Alcohol use and behaviors in women long-distance race participants reporting a history of bulimia and/or anorexia nervosa.

OBJECTIVE: To describe the relationship between a reported a history of an eating disorder, a history of problem alcohol behavior and current alcohol consumption in women long-distance runners. DESIGN: Survey. SETTING: General community. PARTICIPANTS: Women participating in a 20-mile road race (n = 398) and age-matched non-exercising women enrolled in a family practice health maintenance organization (n = 121) (mean age, 37.1 +/- 9.4 years). INTERVENTION: Not applicable. MEASURES: Responses to questions relating to 1) a past history of an eating disorder; 2) weight; 3) running and exercise habits; 4) drinking behaviors using alcoholism screening tests; 5) quantity-frequency data of the previous two week alcohol consumption. RESULTS: Ten percent of racers and 4.1% of controls reported a history of an eating disorder. Those racers reporting a history of bulimia nervosa without anorexia were more likely to report feeling guilty about their drinking, drunk-driving arrests, an elevated score on an alcoholism screening test (suggestive of problem drinking), alcoholism, and seeking help for problem drinking than other racers or the control population without a history of an eating disorder. However, bulimic racers did not report either increased current alcohol consumption or occasions of drinking, including binge drinking (five or more drinks in one episode). CONCLUSIONS: Women racers reporting a history of bulimia nervosa are more likely to report a history of problem behaviors with alcohol but not differences in current alcohol consumptions from that reported by other women racers or women without a history of an eating disorder from the control population.

Medical problems of adolescent female athletes.

Adolescent female athletes represent unique medical challenges. Although still limited, research and understanding of their particular problems has grown over the past 3 decades as female sports participation has increased dramatically. Despite concerns, however, exercise and athletic activity are safe and beneficial for girls and young women, and may help them develop positive attitudes toward self-image and body satisfaction. Several musculoskeletal injuries fairly common among female athletes may be related to structural development. Iron and calcium deficiencies are frequent nutritional concerns for these girls. Disordered eating, a phenomenon exhibited by many adolescent females, may not be more prevalent in athletes. Amenorrhea is a common problem for female athletes, and may contribute significantly to stress fractures and future osteoporosis. For these and other reasons, physicians must be aware of these issues to better help their female patients safely participate in athletics.

A study of various tests to detect asymptomatic urinary tract infections in an obstetric population.

OBJECTIVE: To compare rapid screening techniques for detecting asymptomatic urinary tract infections (AUTIs) in pregnant women. DESIGN: Comparison of results of the screening tests of urinalysis, urine dipstick, and Gram's staining with the results of standard urine culture at an initial prenatal visit. In follow-up visits, urine dipstick testing was compared with urinalysis. SETTING: Departments of Family Medicine and Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn. PATIENTS: Pregnant women (1047) from the local community were screened for AUTI on initial and follow-up visits. METHODS: Initial prenatal urine was tested by using urine dipstick testing, urinalysis, Gram's staining, and urine culture. At each follow-up visit, urine specimens were tested by using urine dipstick and urinalysis. MAIN OUTCOME MEASURES: Sensitivity and specificity, incremental patient costs, and clinical outcomes were used to assess the effectiveness of the techniques. RESULTS: On initial visits, rapid screening tests for AUTI in pregnant women revealed the following: Gram's staining identified 22 of 24 patients with AUTI (sensitivity, 91.7%; specificity, 89.2%); urine dipstick, 12 of 24 (sensitivity, 50.0%; specificity, 96.9%); and urinalysis with presence of leukocytes, six of 24 (sensitivity, 25.0%; specificity, 99.0%). In follow-up visits, urine dipstick tests detected 19 infections and urinalysis, three (positive predictive value, 5% compared with 3%). CONCLUSIONS: Urine dipstick testing for nitrites identified half of all patients with urinary tract infections and was superior to urinalysis on follow-up visits. Although Gram's staining is more expensive, it was more accurate for AUTI than urinalysis or urine dipstick test for nitrites. Urinalysis was never the test of choice because it was more expensive and detected fewer positive cultures. Leukocyte measurement correlated poorly with AUTI.

Bulimia nervosa and associated alcohol abuse among secondary school students.

Four adolescent student populations (totalling 686 girls and 705 boys) completed confidential questionnaires (98.6% response rate) concerning bulimia nervosa and alcohol abuse. All of the DSM-III-R criteria for bulimia nervosa were met by 2.0% of the girls and 0.1% of the boys. On the basis of score greater than or equal to 42 on the Adolescent Alcohol Involvement Scale, 12.5% of all girls and 9.2% of all boys were alcohol abusers. Our results suggest a significant association between bulimic behavior and alcohol abuse in this female population. Other factors associated with bulimic behavior included high maternal vocational status, high socioeconomic class (girls only), high weight for age and height, and low personal ideal weight. Other factors associated with alcohol abuse included high maternal vocational status, low paternal vocational status and education, low socioeconomic class (boys only), low grade point average, high age, and high birth order.

The effect of clobetasol-17-propionate and crude coal tar on dithranol-induced inflammation. A clinical and biochemical study.

Clobetasol-17-propionate (CP) and crude coal tar (CT) have an anti-inflammatory potential. Both agents have been advocated to suppress irritation of the skin during dithranol treatment. The effect of CP and CT on dithranol-induced irritation was studied by the assessment of erythema and measurement of alkaline phosphatase (ALP) as a direct reflection of the metabolic activity of the endothelial cells. Dithranol was applied for 2 h in the relatively high concentration of 10%, which resulted in a marked inflammation of the skin in all volunteers. Neither CP nor CT influenced the erythema. In contrast, CP and CT had a synergistic effect on the dithranol-induced induction of ALP. In conclusion, the present study indicates that CP and CT are not indicated for the treatment of dithranol-induced irritation.

Studies on the time course of dithranol-induced inflammation by quantification of alkaline phosphatase.

An inflammatory response of the skin to dithranol-induced free radicals seems to be essential for its clinical efficacy. In normal volunteers this response was evaluated at the level of the microvasculature following 30 min, 2 h and 24 h applications, using a functional parameter (erythema) and a biochemical parameter (alkaline phosphatase). The results of 'short contact' and 24 h applications were similar. In all schedules a maximum erythema was seen 2-3 days after the application which had resolved totally after 6-8 days. A marked discrepancy was established between the duration of functional and biochemical abnormalities; the alkaline phosphatase activity reached a maximum 1 day after the culmination of the erythema and persisted up to at least 7 days after disappearance of the erythema. These findings are discussed in the light of the day-to-day management of psoriasis with dithranol.