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At least 613 records · Page 34Linked to original sources
PubMed1999

Accessing a WWW reference library of 3D models of pathological organs to support medical education.

A major aspiration of the medical community is to use multimedia databases to disseminate important research or clinical information and for education. We describe a WWW reference library of 3D models of human organs containing pathological and normal organs organised in cases, together with a variety of educational and supporting tools. Although the emphasis is chiefly on the teaching of medical students and the continuing education of physicians, the library is also a potentially-valuable resource for diagnostic investigation. This paper describes the environment, methodologies and tools for supporting 3D models in medical education. The prototype of the system is currently being completed; the full system is scheduled for public access in the year 2000 through multimedia publishers.

Computer-Assisted Instruction↗
PubMed1999

[Use of unlicensed and off-label drugs in hospitalized children].

Many drugs used in children are based on pharmacological data obtained in adults. Therefore, many drugs are either unlicensed for use in children or are prescribed outside the terms of the product license (off-label). This pilot study assessed use of unlicensed or off-label drugs in hospitalized children. Drug orders of patients admitted to a general pediatric ward were reviewed retrospectively in a random sample. Assessment was based on the data of the Physicians' Desk Reference and the Israel Drug Compendium. 80 different drugs and 278 drug orders were written for 92 patients (0.5 months-11 years old, mean 26.9 months) in 97 admissions. Of these 52.9% were either off-label or unlicensed. Patients received 1 or more unlicensed or off-label drugs in 64.9% of admissions. They were more often off-label than unlicensed. The main reasons for use of off-label drugs were unusual doses and inappropriate age. The main reason for unlicensed drugs was modification of a particular formulation of a licensed drug. This pilot study indicates that use of drugs in an off-label or unlicensed manner in children is probably quite frequent in Israel. Our data emphasize the need for licensing a large number of drugs for use in children, based on the same scientific principles as in adults. Further collaborative studies in different pediatric centers in Israel, involving different types of pediatric settings (ambulatory and in-hospital), is required to evaluate comprehensively the magnitude of this preliminary finding.

Adult↗
PubMed2000

[Guichard Joseph Duverney (1648-1730), first French otologist in the 17th century].

PURPOSE OF STUDY: Study and understand the role of Guichard Joseph Duverney in the history of French otology. METHOD: Study of the different works and articles published about him, linked with reading his principal writings. RESULTS: Duverney published one of the first complete works on otology titled Traité de l'organe de l'ouïe (Treatise of the organ of hearing) in 1683. Following a first part containing numerous new notions of anatomy, Duverney developed in the second part a theory of hearing very similar to that of von Helmholtz. In the third part, he finally cover several pathologies of the ear without great innovation. Translated into many languages, this book became the book of reference for all the otologists of the 17th and 18th centuries. CONCLUSION: Duverney is rightly considered to be the first French otologist of the 17th century and also, as certainly one of the first European otologists.

Ear↗
PubMed2001

[Precancerous lesions of the buccal mucosa].

OBJECTIVES: We analyzed data in the literature in comparison with experience at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of la Salpêtrière Hospital on precancerous lesions of the oral mucosa, in order to establish definitions and describe epidemiological, clinical, histological findings as well as natural history and treatment outcome. MATERIAL AND METHODS: Three literature sources were analyzed: Medline and Current Contents searches, books and references listed in articles. The following key words were used and classed into three groups; 1) oral mucosa, epidemiology, precancerous lesions, malignant transformation, dysplasia, leucoplakia, oral lichen planus, erythroplasia, verrucous, cheilitis, candidosis, immunodepression, 2) oral mucosa, tumor markers, carcinogens, keratin, keratinocytes, gene, nuclear proteins, p53 protein, Ki-67 antigen, 3) oral mucosa, therapy, prevention, nutrients. The period chosen ran from 1980 to 1998. This automatic literature search was completed by systematic manual search of summaries in specialized journals published in 1997-1998. The lists of references in the identified articles were consulted and furnished the principal publications concerning precancerous lesions of the buccal mucosa. In all 383 references were selected and analyzed by level of scientific proof. Among these 135 are cited in the text. If data in the literature were insufficient, the physicians at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of La Salpêtrière Hospital were consulted to provide their experience-based recommendations. RESULTS AND DISCUSSION: Clear and practical definitions drawn from current knowledge were adopted. Precancerous lesions were distinguished from precancerous states. Precancerous lesions included chronic lesions of the oral cavity on which cancer of the oral cavity is known to develop. These were: leucoplakia, oral lichen planus, erythroplasia, papillomatous lesions, actinic cheilitis, submucosal fibrosis, keratotic candidosis, and tertiary syphilis. The precancerous states included cancers occasionally observed in the oral cavity: immunodepression and Plummer Vinson syndrome were analyzed. Epidemiological, clinical, histological, and evolutive data as well as therapeutic strategies were described. A decisional algorithm was elaborated for leucoplakia. The text was enriched with images available in the Department. CONCLUSION: Precancerous lesions of the oral mucosa offer a particularly interesting area of research for understanding the process of cancer formation and its prevention. The level of scientific proof available in the large majority of the published reports is low. Few recent publications provide relevant data. In practice, the experience in the management of cancer and precancerous lesions of the oral mucosa accumulated over the last 40 years at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of la Salpêtrière Hospital provides an invaluable source of information.

Biomarkers, Tumor↗
PubMedDate not supplied

[Impact of meta-analysis in clinical practice: the example of psychiatry].

BACKGROUND: To analyze the features of the studies on meta-analysis in psychiatry and assess the effect of these papers on the psychiatric reference textbooks. METHODS: Two researchers reviewed electronic databases Medline and Embase during the period 1977-98, using the key words: clinical trial, randomized observational trial, metaanalysis, systematic review. To confirm the validity of the searching strategy inter and intra-raters reliability was studied with satisfactory kappa figures. RESULTS: Psychiatry is the medical specialty in which more studies on meta-analysis have been carried out (N= 179, 11,79% out of the total), followed by cardiology and oncology. The increase in this kind of research during 1977-98 has been very high in all medical fields and, specifically, in psychiatry. There is no correlation between impact factor of a scientifical journal and number of meta-analysis published in it. Only 0.002% of the references of one of the most important textbook in psychiatry (Kaplan) are related to meta-analysis. There is no studies on meta-analysis developed by Spanish researchers. CONCLUSIONS: Studies on meta-analysis are not referred by psychiatric reference textbooks. As a consequence, their impact on clinical practice is scarce.

Meta-Analysis as Topic↗