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PubMed2002

[Advances in monoclonal antibody researches].

Monoclonal antibody techniques are very important tools in modern life science research. Despite extensive research efforts paid in recent years, and promising results yielded in the study on the structure and function of genes and proteins, there is still a great need for further researches on the definition, principle and applicability of some immunological methods. This review gives an overview of the advances in immunological researches, including DNA immunization, cellular immunization and preparation of monoclonal antibodies. Using methods of modem molecular immunology, such as genetic immunization, cellular immunization, subtractive immunization and repetitive immunization multiple sites (RIMMS), to construct eukaryotic expression vector and to prepare high-affinity monoclonal antibodies in short time, the conventional method which is time-consuming and laborious could be improved. It is meaningful to the field of basic research and application, such as proteomics, biochip, clinical medicine and diagnosis and therapy of diseases.

Aerospace Medicine↗
PubMed2002

Contraception and society.

When an idea meets the exigencies of an epoch, it becomes stronger than any form of political power and it becomes the common property of humankind. Such an idea was the development of contraceptives. In retrospect, the invention of contraceptives was as fundamental for the evolution of humankind as the invention of the wheel; today more than 550 million couples are using contraceptive methods. The large-scale use of contraceptives triggered the most powerful social revolutions of a century in reproductive health and gender equity, and substantially contributed to an unparalleled demographic change, characterized by a rapid aging of populations. One of the important reasons for population aging is a significant decline in fertility rates, resulting in gradually changing population structures with fewer and fewer children and more and more elderly persons. The causes underlying these demographic changes are complex and manifold; they reflect major societal changes of historical dimensions. Many of our institutions cater increasingly for a population structure that no longer exists. There is therefore an increasing need for institutional reforms in social security, health care, housing and education. In addition, several surveys conducted in the developed world have indicated an erosion of confidence in our basic institutions, e.g. courts and justice, the Church and Parliament. Whereas modem sociologists are concerned about an increase in crime, decrease in trust and depleted social capital, one can also observe an accelerated perception of our global destiny and a re-awakening of the moral impulse with a strong demand for increased transparency in public affairs. Also, various global communities have assumed a growing importance. It can be predicted that international professional communities, such as the European Society of Contraception, will play an increasingly important future role in influencing policies in general and health policies in particular. because of their profound commitment to the improvement of the human condition by the judicious use of new scientific information.

Adult↗
PubMed2002

The comparison of reproductive health data in a rural district in Turkey (1981-2001).

OBJECTIVES: The main objective was to compare new reproductive and family planning data with data from the 1981 survey. METHODS: All 15-49-year-old married women living in seven villages of Gemlik were interviewed and the data were compared with the 1981 data of the same villages. RESULTS: In 1981, 66.8% used a family planning method, 6.8% used an intrauterine device, 10.2% used oral contraceptives and 10.0% used condoms. In 2001, these values were 93.0%, 36.5%, 6.0% and 14.8%, respectively. In 1981, 51.5% and in 2001 35.5% used coitus interruptus. CONCLUSION: In 20 years, users of both current family planning methods and modem methods have increased; users of traditional methods have decreased.

Adolescent↗
PubMed2002

Integrated regional services: are working process changes desirable and achievable?

In the hospital district of Helsinki and Uusimaa, 32 municipalities with one or more health centres provide primary care to their residents. Legal and organizational barriers between primary care and hospital care impede the continuity of patient care. Integrating primary and secondary care with the aid of information technology may facilitate a virtual electronic patient record, in which the viewing of images and other patient data is possible regardless of the organization that produced them. For example, in one trial, diabetic patients sent their home blood glucose measurements by modem to their health centre. Preliminary observations suggest that they could increase their glucose testing largely because they were able to transmit the results to the database and receive teleconsultations. Also, a picture archiving and communication system (PACS) has been in operation in two clinics of the Helsinki University Central Hospital for over two years and seven hospitals had become filmless by the end of 2001. A regional PACS is planned to be completed by the year 2004.

Adolescent↗
PubMed2003

Provocative test occlusion or the Matas test: who was Rudolph Matas?

Temporary occlusion of large vessels (the Matas test) to test the adequacy of collateral circulation is part of daily clinical practice. Nevertheless, only a few clinicians are aware of Rudolph Matas and his pioneering work in different fields of medicine. A legendary New Orleans surgeon, Rudolph Matas (1860-1957) lived nearly a century. During that time he witnessed enormous progress in medicine and greatly contributed to its evolution. He is unanimously recognized as the father of modem vascular surgery for his creation and popularization of aneurysmorrhaphy, a technique for the definitive treatment of aortic and peripheral aneurysms. He also made significant contributions to the then burgeoning fields of anesthesia, critical care, and infectious disease (yellow fever in particular). In 1911, he wrote a landmark article in which he described a challenge test to assess the degree and efficacy of the collateral circulation in patients under consideration for permanent occlusion of a major vessel. Matas studied the feasibility of such a test by temporarily occluding the carotid and femoral arteries in dogs for variable periods of time. In the introduction to his seminal article on the subject, he stated that "the chief object of this inquiry has been to determine whether the large arteries can be occluded long enough to make it possible to observe the effect of the arrested circulation in the territory supplied by the occluded vessel, without irreparably damaging the artery during the period of observation." He definitively achieved his stated goal: the Matas test, although greatly modified by contemporary endovascular techniques to be safer and more reliable, is in essence still routinely performed worldwide 90 years after its initial description.

Eponyms↗
PubMedDate not supplied

[Working experience of the analytical group of the specialized epidemic brigade].

The working experience of the analytical group as the section of the specialized antiepidemic brigade for the organization and realization of antiepidemic measures, made under the conditions of the antiterrorist operation in the Chechen Republic in the year 2000, is generalized. The necessity for equipping the specialized brigade with a modern computer with peripherals and the necessary specialized computer programs, as well as with modem and fax-telephone facilities, is shown. The necessity of equipping this brigade with the electronic variant of the information and legal data base (references on methods, sanitary norms and other normative documents on sanitation, hygiene, epidemiology, bacteriology and the organization of health service) is indicated.

Communicable Disease Control↗
PubMed2003

Knowledge of, attitudes towards, and practices relating to child-spacing methods in northern Burkina Faso.

This study was carried out to document current trends in knowledge of, attitudes towards, and practices relating to traditional and modern child-spacing methods in a remote area in northern Burkina Faso. Information on sexual abstention, weaning, and contraception was elicited from 296 women of reproductive age, involving 413 postpartum intervals. A number of older women and key informants were also interviewed. The findings depicted significant diversity in that durations of individual postpartum sexual abstinence varied between 40 days and 3 years, with shorter durations associated with stricter adherence to Islamic beliefs and, possibly, a trend towards a less collective and, for the family unit, more labour intensive, agro-pastoral subsistence economy. Although durations of amenorrhoea were relatively short at between (median) 9 and 11 months, they determined the length of non-susceptible periods in almost 90% of cases. The median timing of weaning was stable at 24 months across all three main ethnic groups. However, changes in the frequency and type of complementary feeds may have impacted on the duration of amenorrhoea. Both demand for modem contraception and contraceptive prevalence (< 1%) were very low. The creation of new child-spacing norms and the promotion of modern contraceptive methods are likely to be successful in areas like this one only, if the population can be sensitized to the idea that Islam does not necessarily discourage contraception.

Adult↗
PubMedDate not supplied

Effect of combined treatment with paroxetine and transcranial magnetic stimulation (TMS) on the mitogen-induced proliferative response of rat lymphocytes.

Depression is associated with abnormal functions of the immune system. In this study, we investigated how two modem antidepressant therapies, chronic treatment with transcranial magnetic stimulation (TMS) and administration of an antidepressant belonging to selective serotonin reuptake inhibitors (SSRI), paroxetine, affect the proliferative response of thymocytes and splenocytes stimulated in vitro with various mitogens. Paroxetine (10 mg/kg) and TMS (B = 1.2 T, f = 30 Hz, t = 330 s) were applied once daily for 12 consecutive days, while, if given jointly paroxetine was injected 30 min before TMS. The mitogens used were: concanavalin A (Con A), pokeweed mitogen (PWM) or lipopolysaccharide (LPS). While either treatment applied alone had no effect on proliferative response, the joint application of paroxetine and TMS significantly depressed it. The literature data suggest that pulsed magnetic field may directly inhibit mitogen-activated lymphocyte proliferation, which is also inhibited by the presence of high level of serotonin. The present results suggest that both effects are additive, and because of that application of both treatments, whose effects alone are insufficient to prompt the reaction, possibly because adaptive changes during chronic treatment, results in a significant inhibition of lymphocyte proliferation.

Animals↗
PubMed2003

Food allergies--leads from Ayurveda.

Food allergy being a common health problem needs attention. The experience of Ayurveda can be utilized to accelerate our understanding and management of food allergies and related phenomenon like allergic tension fatigue syndrome, intolerance and indigestion associated with certain foods. Prevention of food allergies by carefully selecting the foods in accordance with the individual's body constitution and seasonal alterations, is considered as the best strategy in Ayurveda. If possible, the concept of prakriti and properties of food as described in Ayurveda, should be interpreted in modern terminology. Moreover, to scientifically validate them, an appropriate correlation with modern concepts is required along with scientific studies on modern parameters. Rasayanas may also prove helpful in the management of food allergies. It is obvious that there, is an urgent need for multidimensional and planned investigations of these Ayurvedic rasayanas in management of food allergies. The clinical acceptability of rasayanas for the treatment of food allergies entirely rests on such studies. Food intolerance and allergies are common health problems which are difficult to diagnose and still more difficult to treat. This problem is well addressed in Ayurveda and guidelines are available for their management. This paper aims to present the Ayurvedic concepts in the management of food intolerance/ allergies and its correlation with the evidences available from modem scientific laboratories. The understanding of this ancient wisdom may prove to be of immense importance in patient care.

Food Hypersensitivity↗
PubMed2003

[The making of hygienic modernity in Meiji Japan, 1868-1905].

This article is based on conceptual and methodological understanding of hygienic modernity in the nineteenth-century Western countries: one is the concept of modern hygiene in the context of modern state and the other is methodological relation of modern hygiene to scientific theory of germ . While modern state calls for the institutionalization of medical police as an administrative tool for consolidating the governmentality what Michel Foucault calls, scientific 'invention' of germ may be considered as 'logical, philosophical and historiographical'. Furthermore, the Meiji medicine men preferred Koch's to Pasteur's laboratory framework, not because the former was scientific than the latter but because Koch's programs were more compatible with imperial needs. The objective of this paper is to investigate four ways in which hygienic modernity had been established in Meiji Japan; (i) how Meiji imperialists perceived and managed to control Japanese hygienic condition, (ii) how Meiji-leading doctors learned about the German modern system of hygiene to consolidate Meiji empire; (iii) how modern germ theory functioned as the formation of imperial bodies in Meiji period; and (iv) how modem military hygiene contributed to Japanese defeat of Russia. Although I try to contend that modern hygiene was adopted as one of the most significant strategies for intensifying and extending the Meiji empire, this paper has some limits in not identifying how Japanese perception of infectious diseases were culturally adaptive to science-based hygienic programs the Meiji administrators had installed.

Communicable Diseases↗
PubMed2003

Virtopsy-postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) in a fatal scuba diving incident.

The body of a 44-year-old scuba diver was examined using postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI), and findings were verified by subsequent autopsy. The goal was to find out whether the important pathomorphological findings for the reconstruction of events and the identification of cause and manner of death could be identified using modem digital cross-sectioning techniques. The findings of a massive vital decompression with pulmonary barotrauma and lethal gas embolism were identified in the radiological images. MSCT and MRI were superior to autopsy in the demonstration of the extent and distribution of gas accumulation in intraparenchymal blood vessels of internal organs as well as in areas of the body inaccessible by standard autopsy.

Abdomen↗
PubMed2003

A new addition to the structural bioinformatics toolbox: 3D models of short bioactive peptides from multiple sequences using feedback restrained molecular dynamics (FRMD).

Modem molecular biology techniques allow the use of new approaches for the 3D mapping of 1D information. Molecular biology techniques are capable of producing large amounts of 1D information (sequences) from a number of different sources (phage displays, ESTs, etc.). In this work, we present a technique that takes advantage of large sets of 1D information and increasingly available computer power to create 3D models. For the purpose of validation the technique is first applied to the modeling of an erythropoietin analog of known 3D structure from 1D information only. The technique is then used to model the immunoreactive region of echinococcus granulosus AgB based on phage raised mimotopes for which there is no previous structural information. The technique here presented is of general application to similar problems where 1D information is available and structure activity relationships (SAR) is needed.

Animals↗
PubMed1992

Increases in knowledge and use of information technology by entering medical students at McMaster University in successive annual surveys.

OBJECTIVE: To determine self-reported microcomputer and information technology competency, access, and usage by entering medical students and their perceptions of the need for training in additional applications. DESIGN: Cross-sectional surveys of successive classes. SETTING: McMaster University Faculty of Health Sciences Medical Undergraduate Program, which has a 33-month, problem-based, self-directed learning curriculum and a high applicant-to-student ratio. PARTICIPANTS: Medical school classes entering in 1987, 1988, and 1989. Response rates were 80%, 90%, and 86% respectively. MEASURES: A self-report questionnaire was sent to each student, with up to two follow-up letters to prompt a response. RESULTS: There was a progressive rise in reported information technology access and use for the three years. For the classes starting in 1987, '88, and '89 respectively, computer access was 29%, 49%, and 49% (P < 0.002 for linear trend), and, among those with computer access, modem access was 17%, 29% and 50% (P = 0.012). Self-service MEDLINE use on CD-ROM at the Health Sciences Library was 65%, 75%, and 89% respectively (P < 0.001) for all respondents within the first few months of starting medical school. Over 50% of each class stated they would take courses, if available, on clinical applications software, office management, online searching, filing, and CD-ROM searching. CONCLUSIONS: Half of the most recent entering students already had access to a personal computer and most wished to learn computer applications that would assist them with patient management, and with information access and organization. Medical schools need to address which applications they will teach or make available and how to bring all students to acceptable competency in their use.

Computer Literacy↗
PubMed2003

Applications of ultrasonography in oral and maxillofacial surgery: a review of the literature.

Ultrasonography is a diagnostic medical procedure that employs high frequency sound waves to produce dynamic visual images of organs, tissues, or blood flow inside the body. Until recently it found little application in oral and maxillofacial surgery despite the fact that it is readily available, non-invasive, relatively inexpensive, painless and can be repeated as often as possible without risk to the patient. This article reviews the available literature on the ultrasonographic examination of the head and neck with particular reference to oral and maxillofacial surgery and evaluates the applications of this imaging modality in modem clinical practice. It further highlights the need for clinicians to explore and fully appreciate the diagnostic value of this highly under-utilised imaging modality.

Craniofacial Abnormalities↗
PubMed2004

[Use of teleradiology in the evaluation and management of head-injured patients. Results of a pilot study of a link between a district general hospital and a neurosurgical referral center].

UNLABELLED: Because of the centralization of neurosurgical services, many head-injured patients who are initially evaluated in district general hospitals need to be transferred to a high technology centre for neurosurgical assessment. However, after assessment, many of these patients are sent back to the original hospital. Establishing a teleradiological system between the two hospitals would eliminate these unnecessary transfers. OBJECTIVES: 1) to describe our initial experience and the results of a pilot study of the teleradiological link between a district general hospital and a tertiary hospital for neurosurgical assessment of head-injured patients, 2) to describe the infrastructure and the technological support required for this project, 3) to analyse the effects of the teleradiological link in both centers (referring and receiving), 4) to evaluate the effectiveness of the system in avoiding unnecessary transfers, and 5) to assess its effectiveness in improving the speed and the quality of transfers in head-injured patients. MATERIAL AND METHODS: In January 1998, the Neurotraumatology Unit of Vall d'Hebron University Hospital established a teleradiological link with the General Hospital of Vic for the neurosurgical evaluation of headinjured patients. The General Hospital of Vic sent the patients' clinical information by fax. CT scan images were digitalized, compressed and prepared for transmission with the StatView program, and were then transmitted by modem to the receiving center. The duty neurosurgeon viewed the images on a PC screen using MutiView software. After evaluating this clinical and radiological information the neurosurgeon sent a report back to the referring center recommending transfer or management (admission, observation, etc.). RESULTS: We analyse the results of our experience 5 years after the implantation of the teleradiological link. CONCLUSIONS: The use of teleradiology in the daily management of head-injured patients provides clear benefits and leads to a more rational use of resources, thus significantly reduces costs. The effectiveness of the system in reducing the interval between the injury and treatment in severe cases depends more on the infrastructure of the health system in each geographical area than on sophisticated telemedicine systems. These methods should be accompanied by other measures designed to hasten the transfer of selected patients.

Adolescent↗
PubMed2003

Informed consent: information or knowledge?

A fiduciary relationship should be nurtured between patient and physician. This requires effective communication throughout all aspects of care - especially pertaining to treatment decisions. In the context of illness as experienced by the patient a unique set of circumstances is presented. However, communication in an illness context is fraught with problems. The patient is vulnerable and the situation may be overwhelming. Voluminous amounts of information are available to patients from a host of health care providers, family members, support groups, advocacy centers, books, journals, and the internet. Often conflicting and confusion, frequently complex, this information may be of greater burden than benefit. Some information is of high validity and reliability while other information is of dubious reliability. The emotional freight of bad news may further inhibit understanding. An overload of information may pose an obstacle in decision-making. To facilitate the transformation of information into knowledge, the health care provider must act on some occasions as a filter, on other occasions as a conduit, and on still other occasions simply as a reservoir. The evolution of patient rights to receive or refuse treatment, the right to know or not to know calls for a change in processing of overwhelming information in our modem era. In this paper we will discuss the difference between information and knowledge. How can health care providers ensure they have given their patients all necessary and sufficient information to make an autonomous decision? How can they facilitate the transformation of information into knowledge? The effect of knowledge to consent allows a more focused, relevant and modern approach to choice in health care.

Comprehension↗
PubMed2004

Developing cultural competence and social responsibility in preclinical dental students.

Dental student development of cultural competence and social responsibility is recognized by educators as an important element in the overall shaping of minds and attitudes of modem dental practitioners. Yet training modalities to achieve these competencies are not clearly defined, and outcome measurements are elusive. This article shows an effective method to meet these desired outcomes. Sixty-one freshmen (class of 2005) participated in forty hours of nondental community service, and reflective journals were completed by the end of second year. Competency outcomes were measured by selecting key words and phrases found in the individual journals. Key phrases were related to compassion, righteousness, propriety, and wisdom. Also, phrases had to be accompanied by written indications of direct program causation. The combination of active-learning (based upon service learning models) in public health settings outside of the dental realm, accompanied by reflective journaling, enhanced cultural understanding and community spirit in the majority of students.

Clinical Competence↗
PubMed2004

Chemical agents and chemical terrorism.

Chemical terrorism is a new threat to the security of mankind, which scale essentially exceeds the impact of use of the most modem firearms. At present time all over the world threats from different radical elements to use radioactive materials, potent poisonous substances and pathogenic microorganisms for terrorist purposes became more frequent. High-toxic chemical substances can fall in terrorist hands through wide range of sources. Potentially misused types of chemical compounds are discussed in this article.

Chemical Warfare↗