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At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Handheld tools assess medical necessity at the point of care.

An emerging strategy to manage financial risk in clinical practice is to involve the physician at the point of care. Using handheld technology, encounter-specific information along with medical necessity policy can be presented to physicians allowing them to integrate it into their medical decision-making process. Three different strategies are discussed: reference books or paper encounter forms, electronic reference tools, and integrated process tools. The electronic reference tool strategy was evaluated and showed a return on investment exceeding 1200% due to reduced overhead costs associated with rework of claim errors.

Computers, Handheld↗
PubMed2006

Rinsing with chlorhexidine gluconate solution after brushing and flossing teeth: a systematic review of effectiveness.

OBJECTIVE: The purpose of this study was to discuss the concept of delaying the use of chlorhexidine mouthrinse (CHX) until some time after the use of dentifrice. METHOD AND MATERIALS: Sources included 13 electronic databases, 7 international drug reference books, and the World Wide Web; references of all relevant papers; and further information requested from authors and organizations. Inclusion criteria were a predefined hierarchy of evidence. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. RESULTS: CHX, a cation, interacts and forms salts of low solubility and antibacterial activity with anions, such as sodium lauryl sulfate (SLS) and sodium monofluorophosphate (MFP). CHX and MFP are not compatible in clinically relevant concentrations in vitro. A 30-minute interval between SLS and CHX rinsing gave a significantly reduced antiplaque effect of CHX, whereas after 2 hours the neutralizing effect of SLS disappeared. Rinsing with dentifrice slurry and CHX produced a significantly increased plaque score compared to CHX and water. In regard to tooth staining by CHX mouthrinses, use of dentifrice before CHX showed a reduction in staining of 18%, whereas CHX followed by dentifrice showed a reduction in staining of about 79%. Literature relating to this interaction is limited; more controlled microbiologic and clinical studies are needed to certify the inaccuracy of this modality of administration. CONCLUSION: To optimize the antiplaque effect of CHX, it seems best that the interval between toothbrushing and rinsing with CHX be more than 30 minutes, cautiously close to 2 hours after brushing.

Chlorhexidine↗
PubMed1997

University hospital-based drug information service in a developing country.

In 1994, a clinically oriented drug information unit was established at the Tribhuvan University Teaching hospital in Nepal, with a view to providing objective and independent information through a question-answer service and bulletin production. During the first 2 years of its service, the unit received a total of 674 encounters, with an average of 28 inquiries a month (range 13-42): about three-quarters (74.5%) of all the inquiries were from prescribing doctors, including 38.0% from specialist clinicians: about a quarter (24.6%) were related to patient problems. Most (86.8%) of the responses were provided within 24 h of the inquiry. Frequently encountered queries related to: pharmacotherapy of a disease or drug indication(s), adverse drug reactions, drug doses, availability, drug use in pregnancy, ingredient(s) of a proprietary product, precautions for use and drug interactions. Details of the inquiries received and the responses provided by the unit are documented in a standard question-answer form. The unit also carries out proactive dissemination of information through the publication and free distribution of a bimonthly bulletin which includes brief referenced reviews on drug- and therapeutics-related topics. Nepal- or the local situation-related write-ups are now being increasingly included in the bulletin. A users' survey carried out at the end of 1-year service indicated that the question-answer and bulletin production activities of the unit were well-perceived by its target audiences, i.e. the prescribing doctors and postgraduate medical students. Although Medline on CD-ROM and original journal articles available in the hospital library were consulted for answering a few of the questions, the vast majority of them could be adequately handled by consulting a limited number of well-known drug information books. Our experience indicates that in developing countries such as Nepal, where funds are often severely limited, a small-scale drug information centre, serving a local area, can be usefully initiated by a few motivated staff with a modest collection of about a dozen key reference books.

Adult↗
PubMedDate not supplied

[Experience in creating a card file of reference publications on foreign institutions working in the field of the science of nutrition].

Work on detecting reference publications on foreign scientific institutions active in the domain of nutritional science is summed up. Information on reference books and guides embracing scientific and research establishments of the whole world, individual countries and also on the guides containing information on international bodies and prominent figures in nutritional science is offered.

Academies and Institutes↗
PubMed1999

[A quality reference manual for radiology].

The purpose of this article is to introduce a quality manual for radiology departments. A radiology department has implemented a quality improvement program since 1996. This manual was developed as a tool for quality improvement program. This manuscript, was based on foreign accreditation manuals as well as from French experiences and summarized. In addition, new criteria were added, especially in the field of interventional radiology. This reference book is first dedicated to the self-assessment of radiology departments. It can also be used for an external audit.

Accreditation↗
PubMed2006

Terminology used to describe volume expanding resuscitation fluid.

Many published reports state that the type of resuscitation fluid to be used for volume expansion should be "isotonic crystalloid" or "isotonic fluid". Generally, this terminology refers to normal saline (NS) and lactated Ringer's (LR) solution. This terminology is suboptimal technically since not all "isotonic" crystalloids are sufficient volume expanders. A total of 48 reference books from the areas of general pediatrics, pediatric emergency medicine, emergency medicine, pediatric critical care, pediatric surgery, general surgery, internal medicine, family medicine, adult critical care, obstetrics and gynecology, endocrinology, and life support course manuals were reviewed. The description of fluids for hypovolemic shock, trauma, and diabetic ketoacidosis resuscitation was accurate in 46% of the time.

Diabetic Ketoacidosis↗
PubMedDate not supplied

Renal diseases in John Allen's 'Synopsis Universae Medicinae Practicae...'.

John Allen, a British physician of the eighteenth century, deserves being remembered for a series of inventions, but most importantly -- from a 'medical' point of view -- for his highly praised manuscript, the 'Universae Medicinae Practicae,sive Doctissimorum Virorum de Morbis Eorumque Causis ac Remediis Judicia', which long served as a text-book for medical students of the time, and also as a reference book for practitioners throughout European countries, for several decades after its original first publication. It contains the opinions ('Sententiae') of the most celebrated authors of all ages, from Hippocrates, Galen and Avicenna up to Allen's contemporaries, concerning a wide number of diseases, their causes, signs, symptoms, and therapeutical remedies where available. The present paper deals mostly with parts of the Synopsis concerning renal diseases and related clinical signs.

England↗
PubMed2005

Clotting factor concentrates given to prevent bleeding and bleeding-related complications in people with hemophilia A or B.

BACKGROUND: People with severe hemophilia A or B, X-linked bleeding disorders due to decreased blood levels of coagulants, suffer recurrent bleeding into joints and soft tissues. Before clotting factor concentrates were available, most people with severe hemophilia developed crippling musculoskeletal deformities. Clotting factor concentrate prophylaxis aims to preserve joint function by converting severe hemophilia (factor VIII or IX less than 1%) into a clinically milder form of the disease. Prophylaxis has long been used in Sweden, but not universally adopted because of medical, psychosocial, and cost controversies. Use of clotting factor concentrates is the single largest predictor of cost in treating hemophilia. OBJECTIVES: To determine the effectiveness of clotting factor concentrate prophylaxis in the management of people with hemophilia A or B. SEARCH STRATEGY: We searched the Cystic Fibrosis and Genetic Disorders Group's Trials Register comprising references from comprehensive electronic database searches and handsearches of journals and abstract books. Reference lists of relevant articles were reviewed. Most recent search: January 2002. SELECTION CRITERIA: Randomized controlled trials (RCTs) evaluating people with severe hemophilia A or B, receiving prophylactic clotting factor concentrates. DATA COLLECTION AND ANALYSIS: Two reviewers independently reviewed studies for eligibility, assessed methodological quality and extracted data. MAIN RESULTS: Twenty-nine studies were identified, of which four (including 37 participants) were eligible for inclusion. Three studies evaluated hemophilia A; one showed a decrease in frequency of joint bleeds with prophylaxis compared to placebo (non-physiological dose), with a rate difference (RD) -10.80 (95% confidence interval (CI) -16.33 to -5.27) bleeds per year. The remaining two studies evaluating hemophilia A compared two prophylaxis regimens, one study showed no difference in joint bleed frequency, RD -5.04 (95%CI -17.02 to 6.94) bleeds per year and another failed to demonstrate an advantage of factor VIII dosing based on individual pharmacokinetic data over the standard prophylaxis regimen with RD -0.14 (95% CI -1.34 to 1.05) bleeds per year. The fourth study evaluated hemophilia B and showed fewer joint bleeds with weekly (15 IU/kg) versus bi-weekly (7.5 IU/kg) prophylaxis, RD -3.30 (95% CI -5.50 to - 1.10) bleeds per year. AUTHORS' CONCLUSIONS: There is insufficient evidence to determine whether prophylactic clotting factor concentrates decrease bleeding and bleeding-related complications in hemophilia A or B, compared to placebo, on-demand treatment, or prophylaxis based on pharmacokinetic data from individuals. Well-designed RCTs are needed to assess the effectiveness of prophylactic clotting factor concentrates. Two clinical trials are ongoing.

Blood Coagulation Factors↗
PubMed2006

Clotting factor concentrates given to prevent bleeding and bleeding-related complications in people with hemophilia A or B.

BACKGROUND: People with severe hemophilia A or B, X-linked bleeding disorders due to decreased blood levels of coagulants, suffer recurrent bleeding into joints and soft tissues. Before clotting factor concentrates were available, most people with severe hemophilia developed crippling musculoskeletal deformities. Clotting factor concentrate prophylaxis aims to preserve joint function by converting severe hemophilia (factor VIII or IX less than 1%) into a clinically milder form of the disease. Prophylaxis has long been used in Sweden, but not universally adopted because of medical, psychosocial, and cost controversies. Use of clotting factor concentrates is the single largest predictor of cost in treating hemophilia. OBJECTIVES: To determine the effectiveness of clotting factor concentrate prophylaxis in the management of people with hemophilia A or B. SEARCH STRATEGY: We searched the Cystic Fibrosis and Genetic Disorders Group's Trials Register comprising references from comprehensive electronic database searches and handsearches of journals and abstract books. Reference lists of relevant articles were reviewed. Most recent search: November 2005. SELECTION CRITERIA: Randomized controlled trials (RCTs) evaluating people with severe hemophilia A or B, receiving prophylactic clotting factor concentrates. DATA COLLECTION AND ANALYSIS: Two authors independently reviewed studies for eligibility, assessed methodological quality and extracted data. MAIN RESULTS: Twenty-nine studies were identified; four studies (including 37 participants) were eligible for inclusion. Three studies evaluated hemophilia A; one showed a decrease in frequency of joint bleeds with prophylaxis compared to placebo (non-physiological dose), with a rate difference (RD) -10.80 (95% confidence interval (CI) -16.33 to -5.27) bleeds per year. The remaining two studies evaluating hemophilia A compared two prophylaxis regimens, one study showed no difference in joint bleed frequency, RD -5.04 (95%CI -17.02 to 6.94) bleeds per year and another failed to demonstrate an advantage of factor VIII dosing based on individual pharmacokinetic data over the standard prophylaxis regimen with RD -0.14 (95% CI -1.34 to 1.05) bleeds per year. The fourth study evaluated hemophilia B and showed fewer joint bleeds with weekly (15 IU/kg) versus bi-weekly (7.5 IU/kg) prophylaxis, RD -3.30 (95% CI -5.50 to - 1.10) bleeds per year. AUTHORS' CONCLUSIONS: There is insufficient evidence from randomised controlled trials to determine whether prophylactic clotting factor concentrates decrease bleeding and bleeding-related complications in hemophilia A or B, compared to placebo, on-demand treatment, or prophylaxis based on pharmacokinetic data from individuals. Well-designed RCTs are needed to assess the effectiveness of prophylactic clotting factor concentrates. Two clinical trials are ongoing.

Blood Coagulation Factors↗
PubMed1985

The Eck-Pavlov connection.

In 1877, N. V. Eck described the surgical creation of a fistula between the inferior vena cava and the portal vein in a dog. At the same time he suggested that this operation might be of use in humans for the treatment of ascites. But it was not until more than 50 years later that A. O. Whipple's report of his experience with Eck's operation ushered in the so-called modern era of the portacaval shunt. While there has been sporadic reports about various phases of Eck's life, most reference books do not even give the date of his death, and some references disagree as to the date of his birth. He has been mistakenly placed among the physiologists rather than the surgeons of Russia, and while quoted as a "brilliant student," he has been accused of being "ill-suited" to his profession by the same source. For his intense interest in other areas such as mining and geology, he is depicted as an erratic man who sought something he probably never found. It is said that for 13 years he was divorced from medicine and surgery, when in fact it was during this period that he performed the only clinical portocaval shunt of his career (and it was successful). Unable to find answers to many questions concerning the 59 years of this man's life in the Western world, a recent trip to Leningrad by the author was informative, interesting, and even surprising. Eck's rarely quoted connection with I. P. Pavlov was more than just an acquaintance, and the famed "Eck-fistula" of the Western world is known as the "Eck-Pavlov shunt" in Leningrad.

Animals↗
PubMed1997

[Value of automated medical indexing of an image database and a digital radiological library].

We indexed the contents of a radiology server on the web to facilitate access to research documents and to link reference texts to images contained in radiology databases. Indexation also allows case reports to be transformed with no supplementary work into formats compatible with computer-assisted training. Indexation was performed automatically by ADM-Index, the aim being to identify the medical concepts expressed within each medical text. Two types of texts were indexed: medical imaging reference books (Edicerf) and case reports with illustrations and captions (Iconocerf). These documents are now available on a web server with HTML format for Edicerf and on an Oracle database for Iconocerf. When the user consults a chapter of a book or a case report, the indexed terms are displayed in the heading; all reference texts and case reports containing the indexed terms can then be called up instantaneously. The user can express his search in natural language. Indexation follows the same process allowing instantaneous recall of all reference texts and case reports where the same concept appears in the diagnosis or clinical context. By using the context of the case reports as the search index, all case reports involving a common medical concept can be found. The context is interpreted as a question. When the user responds to this question, ADM-Index compares this response with the answer furnished by the reference texts and case reports. Correct or erroneous responses can thus be identified, converting the system into a computer-assisted training tool.

Abstracting and Indexing↗
PubMed2004

Monoliths for fast bioseparation and bioconversion and their applications in biotechnology.

Monoliths have consolidated their position in bioseparation. More than 200 different applications have been reported in the past two decades and their advantages compared to conventional chromatography demonstrated. These include the high mass transfer efficiency due to the convective flow enabled by the macroporous character of the matrix. Recently plasmid DNA and viruses were separated with high efficiency and cryogels and monolithic superporous agarose were developed for capture of proteins from crude homogenates and separation of microorganisms or lymphocytes. Currently four companies manufacture monoliths mainly for analytical applications although monoliths with a volume of 0.8 liter are commercially available and 8 L are available as prototypes. A book entitled "Monolithic materials: preparation, properties and applications" was published in 2003 and became standard reference of the status of this area. This review focuses on the progress in monoliths that goes beyond the scope of this reference book. Less progress has been made in the field of bioconversions in spite of the fact that monolithic supports exhibit better performance than beads in enzymatic processing of macromolecules. It appears that the scientific community has not yet realized that supports for these applications are readily available. In addition, monoliths will further substantially advance bioseparations of both small and large molecules in the future.

Animals↗
PubMed2001

Induction of labour and scheduled cesarean deliveries in twin pregnancies at the Port-Royal Maternity Hospital in Paris France.

The study is a critical analysis of the decisions to induce labour or schedule cesareans in the practice of a third level referral centre, with as outcome criterion the reduction of fetal death. 783 women pregnant with twins were included from 1.1.1993 to 31.12.1998, in three groups: originally booked, referred for care during pregnancy, or transferred from another institution. The results show that an important proportion of preterm deliveries result from a medical decision to induce labour or from a scheduled cesarean in the originally booked group with even higher proportions in groups of referred and transferred women. These results are discussed in relation to fetal death rates and causes. Deaths related to fetal growth restriction were not observed in women originally booked for care. The hospital bias has been discussed. The conclusion is that decisions to minimize fetal deaths in twin pregnancies increased preterm deliveries by medical decision.

Cesarean Section↗
PubMed1987

A segmentational analysis of prescription drug information seeking.

Drug information-seeking proclivities were examined using data from a telephone survey of 835 individuals who had obtained new outpatient prescriptions within the previous 4 weeks. Factor analytic and clustering techniques were used to segment patients based on the source and nature of drug information received in conjunction with the prescription. A four-cluster solution appeared to represent the most stable, distinct, yet homogeneous solution for the data. The groups were named "physician reliant" (40%), "pharmacist reliant" (19%), "questioners" (7%), and "uniformed" (34%). The four groups were compared for demographic, situational, and attitudinal differences. The physician-reliant group appeared most satisfied with the direct counseling of the doctor. Although this group may have sought additional information, the information appeared to reinforce the physician's directions. The pharmacist-reliant group often obtained prescriptions at independent pharmacies and tended not to rely on magazines or reference books for additional information. The questioners were often taking multiple medications. This group tended to seek out reference information from nonprofessional sources and reported several barriers to seeking information from professionals. The uninformed group was the oldest, tended to receive little information, and was more likely than the other groups to agree that one need not ask questions if one trusts the doctor. Different types of patient education programs were recommended as appropriate for each of the four groups. Motivational messages directed to the uninformed segment appeared to be the largest unmet need in patient-oriented prescription drug education.

Adult↗
PubMed2002

Dietary supplements.

The amount of published information on dietary supplements mushroomed in the 1990s. In fewer than 5 years, publications increased at least 100-fold in the medical literature alone. Dietary supplements are an uncharted territory that warrants complete and accurate exploration. One should not be surprised that disease and illness may respond to dietary supplements. Nutrition is the foundation to good health, and dietary supplements may prove to be some of the most powerful medicines ever discovered. An especially exciting discovery is that dietary supplements may enhance the effects of specific drugs. This discovery may lead to more effective and safer protocols for the treatment of cancer, heart and lung disease, and a host of chronic medical conditions. Information about dietary supplements is becoming more common in the popular medical literature and is creating increased curiosity and an increased awareness. The explosion of the dietary supplement market is compelling physicians to become aware of dietary supplements. Whether or not they are used in clinical practice is a decision for the individual physician. Given the increasing number of patients who are using dietary supplements, however, it is imperative that physicians have a good understanding of this topic. Considering the increasing complexity and magnitude of this topic, physician specialization may be essential. There are many good reference books, review articles, and internet sites on specific supplements that probably should be part of every physician's reference library. The accompanying box provides a brief list of such sources.

Dietary Supplements↗
PubMed1985

A recommended core book list for public health libraries.

Public health is a multidisciplinary field ranging broadly across the health care spectrum. In light of this diversity the selection of basic reference books and textbooks in the field is a complex task. This paper first defines the components of what is public health and then presents such a list to serve as a guide to the librarian faced with this task.

Bibliographies as Topic↗
PubMed1997

Dental chapters of Serefeddin Sabuncuoglu's (1385-1468?) illustrated surgical book Cerrahiyyetu'l Haniyye.

From the 7th to the 11th centuries Arabic authors translated ancient Greek and Roman medical textbooks into their own languages. In the 11th and 12th centuries, noted authors used these early translations when writing other classical texts. One of these was that of the Andalusian surgeon, Albulcasis (936-1013), whose famous work is entitled, at-Tasrif (4,6). It has been used as a reference book for centuries and was translated into Latin in the 15th century and into Turkish by me when I discovered a manuscript of it in the Manisa Library in Turkey (14). The best interpreter of it, however, was Serefeddin Sabuncuoglu (1365-1468). He used the classification of at-Tasrif, but improved on it by adding original observations and three original chapters. His book is entitled, Cerrahiyyetu'l Haniyye which means The Imperial Surgery (15).

Arab World↗