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Haematological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
A positive family history suggests an inherited disorder. In bleeding disorders, a sex-linked inheritance pattern may be evident, increasing the likelihood of a diagnosis of haemophilia.
Exercise testing in females
Published in R. C. Richard Davison, Paul M. Smith, James Hopker, Michael J. Price, Florentina Hettinga, Garry Tew, Lindsay Bottoms, Sport and Exercise Physiology Testing Guidelines: Volume II – Exercise and Clinical Testing, 2022
Kirsty M. Hicks, Anthony C. Hackney, Michael Dooley, Georgie Bruinvels
Practitioners often pay close attention to the effect of circadian, diurnal and ultra-dian rhythms on exercise and health in athletes. However, in female athletes, the menstrual cycle, which is an infradian rhythm, is sometimes overlooked. The menstrual cycle is an essential biological rhythm during which ovarian sex hormones, specifically oestrogen and progesterone, fluctuate. These hormones exert biological effects on several body systems, including the reproductive, immune, cardiovascular, neuromuscular and musculoskeletal systems (e.g., Enns and Tiidus, 2010; Ansdell et al., 2019). Consequently, the cyclical pattern of changes in hormonal concentrations can result in a plethora of systemic physiological-psychological alterations, which can affect exercise responses. Despite these potential effects, most practitioners do not consider the influence of the menstrual cycle. Therefore, this chapter presents a systematic framework for working with female athletes, by providing insight into the implementation and interpretation of screening and monitoring tools (Figure 5.10.1). Screening tools, including questionnaires and/or interviews, are designed to obtain medical and family history, and identify any pre-existing conditions and risks which might precede medical conditions. Monitoring, conversely, is a systematic, continuous process of data to detect changes from the individual’s ‘baseline’. collecting and analysing
Clinical Cancer Genetics
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Rosalind A. Eeles, Lisa J. Walker
In the hospital oncology setting, if an individual has presented with cancer at a young age, it is now becoming more common for that individual’s family history to be requested by cancer geneticists working as part of the multidisciplinary team coordinating the patient’s care. If there is significant family history in addition to the presenting cancer, a referral is made. Sometimes, a referral is made simply because an individual presents with an unusual type of cancer at a young age, for example, medullary thyroid cancer in childhood. In other settings, unless an individual directly expresses concern about their perceived risk, then the only way an at-risk family will be identified is by systematic questioning of all patients about a family history of cancer while eliciting a general medical history. As a quick guideline, taking a history of all first-degree relatives only (parents, siblings, and children) and then asking if there are any other cancers in the family will detect 95 per cent of familial syndromes. Due to the limited time available during most consultations, it would not be appropriate to obtain a detailed family history from the patient. From this quick family history it should, however, be possible to make an assessment of whether the family history warrants further investigation.
Parental Education and Delirium Risk after Surgery in Older Adults
Published in Clinical Gerontologist, 2023
Franchesca Arias, Fan Chen, Haley Shiff, Edward R. Marcantonio, Richard N. Jones, Eva M. Schmitt, Eran Metzger, Tamara G. Fong, Thomas G. Travison, Sharon K. Inouye
Previous studies have suggested that early-life exposures, such as parental education, can influence late-life health outcomes via cognitive functioning (Turrell et al., 2002) or adult SES (Haas, 2008). In our sample, the effect of paternal education on delirium incidence persisted independently of cognitive function at baseline and adult SES. Thus, it is possible that paternal education is associated with delirium risk via pathways not systematically assessed in our study (e.g., nutrition during formative years, childhood illnesses). Additionally, other paternal characteristics may contribute to the association between paternal education and delirium incidence. Paternal mental health, physical health, and age have been found to be associated with offspring health later in life (Manios et al., 2007; Vervoort, Delger, & Soubry, 2021). For example, advanced parental age has been associated with offspring mortality (Myrskylä et al., 2014), and that association is, at least in part, mediated by early parental loss. It is worth highlighting that the association between paternal education may be explained by factors that preceded both paternal education and delirium and not necessarily related to childhood SES (e.g., familial predisposition to a given condition, shared exposure to environmental factors). Thus, causal association cannot be derived from this analysis. Collection of more detailed information on family history in clinical practice and research may provide a more complete representation of the overall risk profile for each patient.
Long-term prognosis after a first myocardial infarction: eight years follow up of the case-control study PAROKRANK
Published in Scandinavian Cardiovascular Journal, 2022
Giulia Ferrannini, Mariam Almosawi, Kåre Buhlin, Ulf De Faire, Barbro Kjellström, Björn Klinge, Åke Nygren, Per Näsman, Elisabet Svenungsson, Lars Rydén, Anna Norhammar
Outpatient visits for study enrolment of participants were carried out at the local departments of cardiology. Patients were scheduled approximately 6–10 weeks after the acute event, in accordance with national routine care. To ascertain that the controls would undergo their investigations during the same season, they were contacted within 10 days after their matched patient had their visit. All study participants had fasted and abstained from smoking during at least 12 h prior to their physical examination and venous blood sampling. Information on medical and family history was collected through a set of standardized questionnaires. The self-assessment version of the Montgomery Åsberg Depression Rating Scale (MADRS) was used to evaluate symptoms of depression [15]. It includes nine questions concerning symptoms of depressive illness, i.e. sadness, inner tension, sleep, appetite, concentration, lassitude, inability to feel, pessimistic thoughts and suicidal thoughts [16].
Familial colonoscopic screening: how do French general practitioners deal with patients and their high-risk relatives. A qualitative study
Published in European Journal of General Practice, 2022
Isabelle Ingrand, Nicolas Palierne, Pauline Sarrazin, Yvan Desbordes, Clara Blanchard, Pierre Ingrand
The updating of family histories is constrained by the time GPs can spare, and the information given by relatives [7,21]. Thus, despite the undisputed fact that physician endorsement is a key factor in participation in family screening [27], this study confirms that the GPs interviewed did not regularly ask their patients about their family history. Systematic and cost-effective procedures are required to facilitate family history updating for risk assessment and to deliver screening advice within the primary health care setting [28,29]. Being aware of a family history of CRC is related to greater adherence to CRC OS [30]; updating family history is also an essential step in the process of CRC OS to correctly evaluate the risk level and propose an adequate screening strategy [30].