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PubMed2002

Are bipolar I depressive patients less responsive to treatment with antidepressants than unipolar depressive patients? Results from a case control study.

The increasing evidence that bipolar and unipolar affective disorders have different biological etiologies and courses of illness has been associated with an intensifying interest in specific treatment regimens for both disorders during the last decade. In this context, the question arose whether antidepressants exert similar efficacy in the acute treatment of bipolar compared to unipolar depression. Although the clinical impression does not indicate substantial differences in the efficacy of antidepressants between these groups of patients, empirical databases concerning this topic are rare. The present study compared the efficacy of antidepressants in 50 unipolar and 50 bipolar depressed inpatients (ICD-9 criteria) under naturalistic treatment conditions. Both groups of patients were matched for age, gender and duration of illness. Clinical assessments of status at the time of admission and at discharge were used to rate response to antidepressant treatment. Analyses of the data revealed that both groups of patients needed the same time for treatment response and did not show any significant differences in outcome measures at discharge. These findings do not concur with the hypothesis formulated by some experts in the field of affective disorders that antidepressants are less effective in the acute treatment of bipolar depressed patients compared to unipolar depressed patients.

Antidepressive Agents↗
PubMed1999

Peer-reviewed publication following presentation at a regional surgical meeting.

OBJECTIVES: The aim of the study was to investigate the proportion of publications arising from work presented at a regional surgical meeting. DESIGN: A list of all presentations to the Welsh Surgical Society 1983-95 was compiled and a detailed search made of the Medicine Database. The surgical topic of each presentation, the date of presentation, the date of publication and the journal of publication were recorded. SETTING: University Hospital of Wales. RESULTS: Four hundred and ninety-six papers were presented to the society, of which 402 (81%) were by trainees. The most frequent topics of presentation were colorectal (15%), vascular (15%) and hepato-pancreatico-biliary (11%). Two hundred and thirty-three papers (47%) have been published in peer-reviewed journals. The most popular journals for publication were Annals of the Royal College of Surgeons of England (19%), British Journal of Surgery (16%) and Journal of the Royal College of Surgeons of Edinburgh (8%). The median time from presentation to publication was 17.0 months (interquartile range 10.0-27.5 months). CONCLUSIONS: Regional surgical meetings have an important role in the annual surgical calendar and they are the ideal initial setting for presentation by trainees.

Education, Medical, Continuing↗
PubMed2000

Sequence analysis of the MEN I gene in two patients with multiple cutaneous lipomas and endocrine tumors.

The discovery of mutations of the menin gene in a few multiple endocrine neoplasma type 1 (MEN I)-associated lipomas and loss of heterozygosity (LOH) on chromosome 11q13 in some sporadic lipomas has stimulated the hypothesis that lipomas may belong to the group of sporadic tumors caused by defects of the gene responsible for MEN I. Since it is unclear if the above hypothesis applies to all patients with lipoma or just to specific subsets, we searched to enlarge the database on this topic. For this purpose, we identified two patients with multiple cutaneous lipomas. One had an additional pituitary adenoma and familial presentation of multiple lipomas, the other had recurrent goiter in the setting of a family history of adenomatous goiter. Deoxyribonucleic acid (DNA) was analyzed by complete direct DNA sequencing of all coding exons and splice junctions of the MEN I gene. No mutation was identified in the coding exons of the menin gene. In contrast to former data on sporadic lipomas, these data are the first to render evidence that mutations of the MEN I gene may not be responsible for the formation of multiple lipomas, even if they appear in the context of other endocrine tumors.

Adenoma↗
PubMed1987

Stereotactic biopsy and brachytherapy of brain tumours.

This paper discusses 98 patients who had their cerebral lesions stereotactically biopsied. Modified Riechert-Mundinger instrumentation was employed. Of the 98 patients, eight received only biopsy and 90 were then interstitially radiated with iridium-192 (192Ir) custom stacked in afterloading catheters. The vast majority of brachytherapeutically treated lesions were anaplastic or malignant astrocytomas. There were some metastatic lesions, and in two instances the tumour occupied the infratentorial compartment. Two-thirds of the patients had received prior teletherapy; in the remainder, stereotaxis provided the initial diagnosis and brachytherapy the principal treatment. The survival data suggest reasons for optimism. Eighty percent of patients with anaplastic astrocytoma were alive 2 yr later, compared with 55% for those harbouring malignant astrocytomas. Since this is the largest database on this topic in the U.S.A., we are in the process of a more critical review. Complication rate is low. Diagnostic tissue was obtained in all instances. Delayed radionecrosis at the site of implant may aggravate neurological deficits when lesions involve functionally sensitive cortex or their pertinent underlying structures. Such reactions may appear 4-18 mnth after brachytherapy and are more likely to occur in patients who were previously radiated.

Adolescent↗
PubMedDate not supplied

The value of FDG positron emission tomography in the management of patients with breast cancer.

Increasing experience with positron emission tomography (PET) scanning in breast cancer patients is revealing a significant role for this imaging modality. This report summarizes the experience of 2-[F18]fluoro-2-deoxy-D-glucose (FDG) PET scanning in 165 breast cancer patients from the BC Cancer Agency, British Columbia, Canada, and reviews the literature on this topic. Using the database at PETSCAN Vancouver, we identified imaged patients with a diagnosis of breast cancer. We then conducted a retrospective review of these patients' BC Cancer Agency charts to extract demographic and follow-up information. Between November 2000 and March 2003 we identified 165 patients with histologically confirmed breast cancer who had undergone PET scanning, were registered at the BC Cancer Agency, and had follow-up information. The median patient age was 52 years. The sensitivity of PET in detecting axillary metastases was 28%, and the specificity was 86%. At diagnosis, 5% of patients were diagnosed with distant metastases. In patients undergoing PET scanning because of suspected recurrence, the sensitivity and specificity for detecting recurrence were 89% and 88%, respectively. Distant metastases were demonstrated in 30% of patients who were thought only to have local-regional recurrence. The results suggest that there are two clinical situations in which PET appears to be particularly valuable. The first is in the evaluation of patients who are suspected of having a tumor recurrence. The other is in identifying patients with multifocal or distant sites of malignancy who otherwise appear to have an isolated, potentially curable, local-regional recurrence.

Adult↗
PubMed2000

Development of a pollution prevention and energy efficiency clearinghouse for biomedical research facilities.

This is the report of the National Association of Physicians for the Environment Committee on Development of a Pollution Prevention and Energy Efficiency Clearinghouse for Biomedical Research Facilities from the Leadership Conference on Biomedical Research and the Environment held at the National Institutes of Health in Bethesda, Maryland, on 1--2 November 1999. A major goal of the conference was the establishment of a World Wide Web-based clearinghouse, which would lend tremendous resources to the biomedical research community by providing access to a database of peer-reviewed articles and references dealing with a host of aspects of biomedical research relating to energy efficiency, pollution prevention, and waste reduction. A temporary website has been established with the assistance of the U.S. Environmental Protection Agency (EPA) Regions III and IV, where a pilot site provides access to the EPA's existing databases on these topics. A system of peer review for articles and promising techniques still must be developed, but a glimpse of topics and search engines is available for comment and review on the EPA Region IV-supported website (http://wrrc.p2pays.org/).

Biomedical Technology↗
PubMed2002

[Long-term use of combined hormonal contraception--myths and reality].

OBJECTIVE: To assess relationship of long-term use of combined oral contraception (COC) and women health, discussion about myths connected with use of COC. DESIGN: Review of literature. SETTING: Department of Obstetrics and Gynaecology, Hospital of Merciful Brothers, Brno, Czech Republic. METHODS: Identification of studies able to address the topic using Medline database search. RESULTS: Besides reliable control of fertility COC protect women against dysmenorrhea, iron deficiency anemia, ovarian cysts and uterine fibroids. COC plays very important role in gynecologic endocrinology suppressing effectively hyperandrogenism, which has not only cosmetic effect but brings also improvement in cardiovascular health of affected perimenopausal women. Premenopausal using of COC could help preserve bone mineral density and can reduce the risk of developing Alzheimer's disease. The most important feature is protective effect against endometrial (by 70%) and ovarian (by 50%) cancer which increases with duration of COC use and is long lasting and may be observed 15 to 20 years after stopping use. Association of use COC with increased risk neither of cervical cancer nor breast cancer has not been confirmed. Controversy still persists over the association of long-term (longer than 8 years) COC use by young nulliparas and breast cancer. The risk in this group of users is probably slightly increased. But no authorities recommended any restriction of COC's prescription. Some studies have suggested an inverse relationship between use of COC and risk of colorectal cancer. The only established evidence of direct association between OC use and cancer risk is the increased risk for hepatocellular carcinoma in the absence of hepatitis B (but maximum by 4 cases per 1,000,000 users per year). CONCLUSION: Most non-contraceptive health benefits of COC are still not widely appreciated in spite of much evidence. The final decision of contraception method is upon well and adequate informed user by well educated doctor.

Contraceptives, Oral, Combined↗
PubMedDate not supplied

[Cardiopathy caused by physical or chemical agents].

BACKGROUND: Occupational cardiovascular diseases do not possess any specific clinical and physiopathogenetic features. OBJECTIVES: The paper summarizes the results of the most recent studies on chemical and physical cardiovascular risks, and assesses the current degree of risk for occupational cardiovascular disease. METHODS: Scientific literature and medline databases on this topic were carefully considered. RESULTS AND CONCLUSION: The scientific literature often provides interesting information on the cardiotoxicity of chemical and physical agents in workplaces; however, a large amount of data refers to high-dose exposures. On the contrary, nowadays exposure conditions have progressively improved and toxic concentrations in air in most cases are below the environmental threshold limit values. In workplaces multiple exposures to different cardiovascular risks, both occupational and non-occupational, are often present simultaneously and these cardiovascular diseases have not been adequately studied in comparison to other occupational organic and systemic diseases. Moreover, possible interferences between occupational cardiotoxic substances and cardiological therapy are still poorly investigated, even though such situations frequently occur.

Air Pollutants, Occupational↗
PubMed2005

Ranking the whole MEDLINE database according to a large training set using text indexing.

BACKGROUND: The MEDLINE database contains over 12 million references to scientific literature, with about 3/4 of recent articles including an abstract of the publication. Retrieval of entries using queries with keywords is useful for human users that need to obtain small selections. However, particular analyses of the literature or database developments may need the complete ranking of all the references in the MEDLINE database as to their relevance to a topic of interest. This report describes a method that does this ranking using the differences in word content between MEDLINE entries related to a topic and the whole of MEDLINE, in a computational time appropriate for an article search query engine. RESULTS: We tested the capabilities of our system to retrieve MEDLINE references which are relevant to the subject of stem cells. We took advantage of the existing annotation of references with terms from the MeSH hierarchical vocabulary (Medical Subject Headings, developed at the National Library of Medicine). A training set of 81,416 references was constructed by selecting entries annotated with the MeSH term stem cells or some child in its sub tree. Frequencies of all nouns, verbs, and adjectives in the training set were computed and the ratios of word frequencies in the training set to those in the entire MEDLINE were used to score references. Self-consistency of the algorithm, benchmarked with a test set containing the training set and an equal number of references randomly selected from MEDLINE was better using nouns (79%) than adjectives (73%) or verbs (70%). The evaluation of the system with 6,923 references not used for training, containing 204 articles relevant to stem cells according to a human expert, indicated a recall of 65% for a precision of 65%. CONCLUSION: This strategy appears to be useful for predicting the relevance of MEDLINE references to a given concept. The method is simple and can be used with any user-defined training set. Choice of the part of speech of the words used for classification has important effects on performance. Lists of words, scripts, and additional information are available from the web address http://www.ogic.ca/projects/ks2004/.

Abstracting and Indexing↗
PubMed2003

The Genetics Home Reference: a new NLM consumer health resource.

The Genetics Home Reference (GHR) is a new information resource developed to be part of the National Library of Medicine's (NLM's) consumer health initiatives. The GHR's guiding principle is to make the health implications of the Human Genome Project accessible to the public. The GHR accomplishes this by providing a bridge between the NLM's consumer health systems MEDLINEplus and ClinicalTrials.gov on the one hand and the multiple resources emanating from the Human Genome Project on the other. The initial focus is on single gene conditions that are main topics in MEDLINEplus.

Databases as Topic↗
PubMed2000

What is the role of procedural justice in civil commitment?

OBJECTIVE: To determine best practice management strategies in the clinical application of civil commitment. METHOD: All relevant literature on the topics of 'civil commitment', 'coercion' and 'procedural justice' were located on MEDLINE and PsychLIT databases and reviewed. Literature on the use of Ulysses contracts and advance directives in mental health treatment was integrated into the findings. RESULTS: Best practice evidence that guides management strategies is limited to the time of enactment of civil commitment. Management strategies involve enhancing the principles of procedural justice as a means of limiting negative patient perception of commitment. In the absence of evidence-based research beyond this point of enactment, grounds for the application of the principles of procedural justice are supported by reference to ethical considerations. Ulysses contracts provide an additional method for strengthening procedural justice. CONCLUSIONS: Procedural justice principles should be routinely applied throughout the processes of civil commitment in order to enhance longer term therapeutic outcomes and to blunt paternalism.

Advance Directives↗
PubMed1997

Mapping the literature of allied health: project overview.

The Nursing and Allied Health Resources Section of the Medical Library Association (MLA) created the Task Force on Bibliographic Access for the Allied Health Literature to identify the core journals of various allied health fields and assess the coverage given these titles by the major indexing and abstracting services. The larger objective is to influence increased bibliographic access to the core literature. This paper introduces the Project for Mapping the Literature of Allied Health and the common bibliometric methodology used for the five specific studies reported in the accompanying papers. Findings relating to format used, age of citations, dispersion of literature, and indexing coverage for the different fields are compared. Journals are the most heavily cited format. Fields differ by the currency of cited material, with physical therapy and speech language pathology displaying use of the oldest citations. The set of core journals is small for each field, particularly in speech-language pathology. MEDLINE provided the strongest indexing coverage overall, followed by EMBASE. Information such as that reported by the project can help librarians in improving information transfer for the allied health professionals they serve.

Abstracting and Indexing↗
PubMed1997

Mapping the literature of health education.

Health education is a relatively new multidisciplinary field concerned with educational programs that empower individuals and communities to play active roles in achieving, protecting, and sustaining their health. Its practitioners have bachelor's, master's, or doctoral degrees and work in educational, worksite, health facility, or agency settings. This bibliometric study was part of the Medical Library Association (MLA) Nursing and Allied Health Resources Section's Project for Mapping the Literature of Allied Health. It sought to identify the core journals in health education and to determine the extent to which these titles are covered by the standard indexing sources. Cited references appearing from 1991 through 1993 in articles of four journals published by the major professional associations in the field were analyzed. It was found that only thirteen journals supply one-third of all references in the study. Another eighty journals provide the second third. MEDLINE gives the best indexing coverage with nearly 69% of the journals receiving indexing for at least half of their articles, followed by EMBASE (52%) and PsycINFO (43%). Limited coverage is given by the Cumulative Index to Nursing and Allied Health Literature (16%) and ERIC (14%). The findings name titles that should be added by indexing services and those that should have more complete coverage.

Abstracting and Indexing↗