Understanding the association between socioeconomic status and physical health: Do negative emotions play a role?

In this article, the authors evaluate the possible roles of negative emotions and cognitions in the association between socioeconomic status (SES) and physical health, focusing on the outcomes of cardiovascular diseases and all-cause mortality. After reviewing the limited direct evidence, the authors examine indirect evidence showing that (a) SES relates to the targeted health outcomes, (b) SES relates to negative emotions and cognitions, and (c) negative emotions and cognitions relate to the targeted health outcomes. The authors present a general framework for understanding the roles of cognitive-emotional factors, suggesting that low-SES environments are stressful and reduce individuals' reserve capacity to manage stress, thereby increasing vulnerability to negative emotions and cognitions. The article concludes with suggestions for future research to better evaluate the proposed model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inflammatory bowel disease: importance of nutrition today

BACKGROUND: Respiratory infections are the most frequent reason for primary health care consultation. Although generally not severe, they are responsible for a large number of days of laboral and scholar absenteeism and an excessive use of antibiotics. METHODS: The clinical and epidemiologic data of extrahospitalary infections in primary health care centers throughout Spain were collected according to the one day cut off system repeated trimestrally over one year. RESULTS: Data of 3,732 days of consultation were collected in which a total of 144,608 patients were attended. Of these, 20,614 had respiratory infections and 11,684 extrarespiratory infections. The most frequent processes were pharyngitis (33.7%), common cold (31.7%) followed by bronchitis (18.7%), otitis (11%), influenza (4.6%), laryngitis (4%), sinusitis (3.6%) and pneumonia (1.8%). Antibiotic treatment was prescribed in 13,488 patients (65%). The type of antibiotic was analyzed in the 11,977 patients treated for only one infection. Penicillins were the antibiotics most used followed by cephalosporins. The antibiotic prescribed was considered adequate in 70% of the 8,484 patients treated for potentially bacterial infection. A total of 3,493 patients had infection considered to be of viral etiology. CONCLUSIONS: Twenty-two percent of the patients attending a primary health care center presented infection and of these two out of three cases had respiratory infection. Pharyngitis and common cold were the most frequent processes observed. Two thirds of the patients consulting for respiratory infection received antibiotic treatment, with 29.2% being diagnosed with infections considered to be of viral etiology. The empiric treatment chosen for the two thirds of the potentially bacterial infections was considered as adequate.     

Leisure-time physical activity and marital status in relation to depression between men and women: A prospective study.

Background: Previous studies have identified the preventive effect of leisure-time physical activity (LTPA) on depression. Women and men have different emotional vulnerabilities. The impact of LTPA on depression varies by gender. Little is known about the impact of LTPA on depression for people with different marital status. Objectives: The objective of this study was to assess the long-term effects of LTPA, changes in LTPA, and marital status on the risk of developing depression for general Canadians. Methods: Data from the biennial National Population Health Survey (NPHS) cycles conducted between 1994/95 and 2004/05 were analyzed in 2008. After excluding individuals with preexisting depression at baseline, respondents were classified as physically active or inactive and then followed up in subsequent cycles of the NPHS to look at risk of developing depression. Individuals who changed their activity level were also examined. Subgroup analyses by different marital status were performed to identify high-risk populations. Results: In 1994/1995, 17,276 participants were included in the NPHS longitudinal panel. Respondents who were inactive were more likely to be older, female, obese, widowed/separated/divorced, not working, low income, and lacking social support. After controlling for potential confounding factors, it was found that LTPA reduced the risk of developing depression for women. The modest risk reduction observed for men was not statistically significant. Women who were active at baseline and two years of follow-up were significantly less likely to report depression at four years of follow-up compared to women who were inactive at baseline and at two years of follow-up. A 51% greater probability of developing depression was observed after two years for women who changed their LTPA from active to inactive compared to women who remained active. No significant results were found for men. Divorced/separated/widowed women who stopped LTPA had 4.2 times the risk of developing depression after two years compared to those who remained active. The risk of developing depression after stopping activity did not vary according to marital status among men. Conclusions: LTPA has preventive effects on depression for women. Reduction in LTPA level is associated with subsequent depression for women. Divorced/separated/widowed women are at particularly high risk of developing depression if LTPA is stopped. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Inflammatory bowel disease. 1. Origins, presentation, and course

The exact source of interference with the normal protective immune response in patients with inflammatory bowel disease remains unclear. Infectious causes have been proposed, and the increased incidence among family members indicates genetic predisposition. No matter what the pathogenesis may be, the disease is chronic, recurrent, and destructive in many cases. Conventional therapy with 5-ASAs, corticosteroids, immunomodulating agents, methotrexate, and antibiotics often offers relief. However, adverse effects accompany long-term use of many of these agents, so follow-up is important. Much investigation of alternative methods is under way, and anecdotal as well as published experience suggests benefits in at least some patients. Because of the chronic nature of their condition, patients with inflammatory bowel disease often become quite sophisticated in their understanding of treatment methods. Therefore, they should be told of updates regarding new options for disease control. We recommend that patients be seen periodically by a gastroenterologist who has expertise in inflammatory bowel disease, even when the disease is quiescent. Our experience in observing these patients over time strongly supports use of some of the agents discussed in this article for prophylaxis against flares and chronic inflammation.     

The association between major depression and headache: results of a longitudinal epidemiologic study in youth

Retrospective epidemiologic research in adults suggests that a long-term association between major depression and headache arises during childhood or adolescence. This study uses data from a prospective epidemiologic study to examine the association between major depression and headache from late childhood into early adulthood. An epidemiologically selected sample of 776 youth, aged 9-18, was assessed psychiatrically in 1983 using DISC interviews with both youth and parent informants. Reassessments were conducted in 1985-1986 and 1992. Current and past histories of functionally impairing migraine or chronic headache were elicited in both 1985-1986 and 1992. Regression analyses examined the relationships between major depression and headache status. The prevalence of current functionally impairing headache was approximately 10% in both 1985-1986 and 1992. There were lifetime and cross-sectional associations between headache and major depression. Headache was approximately twice as common in depressed adolescents compared with nondepressed adolescents. Major depression in adolescents, without current or past headache, prospectively predicted the new onset of headaches in young adulthood. Among adolescents who had no history of chronic impairing headache in 1985-1986, those with current major depression faced a nearly tenfold increased risk of developing such headaches at some time during the next 7 years. Consistent with findings of retrospective studies among adults, a longitudinal/ developmental relationship between major depression and functionally impairing headache was found in this prospective epidemiologic study of youth. These findings suggest that (1) neurochemical and pharmacologic commonalities between depression and headache should receive further investigation and that (2) it may be clinically useful to inquire about family history of headache syndromes in adolescents with major depression because such questioning may provide insight about the risk of subsequent functionally impairing headache in a depressed adolescent.     

Covert fears, anxiety and depression in congenital heart disease

Our experience from attempts to identify bacteria isolated from boar bite/gore wounds is the background for a discussion of identification problems. Some organisms, although not very common or well-known, can be identified when using commercial kits or conventional methods, provided they are sufficiently characterized, as exemplified by Pasteurella aerogenes isolated from cases 1 and 2. Some organisms may be wrongly identified, or not identified, by both commercial kits and conventional methods, unless seen by experienced microbiologists with knowledge of the original literature. This is exemplified by case 3, in which the final identification result was Bisgaard's taxon 15. Sometimes isolates cannot be identified even in reference laboratories and by using available identification tables and databases. In such cases, the organism involved may turn out to belong to a previously undescribed taxon. This is illustrated by the strains isolated from cases 4 and 5.     

Swallowing changes in cerebrovascular accidents: incidence, natural history, and repercussions on the nutritional status, morbidity, and mortality

OBJECTIVE: To determine the frequency of dysphagia in CVA, its natural history and value as a risk factor of respiratory infection, malnutrition and death. PATIENTS AND METHODS: A prospective study was made of 187 consecutive patients with cerebrovascular accidents (CVA). A standardized test for dysphagia was done during the first two days of the illness and repeated three days a week. The levels of urea, total proteins and albumin were determined on admission and on discharge. The patients were questioned by phone after 6 months. RESULTS: There was dysphagia of liquids in 36.4% of the patients. The incidence of dysphagia for semisolids was of the same frequency but more severe. Coma was the cause of inability to swallow in 25.7% of the patients. During their stay in hospital one third of the patients with dysphagia died, one third became normal and one third still had dysphagia when they were discharged. After one week, one, three and six months respectively, the cure rate for dysphagia was 29.4%, 4.1%, 55.9% and 55.9%, and survival 83.8%, 67.6%, 61.8% and 60.3%. Thus after 6 months only 3 patients (4.4%) were alive and dysphagic. Half of the 'cures' occurred in the first week, and none occurred after more than 77 days. As compared to the non-dysphagic patients, the dysphagic patients had 10 times more risk of respiratory infection, 18 times higher risk of death, greater loss of albumin and less loss of urea. CONCLUSIONS: There is a high prevalence of dysphagia in CVA and although functional prognosis is not unfavorable, respiratory infections, malnutrition and death are frequent.     

Inflammatory bowel disease: Part I. Clinical features and diagnosis

Familial and epidemiologic studies of inflammatory bowel disease indicate a strong genetic predisposition that is modified by certain environmental factors. Abnormal submucosal immune activation may be important in the etiology of the disease. Yersinia enterocolitica infection, various "gay bowel syndromes" and other recently described enteric infections often mimic Crohn's disease. An initial barium study is useful in documenting the extent of disease and complications. Endoscopic biopsy confirms the surface appearance and histologic features of inflammatory bowel disease. Newer photodocumentation techniques are expected to improve the comparability of endoscopic observations. Complications of inflammatory bowel disease occur frequently, may involve any organ system and may precede the onset of bowel symptoms.     

Inflammatory bowel disease in Saudi Arabia: presentation and initial management

Elective cholecystectomy in the asymptomatic patient has elicited considerable controversy, going back to the prelaparoscopy cholecystectomy era. Surgical services often see patients with known or unidentified cholelithiasis who, having been asymptomatic, present with serious complications, potentially lethal, in whom emergency operations are associated with technical difficulties that lead to high conversion rates and significant mortality and morbidity. Elective cholecystectomy is a safe procedure associated with low morbidity and no mortality. Based on an analysis of our experience and a review of the literature, we discuss the indications for elective laparoscopic cholecystectomy in asymptomatic patients at high risk of developing complications of their asymptomatic disease. The following high-risk criteria are proposed for elective cholecystectomy: life expectancy > 20 years; calculi > 2 cm in diameter; calculi < 3 mm and a patent cystic duct; radiopaque calculi; polyps in the gallbladder (GB); nonfunctioning GB; calcified ("porcelain") GB; concomitant diabetes; women < 60 years; and individuals in geographic regions with a high prevalence of GB cancer.     

Adult physical health outcomes of adolescent girls with conduct disorder, depression, and anxiety

We have previously shown that feather formation in chick embryonic skin depends on accumulation of sulphated glycosaminoglycans in the underlying mesenchyme, and that addition of spermidine to chick embryo fibroblasts increases the extracellular sulphated glycosaminoglycans. In the present work, using histological, histochemical and biochemical procedures, we have investigated the effects on glycosaminoglycan accumulation and on epithelial differentiation of adding spermidine and bis-cyclohexylammonium sulphate, a spermidine inhibitor, to embryonic chick skin cultures. Our results demonstrate that spermidine induces an accumulation of sulphated glycosaminoglycan and an increase in feather formation, suggesting that the morphogenetic effect of spermidine may be dependent on specific glycosaminoglycan accumulation.     

Differentiation between depression and anxiety: A new scale.

Describes the development of the Paired Anxiety and Depression Scale which measures the relative balance between depression and anxiety but does not yield a quantitative measure of either. Results from undergraduates show that the amount of variance accounted for by the new scale was much greater than the Profile of Mood States and that all differences between Ss instructed to respond as "very depressed" or "very anxious" were significant. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term follow-up in Crohn's disease. Mortality, morbidity, and functional status

BACKGROUND: The purpose of this study was to analyse long-term results of an active approach to surgical treatment of Crohn's disease. METHODS: One hundred and thirty-six patients were studied after first resection for primary Crohn's disease during 1968-77. RESULTS: Mean follow-up was 16.6 years; 18 patients had died (3 of Crohn's disease). Cumulative risk for a second resection was 0.40 (95% confidence interval, 0.29-0.51) at 10 years and 0.45 (0.32-0.58) at 15 years, similar in classical disease and colitis. Cumulative risk of a third and fourth resection was 0.5 at 10 years. Median resected bowel length at the first operation was 8%. After two and three resections the cumulative resection was 23% and 33%, respectively. Of the patients 73% claimed full working capacity and 7% had disability pension. CONCLUSIONS: An active surgical approach in Crohn's disease is associated with low operative mortality and morbidity and good functional results and offers good symptomatic relief.     

Inflammatory bowel disease workshop. Vail, Colorado, March 22 and 23, 1998. Management of fistula disease

Prevention of disease and disability and preservation of health are compelling strategies that are endorsed by the public, health care providers, and researchers. Despite this general acceptance of the concept, the "devil is in the details." What can and should be recommended with confidence to the public and health care providers regarding prevention and how can these recommendations be implemented? Prevention programs should be based on durable evidence of efficacy and should assure that the benefits of interventions and changes exceed the risks. The latter is particularly important for population-based primary prevention because many are influenced but fewer may benefit. Prevention research must provide the evidence of benefit and risk. The responsibility of the National Institutes of Health (NIH) is to develop the scientific basis for prevention and to train prevention scientists who are responsible for creating this science base. The interpretation and dissemination of information from research studies are important and necessary aspects to assure translation of the science into personal and public health practices. The components of prevention research are investigation of the factors that place individuals and groups at risk of disease and disability; trials of the interventions that can modify this risk; and testing the approaches that can effectively implement beneficial changes. NIH is committed to addressing these endeavors, and its individual Institutes and Centers support a broad portfolio of prevention research. This paper will provide an overview of NIH support, the functional relationships of prevention research within NIH, and background information that can be useful to those interested in research.