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The relative importance of traditional and "modern" foods for Israeli Negev Bedouins. A population in transition.

The impact of urbanization on the health and nutritional status of developing populations is an issue of concern worldwide. The Bedouin Arabs in Southern Israel are a traditionally semi-nomadic/nomadic population undergoing a rapid process of urbanization which is accompanied by rising chronic disease rates. We examined the diet of urban and rural (more traditional) Bedouins to determine the relative importance of modern foods and drinks in their daily diet. We found that for main meals both populations rely heavily on traditional foods (available before 1948) but for snacks and drinks many manufactured products are used. These products rich in calories may contribute to the changing disease patterns. Rural areas rely more on traditional milk products which are made non-perishable, while urban populations use more meat products and pre-prepared meals because of the availability of electricity and refrigeration. Traditional foods and drink and the traditional way of eating (eating from a common plate) is still a very important part of the Bedouin way of life. This pattern of eating requires the development of culture-specific dietary assessment methodology to allow quantitative assessment of both traditional and more modern foods consumption and handle the eating practices of the Bedouin society today.

Adult↗

Modern imaging methods and preoperative management of pheochromocytoma: review of the literature and case report.

OBJECTIVES: To discuss the modern imaging techniques and preoperative management of pheochromocytoma and to report on one additional case. METHODS: A 66-year-old male with an incidentally discovered left adrenal mass is described. The adrenal medulla strongly accumulate 131 I-metaiodobenzylguanidine (MIBG). The patient underwent left adrenalectomy after preoperative therapy with alpha and beta-blockers. The recent literature on pheochromocytoma modern imaging techniques and preoperative management is reviewed. RESULTS: MIBG scintigraphy diagnosed a benign functioning adrenal pheochromocytoma, allowing preoperative medical management. Postoperative workup was unremarkable. Diagnosis of pheochromocytoma was confirmed by immunohistopathology. At 18 months follow-up, the patient is alive and disease-free. CONCLUSIONS: Incidentally discovered adrenal masses have to be investigated to detect malignancy and subtle hormonal overproduction. MIBG scintigraphy has a high specificity (100%) in detecting pheochromocytoma, metastasis, surgical residual tumor, local relapse and other adrenal crest tumors. Positive results of octreotide scintigraphy in detecting malignant pheochromocytoma have been reported. Currently, pheochromocytoma removal is a safe operation with mortality rates ranging from 0 to less than 3%. Preoperative alpha adrenergic blockage with phenoxybenzamine or prazosin is important in decreasing the operative risk. Beta-blockers may be necessary for cardiac arrhythmia. Intraoperative invasive monitoring of hemodynamic variables may be both diagnostic and therapeutic of inadequate preoperative management. Lifelong follow-up for patients with pheochromocytoma is important.

3-Iodobenzylguanidine↗

[The thinking about modern biological technology].

The way of life and mode of thinking of mankind is being changed by modern biological technology. It may be come true again that coexist and evolution of man and nature because the development of modern biological technology, but it also cannot avoid produce some new problem which made people have a think deeply to biological warfare, ethics and morals, law, society, food safety, production of industry and agriculture, energy resources, environment.

Agriculture↗

[General practice in a modern health care system--consequences for medical research, education and practice].

This first of two articles describes the far-reaching changes to the practice and theory of general practice that are leading from the old-style general practitioner changing to the modern-day primary health care specialist. These already partly accomplished changes, whilst bringing into focus the future role of general practice in a modern health care system, are altering the self-awareness of the profession and the way it defines itself. Specifics of the theory and practice of decision-making in primary health care, within this context of vital importance but as yet barely taken into account, are explained on the basis of Bayes' theorem and with the aid of examples of empirical data on the rational diagnosis of thyroid dysfunction. Making use of examples of coronary heart disease diagnostics, the second part of this article illustrates important differences between health care-service levels and the consequences arising from these differences for medical research, education and practice.

Delivery of Health Care↗

Davidson and O'Leary talk to each other--and Modern Healthcare. Interview by John Morrissey.

The heads of the American Hospital Association and the Joint Commission on Accreditation of Healthcare Organizations waged a war of words this spring. At issue was the JCAHO's plan to seek a contract that the AHA contended would push the commission into the role of a regulator. Modern Healthcare broke the story about the disagreement. Now, Richard Davidson and Dennis O'Leary tell Modern Healthcare in an exclusive interview that they have patched up their differences.

Accreditation↗

[Validity of the modern fetal monitoring methods in the decision of emergency obstetric operations].

The validity of the modern methods of fetal monitoring to decide for the indication of urgent obstetric operations. The reliability of the modern supervision of the fetus is studied in cases of doubtful fetal heart action. Up to the present day we have no method for the exact estimation of the degree of a damage to the fetus. In such a precarious situation we should use all available methods for the diagnosis of the fetal condition, because the results of only one of the methods offer insufficient evidence. By means of the literature the alterations in the ECG of the dying fetus are interpreted in comparison to artefacts. In cases of doubtful fetal heart action we recommend in addition to the clinical findings to record the fetal ECG, to controll the actual fetal pH and attempt an investigation by ultrasonic.

Electrocardiography↗

[Status and perspectives in modern neurology. Problems of organization of neurologic services worldwide and in Croatia].

Modern neurology has completely changed in its concepts of science and medical discipline regarding the etiologies and the capabilities in the diagnostics, management, rehabilitation and prevention of neurological diseases. Advances in neurological sciences produced a rapid growth in the number of neurologists, new subspecialties and neurological institutions worldwide, opening questions on their possible application due to financial restrictions in many countries. Neurology in Croatia followed the modern tendencies in the world: in line with its humanistic tradition its orientation to the patient early appeared. From this experience developed a care on the optimal organization of neurological services, later on initiated in the Research Group on the Organization and Delivery of Neurological Services, founded in the World Federation of Neurology. The main activities and the Recommendations related to Neurology in Public Health are described, with the proposed levels of organization of neurological services, aiming at the optimal and rational neurological care. Problems of international collaboration on cost-effectiveness in neurology are accentuated.

Croatia↗

Revealing the secrets of the body: medical tests as legal evidence in personal status disputes in modern Egypt.

The study seeks to answer the following question: In the field of personal status, what kinds of medical tests have been considered reliable and acceptable by Egyptian courts of law, what kinds have been less accepted, and why? The main finding is that, on the one hand, the judges (qădĭs) have welcomed tests that seek to determine age or to discover physical diseases and/or mental disorders. On the other hand, they have been reluctant to introduce tests to determine virginity and pregnancy tests, and even more so to introduce paternity tests that might bring into light manifestations of moral laxity within Egyptian society and jeopardize the future of illegitimate children. In conclusion, the main resistance to the reliance on modern medical evidence has not been the lack of modern knowledge and technologies or opposition to this, but rather traditional moral and social perceptions.

Child↗

[Chemical approaches to the research & development of modern traditional Chinese pharmacy].

OBJECTIVE: To study chemical approaches to the research and development of modern traditional chinese pharmacy. METHOD: To put forward several views on the aspects that concerns chemical approaches to the research and development of modern traditional chinese pharmacy. RESULT AND CONCLUSION: Dactyloscopic system should be set up for the quality control of traditional chinese medicinal materials and preparations. In the research of effective components in traditional chinese medicines proper treatment should be given to the new compounds that arise in the process of decocting compound prescriptions.

Animals↗

Malthus' preconditions to moral restraint and modern population economics.

The author examines the writings of Malthus and compares them with basic tenets of two modern economic approaches to fertility studies. It is suggested that "Leibenstein and Easterlin, on the one hand, base their arguments on the central role of aspirations and of relative income or status, whether it be that of the parents or of the friends and neighbors. We argue that aspirations and relative income effects are quite close to Malthus' ideas on 'forward looking' and self respect. The other modern economic approach to fertility studies, the Chicago school, is centered on the effect of human capital on consumption and fertility decisions, and we think that this idea was not too strange to Malthus when he emphasized foresight and the desire for knowledge." (SUMMARY IN FRE AND ITA)

Behavior↗

Data acquisition, data storage, and data presentation in a modern genetics laboratory.

Modern genetic analysis can be divided into three main areas of investigation. The first is data acquisition, in the form of genomic sequence and the cataloguing of polymorphism data of the single nucleotide polymorphism variety (so called SNPs). Once identified, such genetic information can be adapted into high throughput tests to examine genetic information in large populations, making the analysis of sufficiently large numbers both cost and time effective so that relatively low-penetrant genetic effects can be accurately detected. The third step is correlating variation with phenotype (e.g. disease susceptibility or resistance) for a variety of disorders is paramount in our motivation and indeed is a common goal of modern human genetic analysis. While the technology to acquire vast amounts of genetic data is now well established and continues to expand, the ability to deal with such data, from the process of acquisition, storage, and analysis depends fundamentally on a solid informatics infrastructure as an essential component. Indeed, most of the major gains in productivity in this field are to be realized on the informatics front, and involve automating data acquisition, defining and sorting data in databases for quality control and analysis and facilitating access to data for the large variety of data analyses. Informatics-related issues including those relating to data acquisition, database structure, and analysis tools are summarized here in an effort to define some of the issues relevant to establishing informatics infrastructure in a small genetics laboratory focused on resequencing human immune response genes. From inherited diseases to drug efficacy to the specific genetic changes occurring during tumor development, this new field of medical genetics promises a profound impact on the state of human health. Ultimately, any and all advances in this field will continue to depend on major investments in informatics.

Computational Biology↗

[Modern results and old-established methods in obstetrics (author's transl)].

More than 20.000 obstetric cases were attended to during the years 1965 to 1974 at the Semmelweis-Klinik in Vienna. The perinatal maternal mortality rate was 0.1% and the perinatal infant mortality rate was finally 15%. The cases were treated according to oldfashioned obstetric principles. Hence, although the more modern obstetric methods might be of some scientific value, their importance appears to have been overestimated from a practical point of view. A return to the conscientious implementation of simple, long-established methods of pernatal care appears to be called for, even with the most modern monitoring machines at hand.

Adult↗

Modern unicompartmental knee arthroplasty with cement: a three to ten-year follow-up study.

BACKGROUND: Unicompartmental arthroplasty is a treatment alternative when only one compartment of the knee is affected with arthritis, but the reported results of this procedure have been variable. The purpose of the present study was to evaluate the results of a modern unicompartmental knee arthroplasty performed with use of a cemented metal-backed prosthesis and surgical instrumentation comparable with that used for total knee replacement. METHODS: The indications for the procedure were osteonecrosis or osteoarthritis associated with full-thickness loss of cartilage that was limited to one tibiofemoral compartment as evaluated on standing and stress radiographs. One hundred and sixty consecutive cemented metal-backed Miller-Galante prostheses in 147 patients were evaluated after a mean duration of follow-up of sixty-six months (range, thirty-six to 112 months). The mean age of the patients at the time of the index procedure was sixty-six years. RESULTS: Three knees were revised because of progression of osteoarthritis in the patellofemoral joint (two knees) or the lateral tibiofemoral compartment (one knee). Two knees had revision of the polyethylene liner. The average Hospital for Special Surgery knee score improved from 59 points preoperatively to 96 points at the time of the review. According to Kaplan-Meier analysis, the ten-year survival rate (with twenty-nine knees at risk) was 94% +/- 3% with revision for any reason or radiographic loosening as the end point. CONCLUSIONS: A modern unicompartmental knee arthroplasty is a valid alternative for patients with unicompartmental tibiofemoral noninflammatory disease. The patient selection must be strict with regard to the status of the patellofemoral joint. The preoperative planning includes stress radiographs to assess the correction of the deformity and the status of the uninvolved compartment. Continued long-term follow-up is necessary to evaluate long-term polyethylene wear.

Adult↗

Prognosis of tuberculous meningitis in adults in the era of modern antituberculous chemotherapy.

This study reviewed the clinical manifestations and outcome of tuberculous meningitis in the era of modern antituberculous chemotherapy and applied these data in assessing the role of clinical staging evaluated 30 days after treatment in predicting long-term outcome. A total of 41 adult patients with tuberculous meningitis hospitalized at a university hospital in Taiwan from June 1994 through August 1999 were included in this retrospective study. Their age ranged from 16 to 80 years (median, 41 years), and 17 (41.5%) patients had had a variety of underlying immunocompromising diseases. Fever (90%), headache (75.6%), neck stiffness (68.3%), altered consciousness (26.8%), and nausea and/or vomiting (26.8%) were the leading initial presentations. During the treatment course, 19 patients experienced new neurologic complications. The overall case fatality rate was 9.8% and morbidity rate 56.1%. More advanced clinical stage evaluated at 30 days after initiation of antituberculous chemotherapy and positive cerebrospinal fluid culture for Mycobacterium tuberculosis were the only 2 factors significantly associated with a worse long-term prognosis. Results indicate that tuberculous meningitis is associated with a high morbidity, consisting of minor and major neurologic sequelae, despite modern antituberculous chemotherapy. In addition, more advanced clinical staging evaluated at 30 days after the start of antituberculous chemotherapy and a positive cerebrospinal fluid culture for M. tuberculosis were associated with a poor prognosis.

Adolescent↗

[The development of private hospital in modern Korea, 1885-1960].

Modern hospital in Korea was the space of competition and comprise among different forces such as the state power and social forces, imperialism and nationalism, and the traditional and modern medicine. Hospital in the Japanese colonialism was the object of control for establishing the colonial medical system. Japanese colonialism controlled not only the public hospital but also the private hospital which had to possess more than 10 infectious beds in the isolation building by the Controlling Regulation of Private Hospital. In fact, the private hospital had to possess more than 20 beds for hospital management. As a result, its regulation prevented the independent development of the private hospital. But because the public hospital could not accommodate many graduates of medical school, most of them had to serve as practitioner. Although some practitioners had more than 20 beds in their clinics, they were not officially included in the imperial medicine. By concentrating on the trend of the number of beds in the hospital, this paper differs from most previous studies of the system of hospital, which have argued that the system of hospital was converted the public-centered hospital system under the colonial medical system into the private-centered hospital system under the U. S. medical system after the Liberation in 1945. After Liberation, medical reformers discussed arranging the public and the private hospital. Lee Yong-seol, who was a Health-Welfare minister, disagreed the introduction of the system of state medicine. Worrying about the flooding of practitioners, he did not want to intervene the construction of hospital by state power. Because the private hospital run short of the medical leadership and the fundamental basis, the state still controlled the main disease in the public health and the prevention of epidemics. This means the state also played important part in the general medical examination and treatment. The outbreak of Korean War in 1950 reinforced the role of state. The leadership of the public hospital verified the trend of the quantity of beds. The number of beds in the private hospital exceeded that of the public hospital in 1966 for the first time. Futhermore, the number of beds in the public hospital doubled that of private hospital in the new general hospital of 1950s. This means the system of hospital after the Liberation was not converted the public-centered hospital system into the private-centered hospital system, but maintained the public-centered hospital system until 1960s.

Colonialism↗

[Biological activity in the modern and buried soils of the St.Petersburg's historical center].

Biological activity in the urban modern and medieval soils of St. Petersburg was determined using soil samples taken from sections located at the historical center of this city nearby the Kazan Cathedral, the Twelve Colleges building (now the main building of St. Petersburg State University), and on the site where the Swedish fortress Nienshants formerly existed. The studied parameters of biological activity included the microbial transformation rate of organic matter under aerobic and anaerobic conditions, the intensity of denitrification and nitrogen fixation, and the amount of microbial biomass. This investigation is the first attempt to comparatively study modern urban anthropogenically impacted soils and buried soils that had formed the soil cover of this region before St. Petersburg was founded. The major microbiological and physicochemical parameters of the soils were subjected to correlation analysis.

Biomass↗

Diagnostic evaluation of pulmonary tuberculosis: what do doctors of modern medicine do in India?

SETTING: Out- and in-patient services of the Department of Tuberculosis and Chest Diseases, King George's Medical College, Lucknow, India. OBJECTIVE: To analyse diagnostic practices for pulmonary tuberculosis (PTB) among doctors of modern medicine and to estimate their association with diagnostic accuracy. DESIGN: A consecutive case series. The diagnostic practices of 518 doctors who had prescribed treatment for PTB to 270 patients were analysed. RESULTS: Almost all of the doctors (99.8%, 95% CI 98.9-100.0) used chest X-ray, while 49.2% (95% CI 44.8-53.6) advised chest X-ray alone for diagnosis of PTB. On the other hand, 50.6% (95% CI 46.2-55.0) performed sputum microscopy while none used it without chest X-ray. Sputum microscopy was used three times more frequently by chest specialists compared with non-chest specialists (81.9% vs. 25.8%, P = 0.0000). Non-utilisation of sputum microscopy was associated with a significantly higher probability of prescribing anti-tuberculosis treatment for PTB in patients with non-tuberculous conditions (odds ratio 5.0; 95% CI 2.72-9.83). CONCLUSION: Non-utilisation of sputum smear microscopy and continued reliance on chest X-ray only by up to 49% of practitioners of modern medicine might have serious public health implications. Strategies for their continued medical education and audit of their practices should be implemented without delay.

Humans↗

[Pathophysiological mechanisms of formation of iron deficiency states and modern approaches to administration of oral forms of iron preparations in their prophylaxis and treatment].

In the review, modern conceptions are presented on mechanisms of formation of iron deficiency states and status of the problem of administration of pathogenetically validated treatment in iron deficiency anemia (IDA) is analyzed. A brief comparative analysis is given of iron-containing medicines used in Ukraine. Current principles of medical management of IDA are set forth. Under adequate treatment with making use of modern iron-containing medicinal agents one can achieve a positive clinical effect. Data are submitted on high efficacies and good tolerability of the hydroxidepolymaltose-based iron preparations to be employed in IDA.

Administration, Oral↗