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PubMed1993

International access to the Chinese medical literature through MEDLINE.

This article reviews, for authors publishing in the Chinese literature, the characteristics of MEDLINE users, the format of MEDLINE citations and the main retrieval strategies used with the system. References were retrieved and data collected through MEDLINE searches of the database 1988-June 1992. Thirty-six indexed journals from the People's Republic of China (PRC) were analyzed. The items of a MEDLINE citation are described. Titles of Chinese journals are listed in English as well as Chinese in the annual "List of Serials Indexed" of Index Medicus. Articles from journals in the PRC are indexed at the China MEDLARS Center, Beijing, PRC. For the 36 journals analyzed, 12,530 citations appeared in MEDLINE during the search period. Basic search strategies are described. Users doing author searches may have difficulties with common Chinese surnames, especially if only one given name initial is used. Journal searches of specialty journals, as well as address field searches for publications from a particular institution, may be helpful to scientists planning a visit to China. Effective use of MEDLINE has become an opportunity and responsibility for scientists and physicians over the world. Suggestions for preparation of English titles and abstracts to assure optimal information transfer and retrieval efficiency are: think about your audience; do not waste words; include key features in the title; be consistent with names and affiliations; use MeSH terms; include important non-MeSH terms in text; use structured abstracts; and obtain MEDLINE printouts of your own citations.

Authorship↗
PubMed1993

Vitamin A supplementation and child mortality. A meta-analysis.

OBJECTIVE: A two-part meta-analysis of studies examining the relationship of vitamin A supplementation and child mortality. DATA SOURCES: We identified studies by searching the MEDLARS database from 1966 through 1992 and by scanning Current Contents and bibliographies of pertinent articles. STUDY SELECTION: All 12 vitamin A controlled trials with data on mortality identified in the search were used in the analysis. DATA EXTRACTION: Data were independently extracted by two investigators who also assessed the quality of each study using a previously described method. DATA SYNTHESIS: We formally tested for heterogeneity across studies. We pooled studies using the Mantel-Haenszel and the DerSimonian and Laird methods and adjusted for the effect of cluster assignment of treatment groups in community-based studies. Vitamin A supplementation to hospitalized measles patients was highly protective against mortality (DerSimonian and Laird odds ratio, 0.39; 95% confidence interval, 0.22 to 0.66; P = .0004) (part 1 of the meta-analysis). Supplementation was also protective against overall mortality in community-based studies (DerSimonian and Laird odds ratio, 0.70; clustering-adjusted 95% confidence interval, 0.56 to 0.87; P = .001) (part 2 of the meta-analysis). CONCLUSIONS: Vitamin A supplements are associated with a significant reduction in mortality when given periodically to children at the community level. Factors that affect the bioavailability of large doses of Vitamin A need to be studied further. Vitamin A supplements should be given to all measles patients in developing countries whether or not they have symptoms of vitamin A deficiency.

Child↗
PubMedDate not supplied

Acute management of patients with hip fracture. A research literature review.

PURPOSE: To provide the orthopaedic nurse a summary of the significant research concerning the management of patients with a fractured hip. DESIGN: Meta-Analysis. SAMPLE: 135 articles reviewed for possible inclusion, 57 original research reports and publications are reported. METHODS: For the years 1985 to March 1996 Medline, MEDLARS, and CINAHL data bases were searched. Twenty-seven search terms were used, including hip fractured), orthopedic standards, and length of stay. MAIN RESEARCH CLASSIFICATIONS: Preoperative, Operative and Postoperative. Studies arranged by author, outcomes, focus, data source and year, sample, and findings. FINDINGS: Research reports were found concerning: preoperative care including the use of MRI, predictors of complications and transfusion needs, and impact of skin traction on pain; operative studies including spinal anesthesia and oxygen saturation rates, use of blankets to keep patient warm, prophylactic antibiotic use, and impact of delaying surgery; and postoperative reports including the incidence of DVT, nutritional status, cauterization, management protocols, morbidity and mortality risks, length of stay, functional status, and ambulation. CONCLUSION: The scientific merit of each study was not evaluated in depth. With some degree of comfort the review did find one study or several studies to support the findings presented. IMPLICATIONS FOR NURSING RESEARCH: Current research concerning the impact of pressure sores, incontinence, management of falls risk, and the impact the fear of falling on postinjury patients are just a few of the topics not adequately addressed.

Acute Disease↗
PubMedDate not supplied

Gallbladder carcinoma: a 28 year experience.

BACKGROUND: Despite the fact that several studies have been conducted to demonstrate advancements in the treatment and prognosis of gallbladder carcinoma, no standard method of treatment has been identified or agreed upon. OBJECTIVE: The aim of this study were to review the presentation, staging, treatment and prognosis of subjects with cancer of the gallbladder at Howard University and its affiliated Institutions over the last three decades to see if there were any improvement in the survival. METHODS: A retrospective analysis of a 28 year experience at Howard University was performed. Patient gender, age, symptoms, signs, the diagnostic tests, pathology reports, operative and adjuvant treatments of each case were reviewed. A review of the English literature on the subject of gallbladder carcinoma covering the last twenty years using a Medlars search of the subject was also performed. An attempt was made to determine the utility of the various radiological tests used to diagnose and stage gallbladder, cancer. RESULTS: Patients with Stage I tumors using the Nevin classification had a 100% survival at 5 years. Patients with Stage V had 0% survival at 5 years. Stages II, III and IV had survivals of 51%, 12% and 10% respectively. The most common presenting symptom was abdominal pain which was present in 45% of cases. Gallbladder ultrasound studies had a sensitivity of 50% while the CT scanning had a sensitivity of 40% for disease detection. ERCP, when used, had a sensitivity of 75%. Radio and chemotherapy did not influence the survival of patients in this series. The most common surgical procedure performed was cholecystectomy with or without an associated hepatic resection for stage II and III, combined with adjuvant chemotherapy. CONCLUSIONS: The current prognosis of individuals with gallbladder carcinoma is dismal, nevertheless a slightly improvement over the last three decades has been achieved particularly regarding the sensitivity of the radiological tests to diagnosis GBC. Five fluorouracyl may be promising as adjuvant therapy associated with radiotherapy. Consideration should be given to a more aggressive screening with the up-to-date radiological tools, of high risk individuals and early resection of the gallbladder in high risk cases with any findings suggestive of gallbladder cancer.

Adult↗
PubMed1998

[Information retrieval on ethical problems by online consultation of bioethics bibliographic data bases].

In an age when the ever-expanding limits of sciences are requiring an adjustment of moral principles and values, the Bioethics file is an essential tool for those who are in need of updated guidelines on bioethical issues. This database--produced by the Kennedy Institute of Ethics (KIE) in collaboration with the National Library of Medicine (NLM)--is distributed online by different hosts and is also available in print version and on CD-ROM. Structure and contents of the online version of the Bioethics file searchable through MEDLARS are described in details.

Bioethics↗
PubMed1980

The role of the term schizophrenia in the decline of diagnoses of multiple personality.

The syndrome of multiple (dissociated) personality fell into disrepute around 1910. This has been attributed to loss of interest in hypnosis; psychiatrists believed the syndrome resulted from hypnosis and that they were duped. However, around 1910 an important event occurred in psychiatry: Bleuler introduced the term "schizophrenia' to replace "dementia praecox.' This factor also played a role in the decline of recognition of the multiple personality syndrome, and many of these cases were diagnosed as schizophrenia. A review of Index Medicus from 1903 through 1978 shows a dramatic decline in the number of reports of multiple personality after the diagnosis of schizophrenia "caught on,' especially in the United States. A review of clinical reports indicates that many patients with multiple personality had been diagnosed and treated as schizophrenics.

Dissociative Identity Disorder↗
PubMed1983

PaperChase. Self-service bibliographic retrieval.

During the past three years, from terminals within Beth Israel Hospital, Boston, 3,654 persons used a computer program called PaperChase to search the medical literature. While performing 39,022 searches, these persons had 1,976,421 references displayed and selected 449,690 of them for printing. Throughout this period, the program underwent continual modification. Each year the number of searches increased--from 10,678 to 11,541 to 16,803. Each year the percentage of new users who were unsuccessful decreased--from 16 to 13 to 11. By the end of the third year, 549 people had completed 20 or more searches. PaperChase enables people to search the medical literature themselves, and thus provides a new experience in computerized bibliographic retrieval. When made available without charge in a teaching hospital, PaperChase is widely used.

Boston↗
PubMed1986

Morning report. Role of the clinical librarian.

The educational value of morning report should be enhanced by thorough evaluation of the medical literature. We added a clinical medical librarian (CML) program to our morning report 2 1/2 years ago to provide rapid, complete access to reference material relevant to topics discussed in morning report. MEDLINE searches and references are made available on a same-day basis; cumulative lists of these are provided to the staff and house staff at bimonthly and yearly intervals. All house staff used the CML service to some degree and the majority found it to be of value in making patient care decisions. Since the inception of the CML program, the medical library has noted a more than twofold increase in the number of on-line reference searches and a similar increase in requests for searches by house staff. Patient care decisions have been improved through ready access to current medical literature, and the teaching program has been enhanced by the creation of the CML program as an integral part of morning report.

Attitude of Health Personnel↗
PubMed1986

CD-ROM. A new advance in medical information retrieval.

The massive production of medical information is being met by new technologies for storing and retrieving knowledge. Recent years have witnessed the maturation of time-sharing information utilities into a full-blown industry. In medicine these services have provided bibliographic information but have recently expanded to full-text availability of journals and books. Now optical storage technology, most conspicuously the compact disk read only memory (CD-ROM), provides similar massive information storage and retrieval affordable to microcomputer users. Such devices might replace many of the functions of time-sharing.

Computers↗
PubMed1988

Meta-analysis. A quantitative approach to research integration.

Meta-analysis is being used with increasing frequency in clinical medicine as an attempt to improve on traditional methods of narrative review by systematically aggregating information and quantifying its impact. Combining data from several studies using meta-analysis can increase statistical power, provide insight into the nature of relationships among variables, and increase generalizability of results more rigorously than less quantitative review methods. Like all review methods, meta-analysis can be limited by sampling bias, inadequate data, and biased outcome interpretation. Still, the advantages noted above make meta-analysis a methodology that warrants testing and empirical evaluation.

Data Collection↗