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PubMedDate not supplied

Methodologic aspects of the study of modern-age diseases: the example of sick-building syndrome.

In recent decades, variously identified nebulous disorders such as sick-building syndrome, electrical hypersensitivity, and chronic fatigue syndrome, characterized by combinations of nonspecific symptoms and absence of demonstrable signs have appeared. Their similar nonspecific etiologic attributions have given rise to generic names such as "modern-age disease" and "symptom-based conditions." The lack of demonstrable biological correlates as well as the vagueness of the etiologic attributions makes modern-age diseases unusually problematic to study with epidemiologic methods, potentially leading to serious biases. Case studies of sick-building syndrome demonstrate that qualitative methods can help to elucidate the dynamic processes involved in syndrome development.

Epidemiologic Methods↗
PubMed2004

Most of the extant mtDNA boundaries in south and southwest Asia were likely shaped during the initial settlement of Eurasia by anatomically modern humans.

BACKGROUND: Recent advances in the understanding of the maternal and paternal heritage of south and southwest Asian populations have highlighted their role in the colonization of Eurasia by anatomically modern humans. Further understanding requires a deeper insight into the topology of the branches of the Indian mtDNA phylogenetic tree, which should be contextualized within the phylogeography of the neighboring regional mtDNA variation. Accordingly, we have analyzed mtDNA control and coding region variation in 796 Indian (including both tribal and caste populations from different parts of India) and 436 Iranian mtDNAs. The results were integrated and analyzed together with published data from South, Southeast Asia and West Eurasia. RESULTS: Four new Indian-specific haplogroup M sub-clades were defined. These, in combination with two previously described haplogroups, encompass approximately one third of the haplogroup M mtDNAs in India. Their phylogeography and spread among different linguistic phyla and social strata was investigated in detail. Furthermore, the analysis of the Iranian mtDNA pool revealed patterns of limited reciprocal gene flow between Iran and the Indian sub-continent and allowed the identification of different assemblies of shared mtDNA sub-clades. CONCLUSIONS: Since the initial peopling of South and West Asia by anatomically modern humans, when this region may well have provided the initial settlers who colonized much of the rest of Eurasia, the gene flow in and out of India of the maternally transmitted mtDNA has been surprisingly limited. Specifically, our analysis of the mtDNA haplogroups, which are shared between Indian and Iranian populations and exhibit coalescence ages corresponding to around the early Upper Paleolithic, indicates that they are present in India largely as Indian-specific sub-lineages. In contrast, other ancient Indian-specific variants of M and R are very rare outside the sub-continent.

Asia↗
PubMed1998

No long-term increase in cardiac-related mortality after breast-conserving surgery and radiation therapy using modern techniques.

PURPOSE: To determine whether left-breast irradiation using modern techniques after breast-conserving surgery leads to an increased risk of cardiac-related mortality. METHODS: Between 1968 and 1986, 1,624 patients were treated for unilateral stage I or II breast cancer at the Joint Center for Radiation Therapy, Harvard Medical School, Boston, MA, with conservative surgery and breast irradiation. Seven hundred forty-five patients with a potential follow-up of at least 12 years were analyzed. Clinical, pathologic, and treatment characteristics were compared between the 365 patients (49%) who received left-sided irradiation and the 380 patients (51%) who received right-sided irradiation. The relationship between left-sided breast irradiation and the risk of nonbreast cancer- and cardiac-related mortality was examined. RESULTS: There was no significant difference in the distribution of clinical, pathologic, or treatment characteristics between the two groups, with the exception of a small difference in pathologic tumor size (medians, left, 2.0 cm, right, 1.5 cm; P = .007). At 12 years, a majority of patients still were alive. Slightly more patients with left-sided tumors had died of breast cancer (31% v 27%; P = NS). Equivalent proportions from each group died of nonbreast cancer causes (11%), including nine patients (2%) from each group who died from cardiac causes. The risk of cardiac mortality did not increase as time after treatment increased for patients who received left-sided irradiation compared with right-sided irradiation. A model that controlled for clinical, pathologic, and treatment differences showed no significant increase in any category of cause of death (breast, cardiac, or other) for patients who received left-sided irradiation. CONCLUSION: These results suggest that modern breast radiotherapy is not associated with an increased risk of cardiac-related mortality within at least the first 12 years after treatment.

Breast Neoplasms↗
PubMed2001

Risk of death from intercurrent disease is not excessively increased by modern postoperative radiotherapy for high-risk resected non-small-cell lung carcinoma.

PURPOSE: Some studies report a high risk of death from intercurrent disease (DID) after postoperative radiotherapy (XRT) for non-small-cell lung cancer (NSCLC). This study determines the risk of DID after modern-technique postoperative XRT. PATIENTS AND METHODS: A total of 202 patients were treated with surgery and postoperative XRT for NSCLC. Most patients (97%) had pathologic stage II or III disease. Many patients (41%) had positive/close/uncertain resection margins. The median XRT dose was 55 Gy with fraction size of 1.8 to 2 Gy. The risk of DID was calculated actuarially and included patients who died of unknown/uncertain causes. Median follow-up was 24 months for all patients and 62 months for survivors. RESULTS: A total of 25 patients (12.5%) died from intercurrent disease, 16 from confirmed noncancer causes and nine from unknown causes. The 4-year actuarial rate of DID was 13.5%. This is minimally increased compared with the expected rate for a matched population (approximately 10% at 4 years). On multivariate analysis, age and radiotherapy dose were borderline significant factors associated with a higher risk of DID (P =.06). The crude risk of DID for patients receiving less than 54 Gy was 2% (4-year actuarial risk 0%) versus 17% for XRT dose > or = 54 Gy. The 4-year actuarial overall survival was 34%; local control was 84%; and freedom from distant metastases was 37%. CONCLUSION: Modern postoperative XRT for NSCLC does not excessively increase the risk of intercurrent deaths. Further study of postoperative XRT, particularly when using more sophisticated treatment planning and reasonable total doses, for carefully selected high-risk resected NSCLC is warranted.

Adult↗
PubMedDate not supplied

The development of modern intracranial aneurysm surgery.

This history of the steps leading to the modern surgical treatment of intracranial aneurysms begins some 200 years ago when it was found that cervical carotid artery ligations (for trauma) could be tolerated. This discovery led, early in the 1800's to the use of carotid ligation for the treatment of carotid-cavernous fistulas and eventually for the treatment of intracranial saccular aneurysms. The era of modern intracranial surgery for aneurysms began after Moniz introduced cerebral angiography in 1927. The first trapping procedure (for a carotid-cavernous fistula) was performed in 1932, and the first successful planned intracranial operation for a saccular aneurysm was reported in 1933. Subsequent developments are chronologically cited, together with mention of methods now obsolete.

Carotid Arteries↗
PubMed2003

First Turkish neurosurgical journal (1936-1947): Modern Cerrahi ve nöroşirürji mecmuasi.

The publication of neurosurgery-related journals began in the late 1920s. Most of these journals are of Estonian, German, English, American, and French origin. The appearance of such journals is related to the development of neurosurgery and the number of neurosurgeons. This study presents a neurosurgical journal, Modern Cerrahi ve nöroşirürji mecmuasi (Journal of Modern Surgery and Neurosurgery), published between 1936 and 1947 in Turkey. The contents of the journal and some selected articles are also presented. The existence of this journal, which was published before most Western neurosurgical journals, should be regarded from a historical point of view.

History, 20th Century↗
PubMed2004

The "schola medica salernitana": the forerunner of the modern university medical schools.

The schola medica salernitana is considered the oldest medical school of modern civilization. Salerno's long medical tradition began during the Greco-Roman period in a Greek colony named Elea, where Parmenides decided to found a medical school. The fame of the school became more and more important during the 10th century, and it was best known in the 11th century. In the middle of 12th century, the school was at its apogee, and Salerno provided a notable contribution to the formulation of a medical curriculum for medieval universities. The most famous work of the Salernitan School was the Regimen Sanitatis Saleritanum, a Latin poem of rational, dietetic, and hygienic precepts, many of them still valid today. The school also produced a physician's reference book, with advice on how to treat a patient, a sort of code of conduct to help the physician to respect the patient and his or her relatives. The first science-based surgery appeared on the scene of the discredited medieval practice in Salerno, thanks to Roger of Salerno and his fellows. He wrote a book on surgery, called Rogerina or Post Mundi Fabricam, in which surgery from head to toe is described, with surprising originality. The important contribution to the School of Salerno made by women as female practitioners is outlined, and among them, Trotula de Ruggiero was the most renowned. The period when the School of Salerno, universally recognized as the forerunner of the modern universities, became a government academy was when Frederick II reigned over the Kingdom of the Two Sicilies, as Emperor of the Holy Roman Empire.

Female↗
PubMed2006

History and modern concepts in surface replacement.

Hip resurfacing is not a modern concept. Professor Sir John Charnley attempted the first hip resurfacing procedure in the 1950s. This implant failed as a result of unsatisfactory materials and the same problem has troubled hip resurfacing developments over the subsequent forty years. Modern hip resurfacing using metal-on-metal bearings has shown good medium-term results in the most challenging subgroup--young active patients.

Biocompatible Materials↗
PubMed1999

Ancient-modern concordance in Ayurvedic plants: some examples.

Ayurveda is the ancient (before 2500 b.c.) Indian system of health care and longevity. It involves a holistic view of man, his health, and illness. Ayurvedic treatment of a disease consists of salubrious use of drugs, diets, and certain practices. Medicinal preparations are invariably complex mixtures, based mostly on plant products. Around 1,250 plants are currently used in various Ayurvedic preparations. Many Indian medicinal plants have come under scientific scrutiny since the middle of the nineteenth century, although in a sporadic fashion. The first significant contribution from Ayurvedic materia medica came with the isolation of the hypertensive alkaloid from the sarpagandha plant (Rouwolfia serpentina), valued in Ayurveda for the treatment of hypertension, insomnia, and insanity. This was the first important ancient-modern concordance in Ayurvedic plants. With the gradual coming of age of chemistry and biology, disciplines central to the study of biologic activities of natural products, many Ayurvedic plants have been reinvestigated. Our work on Commiphora wightti gum-resin, valued in Ayurveda for correcting lipid disorders, has been described in some detail; based on these investigations, a modern antihyperlipoproteinemic drug is on the market in India and some other countries. There has also been concordance for a few other Ayurvedic crude drugs such as Asparagus racemosus, Cedrus deodara, and Psoralea corylifolia.

Cognition Disorders↗
PubMedDate not supplied

Nurse leadership, interprofessionalism and the modernization agenda.

As part of the drive to deliver effective health and social care, the Government's modernization agenda focuses on strengthening nursing leadership and developing interprofessional collaboration. Senior nurses are well placed to promote the latter by supporting substantive change in NHS culture. Findings from a research study, conducted by the Faculty of Health and Social Care, University of the West of England, Bristol, as part of a research programme evaluating its interprofessional curriculum, have highlighted senior nurses' potential contribution to implementing and maintaining effective interprofessional collaboration. The authors argue that senior nurses are particularly well placed to help students across disciplines gain the experience needed to develop the requisite skills for delivering care within interprofessional services; and that the implementation of roles and initiatives which support senior nurses in developing appropriate leadership skills is a key component underpinning the modernization agenda.

Education, Nursing↗
PubMed2004

Yu Duan practices as embodying tradition, modernity and social change in Chiang Mai, Northern Thailand.

In this paper I examine the traditional postpartum beliefs and practices which still exist in northern Thailand today. The paper is based on qualitative research involving in-depth interviews with 30 women in Chiang Mai province. Beliefs and practices remain an essential part for postpartum care for women and have important consequences for women's health and wellbeing in northern Thailand. Many Thai women see their reproductive health problems as the consequence of inadequate postpartum practices. Thai women also believe that the effects of postpartum taboos would continue for the rest of their lives. Although the traditional postpartum beliefs and practices abound, the level of adherence differs according to the social structure of the women and their families. Poor rural women seem to hold on to their traditions more strongly than their urban counterparts. Urban middle class women in particular embody modernity in their thinking and behaviours concerning postpartum practices. But modernization has brought with it medical dominance. Due to their medical knowledge, doctors retain authority over both knowledge and status. The consequence of this dominance is the attempt to dismiss local traditional knowledge and practices. Although the pattern of traditional postpartum beliefs and practices is changing, it is still observed in northern Thailand. I contend that postpartum care for women incorporates local traditions so that women's health can be optimized at the time when they are in the most vulnerable stage of their lives.

Adult↗
PubMed2002

Modern stroke unit.

The modern stroke unit is making significant contributions to the care of stroke victims and is proving to be an effective, cost-saving enterprise. The precise factors that contribute to the efficacy of these units have yet to be identified, but a combination of protocolized approaches to patient care, critical paths, a focus of expertise, and heightened index of suspicion for comorbidities all probably play a role. This article outlines the basic features of a modern stroke unit and surveys the literature on stroke unit outcomes.

Journal Article↗
PubMed2001

The "foul disease" and privacy: the effects of venereal disease and patient demand on the medical marketplace in early modern London.

This article examines medical advertisements for venereal disease treatment from late Stuart London. It explores how privacy issues influenced the services provided by early modern venereologists. It shows that practitioners who sought to get ahead in the competitive field of venereology began to offer private treatment at a time when other physicians seem not to have provided that service. Therefore, market forces such as patient demand had an innovatory effect on early modern medical ethics. The same dynamic that caused venereal patients to seek privacy also led them to demand a practitioner of their own sex. Infected women clearly wished to be treated by a female practitioner. Many male practitioners forged partnerships with women in order to attract female clientele. These partnerships were frequently based on familial connections, most often between husband and wife. The presence of widespread VD in London helped sustain a sizable number of female practitioners who specialized in venereology.

Advertising↗
PubMed2006

Review of modern techniques to generate antireflective properties on thermoplastic polymers.

Modern optical applications need solutions for providing polymer surfaces with antireflective properties. The problems involved in coating comprise thermal limitations, incompatible mechanical properties of coating and substrate materials, and interaction between polymers and plasma. As an alternative for coating, antireflective properties on polymers can also be obtained by hot embossing or by ion etching of surface structures. My objective is to provide the criteria for choosing suitable deposition or structuring methods based on an understanding of plasma-, radiation-, and ion-induced surface phenomena; material compatibility; mechanical and environmental performance; and cost issues. The potential to produce antireflective interference coatings is documented for plasma-enhanced physical- and chemical-vapor-deposition methods, including modern hybrid techniques, as well as for solgel wet-chemical processes. The review about state-of-the-art coatings focuses on the thermoplastic acrylic, polycarbonate, and cycloolefin polymers.

Journal Article↗
PubMed2025

The modern expansion of Dscam1 isoform diversity in Drosophila is linked to fitness and immunity.

Drosophila melanogaster Down Syndrome cell adhesion molecule 1 (Dscam1) gene encodes 38,016 diverse cell surface receptor proteins via alternative splicing, which have both nervous and immune functions. However, it remains elusive why organisms have evolved such an astonishing diversity of isoforms. Here, we show that fitness and immunity properties have driven the modern evolution of Dscam1 isoform diversity. We assess multiple aspects of fly fitness in deletion mutants harboring exon 4, 6, or 9 clusters, respectively, reducing ectodomain isoform diversity stepwise from 18,612 to 396. All fitness-related traits generally improved as the potential number of isoforms increased; however, the magnitude of the changes varied remarkably in a variable cluster-specific manner. Correlation analysis revealed that fitness-related traits were much more sensitive to reductions in Dscam1 diversity compared to canonical neuronal self/non-self discrimination. We conclude that the role of Dscam1 isoforms in canonical neuronal self-avoidance and self/non-self discrimination is mediated by a small fraction of all isoforms (<1/10), whereas a separate role essential for other developmental contexts and resistances, likely in fitness and immunity, requires almost full isoform diversity. Thus, fitness and immunity properties, rather than canonical neuronal functions, are the dominant drivers during the modern diversification of the Dscam1 isoform. Our findings suggest that Dscam1 diversity is closely linked to adaptation and species diversification in arthropods.

Animals↗
PubMed2003

Invoking vali: painful technologies of modern birth in south India.

As reproduction becomes increasingly biomedicalized throughout the globe, reproductive technologies are used in unique ways and imbued with different meanings. This article explores why lower-class women in south India in the 1990s were demanding to have childbirth labors induced with oxytocin drugs while rejecting anesthesia. Cultural constructions of women's reproductive power are evoked and reworked in discourses of modernity that explain this preference. Discourses on relationships among gender, pain, and modernity relate to political-economic constraints on hospitals to perpetuate this practice.

Anesthesia, Obstetrical↗
PubMed2006

[Modern nursing: the order of care].

With the purpose of placing modern nursing into focus, in this essay I go over the possible conditions for the emergence of nursing practice systems. Based on texts by Michel Foucault and identified with Cultural Studies, I reclaim fragments from nursing history in order to put back together the organization of its practice system at a given historical moment and in a hospital environment. I tell the story of some of this plot's characters in an effort to show that the past can become the product of the present, once it encompasses historical writings devised and set up by the will of its authors. I highlight modern nursing as a practice of care that becomes professional and builds its own knowledge intent on ensuring professional independence.

Brazil↗
PubMed2003

[The sanitary question in the modernity-postmodernity debate].

This work analyzes the sanitary question in the modernity-postmodernity debate. Such analyses are performed form a philosophical position that states the crisis of Modernity and questions the ideological twist that to itself propitiates postmodernity, shutting out questioning views or visions. It propitiates an alternative view of politics, thinking of it from the potency plane and giving a role to the subject in the decision of producing transformations.

English Abstract↗