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PubMed2002

Can patients taking opioids drive safely? A structured evidence-based review.

A structured evidence-based literature review was completed to determine if there was epidemiological evidence of an association of opioid use and intoxicated driving, motor vehicle accidents (MVA) and MVA fatalities; to rate the quality of this research evidence according to Agency for Health Care Policy and Research (AHCPR) type of evidence and strength and consistency of the evidence rating scales; and according to this evidence determine whether patients taking opioids can drive safely. Relevant references were located from Medline, Psychological Abstracts, Science Citation Index and the National Library of Medicine Data Query databases by appropriate subject headings. A manual search was also performed utilizing the reference lists of the retrieved articles. All references relating to intoxicated driving, MVA and MVA fatalities were retrieved and reviewed in detail. Of these, references addressing opioid use were isolated and research information from these references was placed into tabular form under three major headings: Intoxicated driving and opioids; MVA and opioids; and MVA fatalities and opioids. Data were extracted from these references according to the following format: research question addressed, sample size, statistical analysis and results. The type of evidence each study represented was rated according to the AHCPR type of evidence rating scale. Each research area (intoxicated driving, MVA, MVA fatalities) represented by all the studies in each table was then rated utilizing the strength and consistency of the evidence AHCPR rating scale. Of the 6 reports addressing intoxicated driving, 5 were well designed non-experimental studies and one was a well designed experimental study. All studies in this group reported a prevalence for opioid use which was approximately 1/10 that of the point prevalence use for opioids in the general population. This evidence indicated that opioids probably are not associated with intoxicated driving. Overall, the evidence indicates that opioids are not associated with MVA. Of the 9 studies addressing MVA, 5 were well designed quasi-experimental studies and 4 were well designed experimental studies. All reports in this group except one indicated that opioids are not associated with MVA. Of the 10 studies addressing MVA fatalities, 10 represented Type IV studies. For the vast majority of the studies, the prevalence percentages for an opioid association with MVA fatalities was 1/5 that of the point prevalence percentage for opioid use reported in the general population. Only 1 study reported a possible association between opioid use and MVA fatalities. The evidence in this review indicates that opioids do not appear to be associated with intoxicated driving, MVA and MVA fatalities, and consistently indicated that opioids are not associated with MVA. Although the comparison of point prevalence rates to the point prevalence may be problematic, the results of this systematic review support the contention that patients taking opioids may be allowed to drive. As in all clinical decisions, this determination should be individualized according to clinical factors.

Accidents, Traffic↗
PubMed2006

[Medycyna Pracy: the scopus-based analysis of citations].

Medycyna Pracy, a Polish bimonthly published since 1950, forms a long-standing documentation of studies carried out in the area of workers' health protection. The journal is primarily addressed to occupational health physicians and work hygiene specialists in Poland. It is indexed by numerous foreign information services (e.g., MEDLINE, EMBASE, BIOSIS PREVIEWS, BIOLOGICAL ABSTRACTS, SCOPUS) and thus promotes Polish research in occupational medicine throughout the world. The quantitative analysis for the years 1996-2005, grounded on the SCOPUS database, presents an average number of citations concerning a given volume, frequency of citations, articles most frequently cited, and countries, in which articles published in Medycyna Pracy have been referred to. A growing number of citations observed in the recent years signify the importance of issues investigated and discussed in the journal as well as its role in the world-wide circulation of scientific information.

Abstracting and Indexing↗
PubMed1990

PaperChase: a user-friendly program for searching the biomedical literature.

PaperChase is a computer program which provides an efficient interface to the National Library of Medicine's MEDLINE database of references to the biomedical literature. The database includes references (citations) and abstracts compiled from Index Medicus, the International Nursing Index and the Index to Dental Literature. PaperChase may be accessed using any computer terminal or personal computer with modem. No special knowledge of computers or biomedical terms is necessary. Simple menus enable the novice to search the biomedical literature without training. A command language speeds searching for the experienced user. PaperChase does not require the user to know the database's indexing terminology, called Medical Subject Headings. Everyday language may be used and PaperChase will translate, or "map", the user's search term into the required Medical Subject Heading. PaperChase monitors a search in progress and suggests additional Medical Subject Headings which can be used to broaden or narrow a search. The searcher can order a full-text photocopy of any reference found in PaperChase. Support documentation and a subscriber newsletter are provided at no charge. Trained search specialists are available to offer assistance and to answer questions.

MEDLARS↗
PubMed1989

[Influence of sucrose on aspirin ulcer].

UNLABELLED: At the present stage of drug interactions, little has been studied on food-drug interactions. Excess intake of sucrose is well known to cause arteriosclerosis, obesity, diabetes mellitus, toxicity to blood cells, dental caries, and accumulations of metabolic products in blood. Under the such conditions, it is possible that the ulcerogenic drugs, such as synthetic anti-inflammatory drugs, may cause severe gastric lesions by oral administration. The present investigation was undertaken to study the influences of sucrose on the gastric lesions induced by aspirin (aspirin ulcer) in rats maintained with 10% sucrose solution. Thus, the effect of sucrose on aggressive and protective factors, proposed by Shay and Sun, was studied. METHOD: Sixty rats were maintained with 10% sucrose solution ad libitum as drinking solution for 4 weeks (10% sucrose group). As control, purified water was given ad libitum to 60 rats (control group). Rats were starved for 24 hours, but allowed free access of water before the experiment, and then were subjected to the following experiments: (1) Twenty rats from each group were treated to prepare pylorus-ligated rats. Aspirin in 1% CMC (100mg/kg body-weight) was given in 10 rats from each group immediately after the ligation. Gastric juice excreted during 6 hours was collected and its supernatant (1,500 x g) was used for determinations of pH, acidity, acid output, pepsin activity, and pepsin output. Aspirin and salicylic acid contents in gastric juice were also determined by HPLC. (2) The mucosa of the stomach of (1) were subjected to the analysis of hexosamine. Twenty rats from each group without pylorus-ligation were also used for the analysis. Among them, 10 rats from each group were given aspirin in 1% CMC with the dose of 300 mg/kg body-weight. (3) Ten rats from each group were given aspirin with the dose of 300 mg/kg body-weight and the stomach (n = 10 for each group) was extracted 30 minutes after the aspirin administration for histochemical study to obtain covering mucus index, epitherial mucus index, total mucus index, and rate of mucous injury. (4) Aspirin in 1% CMC was given to 10 rats of each group with the dose of 300 mg/kg body-weight. Rats were sacrificed 6 hours after the administration of aspirin, and then stomachs were extracted and treated with 10% neutral formalin. The length of lesions was measured under a microscope (x 10), and then Ulcer Index was obtained.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1986

[Electrocardiographic changes and echocardiography variations in ventricular morphology in left ventricular overload].

In order to compare the ECG patterns to several echocardiographic morphological indexes in different left ventricular overloadings, 15 cases of systolic left ventricular overloading (SLVO) and 17 cases of diastolic left ventricular overloading (DLVO) were analyzed. The current ECG changes of left ventricular hypertrophy and some original parameters of ventricular repolarization have been correlated with volumes, ejection fraction and mass of the left ventricle (calculated by Reichek's formula) and with left ventricular diastolic and systolic eccentricity indexes, derived by the application of Fishl's formula to the 2D echocardiographic four or two chamber apical view. In both SLVO and DLVO we found a correlation between the left ventricular mass and Romhilt-Estes point score system (p = 0.02) as well as the degree of ventricular repolarization abnormalities (p = 0.01). In SLVO we found a direct correlation between negative P wave deflection on lead V1 and diastolic as well as systolic eccentricity index: that is, the more negative P wave the more elongated left ventricular geometry. Moreover, in SLVO we found an interesting apposite correlation, compared with DLVO, between the systolic eccentricity index and the degree of ventricular repolarization abnormalities: in SLVO ST depression or T wave inversion on left limb or left precordial leads was associated with the maintenance of an elongated shape of left ventricle, while in DLVO the same ventricular repolarization abnormalities were associated with the loss of the elongated geometry of left ventricle which became spheric. Thus ECG correlates with echocardiographic left ventricular mass if poliparametric voltage indexes are considered.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve Insufficiency↗
PubMedDate not supplied

Evaluation of the end-expiratory lung volume as an indirect index of bronchial constriction in asthma.

The purpose of this study was to evaluate the merits of the end expiratory lung volume as an indirect ventilatory index of bronchial obstruction and to show an application of continuous monitoring of lung volume in asthmatic patients. The accuracy of the external measurements (IS) of functional residual capacity (FRC) was controlled by comparing them with the helium measurements (DS) obtained during nine methacholine tests (IS = 0.06 + 1.065 DS in litres: R2 = 0.99). Seven asthmatics (18-48 yr) were monitored by measuring rib cage and abdominal perimeter variations. This was done in basal condition, after methacholine-induced bronchoconstriction and after bronchodilation by either salbutamol or oxytropium bromide inhalation. All the subjects were investigated on two separate days and were their own control. Bronchoconstriction produced a significant increase (p less than 0.01) of tidal volume (VT: + 67%), external minute ventilation (VE: + 58%), mean inspiratory flow (VT/TI: + 78%) and FRC (+ 26.5%) while frequency (f) and fractional inspiratory time (TI/TT) fluctuated non significantly. In the group of seven tested subjects, there was a significant correlation (p less than 0.01) between forced expiratory volume in one second (FEV1) and VE, FEV1 and VT/TI, FEV1 and FRC. However, the individual regression line showed a significant relationship only between FEV1 and FRC (R2 = 0.80 +/- 0.04). We therefore conclude that the variation of the end expiratory level can be chosen as an indirect index of bronchoconstriction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Scaling patient reports of hearing aid benefit.

Records of 743 adults seen for rehabilitation with amplification in 1978-82, were used to study the measurement properties of four widely used, single-item benefit scales. Patients in this sample displayed mild to severe adventitious losses and had been fitted with their first aid(s). Data relating to degree of hearing loss, age, and employment status were analyzed. Responses to Hutton's Hearing Problem Inventory (J. Acad. Rehab. Audiol., 1980, 13, 133-154), administered 6 weeks pre and post rehabilitation, were used to obtain estimates of benefit: hrs/day and portion of time aid(s) were worn, its benefit in various situations, and degree of satisfaction. From the HPI was abstracted a single index of perceived pre-post gain (PPPG). Matrix analyses separately for the employed and the unemployed pts isolating hearing loss and employment status revealed that when amount of hearing loss was the validity criterion, the employment groups differed only in hrs/day and portion of time worn, the employed group reporting a trend for more hrs/day of wear as hearing loss increased. When PPPG was the criterion, only one benefit index, dissatisfaction, did not increase with PPPG. Of 16 Spearman rank correlations between benefit indices and validity criteria, 6 were significant. The benefit scale of hrs/day of wear yielded 3, that for dissatisfaction, none. It was concluded that PPPG was the criterion best used to validate benefit scales as compared with the criteria of hearing loss or employment status.

Adult↗
PubMed1979

Indexes of severity: conceptual development.

A discussion of severity index development is presented in relation to conceptual issues in index definition, analytic issues in index formulation and validation issues in index application. The CHOP index is discussed along with six severity indexes described in an earlier paper dealing with underlying concepts to illustrate the material presented. Replies are provided to specific questions raised in an accompanying paper discussing the Injury Severity Score. This conceptual material is presented to provide a foundation for severity index development, to suggest criteria to be used in their formulation and testing, and to identify analyses that can lead to the successful selection and application of an index for a defined purpose.

Abstracting and Indexing↗