Prevalence of substance use among US physicians Hughes, P H; Brandenburg, N; Baldwin, Jr, D C ...
JAMA : the journal of the American Medical Association,
05/1992, Letnik:
267, Številka:
17
Journal Article
Recenzirano
To estimate the prevalence of substance use among US physicians.
A mailed, anonymous, self-report survey that assessed use of 13 substances and permitted comparison with results of the National ...Household Survey on Drug Abuse. Rates of physician substance use were weighted to provide national prevalence estimates.
A national sample of 9600 physicians, stratified by specialty and career stage, and randomly selected from the American Medical Association master file. The response rate after three mailings was 59%. Demographic characteristics of respondents closely reflected those of the US physician population.
Subjects' self-reported use of 13 substances in their lifetime, the past year, and the past month; reasons for use; self-admitted substance abuse or dependence; and whether treatment was received. For controlled prescription substances, respondents were asked to report only use "not prescribed by another physician for a legitimate medical or psychiatric condition."
Physicians were less likely to have used cigarettes and illicit substances, such as marijuana, cocaine, and heroin, in the past year than their age and gender counterparts in the National Household Survey on Drug Abuse. They were more likely to have used alcohol and two types of prescription medications--minor opiates and benzodiazepine tranquilizers. Prescription substances were used primarily for self-treatment, whereas illicit substances and alcohol were used primarily for recreation. Current daily use of illicit or controlled substances was rare.
Although physicians were as likely to have experimented with illicit substances in their lifetime as their age and gender peers in society, they were far less likely to be current users of illicit substances. The higher prevalence of alcohol use among respondents may be more a characteristic of their socioeconomic class than of their profession. A unique concern for physicians, however, is their high rate of self-treatment with controlled medications--a practice that could increase their risk of drug abuse or dependence. Uniform national guidelines are needed to sensitize medical students and physicians to the dangers of self-treatment with controlled prescription substances.
The CLEO III silicon vertex detector Kass, R.; Alam, M.S.; Alexander, J.P. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
03/2003, Letnik:
501, Številka:
1
Journal Article
Recenzirano
The design and operation of the CLEO III silicon vertex detector is described in this report. This detector consists of four layers of double-sided silicon wafers covering 93% of the solid angle. ...After initially meeting its signal-to-noise and spatial resolution design goals, the
r−
φ side efficiency of layers 1 and 2 decreased dramatically due to radiation-induced sensor effects.
It is reported on the interaction of bacterial lipopolysaccharide (LPS, endo-toxin), having different sugar chain length covalently bound to its hydrophobic moiety lipid A, with the polycationic ...antibiotics polymyxin B (PMB) and PMB-nonapeptide (PMBN). The binding enthalpies and the lipid:peptide binding stoichiometries were determined by isothermal titration calorimetry (ITC). For LPS with a long sugar chain (S: smooth form LPS from
Yersinia enterocolitica), the titration curves exhibit a strong exo-therm which can be interpreted to result from the electrostatic interaction of the negative charges of the LPS with the positive charges of the peptides. In contrast, the titration curves of LPS with a short sugar chain (LPS Re from
Escherichia coli) and of free lipid A yield complex patterns of endo- and exo-therms, which result from the superposition of electrostatic binding, fluidization of the acyl chains and a transition between different three-dimensional aggregate structures of the endo-toxins due to peptide binding. Infrared spectroscopy indicates that the fluidizing effect of the polymyxins is similar for both types of LPS and for lipid A. Small-angle X-ray diffraction reveals, however, that the Re-type LPS and lipid A are converted from a cubic into a multilamellar structure, whereas, the S-form LPS transforms from a unilamellar into a multilamellar structure with a small number of lamellae. The presented data allow a better understanding of the interaction of peptides with endo-toxin molecules.
Use of antiepileptic drugs (AEDs) during pregnancy is associated with an increased risk of congenital malformations. Spina bifida aperta has been linked specifically to valproic acid (VPA) (estimated ...risk, 1 to 2%). The actual risk, the exclusive association of VPA with spina bifida and not anencephaly, and the precise causative relation remain matters of discussion. A prospective cohort study of pregnant women with epilepsy receiving AEDs and referred for prenatal diagnosis before week 22 of gestation was conducted, with follow-up to 3 months after birth. Pregnancies (291 singleton and 6 twin) in 261 women were evaluated. The prevalence of anomalies after exposure to any AED was 6.9%. For fetuses exposed to VPA, the prevalence was 9.4%, including six cases of spina bifida, two of which were in monozygotic twins (giving a prevalence rate of 6.3%, or 5.4%, if twins counted as one). Spina bifida was associated with a significantly higher average daily dose of VPA as compared with pregnancies with normal outcome (1.640 +/- 136 mg/d vs 941 +/- 48 mg/d, p = 0.0001). No relation was observed between the occurrence of spina bifida and type of maternal seizure or epilepsy, family history of epilepsy or neural-tube defects, or medical history. From these results we suggest that when the use of VPA during pregnancy cannot be avoided, the teratogenic risk might be diminished by reduction of the daily dose.
Tomography in the diagnosis of petrositis Parnell, F W; Brandenburg, J H; Swingle, J D
Annals of otology, rhinology & laryngology,
03/1974, Letnik:
83, Številka:
2
Journal Article
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