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At least 217 records · Page 12Linked to original sources
PubMed1986

Catamenial pneumothorax--a literature review and report of an unusual case.

As already mentioned, only a few cases of CPT were described in the international medical literature, though there probably are some publications in languages unknown to us. It is quite possible that this syndrome is much more common than known to us, but until now there has been a lack of awareness of it. It may be presumed that in some of the cases of women complaining of some discomfort during menstruation, thorough examination would reveal a mild spontaneous pneumothorax which doesn't require any special treatment and is self-resolving; but most gynecologists are not thoroughly aware of this entity. While examining the clinical findings it is possible to demonstrate that this syndrome has its own clinical characteristics, totally different from those of spontaneous pneumothorax in the population as a whole. One of the characteristics of the syndrome is the assumption that women who do not ovulate, as women during the menarche, pregnant women and women taking contraceptive medications, are not subject to CPT. A case described in this review contradicts this assumption, although treatment with ovulatory suppressants, successfully used so far, should not be undervalued. The etiology and pathogenesis of this syndrome was and still is enigmatic. The accumulated knowledge so far does not point to any one etiologic factor. Therefore the suggested treatment, before definitive operative treatment, is so far experimental only, and its chances of success in any particular case are unpredictable.

Adult↗
PubMed1998

Artificial skin equivalent differentiation depends on fibroblast donor site: use of eyelid fibroblasts.

Our objective was to construct and explore human skin equivalents from several normal and pathologic donor skin sites to determine if the fibroblast origin influences epidermal differentiation. Also, we wanted to find out if fibroblasts from some donor sites produced epidermis of superior quality for plastic surgery repairs. Skin equivalents were constructed from 15 normal skin specimens, 9 normal eyelid specimens, 15 lesional skin specimens taken from patients with psoriasis, and 4 specimens from keloid scars. Results show that the tissue origin of the donor fibroblasts determines epidermal differentiation and the time period for regeneration. Eyelid fibroblasts were very dependable in establishing well-differentiated skin equivalents in all nine specimens. Our findings contribute to the accumulated knowledge of wound healing and should also be of value in skin grafting, especially when large areas are denuded as in burns, severe trauma, or cancer ablation.

Adolescent↗
PubMed1999

The modern hippocratic tradition. Some messages for contemporary medicine.

Hippocrates (5th century B.C.), the most prominent physician of antiquity, was born in the small Greek island of Kos, which is near the coast of Asia Minor. Before his era, medicine was practiced as an empirical art and had a religious nature. Hippocratic medicine represents the landmark for the evolution of Western medicine. This "father" of rational medicine assimilated the accumulated knowledge of the past and formed a diagnostic system based on clinical observation and logical reasoning. The great physician attributed diseases to natural causes, believed in the healing power of nature, and gave special emphasis to the prevention and prognosis of illnesses. He treated patients as psychosomatic entities (a holistic medical approach) in relation to their natural environment. In his treatises, Hippocrates defined the ethical principles guiding medical practice. His entire work was inspired by humanistic ideals and an undeviating dedication to the patient. Modern medicine can derive valuable lessons from the Hippocratic tradition. For the coming 21st century, medicine more than ever senses the need to combine the concepts of humanistic values and the Hippocratic messages with the technologic "imperative" (power). This bond is necessary to the improvement of medicine in the future because, currently, the enormous biomedical technology so far has contributed little to the traditionally human fields of psychosomatic and functional disturbances, posing new dilemmas and threatening scientific problems.

Ethics, Medical↗
PubMed2000

Animal models for the negative symptoms of schizophrenia.

Negative or defect symptoms refer to a reduction in normal functioning. In schizophrenia, negative symptoms encompass, among others, anhedonia, flat affect, avolition and social withdrawal. These symptoms have been found to be particularly prominent in the more chronic phase of the illness and seem to be virtually insensitive to current antipsychotic treatment. This review focuses on the possibilities and limitations of animal models for the negative symptoms of schizophrenia. Following a review of the negative symptoms in schizophrenia, attention is focused on the two symptoms most often modelled in animals - anhedonia and social withdrawal. We then look at the important question of how to model schizophrenic pathology in animals. Since the exact pathology is still far from clear, most efforts have in the past concentrated on using psychotomimetic drugs such as amphetamine or phencyclidine. The recently accumulated knowledge that schizophrenia probably results from disturbances in the normal development of the brain has led to a surge of new animal models in which the long-term consequences of early manipulations are investigated. However, so far these models have predominantly concentrated on the positive rather than the negative symptoms of schizophrenia. The last part of this review is dedicated to the question of validation of animal models for anhedonia and social withdrawal. The general conclusion is that very few models have so far been adequately tested. The lack of currently effective treatment further hampers the study of such validation.

Affect↗
PubMed1995

"Methodological notes on empathy": further considerations.

This article updates and extends Jeannette Gagan's "Methodological notes on empathy," published in the January 1983 issue of ANS. The evolving conceptualization of empathy as a complex, intrapsychic, and interpersonal process suggests that the inconclusiveness and apparent contradictions of research to date might be substantially clarified by considering data from a multidimensional perspective. Attention to the conceptual bases underlying diverse measurement approaches is key to understanding the data produced. Notwithstanding the limitations of their paradigms and models for nursing, the debates and knowledge accumulated in other disciplines can inform a broad range of inquiry relevant to nursing.

Education, Nursing↗
PubMed2004

Growth factors and treatment of intervertebral disc degeneration.

STUDY DESIGN: Literature review. OBJECTIVE: To review the most recent findings of the effects of growth factors on the intervertebral disc and, further, to discuss trends in the biologic repair of the degenerated intervertebral disc. SUMMARY OF BACKGROUND DATA: Since early in 1990, advancements in molecular biology and cell culture technology have enabled researchers to accumulate knowledge about the in vitro actions of growth factors on intervertebral disc cells. More recently, the use of growth factors for the biologic regeneration of the intervertebral disc is of increasing interest to the orthopedic field, and indeed, some preliminary in vivo studies have proven their efficacy. METHODS: Based on a literature search conducted using available databases, such as the National Library of Medicine, as well as data presented at scientific conferences held in the past 2 years, primarily in the United States, the current status of biologic therapy for disc degeneration using growth factors was summarized. RESULTS: With increasing evidence to support the feasibility of biologically regenerating intervertebral disc tissues, the clinical application of growth factors has become more plausible. The effects of growth factors on the metabolism of intervertebral disc cells or tissues have been extensively studied using in vitro approaches. More recently, the efficacy of an injection of growth factor protein to reverse disc regeneration has been shown in vivo using a small animal disc degeneration model. The confirmation of those effects and a detailed dose-response study, as well as a long-term safety study, in a large animal model is highly anticipated. Hopefully, the expansion of the clinical use of improved imaging techniques for the early detection of disc degeneration and promising results about the effects of growth factors on intervertebral disc regeneration will benefit the human population in the near future. CONCLUSIONS: The results from these in vitro and in vivo studies reviewed here clearly suggest the potential usefulness of growth factor injections as a new approach to restore intervertebral disc degeneration at an early stage.

Animals↗
PubMed2003

Mechanical injury and repair of cells.

OBJECTIVE: To concisely review the field of cell plasma membrane disruption (torn cell surface) and repair. MAIN POINTS: Plasma membrane disruption is a common form of cell injury under physiologic conditions, after trauma, in certain muscular dystrophies, and during certain forms of clinical intervention. Rapid repair of a disruption is essential to cell survival and involves a complex and active cell response that includes membrane fusion and cytoskeletal activation. Tissues, such as cardiac and skeletal muscle, adapt to a disruption injury by hypertrophying. Cells adapt by increasing the efficiency of their resealing response. CONCLUSION: Plasma membrane disruption is an important cellular event in both health and disease. The disruption repair mechanism is now well understood at the cellular level, but much remains to be learned at the molecular level. Cell and tissue level adaptational responses to the disruption either prevent its further occurrence or facilitate future repairs. Therapeutically useful drugs might result if, using this accumulating knowledge, chemical agents can be developed that can enhance repair or adaptive responses.

Adaptation, Physiological↗
PubMedDate not supplied

Gene therapy for type 1 diabetes.

The most intensively studied autoimmune disorder, type 1 diabetes mellitus (DM1), has attracted perhaps the greatest interest for gene-based therapeutic and prophylactic interventions. The final clinical manifestation of this immunologically and genetically complex disease, the absence of insulin, is the major starting point for almost all the gene therapy modalities attempted to date. Insulin replacement by transplantation of islets of Langerhans or surrogate beta cells is the obvious choice, but the allogeneic nature of the transplants activates potent antidonor immunoreactivity necessitating gene and cell-based immunosuppressive strategies as an alternative to the toxic pharmacologic immunosuppressives indicated for classic solid organ transplants. Accumulating knowledge of the cellular mechanisms involved in onset, however, have yielded promising tolerance induction prophylactic approaches using genes and cells. Despite the early successes in a number of animal models, the true test of efficacy in humans remains to be demonstrated.

Animals↗
PubMed2005

Primary care attributes, health care system hassles, and chronic illness.

BACKGROUND: Patients with a chronic illness are likely to report difficulties in their encounters with the health care system. Although most patients with a chronic illness are managed by primary care clinicians, little is known about how the attributes of primary care might be related to health care system hassles. OBJECTIVE: We sought to examine the relationship between attributes of primary care and health care system hassles among veterans with one or more chronic illnesses. RESEARCH DESIGN: This was a cross-sectional mailed survey. SUBJECTS: We included veterans with one or more chronic illnesses who were cared for in the South Texas Veteran's health care system. MEASURES: The Components of Primary Care Instrument was used to measure 4 attributes of primary care: accumulated knowledge of the patient by the clinician, coordination of care, communication, and preference for first contact with their primary care clinician. A 16-item health care systems hassles scale was constructed and demonstrated good face validity and reliability with a Cronbach's alpha of 0.94. RESULTS: Of the 720 surveys administered by mail, 422 (59%) were returned. Patients with multiple chronic illnesses reported a higher level of hassles than patients with a single chronic illness. After controlling for patient characteristics, primary care communication and coordination of care were inversely associated with patient hassles score: as communication and coordination improved, the reported level of hassles decreased. CONCLUSIONS: Effective delivery of primary care to patients with one or more chronic illnesses may be important in decreasing the level of hassles they experience as they interact with the health care delivery system.

Chronic Disease↗
PubMed2005

Gene expression profiling in acute myeloid leukemia.

PURPOSE OF REVIEW: This review deals with the emerging promises of gene expression profiling (GEP) and the currently accumulating knowledge about the classification and the discovery of novel disease entities in clinical acute myeloid leukemia (AML). RECENT FINDINGS: Gene expression profiling studies in AML have shown that known and novel classes of disease can be recognized by unsupervised analyses. Prognostically informative molecular signatures can be deduced. Supervised analyses show that particular clinically relevant subsets of AML can be predicted with high accuracy with minimal sets of genes. SUMMARY: The AML GEP studies published to date show a remarkable level of concordance in findings, especially for similar GEP platforms. This confirms the robustness of the methodology and the promise for future applicability of GEP in clinical diagnostics. For the time being, certain technical hurdles remain to be overcome. These relate, for instance, to the conversion of data between different GEP platforms, the effect of differences between various statistical clustering methods, and the still incomplete understanding of the effect of biologic (eg, morphology) and genetic factors on the expression signature. GEP analyses, perhaps in combination with high-throughput mutation analysis and proteomic approaches, may ultimately result in the establishment of a comprehensive diagnostic approach that will yield a key to the precise pathobiologic nature of AML.

Gene Expression Profiling↗
PubMed2004

Neurophysiologic evaluation of spastic hypertonia: implications for management of the patient with the intrathecal baclofen pump.

A number of techniques attempt to objectively quantify various clinical characteristics associated with spastic hypertonia and related motor disorders. These range in cost, complexity, physiologic basis of measured response, and invasiveness. With a greater range of treatment options for spasticity and an increase in the number of centers participating in studies of interventions for spasticity, published reports reflect increasing use of objective quantification techniques. We review studies that highlight the potential utility of neurophysiologic techniques, including the H-reflex, F-wave, and flexion withdrawal reflex, in the objective evaluation of response to intrathecal baclofen administration. The accumulated knowledge suggests that neurophysiologic evaluation is useful for assessing spinal cord responsiveness, and we recommend it as an adjunct to clinical evaluation when judging the overall effectiveness of intrathecal baclofen administration.

Baclofen↗
PubMed2003

Self-organized living systems: conjunction of a stable organization with chaotic fluctuations in biological space-time.

Living systems have paradoxical thermodynamic stability, the intrinsic property of self-organization, fluctuation and adaptation to their changing environment. Knowledge accumulated in the analytical reductionist framework has provided useful systematic descriptions of biological systems which appear to be insufficient to gain deep understanding of their behaviour in physiologic conditions and diseases. A state-of-the-art functional genomics study in yeast points to the current inability to appraise 'biological noise', leading to focus on few genes, transcripts and proteins subject to major detectable changes, while currently inaccessible small fluctuations may be major determinants of the behaviour of biological systems. We conjecture that biological systems self-organize because they operate as a conjunction between the relatively variable part of a stable organization and the relatively stable part of a chaotic network of fluctuations, and in a space with a changing number of dimensions: biological space-time. We propose to complement the precepts of the analytical reductionist framework with those of the biosystemic paradigm, in order to explore these conjectures for systems biology, combining in an iterative mode systemic modelling of biological systems, to generate hypotheses, with a high level of standardization of high-throughput experimental platforms, enabling detection of small changes of low-intensity signals, to test them.

Adaptation, Physiological↗
PubMed2003

Measurement of quality of life IV. Use of the SEQOL, QOL5, QOL1, and other global and generic questionnaires.

Quality-of-life (QOL) rating scales can be used to measure and describe the quality of life of a specific population or patient group. Many decisions can be taken and policies implemented when we know more about a group or population. The global quality-of-life concept may help in expressing the objective of the initiatives taken to benefit specific groups. The objective may be that we hope the efforts will increase their quality of life by a certain percentage. This explicit expectation will force the decision makers to stand by their noble intentions. They are obliged to evaluate their efforts and will have to learn something from it. A questionnaire thus constitutes a useful scientific instrument, as databases based on comprehensive and thorough questionnaire surveys that seek to encompass all aspects of life can provide valuable and precise information. The value of such a database depends on the correct use of the questionnaires and this paper examines some examples of how quality-of-life rating scales can be used. We identified at least ten ways to use the quality-of-life questionnaire: describing the quality of life of a population or patient group; formulating an objective for support, treatment, or care; screening or identifying individuals who need treatment; evaluating treatment and care; facilitating communication between physician and patients; involving the patient in the decision-making process; allocating resources; investigating the causal relation between the quality of life and ill health in prospective studies; creating an awareness of the quality of life and health promotion; and helping the practitioner to accumulate knowledge. Enhancing the quality of life is therefore a determining factor in the process of increasing awareness and responsible conduct in relation to the environment, natural resources, the working environment, and the structure of society. Putting the quality of life on the agenda inherently has a constructive and positive effect on the life and functioning of the individual and society.

Health Status↗
PubMed2005

Impact of genomics on research in the rat.

The need to translate genes to function has positioned the rat as an invaluable animal model for genomic research. The significant increase in genomic resources in recent years has had an immediate functional application in the rat. Many of the resources for translational research are already in place and are ready to be combined with the years of physiological knowledge accumulated in numerous rat models, which is the subject of this perspective. Based on the successes to date and the research projects under way to further enhance the infrastructure of the rat, we also project where research in the rat will be in the near future. The impact of the rat genome project has just started, but it is an exciting time with tremendous progress.

Animals↗
PubMed2003

Making connections: studies of the social organisation of healthcare.

This paper explores the questions: What has work published in Sociology of Health and Illness contributed to our understanding of 'healthcare organisation'? What are the key research issues for the future? The paper reviews past articles with these questions in mind and uses the first issue of the Journal as a starting point for identifying themes and issues which have remained relevant throughout the first 25 years of its history. I argue that, though the disparate contributions in this area sometimes fail to build on earlier research, when read together they offer a valuable picture of a complex range of healthcare settings and their social organisation. The importance of insights gained from other areas of sociological work is emphasised and some significant examples are identified. The willingness to cross boundaries into other disciplines is also recognised as a strength and this is seen as an important issue for future research, as is increased attention to international comparative research. In similar vein the author argues that the multiplicity of methodological approaches allows the reader to weigh the value of different kinds of data and to look for common underlying patterns of action. It is suggested that future work could usefully revisit past studies, so that we consolidate and accumulate knowledge of the field and avoid a cycle where we continually retread old ground.

Bibliometrics↗
PubMed2004

Strong irritants masquerading as skin allergens: the case of benzalkonium chloride.

Chemicals may possess a number of hazards to human health including the ability to cause skin irritation and contact allergy. Identification and characterization of these properties should fall within predictive toxicology, but information derived from human exposure, including clinical experience, is also of importance. In this context, it is of interest to review the case of benzalkonium chloride, a cationic surfactant. This chemical is a well-known skin irritant, but on occasions it has also been reported to have allergenic properties, typically on the basis of positive diagnostic patch test data. Because the accumulated knowledge concerning the properties of a chemical is employed as the basis for its regulatory classification (e.g. in Europe), as well as for informing the clinical community with respect to the diagnosis of irritant versus allergic contact dermatitis (ACD), it is important to distinguish properly which chemicals are simply irritants from those which are both irritant and allergenic on skin. A review of the information on benzalkonium chloride confirms that it is a significant skin irritant. However, both predictive test results and clinical data lead to the conclusion that benzalkonium chloride is, at most, an extremely rare allergen, except perhaps in the eye, but with many supposed cases of ACD being likely to arise from the misinterpretation of patch test data. As a consequence, this substance should not normally be regarded as, or classified as, a significant skin sensitizer.

Benzalkonium Compounds↗
PubMed2004

Effect of intranasal fluticasone propionate and triamcinolone acetonide on basal and dynamic measures of hypothalamic-pituitary-adrenal-axis activity in healthy volunteers.

BACKGROUND: Most published studies show that intranasal corticosteroids have no effect on the hypothalamic-pituitary-adrenal (HPA) axis, but there have been isolated reports to the contrary, contradicting accumulated knowledge on pharmacokinetics. OBJECTIVE: To re-evaluate the effect of fluticasone propionate aqueous nasal spray (FPANS) and triamcinolone acetonide (TAA) aqueous nasal spray on the HPA axis using an improved study design. METHODS: Twenty-three healthy volunteers were randomized in a double-blind, three-way crossover study. The study comprised a 4-day placebo run-in phase followed by three 4-day treatment periods (placebo, FPANS (200 microg once daily) or TAA aqueous nasal spray (220 microg once daily)), separated by 7-14 days washout intervals. Before the first, and on the last day of each treatment period, 12-h overnight urine was collected to assess cortisol excretion and cortisol creatinine ratio. Approximately 26 h after the last administration of study medication, volunteers underwent stimulation with 0.5 microg adrenocorticotropic hormone (ACTH). Serum cortisol concentrations were measured before and 20 and 30 min after injection. Blood and urine samples were analysed for cortisol by liquid chromatography tandem mass spectrometry. RESULTS: Compared with placebo, EP or TAA had no significant effect on mean overnight (12 h) urinary cortisol excretion, and did not significantly suppress the overnight geometric mean urinary cortisol/creatinine excretion ratio. Values for serum cortisol before and after ACTH simulation showed no significant suppression, although there was a slight blunting of the HPA-axis response following TAA treatment. CONCLUSION: This study confirms that there are no detectable effects on the HPA axis following short-term intranasal FP or TAA at their recommended dosages.

Administration, Intranasal↗
PubMed1996

Undernutrition and elderly hospital patients: a review.

Numerous surveys have revealed that many hospital patients are undernourished. Elderly patients are particularly vulnerable to the adverse consequences of undernourishment. Slow acquisition and application of available knowledge has been blamed as a principle reason for lack of progress in tackling the problem of 'hospital malnutrition'. This paper provides a resumé of the knowledge accumulated from research with the purpose of promoting active and informed nursing involvement in the detection and management of undernutrition in hospital wards.

Age Distribution↗