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PubMed1981

[Laennec. The bicentenary of the birth of the author of "auscultation mèdiate" (author's transl)].

R. T. H. Laennec (17. 2. 1781-13. 8. 1826), the founder of the principles of auscultation, started from poor beginnings to become the leading clinician of France. In the prime of life, holder of two chairs of clinical medicine and physician to prominent persons in public life, Laennec contracted pulmonary tuberculosis, which led to his death at his home in Brittany at the early age of 45 years. Laennec is still remembered by posterity as the inventor of the stethoscope and author of a pioneering textbook on diseases of the heart and lungs, which is still worth reading today.

Auscultation↗

PubMedDate not supplied

[Epidemiologic study of S. haematobium bilharziasis in the rice fields of Yagoua (North Cameroon) II. Distribution and ecology of intermediate hosts].

While inventoring the local malacological fauna and evaluating the density of species acting as intermediate hosts of human schistosomes it has been shown that Bulinus truncatus is predominant in the study area. Bulinus globosus is scarcely encountered. Biomphalaria pfeifferi is only found in the Mayo Guerleo, in irrigation canals and draining ditches. But B. globosus and B. pfeifferi have not yet invaded the recent aquatic network and are not found in the lake nor in the newly created irrigation systems. Snails shedding cercariae of S. haematobium and S. mansoni have been collected in the area. Bulinus forskalii is found in all types of permanent of temporary waterbodies but S. intercalatum has not yet been reported from North-Cameroon. Lymnaea natalensis, the intermediate host of Fasciola gigantica, is found in the lake and in the canals, in the Mayo Guerleo and in the Toupasko pool. The rice field does not form by itself a favorable environment for snails to develop in it. Spots where transmission occurare more often in the area the secondary of tertiary irrigation canals and the brains. The ditches obstructed by plants are the places where the snails are developing best. Bulinus spp. are found in large numbers in the lowest parts of the aquatic network and they accumulate there to survive drought conditions in the mud. The recently built irrigation systems are not massively invaded by the snails yet and the prevalence of bilharziasis in the area correspond to the distribution of the intermediate hosts of schistosomes and to the density of the snails populations.

Agriculture↗

PubMed1980

[A new method of gravity drainage].

Drains commonly used in abdominal surgery are to a large extent either ineffective or damaging. A new drainage system, called Robinson after its inventor has demonstrated its efficacy in broad clinical use in general surgery. Particular features of note are an inseparable drain bag unit, a one-way valve eliminating reflux from the bag, a silicon drain which does not block, as well as other useful attributes. In no case did complications occur.

Drainage↗

PubMed1995

[Revolution in diagnostic microbiology. Needs, driving forces and consequences].

Introducing molecular biological technology into medical microbiology promotes deeper insight into the epidemiology, pathogenesis, diagnostics and treatment of infectious diseases. New technology has helped to highlight the complicated biological interaction between host and microbes and has created a need for more advanced technology both in microbiological diagnostics and in microbiological science. Extra-professional factors like the high prestige of new techniques have also been of considerable significance. Medical microbiologists will become an important link between the inventors of new technology and the physicians who diagnose and treat the patients. Through these contacts and their diagnostic laboratory work, they will become important generators and communicators of knowledge. In this connection it will be important to represent reason in introducing technology in medical microbiological diagnostics. Since patients are expected to play a more active part in health care, communicating knowledge to patients and the population in general will become an obligation.

Genetic Techniques↗

PubMedDate not supplied

[The Phlebotomine sandflies (Diptera) from the Mayombe area in the Popular Republic of Congo (author's transl)].

Fifteen species and subspecies of Phlebotomine sandflies have been inventorized in the Mayombe forest in the People's Republic of the Congo. Nine of them are confined strictly to the rain forest; the others belong to secondary forest, clearing or savannah. We have drawn a comparison between the Phlebotomine fauna in the Mayombe and those existing in several other dense Congolense forests.

Animals↗

PubMed1995

[Symptoms of disease and food allergy in children with Down syndrome].

OBJECTIVE: To obtain an impression of how often parents of children with Down's syndrome suspect their children of having a food allergy and what action results from this suspicion. DESIGN: Inventorizing controlled descriptive study. 'Zuid-Holland' in the Netherlands. METHODS: An anonymous questionnaire was sent to 110 parents of children with Down's syndrome and 223 control parents. RESULTS: The parents of children with Down's syndrome reported symptoms of their child which might relate to food allergy more frequently than control parents. They reported more respiratory disease symptoms (62% and 53% respectively; pneumonia: 22% and 3%), more gastrointestinal disease symptoms (28% and 17%; constipation or diarrhoea: 28% and 13%), but fewer skin disease symptoms (12% and 26%). 34% of the parents of Down's syndrome children and 22% of the control parents suspected their child of having an allergy and 13% in both groups suspected food to be the allergenic responsible. Medical and laboratory investigations were performed in 37% and 31% and food allergy was diagnosed in 7% and 31% respectively. No elimination-reïntroduction diet was reported as used for diagnosing. Parents of children with Down's syndrome were less satisfied with their consultation of health workers. All parents in both groups who suspected their children of having a food allergy started an elimination diet, 66% found it had a beneficial effect. CONCLUSION: Compared with control parents, parents of children with Down's syndrome reported symptoms relating to food allergy more frequently, suspected their children of having a food allergy equally often, but had it diagnosed less frequently. However, neither group of parents mentioned that an elimination-provocation test was used for the diagnosis.

Animals↗

PubMedDate not supplied

[100 years since the death of Helmholtz].

In September 1994, we celebrated 100 years since Hermann von Helmholtz died. Inventor of the ophthalmoscope, professor in physiology since he was 30 (at Königsberg), Helmholtz also contributed to the development of thermodynamics, hydrodynamics, electrodynamics, he made studies on muscular contraction, music, theory, accommodation mechanisms. He also revealed that the interpretation of sounds is done at the level of resonators--represented by perilympha and basilar lamellae which enter in vibration accordingly with the respective sound frequency.

Germany↗

PubMed1994

[Surgical treatment of atrial fibrillation].

The persistence of atrial fibrillation with a controlled ventricular response with medical treatment or ablation of the His bundle, suppresses troublesome palpitations but leaves potential haemodynamic problems and the risk of thromboembolism. Surgical treatment of this arrhythmia, by leaving an anatomic bridge between the sinus and atrioventricular nodes, aims to allow acceleration of the ventricular rhythm on exercise whilst preventing by partial, total or selective exclusion of atrial tissues, the multiple intra-atrial reentries responsible for atrial flutter or fibrillation. The first method proposed was isolation of the left atrium (Cox, 1980) which allows acceleration of the ventricular rhythm during exercise, leaving little or no haemodynamic disturbance, but, in theory, the same risk of embolism. The second method, the "corridor" operation (Guiraudon, 1985) consists in isolating both atria, but significantly alters the haemodynamic efficacy without reducing the embolic risk, and hardly offers any advantage over ablation of the nodo-hisian pathway completed by implantation of a ventricular, rate responsive, pacemaker. The recently described "maze" procedure (Cox and Boineau, 1991) would seem to be more promising with judiciously chosen incisions (at the base of the atria, around the pulmonary veins, between the vena cavae, along the interatrial septum, etc.) and points of cryoablation in the region of the coronary sinus, allowing modulation of the ventricular response with activation of sufficient atrial tissue to prevent reentry and recurrence of atrial fibrillation without affecting haemodynamic efficacy. The results of this technique are encouraging in the hands of its inventors but require confirmation in larger series of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed1994

[Tomodensitometry: current technique and perspectives].

The inventors of computed tomography were rewarded by the Nobel Prize for Medicine in 1979. This apparatus, now used routinely, is based on the physical principle of attenuation of x-rays combined with computerised calculation to generate a tomographic image of the human body. This article describes the components of computed tomography, the mode of acquisition, calculation and image reconstruction and the criteria of image quality and artefacts. Continuous rotation of the x-ray tube, now available on the latest machines, allows rapid 3D acquisition of raw data, largely eliminating movement artefacts, particularly those related to respiration. It is also possible to reconstitute images in a different plane from the plane of acquisition and to obtain 3D representations of the volume studied. The advantages and disadvantages of this recent technique are discussed.

Artifacts↗

PubMed1994

Stephen Hales and the measurement of blood pressure.

Natural philosopher and inventor, Stephen Hales (1677-1761), undertook a lengthy series of experiments on animals described in Haemastaticks (1733) which led to the first direct measurement of blood pressure. Hales retained his interest in health and disease throughout his life, and this prompted what he regarded as his most important work: the invention of ventilation systems for use in ships or prisons. Hales was the 'perpetual curate' of Teddington, Middlesex, and he combined a mechanistic, quantitative approach to his experimental work with a need and, as he saw it, a duty to discover and wonder at the wisdom and goodness of God by studying His creation.

Animals↗

PubMed1994

[Aretaios concerning the relationship melancholy-mania and psychogenesis: a look backwards on a "forward" look].

This contribution to the study of the evolution of fundamental concepts in psychiatry, and in particular of the history of "atrabilious disease", focuses on Aretaios the Cappadocian, one of the most eminent medical authors of Greek antiquity. A rigorous reading, both philological and psychiatric, of Aretaios' text clearly illustrates his importance as a psychiatric nosologist, especially with regard to the articulation between melancholia and mania, which are nowadays considered to be antinomous mood disorders. Contrary to the assumption of most scholars, Aretaios cannot be considered the "inventor" of "manic-depressive psychosis", but rather a "precursor" of "unitary psychosis", a concept that emerged in German psychiatry in the middle of the 19th century. Het may also be regarded as the first author to focus on "premorbid characteristics" in patients with melancholia and mania. Moreover, he assumed a psychogenetic, not merely organogenetic etiology of these psychiatric disorders and, consequently, the possibility of psychotherapy for these conditions.

Bipolar Disorder↗

PubMed1994

Patents and the nurse scholar, Part I: The basic philosophy of intellectual property.

Patenting intellectual property is important for a number of reasons. Health care products are designed to improve the effectiveness and efficiency of care. Without the patent, the property would most likely never enter into the public market for general use by either health care providers or clients. Products such as the specialized IV pole which also accommodates dependent drains (e.g. urinary drainage bags) (Rebar, 1991) or the premature infant pacifier (Engebretson & Wardell, 1991) are valuable assets to patient care. However, without patents to protect them as property, their value in the commercialization process would be nil. Therefore, the public benefits from this system for three reasons: (1) it encourages the inventor to make the invention; (2) the public is given the opportunity to use the invention; (3) the knowledge of the invention is made available to everyone; and (4) often royalties are returned to the institution for further research and development activities.

Clinical Nursing Research↗

PubMed1975

[The Noble Prize--is it still up-to-date (author's transl)].

Alfred Nobel was an original personality: inventor, cosmopolitan, pacifist. Concern for the future and belief in scientific progress provided the motive for the foundation of the Prize which, in our time, is one of the most coveted of honours. But times have changed and closer consideration shows that the award today neither corresponds to Nobel's intentions nor does it take into account the circumstances of modern sciences. These developments could not have been foreseen at the turn of the century. Attempts to actualize the Foundation meet growing criticism.

History, 19th Century↗

PubMed1994

The surgical and health care innovator: patents and marketing guidelines.

Many physicians and health professionals have had ideas for new devices but are reluctant to pursue the idea to production. Some abandon a sound innovation because of unfamiliarity with the intricate processes from concept to final marketing. The subject of surgical or medical innovation is not taught in medical schools or in residency training and few articles have appeared in the medical literature. This presentation is meant to guide the potential inventor from the concept stage through protection measures and the patent process to the final manufacture of a new device. It is hoped that this article will provide the innovator with a sound footing and stimulate him to contribute to medical technology and medical progress. Other disciplines (scientific, academic, and industry) might also be interested in these guidelines on patents and marketing strategies.

Commerce↗

PubMed1994

Active and passive ozone samplers based on a reaction with a binary reagent.

Ozone is one of the most toxic common air pollutants (judging from short-term animal and human exposure studies at realistic concentrations) and one of the most difficult and expensive pollutants to control. Because of ozone's high chemical reactivity, its concentrations may vary greatly over short distances, and fixed-site air quality monitors may not accurately estimate exposures of human populations. Epidemiologic research on ozone's long-term health effects has been inconclusive, partly because of the lack of reliable personal exposure information. The objective of this project was to develop a practical personal ozone exposure monitoring technique, and to document its precision and accuracy in actual use by representatives of freely ranging, ozone-exposed populations. The project site, Los Angeles, is the nation's metropolitan area with the highest level of ozone pollution and, thus, probably the most important locale for personal exposure assessment. Our overall strategy was (1) to select the most promising laboratory technique for ozone detection from published literature and private communications; (2) to design and test personal monitors using this technique; and (3) when feasible, to evaluate concurrently alternative methodologies developed by others. As indicated below, parts 1 and 2 of our strategy yielded a limited success with respect to short-term active sampling, i.e., measuring personal ozone exposure levels during one to two hours with a monitor incorporating a battery-powered air pump of the type used in industrial hygiene investigations. The same approach was not successful in passive sampling, i.e., measuring exposure levels during multihour or multiday periods with a light-weight, diffusion-controlled "badge" sampler having no moving parts. Passive badge samplers could be calibrated reasonably well in laboratory exposures to ozone in otherwise pure air, but they greatly overestimated ozone levels in outdoor ambient air. Part 3 of our strategy yielded more promising information on an alternative passive badge design. After testing and rejecting two other possibilities, we chose a binary organic reagents, 3-methyl-2-benzothiazolinone acetone azine with 2-phenylphenol, as the most promising chemical detector of ozone. Filter papers impregnated with the binary reagent develop a characteristic intense pink color when exposed to ozone. The inventors, J.E. Lambert and associates of Kansas State University, had intended only to develop a rough qualitative ozone monitor (Lambert et al. 1989). However, our initial laboratory testing (in exposure chambers containing ozone in otherwise very clean air, away from humans), revealed fairly accurate quantitative response.(ABSTRACT TRUNCATED AT 400 WORDS)

Benzothiazoles↗

PubMed1993

[Estimation of the possibility of HIV or hepatitis B infection transmission in ambulatory care of substance dependence].

OBJECTIVE: To estimate the risk of HIV or hepatitis B infection after pricking accidents in the ambulant care and treatment of drug addicts. DESIGN: Risk estimation. SETTING: Aid station for drug addicts in Nijmegen. METHOD: Inventorization of the pricking accidents at the above-named aid station and calculation of the risk of infection. RESULTS: During 30 years on the job, a worker in addict care outside Amsterdam runs a 0.007% risk of job-related HIV infection and a 4.5% risk of hepatitis B infection. The corresponding figures for Amsterdam are 0.05% and 7%, respectively. The job-related risk for workers in general hospitals in Amsterdam is 0.0012-0.015% for a job-related HIV infection and 1-5% for a job-related hepatitis B infection. CONCLUSION: The risk of workers in an aid station for drug addicts of contracting a job-related HIV or hepatitis B infection is relatively high compared with workers in health care in general. An active infection prevention policy for workers in addict care is to be recommended.

Ambulatory Care↗

PubMedDate not supplied

[A treatment method for chronic parenchymatous parotitis].

A method for therapy of chronic parenchymatous parotitis is suggested supplementing dimethyl sulfoxide. As reported, the parotid glands produce parotin, an insulin-like substance, whose production is reduced in chronic parotitis; hence, short-acting insulin administered in microdoses was chosen for therapy. To potentiate local insulin effect and increase the sensitivity of oral mucosa peripheral receptors to it a 5% calcium pantothenate solution was used. This method was used in the treatment of 42 patients with chronic parenchymatous parotitis aged 23 to 62. The method is effective, it can be easily used by the patients themselves, and there are virtually no contraindications against such therapy. The authors have applied for inventors' certificate, the priority certificate is No. 4836436/14 as of June 27, 1990.

Adult↗

PubMed1993

[Research in emergency medicine. Ethical requirements].

Having pointed out some curriculum goals in medical ethics, a plea is made for extensive animal experimentation, especially in emergency medicine in order to minimize necessary investigations in human beings. Although certain groups of patients (persons in custody, minors) are protected nowadays against unjustified research activities by legal restraints, well-designed therapeutic (even nontherapeutic) investigative projects can be facilitated under certain conditions. The same attitude might be adopted for "special" populations (e.g., HIV patients), which are very often excluded for various reasons. Research protocols and statistical evaluation should not be permitted to differ in these groups in comparison to "normal" patients. The issue of "informed consent" in emergency research with the main emphasis on resuscitation cannot be considered as resolved since many patients are unconscious or at least incompetent. Irrespective of the number of legislative constructions proposed mainly in the USA ("proxy consent", "substitute decision making," "deferred consent"--the latter being already declared a misnomer by its "inventor", ethical standards might better be adapted to the respective situations guided by competent ethical committees. As for the particulars of research protocols, randomization combined with a blind or double-blind study design is now considered to be ethically desirable by a majority of authors, the same holding true for risk stratification and sequential test procedures in order to reduce the number of patients required. The "theory of intuitive thinking" is briefly touched upon as a futuristic investigative method and/or decision strategy.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergency Medicine↗