An assessment of home remedy use by African Americans.

This analysis represents the first national look at family and individual use of home remedies by African Americans. The purpose is to examine home remedy usage by African-American individuals and their families and assess the relationship between sociodemographic characteristics and home remedy usage for African-American families and African-American individuals. Using logistic regression, a secondary analysis of the National Survey on Black Americans (NSBA) data (N = 2107) was conducted to examine factors associated with home remedy use. Multivariate analysis indicated that parent's education, importance of religion, living with a grandparent, and living in a rural area were associated with families' use of home remedies. Age, gender, living with a grandparent, education, and geographic region were associated with individual home remedy use. The results of this research may provide insight to health care practitioners in their challenge of appropriately integrating self-care practices (i.e., home remedy use) and the use of the formal health care system among the patients that utilize both "scientific" and "folk" medical systems. When possible, treatment plans should be adapted to consider patients' demographics, health beliefs, and self-care practices. Health care providers should encourage patient and family involvement and dialogue regarding therapeutic approaches. As more information becomes available, health care practitioners will be better able to ascertain the possible health consequences of concurrent usage of home remedies and prescription drug therapies.

Nonprescription and alternative medication use by individuals with HIV disease.

OBJECTIVE: To examine the strength of the associations between predisposing, enabling, and need-for-care variables and the self-treatment of HIV disease; and to compare sociodemographic and illness-related factors associated with the use of vitamins, nonprescription medications, herbs, and recreational substances among HIV-infected individuals. METHODS: Data were derived from 7887 interviews conducted as part of the AIDS Cost and Services Utilization Survey. The conceptual framework was the Andersen Behavioral Model of Health Services Use. Factors associated with nonprescription and alternative medication use were assessed using logistic regression. Generalized estimating equations were applied to adjust variance estimates for within-person correlations of drug use over time. RESULTS: After adjusting for perceived health status, T cell count, and stage of disease, the results indicated that African-Americans were less likely to use nonprescription drugs (odds ratio [OR] 0.65, 95% CI 0.52 to 0.81), vitamins (OR 0.59, 95% CI 0.48 to 0.73), and herbs (OR 0.41, 95% CI 0.22 to 0.76), compared with non-Hispanic whites. Similarly, Hispanics were less likely to report use of herbs (OR 0.58, 95% CI 0.34 to 0.98) or recreational drugs (OR 0.34, 95% CI 0.15 to 0.76) than were non-Hispanic whites. Oppositely, individuals who had a college education were more likely to use vitamins (OR 1.26, 95% CI 1.05 to 1.50) and herbs (OR 2.47, 95% CI 1.56 to 3.91). Enabling variables such as insurance status and income were generally associated only with use of recreational drugs. Need-for-care variables were generally associated only with use of nonprescription drugs and vitamins. CONCLUSIONS: Predisposing, enabling, and need-for-care variables from the Andersen Behavioral Model were significantly associated with the use of four categories of drugs to self-treat HIV disease. However, there was not a consistent pattern across the drug categories.

Acute maternal renal insufficiency in premature labor treated with indomethacin.

Three cases of acute renal insufficiency in pregnant women who were treated with indomethacin for premature labor are reported. At the time of presentation, all three women had normal renal function but within 30 hours of indomethacin therapy they were noted to have significant decreases in urine output and rising serum creatinines. The average time to recovery of renal function was 5 days. A consistent feature in all three women was the development of dyspnea associated with hypoxemia.

Detecting and preventing adverse drug interactions: the potential contribution of computers in pharmacies.

For patients taking two or more medications concurrently, interactions among the drugs can cause undesirable effects or negate desired responses. In modern pharmacy practice, an important role of the pharmacist is to detect potentially harmful interactions and take appropriate action to prevent their occurrence. Pharmacy computer systems offer potential for improving pharmacists' effectiveness in the detection and followup of drug interactions. Based on a survey of southern Michigan pharmacists, relationships between computer use and pharmacists' attitudes and activities in drug interaction monitoring were investigated. Respondents included users of two major computer systems as well as pharmacists who do not use computers. Results suggest that general statements cannot be made about the effect of computer use on drug interaction detection. Users of one of the two computer systems detected and followed up on interactions more frequently and were more likely to report improved knowledge of drug interactions than non-users. Frequencies of drug interaction detection and other related measures reported by users of the second computer system were similar to those for pharmacists not using computers. Computer system characteristics which might lead to these differences are discussed.

Relationships between computer use and pharmacists' professional behavior.

Relationships between use of pharmacy computers and performance of selected professional activities were investigated, via a survey of southern Michigan pharmacists. Respondents included users of two major computer systems as well as pharmacists who do not use computers. A net response rate of 65.7 percent (213 usable questionnaires) was achieved. In general, computer users reported encountering more drug-related problems than did nonusers and more frequent contacts with prescribers for drug-therapy problems. Little difference was found between the two groups in regard to patient counseling activities, except that computer users were more likely to use auxiliary labels. When responses from users of the two computer systems were examined separately, results suggested that one of the systems contributed positively to certain aspects of pharmacists' professional activities while the other system had little influence. These results indicate that it may not be possible to state general conclusions about the effect of computers on the professional practice of pharmacy.

Early antigen titers in pediatric patients with acute cervical lymphadenitis.

Eight pediatric patients with acute cervical lymphadenitis or neck mass, alone or in association with nonspecific upper respiratory complaints, were screened for the presence of a primary or reactivation Epstein-Barr virus infection. All were found to have elevated antibodies to the early antigen (EA) and 75% (6) of these were found to be reactivations. Only one had a positive heterophile. Half of the patients had elevation of the EA-specific IgA, and 75% (6) had elevation of viral capsid antigen-specific IgA. All had elevated levels of soluble immune complexes. There was not a direct relationship between the EA titer or soluble immune complex level and severity of disease.