International Journal of Risk & Safety in Medicine - Volume 11, issue 4

Article Type: Other

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 207-208, 1998

Authors: Ernst, E. | Armstrong, N.C.

Article Type: Research Article

Abstract: The aim of this paper was to evaluate lay books on complementary medicine with a view to answering the question whether such literature has the potential to enhance or jeopardise the health of the reader. A sample of six books published in 1997 was chosen at random. Their contents were independently assessed by both authors according to pre‐defined criteria: information on adverse effects of selected therapies, information on invalid or insufficiently tested methods, information on the treatment of potentially serious conditions. The results show that the information provided is both incomplete and misleading. If followed by the reader, it is …conceivable that such information may do considerable harm. This pilot project leads to the hypothesis that the lay literature on complementary medicine is far from adequate and has the potential to put the health of the reader at risk. The hypothesis now requires testing with adequate methodology. Show more

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 209-215, 1998

Authors: Martínez‐Frías, María Luisa | Bermejo, Eva | Prieto, Luis

Article Type: Research Article

Abstract: The objective is to analyze the potential effect on the embryo of maternal occupation in agriculture during pregnancy. Study design: We have used the ongoing case‐control data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), to analyze the possible association between maternal occupation in agriculture during pregnancy and congenital defects. Cases and controls are identified by pediatricians at each of the collaborating hospitals. The same physicians collect the child’s and obstetrical data and interview the mothers of cases and controls within the first 3 days of life. The results indicated that working in agriculture during pregnancy implies …a small but statistically significant risk for congenital defects (OR{}={} 1.28; Confidence Intervals – CI: 1.09–1.50). We applied different logistic regression models to control for the following possible confounders: parental consanguinity, previous spontaneous abortions, number of pregnancies, maternal age, maternal educational level, maternal smoking, alcohol consumption, intake of vitamins, minerals, iron, and other drugs, vaginal bleeding, maternal acute and chronic diseases, fever, and birth weight. Conclusion: The results suggest that maternal occupation in agriculture during pregnancy increases the risk for microcephaly (OR = 5.84; p={} 0.04), and cardiovascular defects (OR{}={} 3.27; p={} 0.0007). The results also suggest a relationship with neural tube defects (OR{}={} 2.42; p={} 0.08). Show more

Keywords: Epidemiology, risk factors, case‐control studies, agriculture, maternal occupation, maternal work, microcephaly, cardiovascular defects, NTD

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 217-224, 1998

Authors: Martínez‐Frías, M.L. | Bermejo, E. | Rodríguez‐Pinilla, E. | Prieto, L.

Article Type: Research Article

Abstract: Information on a possible prenatal effect of maternal occupation as anesthetists or in operating rooms is scarce, and most of the studies are on women who underwent surgery during gestation. Some studies observed an increased risk for spontaneous abortions in women with that occupation. Some identified a risk for infants with congenital defects, while this was not observed by others. However, many of the previous studies have been criticized because of methodological problems. Here we present the results of a case‐control analysis with the data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), on the possible association between …congenital anomalies and maternal occupation as anesthetists or in operating rooms during pregnancy. To generate hypotheses, we analyze 9 selected congenital defects. We observed ORs with magnitudes over one for eye defects, oral clefts, limb deficiencies and hypospadias. However, after calculation the adjusted ORs by performing multiple logistic regression analyses, the only group of defects that remain statistically associated with this maternal occupation are oral clefts with an OR{}={} 10.41 (CI: 3.48–31.1), p<{} 0.0000. Thus, considering the oral clefts rate in our population and the observed risk value, the absolute risk of women with this occupation during pregnancy for having a child with oral clefts is 1.13%. Nevertheless, as this is the first observation of this association, at this time, we cannot totally exclude that this association may be just by chance. Thus, we think that the observed association must be regarded as hypothetical, to be further analyzed in another large database. Show more

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 225-231, 1998

Authors: Peters, Paul W.J. | Merkel, Bernard C.

Article Type: Research Article

Abstract: The European Community can make a significant contribution in the field of public health by offering the possibility to stimulate work on rare diseases. Genuine economics of scale could be achieved for research into rare diseases by linking at Community level the limited skills and resources available in this field within each individual Member State of the European Union. Persons suffering from rare diseases are often faced with a lack of information: few organizations provide patient support, and the sources of appropriate detection, recognition, treatment and prevention are limited or even non‐existent. Patient support groups can play a key role …in rare diseases, thanks to the wealth of knowledge accumulated through their own experience with the disease or through their collaboration with other groups. Intrinsically rare diseases are linked with the phenomenon of clusters. To deal with clusters of a rare disease it is necessary to identify a real increase in prevalence, for example by early warning systems, to determine specific causal factors, to assess the risks and to assuage public concern. It is on these issues that the programme of Community action on rare diseases within the framework for action in the field of public health is focused. Show more

Keywords: Rare diseases, public health, patient organizations, cluster‐handling

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 233-241, 1998

Authors: Stenson, Bo | Lindgren, Björn H. | Syhakhang, Lamphone | Tomson, Göran

Article Type: Research Article

Abstract: Objective: To describe and discuss the quality of a number of sample drugs collected in private pharmacies in Laos (Lao P.D.R.). Design: A stratified random sample was used to select 115 pharmacies and four sample drugs were collected from each. Three tests were used; identity, assay and measurement of weight variation. The identity was confirmed by TLC, UV and colour reactions. Titrimetric, UV and HPLC methods were used for assay. Setting: Savannakhet province in Laos. Study population: The 214 licensed private pharmacies in the province. Main outcome measures: Drug quality as assessed against the standards of …the British and US pharmacopoeias. Results: 12 (3.3%) out of the 366 drugs contained no active ingredient, 42 (11.5%) had levels of active ingredient outside acceptable limits in assay, 128 (35.0%) had excessive weight variation, and 4 (1.1%) were managed badly in the pharmacy. Conclusions: The major problem is caused by insufficient attention to Good Manufacturing Practice (GMP). Half of the sample drugs would not be approved according to international standards. There is little difference between the private and public sectors. Serious problems such as counterfeit drugs and mix‐ups are not frequent. The government should focus its efforts on ensuring that all drugs in the pharmacies can be traced to manufacturer. Show more

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 243-249, 1998

Authors: Kapp, Marshall B.

Article Type: Research Article

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 251-258, 1998

Authors: Kopp, J.N. | Osinga, M.

Article Type: Research Article

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 259-269, 1998

Authors: Fava, Giovanni A. | Tomba, Elena

Article Type: Research Article

Keywords: SSRI, antidepressant, withdrawal reaction, dependence

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 271-274, 1998

Article Type: Other

Citation: International Journal of Risk and Safety in Medicine, vol. 11, no. 4, pp. 275-277, 1998