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Common Complaints (common + complaints)
Selected AbstractsChildhood Abuse and Common Complaints in PregnancyBIRTH, Issue 3 2009Mirjam Lukasse RM ABSTRACT: Background: Childhood abuse affects adult health. The objective of this study was to examine the prevalence of emotional, physical, and sexual childhood abuse within a large Norwegian cohort of pregnant women and its association with common complaints in pregnancy.Methods: This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Regression analyses were used to examine associations of childhood abuse and 16 common complaints in pregnancy.Results: Eighteen percent (10,363/55,776) of the women reported some type of childhood abuse. Of all women, 3,870 (6.9%) reported sexual abuse, 3,075 (5.5%) physical abuse, and 7,619 (13.6%) emotional abuse as a child. Of those reporting childhood abuse, 31 percent reported two or more types of abuse. All 16 common complaints in pregnancy were associated with reported childhood abuse. Women reporting three types of childhood abuse reported 5.4 common complaints in pregnancy (mean) compared with 3.7 for women without childhood abuse (p < 0.001). Women reporting childhood abuse are more likely to report seven or more common complaints in pregnancy: adjusted odds ratio (AOR) 1.7 (95% CI 1.6,1.9) for emotional abuse; AOR 2.5 (95% CI 2.0,3.1) for combined physical and sexual abuse; and AOR 3.5 (95% CI 3.0,4.0) for all three kinds of abuse. Sociodemographic characteristics and other risk factors did not explain this graded association.Conclusions: Abuse in childhood is associated with increased reporting of common complaints of pregnancy. Clinicians should consider the possible role of childhood abuse when treating women with many common complaints in pregnancy. [source] Common complaints, difficult diagnosis: Multiple myelomaJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2006Clinical Nurse), Colleen Dvorak RN, OCN (Graduate student, currently in the Acute Care Nurse Practitioner Program with a focus in oncology Abstract Purpose: To review the presenting signs and symptoms of multiple myeloma, its pathophysiology, diagnostic evaluation, and treatment options. Data sources: A literature review of research articles and publications by oncology experts who specialize in multiple myeloma, supplemented by a case study. Conclusions: Multiple myeloma is a cancer of the geriatric population, with the average age at diagnosis between 65 and 68 years. As the population of those over age 65 is predicted to double by the year 2050, the incidence of myeloma is expected to increase. Nurse practitioners (NPs) must become familiar with the signs, symptoms, and complications of myeloma for patients to be diagnosed and referred to specialists in a timely manner. Implications for practice: Patients with multiple myeloma often present with vague, common symptoms such as back pain, bony pain, fatigue, and anemia. These symptoms may be treated as separate medical conditions if NPs fail to include multiple myeloma in their differential diagnosis. If NPs are educated on this malignancy, they will have the expertise to look for other signs of the disease such as hypercalcemia, pathological fractures, osteopenia, or renal failure. Without early recognition of multiple myeloma and referrals to oncology specialists, patients are left with a delayed diagnosis and poor symptom control. [source] Ergonomics in Office-Based Surgery: A Survey-Guided Observational StudyDERMATOLOGIC SURGERY, Issue 11 2007ADAM C. ESSER MD BACKGROUND The practice of office-based surgery is increasing in many specialties. OBJECTIVE Using Mohs surgery as a model, we investigated the role of ergonomics in office-based surgery to limit work-related musculoskeletal disorders. METHODS All Mayo Clinic surgeons currently performing Mohs surgery and Mohs surgeons trained at Mayo Clinic between 1990 and 2004 received a questionnaire survey between May 2003 and September 2004. A sample of respondents were videotaped during surgery. The main outcome measures were survey responses and an ergonomist's identification of potential causes of musculoskeletal disorders. RESULTS All 17 surgeons surveyed responded. Those surveyed spend a mean of 24 hours per week in surgery. Sixteen said they had symptoms caused by or made worse by performing surgery. Symptom onset occurred on average at age 35.4 years. The most common complaints were pain and stiffness in the neck, shoulders, and lower back and headaches. Videotapes of 6 surgeons revealed problems with operating room setup, awkward posture, forceful exertion, poor positioning, lighting, and duration of procedures. CONCLUSION Symptoms of musculoskeletal injuries are common and may begin early in a physician's career. Modifying footwear, flooring, table height, operating position, lighting, and surgical instruments may improve the ergonomics of office-based surgery. [source] Association between Insurance Status and Admission Rate for Patients Evaluated in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2003Jennifer Prah Ruger PhD Abstract Objectives: To determine if differences exist in hospital and intensive care unit (ICU)/operating room admission rates based on health insurance status. Methods: This was a retrospective, cross-sectional study of data from hospital clinical and financial records for all 2001 emergency department (ED) visits (80,209) to an academic urban hospital. Hospital admission and intensive care unit (ICU)/operating room admissions were analyzed, controlling for triage acuity, primary complaint, diagnosis, diagnosis-related group (DRG) severity, and demographics. Multivariate logistic regression models identified factors associated with hospital admission for underinsured (self-pay and Medicaid) compared with other insured (private health maintenance organization, preferred provider organization, worker's compensation, and Medicare) patients. Results: Compared with the other insured group, underinsured patients were less likely, overall, to be admitted to the hospital (odds ratio [OR], 0.82; 95% CI = 0.76 to 0.90), controlling for all other factors studied. Subgroup analysis of common complaints showed underinsured patients with a chief complaint of abdominal pain (OR, 0.67; 95% CI = 0.55 to 0.80) or headache (OR, 0.61; 95% CI = 0.39 to 0.95) had the lowest adjusted ORs for admission to the hospital, compared with other insured patients. Underinsured patients with DRG of "menstrual and other female reproductive system disorders" (OR, 0.17; 95% CI = 0.06 to 0.51) or "esophagitis, gastroenteritis, and miscellaneous digestive disorders" (OR, 0.55; 95% CI = 0.28 to 0.96) also were less likely to be admitted compared with the other insured group. No significant differences in ICU/operating room admission rates were found between insurance groups. Conclusions: Whereas there was no difference in admission rates to the ICU/operating room by insurance status, this single-center study does suggest an association between insurance status and admission to a general hospital service, which may or may not be causally related. Factors other than provider bias may be responsible for this observed difference. [source] The clinical and epidemiological burden of chronic lymphocytic leukaemiaEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2004A. REDAELLI phd director of global outcomes research-oncology The purpose of this literature review was to identify and summarize published studies describing the epidemiology and management of chronic lymphocytic leukaemia (CLL). Chronic lymphocytic leukaemia represents 22,30% of all leukaemia cases with a worldwide incidence projected to be between <,1 and 5.5 per 100 000 people. Australia, the USA, Ireland and Italy have the highest CLL incidence rates. Chronic lymphocytic leukaemia presents in adults, at higher rates in males than in females and in whites than in blacks. Median age at diagnosis is 64,70 years. Five-year survival rate in the USA is 83% for those <,65 years old and 68% for those 65 + years old. Hereditary and genetic links have been noted. Persons with close relatives who have CLL have an increased risk of developing it themselves. No single environmental risk factor has been found to be predictive for CLL. Patients are usually diagnosed at routine health care visits because of elevated lymphocyte counts. The most common presenting symptom of CLL is lymphadenopathy, while difficulty exercising and fatigue are common complaints. Most patients do not receive treatment after initial diagnosis unless presenting with clear pathologic conditions. Pharmacological therapy may consist of monotherapy or combination therapy involving glucocorticoids, alkylating agents, and purine analogs. Fludarabine may be the most effective single drug treatment currently available. Combination therapy protocols have not been shown to be more effective than fludarabine alone. As no cure is yet available, a strong unmet medical need exists for innovative new therapies. Experimental treatments under development include allogeneic stem cell transplant, mini-allogeneic transplants, and monoclonal antibodies (e.g. alemtuzumab against CD52; rituximab against CD20). [source] Differential age-related change of prose memory in older Hong Kong Chinese of higher and lower educationINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2004T. M. C. Lee Abstract Background Memory difficulty is one of the most common complaints of older people, with or without psychiatric conditions. It is therefore of utmost important to understand how normal ageing process impacts upon prose memory so as to gain insight into ways to differentiate pathological vs normal age-related changes of the recall of prose observed among older people. Objectives To understand the differential age-related change of prose memory in older Hong Kong Chinese of higher and lower education. Method Forty-eight normal, healthy Cantonese-speaking Chinese were recruited. Seventeen of them were younger, highly educated participants. Among the 31 older people recruited, 19 of them received education comparable with the younger participants and 12 were older people of low education. A prose passage was constructed to measure the different processes of prose memory, including learning efficiency, rate of forgetting, recall accuracy, accuracy of temporal sequence of information recalled, distortions, and recognition memory. Results As expected, ageing affected all the processes of prose memory measured, except the rate of forgetting. Apart from learning efficiency and rate of forgetting, education was observed to modify the effect of ageing on all the processes studied. Conclusions Changes of prose memory associated with ageing and the differential effect of education on prose recall among older people were discussed. The findings seem to suggest that prose memory is a multifaceted construct. Copyright © 2004 John Wiley & Sons, Ltd. [source] Self-rated health as predictor of medicine use in adolescence,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 2 2008Bjørn E. Holstein Mag Scient Soc Abstract Purpose To examine the association between self-rated health (SRH) and medicine use for four common complaints: headache, stomach-ache, difficulties in getting to sleep and nervousness, in a nationally representative sample of adolescents. Methods The study population comprised of all students in the fifth, seventh and ninth grade (mean ages 11.6, 13.6 and 15.6 years) in a random sample of schools in Denmark 2002, participation rate 90.6%, n,=,4.824. The students reported health problems, medicine use, social and psychosocial conditions in an anonymous and standardized questionnaire. The outcome measure was self-reported medicine use during the past month and the determinant was SRH measured by one item. Results There was an association between poor/fair SRH and medicine use for headache and stomach-ache. The associations remained statistically significant even after adjustment for frequency of the complaint for which the medicine was used: OR (95%CI) for medicine use for headache was 1.54 (1.10,2.14) among boys with poor/fair SRH and 1.50 (1.12,2.03) among girls with poor/fair SRH. A similar association was found between poor SRH and medicine use for stomach-ache for both boys (OR,=,3.41 (2.09,5.55)) and girls (OR,=,1.90 (1.36,2.67). Further, there was an association between poor/fair SRH and medicine use for difficulties in getting to sleep among girls, OR,=,2.66 (1.26,5.63) but not among boys. There was no association between SRH and medicine use for nervousness. Conclusion Poor/fair SRH is associated with medicine use for aches among Danish adolescents. Copyright © 2007 John Wiley & Sons, Ltd. [source] Childhood Abuse and Common Complaints in PregnancyBIRTH, Issue 3 2009Mirjam Lukasse RM ABSTRACT: Background: Childhood abuse affects adult health. The objective of this study was to examine the prevalence of emotional, physical, and sexual childhood abuse within a large Norwegian cohort of pregnant women and its association with common complaints in pregnancy.Methods: This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Regression analyses were used to examine associations of childhood abuse and 16 common complaints in pregnancy.Results: Eighteen percent (10,363/55,776) of the women reported some type of childhood abuse. Of all women, 3,870 (6.9%) reported sexual abuse, 3,075 (5.5%) physical abuse, and 7,619 (13.6%) emotional abuse as a child. Of those reporting childhood abuse, 31 percent reported two or more types of abuse. All 16 common complaints in pregnancy were associated with reported childhood abuse. Women reporting three types of childhood abuse reported 5.4 common complaints in pregnancy (mean) compared with 3.7 for women without childhood abuse (p < 0.001). Women reporting childhood abuse are more likely to report seven or more common complaints in pregnancy: adjusted odds ratio (AOR) 1.7 (95% CI 1.6,1.9) for emotional abuse; AOR 2.5 (95% CI 2.0,3.1) for combined physical and sexual abuse; and AOR 3.5 (95% CI 3.0,4.0) for all three kinds of abuse. Sociodemographic characteristics and other risk factors did not explain this graded association.Conclusions: Abuse in childhood is associated with increased reporting of common complaints of pregnancy. Clinicians should consider the possible role of childhood abuse when treating women with many common complaints in pregnancy. [source] Posturographic description of the regaining of postural stability following strokeCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 1 2005Henrik Rogind Summary Background:, Failing balance and increased liability to falling are common complaints among hemiplegic subjects. During rehabilitation much effort is put into regaining postural stability. Purpose:, To describe the regaining of postural stability during rehabilitation for the first year following stroke in hemiplegic patients Materials and methods:, Twenty-six patients were included within 5 days of suffering a stroke resulting from a CT-verified clearly defined thromboembolic lesion, localized in the vascular bed of middle cerebral artery on either side. Posturographic evaluation of sway was performed on a commercially available force plate system (Balance Master Pro®). Measured parameters included per cent maximum stability (PMS), per cent ankle strategy (AST), and average angular velocity (AVE). An additional parameter was derived by calculating the slope (SLP) of the linear relationship between stability and ankle strategy. SLP reflects the predisposition of the stroke patient to keep using ankle strategy when faced with increasingly difficult balance tasks. The presence of familiarization to the measurement method was examined by including a preliminary measurement not otherwise included in the analysis of changes during the first year of follow-up. The temporal evolvement of sway was described by measuring sway parameters 1, 2, 4, 8 and 52 weeks following stroke. The proportions of the variation in sway caused by measurement error and between patients were compared. Results:, All parameters improved over time, as demonstrated by significant improvements from each of week 1, 2, 4 and 8 to week 52. There was evidence of familiarisation for PMS, AST and AVE, but not for SLP. Estimation of variance components showed that between patient variation accounts for between two-thirds and four-fifths of the total variation. A considerable part of this variation was caused by individual differences in the temporal improvement of sway over time. Patients considered the evaluation of postural sway demanding and time consuming resulting in a relatively large loss to follow-up: 15 patients completed the 8-week visit while seven completed the 1 year visit. Conclusion:, Postural stability increases for the first year following stroke. There is evidence of familiarization towards the measurements process for the traditional posturographic parameters PMS, AST and AVE, but not for the derived parameter SLP, which might make the latter a candidate for a sway parameter reflecting basic mechanisms of upholding upright stance in hemiplegic patients. The estimated variance components stress the considerable between-patient variation and question the ability of the force plate method to monitor individual sway performance of such patients during the rehabilitation process. [source] | ||||||||||