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PubMed1994

Common variable immunodeficiency: diagnosis and management.

OBJECTIVE: Common variable immunodeficiency is a heterogeneous syndrome characterized by humoral immunodeficiency, recurrent bacterial infections, and a variety of immunologic abnormalities. The goal of this article is to review the pathogenesis, clinical manifestations, diagnosis, and management of common variable immunodeficiency. DATA SOURCES: References are limited to the English language literature. Sources include computerized databases and bibliographies of recent articles and books. STUDY SELECTION: References that made important contributions to our understanding of the pathogenesis, clinical manifestations, diagnosis, and treatment of this disease were selected for inclusion in this review. RESULTS AND CONCLUSION: Common variable immunodeficiency is an idiopathic state of immune dysregulation that results in impaired antibody synthesis and the development of recurrent bacterial infections. This syndrome is also associated with a variety of autoimmune and neoplastic disorders. Effective management of these patients includes intravenous immunoglobulin replacement, vigorous treatment of infections, and readiness to promptly evaluate and treat unusual autoimmune and neoplastic complications should they appear.

Common Variable Immunodeficiency↗
PubMed1994

Prevalence, economic, and medical impact of tobacco smoking.

OBJECTIVE: The goal of this review is to report the epidemiology and risks associated with tobacco smoking. It also suggests reasons and measures to achieve a smoke-free society. DATA SOURCES: References are limited to the English language and human subjects. All are publications from either the United States or the United Kingdom and extend back to the past 50 years. Sources include computerized databases and bibliographies of recent articles and books. STUDY SELECTION: Papers were selected on the basis of their timeliness, credibility of their data, explanation of important findings, extrapolation of clinical data from large patient populations, and clarification of controversial issues. Approximately 60% of the articles initially reviewed are included in the bibliography. RESULTS: Tobacco smoking continues to affect the lives of millions of Americans. The risks of cardiovascular diseases, cancer, and respiratory diseases are significantly increased in both the smoker and in those exposed to environmental tobacco smoke. CONCLUSIONS: Understanding the consequences of tobacco smoking is necessary to effectively mobilize the appropriate political, social, and medical resources to combat this most important health issue.

Advertising↗
PubMed1994

Lyme disease, Rocky Mountain spotted fever, ehrlichiosis: emerging and established challenges for the clinician.

OBJECTIVE: The goal of this review is to facilitate the management of patients with tick-associated diseases. This article will discuss the epidemiology, clinical diagnosis, and antimicrobial therapy of Lyme disease, Rocky Mountain spotted fever, and ehrlichiosis. DATA SOURCES: References are limited to the English language and extend back to the beginning of the twentieth century. The human and veterinary literature were reviewed. Sources include computerized databases and bibliographies of recent articles and books. STUDY SELECTION: Papers were selected on the basis of their timeliness, explanation of important findings by major investigators, extrapolation of clinical data from large patient populations, and clarification of controversial issues. Approximately 50% of the articles initially reviewed are included in the bibliography. RESULTS: Standardization of laboratory testing for Lyme disease should facilitate more accurate diagnosis in the future. Clinical diagnosis of Rocky Mountain spotted fever and ehrlichiosis prior to laboratory confirmation is necessary in order to ensure timely institution of antimicrobial therapy. CONCLUSIONS: Knowledge of endemic regions and seasonal cycles of vectors, varying clinical presentations of disease and appropriate utilization of the laboratory are critical for the appropriate diagnosis and management of patients with tick-associated diseases.

Animals↗
PubMed1997

[Detoxication in opiate addiction and prevention of recurrence: administration of naltrexone and cognitive behavior therapy].

Rapid opiate withdrawal and relapse prevention in opiate addicts are made possible by naltrexone, clonidine and diazepam in combination with cognitive behavioural therapy according to the Community Reinforcement Approach. In an open pilot experiment 12 addicted patients achieved initial detoxification. At follow-up after a minimum of 6 months, 10 of these had not relapsed. Good results with this detoxification method could be booked by selecting highly motivated opiate addicts.

Adrenergic alpha-Agonists↗
PubMed1964

A HISTORICAL MEDICAL COLLECTION, AND SOME OF THE PROBLEMS IT PRESENTS.

The organization of a historical collection in a medical library presents many problems. Among these are space limitations, choice of material to be included, and classification. This paper discusses the organization of the historical collection particularly as it relates to books and journals in the Rudolph Matas Medical Library of Tulane University. The problem of classification is discussed at length. The principal classification systems are reviewed, particularly that of the National Library of Medicine Classification. The expansion of the NLM scheme to suit our purpose is presented. This includes classifying Americana imprints by subject rather than state, changing the termination date of Americana to 1900, grouping the history of specialties with books on the history of medicine, and recognizing the problem involved in reclassifying books on military medicine and surgery. The selection and arrangement of periodicals relating to the history of medicine is also discussed.

Book Classification↗
PubMed2004

A rounded dozen.

Welcome to a new series in which we invite distinguished psychiatrists from around the world to select the 12 books they have found valuable in shaping their ideas and influencing their clinical practice. I must be candid. I was totally won over to the intrinsic worth of doing such an exercise when I was invited to contribute to the '10 books' series of the British Journal of Psychiatry. I had to think long and hard but the effort was exhilarating. I discovered in an odd sort of way the figures who have proved central to the development of my career. Peter Tyrer, the Editor of the British Journal, graciously encouraged me to imitate the 10 books column. Hence the 'rounded dozen' concept. (I had immense difficulty confining myself to 10 books when I had to make my selections and thought a couple of extra places would not go amiss!) I am delighted that a dear friend and mentor, the eminent German psychiatrist, psychoanalyst and family therapist, Helm Stierlin, acepted my invitation to launch the new column. His 'essay' is not only replete with fascinating psychiatric history but also reveals a colleague who is able to maintain an eager curiosity about the nature of our marvellous profession and a willingness to alter his way of thinking in the light of new conceptual and empirical knowledge. I commend his essay to you and hope you are as inspired by it as I am. I shall be inviting other eminent psychiatrists to prepare a 'rounded dozen' but welcome any suggestions from the readership for potential contributors. Sidney Bloch Editor

Medicine in Literature↗
PubMed1993

Neurotoxicity of antineoplastic agents.

PURPOSE: to review the neurotoxicity associated with antineoplastic agents. METHODS: four hundred articles, abstracts and book chapters were selected for review. One hundred and ninety (articles, book chapters and abstracts) were identified as representative of the important aspects of neurotoxicity to be presented in this review. RESULTS: in general the dose, schedule and route of administration significantly determine the incidence and outcome of antineoplastic agents neurotoxicity. An updated and detailed review of neurotoxicity is provided with special attention to vinca alkaloids, cisplatin and biologic response modifiers. The neurotoxic side effects of some of the new approaches in cancer therapy and some of the investigational agents are discussed. Guidelines for the prevention and management of this toxicity are presented. In addition, suggestions are made in regard to the preclinical and clinical screening of new agents for neurotoxicity. CONCLUSION: quality of life issues have become a focal point in many clinical trials. Neurotoxicity associated with antineoplastic therapy clearly has an impact on the short and long term quality of the life of cancer patients. A better understanding of this toxicity requires developing reliable and predictive models to screen new agents prior to their introduction into clinical trials; a more detailed and uniform grading system; and the prospective evaluation of neurotoxicity in clinical trials of new antineoplastic agents.

Animals↗
PubMed2001

A medical book collection for physician assistants.

Selecting resources for physician assistants is challenging and can be overwhelming. Although several core lists exist for nursing, allied health, and medical libraries, judging the scope and level of these resources in relation to the information needs of the physician assistant is difficult. Medical texts can be highly specialized and very expensive, in essence, "overkill" for the needs of the physician assistant. This bibliography is meant to serve as a guide to appropriate medical texts for physician assistants. Titles were selected from the Brandon/Hill list, Doody's Electronic Journal, and various other reference resources. Resources were evaluated based on the subject and scope, audience, authorship, cost, and currency. The collection includes 195 titles from 33 specialty areas. Standard texts in each area are also included.

Book Selection↗
PubMed2003

Rapid and non-rapid cycling bipolar disorder: a meta-analysis of clinical studies.

BACKGROUND: Rapid cycling, defined as 4 or more mood episodes per year, is a course specifier of bipolar disorder associated with relative treatment resistance. Several risk factors have been suggested to be associated with rapid cycling. The purpose of this meta-analysis was to compare clinical studies for the evidence of discriminating factors between rapid and non-rapid cycling. DATA SOURCES AND SELECTION: We searched MEDLINE and reference lists of articles and book chapters and selected all of the clinical studies published from 1974 to 2002 comparing subjects with rapid and non-rapid cycling bipolar disorder. Prevalence rates and mean random effect sizes for 18 potential risk factors that were reported by at least 3 studies were calculated. In addition, we differentiated between current and lifetime diagnoses of rapid cycling. DATA SYNTHESIS: Twenty studies were identified. Rapid cycling was present in 16.3% of 2054 bipolar patients in 8 studies that included patients who were consecutively admitted to an inpatient or outpatient facility, without a priori selection of rapid cyclers and without matching the numbers of rapid cyclers to non-rapid cycling controls. Female gender and bipolar II subtype both had a small, but statistically significant, effect (p <.000 for female gender, p <.001 for bipolar II subtype). The further absence of recurrences with lithium prophylaxis was reported in 34% of rapid cyclers compared with 47% of non-rapid cyclers, a nearly significant difference, and a partial response was present in 59% and 65% of patients, respectively. The effect of hypothyroidism was significant (p <.01) in studies using current, but not lifetime, definitions of rapid cycling. In 46% of cases, a rapid cycling course was preceded by treatment with antidepressants, but systematic data on their causal role are lacking. CONCLUSION: Rapid cycling is slightly more prevalent in women and in patients with bipolar II subtype. In contrast to common opinion, lithium prophylaxis has at least partial efficacy in a considerable number of rapid cyclers, especially when antidepressants are avoided. Hypothyroidism may be associated with mood destabilization in vulnerable patients.

Bipolar Disorder↗
PubMed1997

Book reviewing: keeping the audience in mind.

Writing book reviews is an excellent way to start your publication experience and develop a relationship with a journal editor. Most nursing journals include book reviews, and some even select editorial board members from book reviewers who have demonstrated their ability to write concise, honest reviews and submit them on time. This author includes tips on writing a high-quality review by keeping the audience in mind.

Authorship↗