RESUMO
Traumatic brain injury (TBI) affects millions globally and is considered a universal public health concern. Our study addresses a considerable knowledge gap about the health of female survivors of TBI. Using a retrospective cohort study design, we examined behavioral risk factors, access to health screenings, and primary care services among women with a history of moderate to severe TBI. We compared findings with a general female population. Female survivors (n = 75) appeared to have comparable use of primary care services with the general population. Significantly more women reported poor mental health postinjury; reported alcohol consumption was also greater.
Assuntos
Lesões Encefálicas/psicologia , Indicadores Básicos de Saúde , Programas de Rastreamento/estatística & dados numéricos , Serviços Preventivos de Saúde/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Idoso , Feminino , Comportamentos Relacionados com a Saúde , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Philadelphia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricosRESUMO
Intravenous doses of medications require formulations that permit accurate preparation and administration. Current equipment does not permit accurate measurement of volumes less than 0.1 mL. In a study of four hypothetical standard pediatric patients, we found that 28 common medications required less than 0.1 mL of available formulation to prepare the dose. In a clinical study of actual use in a pediatric intensive care unit (ICU), 5245 (7.4%) of 71 218 intravenous doses required preparation from less than 0.1 mL of stock solution. For 28.5% of the 1531 ICU admissions, at least one dose was prepared from a volume of less than 0.1 mL. Our findings identify a substantial source of dosing error. Correction will require revision of preparation methods, regulatory requirements and manufacturing practices.
Assuntos
Química Farmacêutica/normas , Erros de Medicação/prevenção & controle , Administração Oral , Canadá , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Infusões Intravenosas , Unidades de Terapia Intensiva Pediátrica , Masculino , Modelos TeóricosRESUMO
Bipolar disorder is a chronic mental illness with high prevalence of co-occurring alcohol use disorder. Linkage studies have revealed several candidate genes in the dopaminergic and serotonergic pathways which may be associated with both bipolar and alcohol use disorders. We investigated the relationship between polymorphisms in candidate genes and alcohol use disorder comorbidity in bipolar patients. We performed a retrospective study of a genomic database consisting of 278 bipolar disorder patients. Diagnosis of bipolar disorder was according to the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). RFLP analysis of single nucleotide polymorphisms were performed in dopamine (DRD1, DRD2 and DRD3) and serotonin receptor and transporter genes (5HTTLPR, 5HT1B, 5HT2A, 5HT2C). There were 179 (64%) females in the database. Seventy-one (25.5%) of the bipolar patients were diagnosed as comorbid alcohol use disorder. Chi-square analysis indicated that in female bipolar patients, there was a significant difference in genotype frequency between the bipolar patients with comorbid alcohol use disorder and non-comorbid bipolar patients for the Ser23Cys (rs6318) polymorphism of the 5HT2C gene. Overall, the results indicate a possible association between 5HT2C and alcohol use disorder comorbidity.
Assuntos
Transtornos Relacionados ao Uso de Álcool/genética , Transtorno Bipolar/genética , Proteínas de Transporte de Neurotransmissores/genética , Polimorfismo de Nucleotídeo Único/genética , Receptores Dopaminérgicos/genética , Receptores de Serotonina/genética , Adulto , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtorno Bipolar/epidemiologia , Distribuição de Qui-Quadrado , Comorbidade , Cisteína/genética , Bases de Dados Genéticas/estatística & dados numéricos , Feminino , Frequência do Gene , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Serina/genética , Índice de Gravidade de Doença , Fatores SexuaisRESUMO
BACKGROUND: This research study examined the prevalence of prescription medication use in persons many years following moderate-to-severe traumatic brain injury (TBI). DESIGN: Retrospective cohort study. SETTING AND SUBJECTS: Consecutive records were examined of persons with moderate-to-severe TBI who were discharged from a large rehabilitation hospital in Pennsylvania from 1973-1989. Consenting participants (n = 306) were interviewed, who were traced up to 24 years post-injury. Data on current use of prescription medications, in addition to demographic characteristics and health conditions were collected from the participants. RESULTS: The prevalence of prescription medication was 58.9% in the sample, greater in females (65.6%) than in males (56.1%). The most prescribed medication types were anti-convulsants (25.8%) followed by anti-depressants (8.2%), painkillers (8.2%) and anti-anxiety medications (5.9%). On average, persons with TBI were prescribed 2.64 (SD = 2.14) medications with a range of 1-12. CONCLUSION: The research findings indicate a high prevalence of prescription medications in persons with past history of TBI. There is also a high prevalence of anti-convulsants medication use.