Diffusion of information about genetic risk within families

Recent developments in genetics are likely to exacerbate the ethical issues in clinical practice, especially with regard to privacy and disclosure of genetic information. To evaluate the behaviour of patients with respect to transmitting carrier information, we undertook a survey of 283 families with a balanced chromosomal rearrangement as a model. In these families, 1816 relatives were considered at risk and 806 of them were karyotyped (44.4%). The percentage of karyotypes performed is significantly related to the number of living children of the index couple, the reason for referral, the nature of the anomaly, the training of the counsellor and the age of the index case. This study shows the limits of the screening of at risk individuals within families, based on the willingness of the patients, and addresses practical and ethical issues around family disclosure in medical genetics.     

Delayed muscle soreness: a review

There are two generally recognized types of muscular pain or soreness associated with severe exercise. These two types are a) acute soreness and b) delayed soreness. Acute soreness or pain occurs during and immediately following exercise. This condition is short-lived and is alleviated when exercise is discontinued. Acute soreness is thought to be associated with lack of adequate blood flow or ischemia to the active muscles. The more serious problem associated with severe exercise is delayed muscle soreness, i.e., pain and soreness that occurs 24 to 48 hours after exercise. Four popular theories of the etiology of this condition are: lactic acid accumulation, spasms, torn tissue, and connective tissue damage. These theories are discussed in light of current biochemical and morphological findings. From recent studies designed to induce delayed soreness, it has been found that the degree of delayed soreness experienced with exercise is related to the type of muscle contraction performed. Maximum soreness is associated with eccentric types of contractions. A possible explanation for this finding is presented.J Orthop Sports Phys Ther 1983;5(1):10-13.     

The role of endorphins in exercise: a review of current knowledge

Exercise training is used increasingly to prevent and treat disease, and millions of healthy persons participate in various aerobic-type sports; yet, the mechanisms by which exercise produces various clinical effects is imperfectly understood. Emerging evidence suggests that the endogeneous opioid endorphins may be involved in two widely varying aspects of exercise: endocrine control and behavior and mood adaptation. The present paper summarizes these findings. The relationship of endorphins and adrenocorticotropin to stress and the aspects of endorphins' involvement in the concept of "runner's high" are discussed. J Orthop Sports Phys Ther 1983;4(3):169-173.     

Putting stress into words: the impact of writing on physiological, absentee, and self-reported emotional well-being measures

BACKGROUND AND PURPOSE. Inhibiting or holding back one's thoughts, feelings, or behaviors is associated with long-term stress and disease. Actively confronting upsetting experiences can reduce the negative effects of inhibition. The present study describes a unique approach to aid individuals in dealing with psychological and emotional issues that they must often face. METHODS. Forty-one of the 81 university employees who were participating in a wellness program agreed to participate in the present study. Subjects were randomly assigned to write about either personal traumatic experiences (n = 23) or non-traumatic topics (n = 18) for 20 minutes once a week for four consecutive weeks. RESULTS. Results indicate that individuals who wrote about upsetting personal experiences evidenced significant drops in selected blood measures compared to those who wrote about non-traumatic topics (e.g., for SGOT: 4.0% drop among traumatic topic group versus 13.1% increase among non-traumatic topic group, ANOVA p = .029; for SGPT: 24.5% drop versus 7.7% increase, p = .001). During the month of writing, traumatic topic group subjects evidenced a 28.6% reduction in absentee rates from work relative to the eight months before the experiment compared with a 48.5% increase in absentee rates among non-traumatic topic subjects (p = .04). Subjects low in emotional inhibition evidenced the greatest reductions in absentee rates following personal disclosure compared to those high in emotional inhibition (p = .011). DISCUSSION. The proposed writing strategy offers a unique tool for health promotion practitioners.(ABSTRACT TRUNCATED AT 250 WORDS)     

The relationship of blood pressure to a brief measure of anger during routine health screening

A brief questionnaire (12 items) was developed to assess aspects of anger that could be expeditiously obtained during health screenings where medical students and residents can acquire valuable research and clinical experience simultaneously. Blood pressures were measured immediately upon sitting and after 3 minutes in 179 subjects who attended a health fair in Nashville. The questionnaire was administered after both blood pressure measurements were acquired. Scores on the measure of anger correlated significantly (P = .0009) with resting systolic blood pressure (SBP) in both blacks and whites while a measure of "John Henryism" showed no correlation with blood pressure in either group (P = .81). The findings are consistent with the literature in supporting a connection between anger and blood pressure but do not support the relationship between John Henryism and blood pressure.     

THIP inhibits feeding behavior in fasted rats

The effects of 4,5,6,7-tetrahydroisoxazolo-[5,4-c]pyridin-3-ol (THIP) were compared with those of d-amphetamine and GABA in fasted rats. Intravenously-administered THIP produced a dose-dependent decrease in food consumption (ED₅₀1.5 mg/kg) by an action that was not reversed by prior subcutaneous or simultaneous intravenous (IV) injection of bicuculline. d-Amphetamine-SO₄ also produced a decrease in food consumption in this model (ED₅₀0.2 mg/kg, IV). Unlike THIP, GABA (in doses up to 100 mg/kg, IV) did not produce a marked anorexigenic effect. These results provide further evidence that THIP can penetrate the blood-brain barrier, and that central GABA-ergic systems are involved in controlling food intake.     

Cost and health related quality of life consequences of multiple sclerosis

Objectives: To (i) quantify the cost of multiple sclerosis (MS) to the Canadian health care system and society; (ii) measure health utility in MS patients, and (iii) examine the influence of disability on patient utility and health care costs. Materials and methods: A comprehensive patient survey and chart review of relapsing MS patients in remission, relapse and recalling a relapse. Results: Annual remission costs increased with EDSS level ($7596 at EDSS 1, $33 206 at EDSS 6). At all EDSS levels the largest costs were due to inability to work, which increased with EDSS. The average relapse cost for all EDSS levels was $1367. An inverse correlation was found between EDSS level and patient utility for patients in remission and relapse. The decrease in remission health utility from EDSS 1 to 6 was 0.24, which is 25% greater than the difference in health status between an average 25 and 85 year-old. Conclusions: This study demonstrates that MS produces substantial health care costs and reductions in patient quality of life and ability to work, losses that can be avoided or delayed if disease progression is slowed. These data provide health-care decision-makers with the opportunity to consider the full impact of MS when faced with budget allocation decisions.     

Urogenital ageing and its effect on sexual health in older British women

Objective To provide information on the extent of problems of urogenital ageing in older British women.
Design A MORI survey of a representative population sample of older British women.
Setting Home interviews.
Participants Two thousand and forty-five women aged 55–85+.
Results Urogenital symptoms had affected 48.8% of the women at some time, but no more than 11% were currently affected by individual symptoms; however, these were often of long duration. The majority (73%) were not sexually active, with lack of a partner being a factor for many. There was also a decreasing prevalence of sexual activity with increasing age. Those sexually active in the 65–74 year old age group (   n = 148  ) tended to have a similar sexual frequency (at least once per month) compared with the younger women studied. Approximately 12% of those who reported dyspareunia and/or vaginal dryness claimed a severe problem; 33% did not seek professional advice and 36% resorted to an over the counter remedy. Use of hormone replacement therapy was generally of relatively short duration. There was a declining gradient of ever-use with age.
Conclusions The extent of significant urogenital symptoms is relatively low, but some women are seriously affected and use self-help as well as professional assistance. The extent of sexual activity in older women and factors affecting this have been defined, and the effect of urogenital symptoms on sexual activity demonstrated.