therefore likely to have a beneficial role in the management of controlled CHF, but further clinical studies are required to show the place of beta-adrenoceptor blocking therapy in general in this indication, and the position of carvedilol relative to other similar agents. Carvedilol is also confirmed as effective in the management of mild to moderate hypertension and ischaemic heart disease.     

Natural history and treatment outcomes of childhood hip disorders

Normal hip joint growth and development occur as a result of a genetically determined balance of growth of the acetabular and triradiate cartilages and the presence of a well located centered spheric femoral head. The majority of acetabular development is determined by age 8 years. This is a watershed age for prognosis in many pediatric hip disorders. Hip joint growth and development and how these are affected by the disease process and treatment interventions profoundly affect outcome. Outcomes of these disease processes (congenital hip dislocation and dysplasia, Legg-Calvé-Perthes disease and slipped capital femoral epiphysis), is multifactorial but profoundly influenced by the age at the disease onset (birth to the adolescent growth spurt), and the effects of treatment on the relationship between femoral head and acetabular development. The natural history of many of these childhood hip disorders is the development of degenerative joint disease. Degenerative joint disease and clinical disability may develop in these conditions despite standard up to date treatment interventions. In most of the hip diseases discussed, patients usually do well clinically for many years regardless of treatment.     

Can we rely on the family history?

Ginseng saponins and their degradation products have been screened for antagonist activity towards [3H]PAF (platelet activating factor) in washed rabbit platelet receptor binding studies. 20(S)- and delta20-ginsenosides Rg3, protopanaxadiol-type saponins, were found to be relatively potent PAF antagonists (IC50 = 4.9 x 10(-5) M and 9.2 x 10(-5) M, respectively).     

Psychiatric family history in adolescents with severe asthma

OBJECTIVE: To examine the hypothesis that an association exists between severe asthma and familial affective and anxiety disorders. METHOD: A parent, usually the mother, of 62 adolescents admitted to a tertiary care asthma center was administered the Family History-Research Diagnostic Criteria Interview. Lifetime prevalence rates of psychiatric disorders in first-degree relatives were compared with previously reported rates. RESULTS: In relatives of asthmatic adolescents, rates for depression, mania (females only), substance abuse (males only), and antisocial personality disorder were significantly higher than the rates in the non-ill comparison sample. Rates for substance abuse (males only) and antisocial personality disorder were higher than the rates for relatives of the depressed comparison sample. Rates for anxiety disorders were not higher than rates in epidemiological samples. Rates of attention-deficit hyperactivity disorder (females only) and posttraumatic stress disorder in relatives were higher than in community samples. CONCLUSIONS: These results support the presence of a link between severe asthma and familial affective disorders, posttraumatic stress disorder, antisocial personality disorder, and substance abuse. Whether these disorders are genetically associated with asthma or represent an association with severe asthma because of environmental effects on the growing child is discussed.