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PubMed2006

Esophageal melanocytosis morphologic features and review of the literature.

Endoscopic or macroscopic esophageal melanocytosis is a benign clinicopathologic entity characterized by melanocytic proliferation in esophageal squamous epithelium and melanin deposition in the mucosa. Little is known about the etiology and natural course of this condition, although it has been suggested to be a precursor of primary esophageal melanoma by some authors. Following a search of the bibliographic databases (PubMed and Medline) regarding esophageal melanocytosis and melanosis, thirty-four cases of isolated esophageal melanocytosis (including one unpublished case from us) were found. The histopathologic features of esophageal melanocytosis are reviewed and its differential diagnosis with other pigmented esophageal lesions is discussed.

Diagnosis, Differential↗
PubMed2001

Therapy for Helicobacter pylori in patients with nonulcer dyspepsia. A meta-analysis of randomized, controlled trials.

PURPOSE: To assess the effect of eradication therapy for Helicobacter pylori on symptoms of nonulcer dyspepsia. DATA SOURCES: Duplicate searches of bibliographic databases, reviews of proceedings of annual gastroenterology and H. pylori meetings from 1995 to 1999, reviews of reference lists, and contact with primary investigators and pharmaceutical manufacturers. STUDY SELECTION: Included studies 1) examined patients with nonulcer dyspepsia and H. pylori infection; 2) used combination therapy for H. pylori and a control therapy without efficacy against H. pylori; 3) were randomized, controlled trials; 4) lasted for at least 1 month after the end of therapy; and 5) assessed symptoms of nonulcer dyspepsia. Ten studies were included. DATA EXTRACTION: Independent, duplicate data extraction of the methodologic quality, population, intervention, study design, duration, and outcome of the trials. DATA SYNTHESIS: The odds ratio (OR) for treatment success in nonulcer dyspepsia with H. pylori eradication therapy compared with control therapy was 1.29 (95% CI, 0.89 to 1.89; P = 0.18). However, significant heterogeneity (P = 0.04) calls the validity of aggregating the data into question. Heterogeneity resolved with the exclusion of one study (OR, 1.07 [CI, 0.83 to 1.37]; P > 0.2). For predefined analysis of trials that used a specifically stated definition of dyspepsia (that is, upper abdominal pain or discomfort), the OR was 1.04 (CI, 0.80 to 1.35) without heterogeneity. For treatment that resulted in cure rather than persistent infection, the OR was 1.17 (CI, 0.87 to 1.59) without heterogeneity. CONCLUSION: This meta-analysis provides little support for the use of H. pylori eradication therapy in patients with nonulcer dyspepsia.

Anti-Bacterial Agents↗
PubMed1999

[The Nordic Cochrane Center. Status after five years and future perspectives].

The aim of the Cochrane Collaboration is to collect all randomised clinical trials and to perform systematic reviews of the effect of the treatments. The Nordic countries contribute importantly to the Cochrane Collaboration. Two of the international Cochrane Review Groups have Nordic leadership and a third is under establishment. Nordic researchers contribute to the work in all the methods working groups, the aim of which is to improve the methodological quality of Cochrane Reviews. The Nordic Cochrane Centre has coordinated the work in the methods groups and edited the Cochrane Handbook which is a guide to doing Cochrane Reviews. Further, the Centre coordinates the software development within the Collaboration and develops the software program which is used to perform Cochrane Reviews. The greatest challenge facing the Cochrane Collaboration will be to succeed in the transition from enthusiasm to management without losing the values which started it all, and which are still the driving force.

Databases, Bibliographic↗
PubMed1998

A database for environmental contaminants in traditional food in northern Canada.

The potential health effects of environmental contaminants in traditional food on indigenous peoples in Northern Canada have been a growing concern. We have conducted an extensive literature review on contaminant levels in Northern Canada through searches of commercial, private, and government databases for the years 1986-1995, including MEDLine, Agricola, Biological Abstracts, Current Contents, Applied Science and Technology, Biosis, CABCD, Aquatic Sciences and Fisheries Abstracts, CRIS/ICAR, and the Northern Aquatic Food Chain Contaminant Database. More than 20,000 data items were identified in over 50 published articles, unpublished data, government reports, and review articles. Ranges of levels of 13 contaminants in major traditional food groups collected from four geographical regions (Yukon, MacKenzie, Keewatin, Baffin and Northern Quebec) were calculated. Exposure levels, particularly according to different dietary patterns, were estimated and discussed in relation to guideline levels.

Animals↗
PubMed1992

On-line medicine.

Explore the source record for details and available documents.

Community Participation↗
PubMed1993

Information sources for medical waste management.

Although many hospital professionals now have personal access to online databases, popular communications services may not have the full range of electronic services needed for technical problem solving. Librarians are practiced at cross-disciplinary technical research and so health professionals may be best served by consulting an experienced database search analyst so that important information is not accidentally missed. Additionally, many commercially produced databases have repackaged and redistributed data developed by NIOSH and other federal agencies, data that are readily available in the public sector. The cost of accessing or purchasing commercial databases is usually higher than for federal databases, though commercial products use the federal databases to develop their products. Public agencies should always be consulted to obtain the most current information issued by those bodies and also because a variety of free and low-cost support materials may be available. Because of the expense of routinely consulting electronic databases when comparable printed materials may be available at a lower cost, a small reference collection of books, journals, and audiovisuals may be desirable. A selective print reference collection is found in Appendix A.

Databases, Bibliographic↗
PubMed1993

Health care-oriented telecommunications: the wave of the future.

This article has examined the impact that telecommunications technologies may have on the way in which health care services are delivered. A number of scenarios of how that might occur were discussed. Some of these scenarios are already being realized. Telemedicine, for instance, is being used in certain geographic regions of the United States. Various community health information networks are in the developmental stages or at varying degrees of operability. Two such networks in Colorado and Wisconsin were offered as examples. The impact of these developments on confidentiality and security of patient information, issues central to the responsibilities of health information managers, has been discussed. These technological advancements will have consequences for health information managers in other ways, too. The types of tasks that are performed and how those tasks are performed related to storing and retrieving information will be different in the future. In the transition period, blurring of job functions may occur as different types of practitioners strive to carve their niche in the electronic environment. For instance, as electronic patient records are linked to bibliographic databases of medical literature, where do the responsibilities of health information managers end and medical librarians begin? The best way to ensure a position on the health care team of the future is to recognize the opportunities provided by this dynamic period in health care.

Colorado↗
PubMed1999

[Nutrition surveys of Spanish school-age children: analysis of the period 1984-1994].

OBJECTIVE: To review available data on the usual dietary intake of school-age Spanish children, by analyzing the nutritional surveys carried out during the period 1984-1994. METHODS: Systematic and comprehensive search of surveys with dietary data in Spanish children aged 6 to 16 years collected during the period 1984-1994 and published after January 1997. The search of bibliographic databases (MEDLINE, IME, ISBN and Teseo), was completed with an extensive search of the gray literature and of unpublished studies through contact with public and private institutions which may fund such studies. The quality of the original surveys was assessed, and the data of the studies fulfilling pre-established quality requirements were summarized and tabulated. RESULTS: We located 65 nutritional surveys in children and adolescents performed between 1984 and 1994, which generated 91 documents. Most surveys (76.9%) were local, while 18.5% of them studied provinces or regions and 3.1% studied more than one region. Only 4 studies (6.2%) met the quality requirements, but the methods or the presentation of the results of these surveys were too heterogeneous. In spite of that, the available data tends to show a certain lack of balance of macronutrient intakes in relation to the usual dietary recommendations. CONCLUSIONS: Available data on nutritional intake of Spanish school-age children during 1984-1994 were too heterogeneous to be comparable, even if the analysis was restricted to high-quality surveys. Furthermore, there are no repeated surveys monitoring changes in intake in representative samples of children performed during the study period. This should be taken into account in future research endeavours which should contemplate a well defined sampling framework and the appropriate methodology to assure the proper interpretation of the eventual results.

Adolescent↗
PubMed1999

Fatal nontraffic injuries involving alcohol: A metaanalysis.

STUDY OBJECTIVE: Estimates of alcohol involvement in fatal injuries vary widely. For injuries other than those involving motor vehicles, no national data exist and the quality of regional data is limited. This study synthesizes US medical examiner studies of nontraffic fatalities for the purpose of estimating alcohol involvement by injury mechanism and intent. METHODS: We reviewed 331 medical examiner studies published between 1975 and 1995 that reported nontraffic injury fatalities. These studies were identified from computerized bibliographic databases and by hand searching of reference lists from 26 review publications and the subject indices of 7 prominent journals. A final total of 65 articles (19.6%) met our inclusion criteria for analysis. National data on motor vehicle fatalities were used for comparison. RESULTS: A total of 7,459 unintentional injury deaths, 28,696 homicide cases, and 19,347 suicide cases were aggregated. The aggregate percentage tested for blood alcohol concentration (BAC) was highest among homicide cases (88.2%), followed by unintentional injury deaths (84.0%) and suicide cases (81.7%). The aggregate percentage determined to be intoxicated (BAC, >/=100 mg/dL) was highest among homicide cases (31.5%), followed by unintentional injury deaths (31.0%) and suicide cases (22.7%). Mean and median comparisons produced comparable findings. Fewer than one quarter of the 65 articles reported gender- and age-specific rates. Inconsistent reporting of gender and age-specific rates in fatal nontraffic injuries prevented their analysis by cause of death. Fatally injured motor vehicle drivers, however, demonstrated distinct variation in alcohol involvement by age and gender. CONCLUSION: This metaanalysis is the first systematic attempt to estimate alcohol involvement in fatal nontraffic injuries at the national level. It demonstrates that alcohol is an important factor in many fatal injuries and that its importance varies by cause of injury.

Accidents↗