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PubMed1992

New chromosome 21 DNA markers isolated by pulsed field gel electrophoresis from an ETS2-containing Down syndrome chromosomal region.

To generate new chromosome 21 markers in a region that is critical for the pathogenesis of Down syndrome (D21S55-MX1), we used pulsed field gel electrophoresis (PFGE) to isolate a 600-kb NruI DNA fragment from the WA17 hybrid cell line, which has retained chromosome 21 as the only human material. This fragment, which contains the oncogene ETS2, was used to construct a partial genomic library. Among the 14 unique sequences that were isolated, 3 were polymorphic markers and contained sequences that are conserved in mammals. Five of these markers mapped on the ETS2-containing NruI fragment and allowed us to define an 800-kb high-resolution PFGE map.

Animals↗

PubMed1986

A straightforward approach to isolate DNA sequences with potential linkage to the retinoblastoma locus.

From a human-Chinese hamster somatic cell hybrid a clone was derived containing chromosome 13 in duplicate as its only human material. This clone was used to construct a human chromosome 13-specific recombinant DNA-library. Overlapping Sau3AI DNA sequences (11.9-17.2 kb) from the cell hybrid were inserted into the lambda phage vector EMBL4. From eleven recombinants having a human insert thirteen putative unique DNA sequences were isolated and cloned into the plasmid vector pBR329. A human-mouse hybrid containing a human chromosome 13 with a deletion of 13q14 and lacking its undeleted homologue was constructed to be used in a selection procedure for DNA sequences belonging to band q14. Three probes originating from two different phages were assigned to 13q14 because they did not hybridise to DNA from this cell hybrid. One of these 13q14 probes detects a low frequency (2/44) MspI restriction fragment length polymorphism. The probes are now being used for screening a cosmid library to find adjacent polymorphic sequences with a RFLP information content suitable for application in the diagnosis of hereditary retinoblastoma.

Animals↗

PubMed2000

[The menstruation cycle in the postoperative phase. Its effect of the incidence of nausea and vomiting].

OBJECTIVE: Several studies suggest that the menstrual cycle has an impact on postoperative nausea and vomiting (PONV). However, many studies report inconsistent results. Thus, in this systematic review the results of all available studies are compared and statistically synthesised. MATERIALS AND METHODS: A systematic search of the literature was performed (Medline, the Cochrane-Library, reference lists of matching articles). The main end point in each study was defined as occurrence of PONV during an observation interval of at least 12 h postoperatively. These data were extracted from each article and the pooled incidences of PONV for each day of the menstrual cycle were calculated. These incidences were analysed using the chi 2-test. Furthermore the pooled incidences of PONV during the following phases of the menstrual cycle were calculated: days 1-7, 8-12, 13-15, 16-24, and 25-end of cycle. RESULTS: A total of 12 studies with 2625 patients containing informations on the incidence of PONV on different days or phases of the menstrual cycle were analysed. The total incidence of PONV was 37.3%. The incidence of PONV was lowest (26.9%) on day 20 and reached its maximum on day 5 (45.0%) with no statistically significant differences concerning the incidences of PONV between the different days (p = 0.75). Furthermore there were no clinically relevant differences in the incidences of PONV during the phases of the menstrual cycle: day 1-7: 40.4%; day 8-12: 32.9%; day 13-15: 38.1%; day 16-24: 34.5%; day 25-end of cycle: 41.5%. Prophylactic administration of an antiemetic in some of the studies had no impact on these results. CONCLUSION: Studies investigating the influence of the menstrual cycle on the incidence of PONV show inconsistent results. Summarising the data of these studies suggests that the phase of the menstrual cycle has no impact on the occurrence of PONV.

Antiemetics↗

PubMed2026

Assessment of temporomandibular joint space changes after orthognathic surgery in skeletal malocclusion patients: a systematic review.

PURPOSE: To interpret postoperative changes in temporomandibular joint (TMJ) joint space dimensions and condylar position following orthognathic surgery in patients with skeletal malocclusions, and to determine whether reported alterations represent clinically meaningful displacement or physiological adaptive remodeling. MATERIALS AND METHODS: A comprehensive search of PubMed, SCOPUS, Web of Science, EBSCOhost, and Cochrane Library was performed to assess pre- and postoperative TMJ changes using three-dimensional imaging. Joint spaces including anterior (AJS), superior (SJS), and posterior (PJS) and condylar morphology were evaluated. Methodological quality was appraised using the Joanna Briggs Institute (JBI) checklist. Due to methodological and clinical heterogeneity, findings were synthesized narratively with attention to malocclusion type and surgical movement. RESULTS: A total of 16 studies consisting 628 patients undergoing BSSO, Le Fort I osteotomy, vertical ramus osteotomy, or bimaxillary surgery were included. Most studies reported minor, adaptive postoperative changes in AJS, SJS, and PJS. Class II patients showed more consistent increases in AJS/SJS, whereas Class III patients demonstrated variable posterior or anterior remodelling depending on surgical movement. Volumetric analyses revealed region-specific adaptations without significant condylar displacement. Postoperative temporomandibular disorder symptoms were infrequent, and no consistent evidence supported detrimental TMJ effects attributable to surgery. CONCLUSION: Postoperative TMJ joint space changes after orthognathic surgery primarily represent physiological adaptive remodeling rather than pathological condylar displacement, with reported variability driven by malocclusion type, surgical movement, fixation method, and imaging protocol. Recognizing these predictable patterns is essential to prevent overinterpretation of postoperative imaging and to improve clinical assessment through standardized three-dimensional and long-term evaluation strategies.

Humans↗

PubMed1994

Users conceptual views on medical information databases.

As information databases we consider all the kinds of information repositories that are handled by computer systems. When querying very large information databases, the end-users are often faced with the problem to parse their questions efficiently into the query languages of the computer systems. Conceptual graphs were initially designed for natural language analysis and understanding. Due to their closeness to semantic networks, their expressiveness is powerful enough to be applied to knowledge representation and use by computer systems. This work demonstrates that conceptual graphs are a suitable means to model both the information in patient databases and the queries to these databases, and that operations on graphs can compute the pattern matching process needed to provide the answers. A prototype that exploits this model is presented. Experiments have been made with the material furnished by the Unified Medical Language System project (version 2, 1992) of the National Library of Medicine, USA.

Abstracting and Indexing↗

PubMed2005

Designing and implementing health data and information providers.

OBJECTIVES: To model and implement web portals providing access to certified and high-quality information in the domain of health. MATERIAL AND METHODS: The Unified Medical Language System (UMLS) knowledge sources of the U.S. National Library of Medicine and principles of implementation resulting from the previous ARIANE project are described. The XML technology that allows files transformations by the means of XSLT is briefly presented. RESULTS: The design and implementation of software modules that exploit knowledge sources, operate the translation of a user's query to selected information sources, and wrap obtained results are detailed. Querying documentary and factual medical databases are presented. DISCUSSION: Current implementation and wrapping perspectives are discussed in terms of integration and interoperability of health information and data resources.

France↗

PubMed2006

Neuromodulatory therapy to improve erectile function recovery outcomes after pelvic surgery.

PURPOSE: Erectile dysfunction is a recognized, common adverse consequence of radical prostatectomy as well as various other pelvic surgeries. While a host of management options have been considered to decrease this complication, neuromodulatory therapy has recently been advanced as an intervention that may be applied for this purpose. We evaluated concepts regarding the neuropathic basis for erectile dysfunction following pelvic surgery, principles for establishing neuromodulatory therapy in this clinical context, evidence from preclinical studies supporting neuromodulatory approaches as a therapeutic strategy and the progress of early clinical developments in this field. MATERIALS AND METHODS: The exercise principally consisted of a current literature search using the National Library of Medicine PubMed Services, a survey of recent abstract proceedings from national meetings relevant to the topic and an Internet online search for current information on federally and privately supported clinical trials specific to this topic. References were made to such key words as neuroprotection, nerve regeneration, nerve growth factors, neurotrophic factors, cavernous nerves, nerve guides and penile erection. RESULTS: Basic science research and clinical studies support the concept that erectile loss after pelvic surgery is frequently related to neuropathic effects, resulting in penile vascular impairment. An assortment of neurobiological studies using rodent models of cavernous nerve injury have shown nerve reconstitutive actions for a host of neurotrophic substances, including classic neurotrophins, growth hormone, cytokines and atypical neurotrophic mediators. Clinical trials of several proposed neuroprotective and neurotrophic applications have been done or are in progress. CONCLUSIONS: Erectile dysfunction is a well recognized and yet ineffectively averted complication of pelvic surgery. Neuromodulatory therapy offers a therapeutic approach for addressing the neuropathic changes of the penis that occurs in this context with the goal of maximally preserving erectile function postoperatively. While several specific neuromodulatory applications have gained interest for their potential benefit with pelvic surgery, determining their actual roles awaits the completion of controlled clinical trials.

Erectile Dysfunction↗

PubMed2007

Role of alpha-blockers in type III prostatitis: a systematic review of the literature.

PURPOSE: We examined the evidence for the effectiveness of alpha-blockers for type III prostatitis. MATERIALS AND METHODS: Studies were identified through a search of MEDLINE, EMBASE and The Cochrane Library as well as a manual search of bibliographies of identified articles and abstract books of recent major international urology conferences. Inclusion criteria included randomized, placebo controlled trials of treatment for type III prostatitis and use of the National Institutes of Health-Chronic Prostatitis Symptom Index outcome measure. RESULTS: Six unique trials in a total of 386 patients met inclusion criteria. One study showed no difference between alpha-blockers and placebo in terms of total or domain National Institutes of Health-Chronic Prostatitis Symptom Index scores and another did not report the p value. All of the remaining 4 studies showed a statistically significant difference in the total score in favor of alpha-blockers, while only 2 showed improved quality of life. Individual treatment effects were statistically significant more often when treatment was administered for 3 months or longer. Despite a common tool for outcome assessment meta-analysis of the results in individual trials was not possible due to differences in the manner of interpreting outcomes and reporting data. CONCLUSIONS: The current published literature is insufficient to conclude with certainty that alpha-blockers are effective for type III prostatitis. Future studies should incorporate uniformity in data collection and reporting with improved health related quality of life as the end point of therapy.

Adrenergic alpha-Antagonists↗

PubMed2003

Chest radiograph interpretation by medical students.

AIM: To assess the ability of final year medical students to interpret conventional chest radiographs. MATERIALS AND METHODS: Ten conventional chest radiographs were selected from a teaching hospital radiology department library that were good radiological examples of common conditions. All were conditions that a medical student should be expected to recognize by the end of their training. One normal radiograph was included. The radiographs were shown to 52 final year medical students who were asked to describe their findings. RESULTS: The median score achieved was 12.5 out of 20 (range 6-18). There was no difference between the median scores of male and female students (12.5 and 12.3, respectively, p=0.82) but male students were more likely to be certain of their answers than female students (median certainty scores 23.0 and 14.0, respectively). The overall degree of certainty was low. On no radiograph were more than 25% of students definite about their answer. Students had received little formal radiology teaching (2-42 h, median 21) and few expressed an interest in radiology as a career. Only two (3.8%) students thought they were good at interpreting chest radiographs, 17 (32.7%) thought they were bad or awful. CONCLUSION: Medical students reaching the end of their training do not perform well at interpreting simple chest radiographs. They lack confidence and have received little formal radiological tuition. Perhaps as a result, few are interested in radiology as a career, which is a matter for concern in view of the current shortage of radiologists in the UK.

Clinical Competence↗

PubMed2002

Isolation and characterization of runxa and runxb, zebrafish members of the runt family of transcriptional regulators.

OBJECTIVE: The AML/RUNX family of transcription factors plays important roles in hematopoiesis, neurogenesis, bone development, and segmentation in vertebrate embryos. The aim of this study was to isolate runt-related genes in a genetically and embryologically exploitable system, the zebrafish, and characterize their function during hematopoietic development. MATERIALS AND METHODS: Two runt-related genes were isolated by degenerate PCR and standard library screening, and a radiation hybrid panel, T51 RH, was used to resolve their chromosomal localization. In situ hybridization demonstrated their expression whereas their transcriptional activity was assessed using an AML1-responsive reporter gene in the MLA 144 T-cell line. RESULTS: We isolated the zebrafish runxa and runxb cDNAs, which encode proteins highly homologous to the human and murine Runx1 (AML1) and Runx3 (AML2) proteins. In contrast to a recent report, we detected runxa expression in both hematopoietic and neural tissues of the developing zebrafish. runxa transcripts first appear during segmentation in bilateral mesodermal cells that coexpress one of the earliest blood and endothelial cell markers, scl/tal-1. By 24 hours postfertilization (hpf), runxa transcripts are seen in the ventral wall of the dorsal aorta. Hematopoietic runxa expression is lost in cloche mutants, which are defective in blood and endothelial cell formation. runxb transcripts are seen in nonhematopoietic domains. Both Runxa and Runxb transactivate an AML1-responsive human promoter in hematopoietic cells. Genomic localization studies demonstrate that runxa is located on linkage group 1 (LG1), and the runxb gene is located on LG13. CONCLUSIONS: Our gene expression analysis strongly suggests that both the functional and spatial aorta-gonad-mesonephros (AGM) region has been conserved throughout evolution. Our runxa spatiotemporal expression data shed light on the role of vertebrate Runx1/AML1 in primitive vs definitive hematopoietic development.

Amino Acid Sequence↗

PubMedDate not supplied

Preliminary investigation of submerged aquatic vegetation mapping using hyperspectral remote sensing.

The use of airborne hyperspectral remote sensing imagery for automated mapping of submerged aquatic vegetation (SAV) in the tidal Potomac River was investigated for near to real-time resource assessment and monitoring. Airborne hyperspectral imagery and field spectrometer measurements were obtained in October of 2000. A spectral library database containing selected ground-based and airborne sensor spectra was developed for use in image processing. The spectral library is used to automate the processing of hyperspectral imagery for potential real-time material identification and mapping. Field based spectra were compared to the airborne imagery using the database to identify and map two species of SAV (Myriophyllum spicatum and Vallisneria americana). Overall accuracy of the vegetation maps derived from hyperspectral imagery was determined by comparison to a product that combined aerial photography and field based sampling at the end of the SAV growing season. The algorithms and databases developed in this study will be useful with the current and forthcoming space-based hyperspectral remote sensing systems.

Algorithms↗

PubMed2002

Information and communication technology among undergraduate dental students in Finland.

Use of information and communication technology (ICT) is rapidly increasing in medical and dental education. The aim of the present study was to determine the knowledge, skills and opinions of dental undergraduate students regarding ICT and to analyze possible shifts in the acquisition of these resources. For these purposes a survey of all undergraduate dental students at the University of Oulu, Finland, was conducted during the spring term 2000. All the students in the 5 years of study (n = 140) were asked to answer a questionnaire presented during a lecture or demonstration. An overall response rate of 95% was achieved. The frequencies and percentage distributions of the items were analyzed separately for each year (1-5). All the students in the faculty are provided with personal e-mail addresses at the beginning of their studies and special emphasis has been laid on the utilization of their ICT knowledge and skills. An overwhelming majority of the students, more than 95%, judged themselves to have good or satisfactory skills in word processing, but only a slight majority considered that they could manage some advanced operating system functions. Use of ICT services was high, as about 60% of the students used e-mail and one-third WWW services daily. Literature retrieval was widely employed, so that almost 80% of the students had used literature databases (including Ovid Medline and collections of electronic full-text articles), which were introduced and provided by the Medical Library when the students were in their second year. More than 50% had received educational material in electronic form often or sometimes, and almost 80% had communicated by e-mail with a faculty teacher. A clear trend (P < 0.05) was found for the younger students to use ICT services in general and for educational purposes more often than the older ones. In conclusion, e-mail and WWW have been widely adopted for both private and educational purposes by dental students in Finland and are employed together with WWW-based medical and dental publication databases. The younger students have more interest in ICT and better skills, which presents a challenge for dental education in the future.

Computer Literacy↗

PubMed1986

Accumulation of chlorpromazine and thiouracil by human melanoma cells in culture.

The uptake (total radioactivity in intact cells) and incorporation (radioactivity bound to acid-precipitable material) of 14C-chlorpromazine (CPZ) and 14C-thiouracil (TU) were studied using a library of 3 human fibroblast strains and 13 tumour cell lines. In contrast to previous studies using rodent melanomas in vivo, the melanoma lines, including lines with high tyrosinase and melanin contents, did not take up more CPZ and TU than non-melanoma cells (fibroblasts, HeLa cells). Incorporation of CPZ was also broadly similar in all cell types studied. TU was selectively incorporated into the melanoma line having a high tyrosinase and melanin content but not into lines with high tyrosinase activity and low melanin content. While supporting the possibility of selective therapy for heavily-pigmented melanomas using labelled TU derivatives, these results suggest that the action of potentially melanoma-affined compounds should be further evaluated in human cells. Unlabelled CPZ or TU was not selectively toxic to melanoma cells. Unexpectedly, methylation-sensitive tumour cells (Mer-phenotype) were highly resistant to TU, thus providing a new experimental tool for understanding the genesis of this phenotype in vivo.

Cell Line↗

PubMed2025

Enhanced fracture detection on radiographs with AI assistance for clinicians: a systematic review and meta-analysis.

BACKGROUND: Emergency radiographic interpretation for fractures is prone to missed or misdiagnoses. Artificial intelligence (AI) is expected to become a powerful tool to assist clinicians in fracture detection. PURPOSE: A systematic review and meta-analysis was performed to assess whether AI improves clinicians' ability to detect fractures on radiographs. MATERIALS AND METHODS: A literature search was conducted in PubMed, Web of Science, and Cochrane Library for studies published between January 1, 2010, and October 10, 2025. A meta-analysis of diagnostic accuracy studies was performed using a Summary Receiver Operating Characteristic (SROC) curve. The quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Subgroup analysis and meta-regression were conducted to explore potential sources of heterogeneity. RESULTS: A total of 26 studies were included . The pooled sensitivity of clinicians increased from 77% (95% CI: 72-81) to 87% (95% CI: 83-90) with AI assistance, while the pooled specificity improved from 88% (95% CI: 85-90) to 92% (95% CI: 89-94). The corresponding AUC values were 0.90 (95% CI: 0.87-0.92) before and 0.95 (95% CI: 0.93-0.97) after AI assistance. Eight studies were rated as high risk of bias. Subgroup analysis and meta-regression identified potential sources of heterogeneity, including fracture location, AI model type, high risk of bias, and reference standards. CONCLUSION: AI assistance significantly improves clinicians' diagnostic performance in detecting fractures on radiographs for extremity and trunk fractures.

Humans↗

PubMed2026

Effects of GLP-1 Receptor Agonists and Dual GIP/GLP-1 Receptor Agonists on Inflammatory and Metabolic Biomarkers in Type 2 Diabetes: A Systematic Review and Meta-Analysis.

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dual GIP/GLP-1 receptor agonists improve cardiovascular outcomes in type 2 diabetes mellitus (T2DM), but their effects on inflammatory and oxidative biomarkers are not fully defined. MATERIALS AND METHODS: We searched PubMed, Ovid MEDLINE, Scopus, Web of Science and the Cochrane Library from inception to 19 February 2026 for randomised controlled trials (RCTs) in adults with T2DM comparing a GLP-1RA or dual GIP/GLP-1 agonist with placebo or active therapy, and reporting C-reactive protein (CRP or high-sensitivity CRP [hs-CRP]), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), malondialdehyde (MDA) or adiponectin. Random-effects meta-analyses were conducted using standardised mean differences (SMDs). RESULTS: Forty-one RCTs were included. GLP-1RAs significantly reduced CRP/hs-CRP (27 studies, 1991 participants; SMD -0.37, 95% CI -0.59 to -0.14) and MDA (3 studies, 272 participants; SMD -0.98, 95% CI -1.65 to -0.30), and increased adiponectin (16 studies, 1327 participants; SMD 0.30, 95% CI 0.13 to 0.46). Pooled effects on IL-6 (17 studies, 1068 participants; SMD -0.14, 95% CI -0.37 to 0.10), TNF-α (16 studies, 1164 participants; SMD -0.25, 95% CI -0.61 to 0.12) and MCP-1 (7 studies, 450 participants; SMD -0.27, 95% CI -0.58 to 0.03) were not statistically significant, although MCP-1 decreased in sensitivity analyses. Across biomarkers, heterogeneity was moderate to high. Two tirzepatide RCTs (562 participants) showed a significant reduction in IL-6 (SMD -0.28, 95% CI -0.47 to -0.09) and a non-significant trend towards lower CRP/hs-CRP. CONCLUSIONS: In adults with T2DM, incretin-based therapies consistently lower CRP/hs-CRP, reduce oxidative stress (MDA) and increase adiponectin, while effects on IL-6 and TNF-α are more variable. These data support a selective anti-inflammatory and metabolic regulatory profile of GLP-1-based therapy, but heterogeneity and limited data for some biomarkers warrant cautious interpretation and further mechanistic studies. TRIAL REGISTRATION: PROSPERO number: CRD420261321430.

Humans↗

PubMed2005

The Primary Care Electronic Library (PCEL) five years on: open source evaluation of usage.

BACKGROUND: The Primary Care Electronic Library (PCEL) is a collection of indexed and abstracted internet resources. PCEL contains a directory of quality-assured internet material with associated search facilities. PCEL has been indexed, using metadata and established taxonomies. Site development requires an understanding of usage; this paper reports the use of open source tools to evaluate usage. This evaluation was conducted during a six-month period of development of PCEL. OBJECTIVE: To use open source to evaluate changes in usage of an electronic library. METHOD: We defined data we needed for analysis; this included: page requests, visits, unique visitors, page requests per visit, geographical location of users, NHS users, chronological information about users and resources used. RESULTS: During the evaluation period, page requests increased from 3500 to 10,000; visits from 1250 to 2300; and unique visitors from 750 to 1500. Up to 83% of users come from the UK, 15% were NHS users. The page requests of NHS users are slowly increasing but not as fast as requests by other users in the UK. PCEL is primarily used Monday to Friday, 9 a.m. to 5 p.m. Monday is the busiest day with use lessening through the week. NHS users had a different list of top ten resources accessed than non-NHS users, with only four resources appearing in both. CONCLUSIONS: Open source tools provide useful data which can be used to evaluate online resources. Improving the functionality of PCEL has been associated with increased use.

Information Dissemination↗

PubMed2001

[Application of a computer-aided detection (CAD) system to digitalized mammograms for identifying microcalcifications].

PURPOSE: It is estimated that during mammographic screening programs radiologists fail to detect approximately 25% of breast cancers visible on retrospective review; this percentage rises to 50% if minimal signs are considered. Independent double reading is now strongly recommended as it allows to reduce the rate of false negative examinations by 5-15%. Recent technological progress has allowed to develop a number of computer-aided detection (CAD) systems. The aim of CAD is to help radiologists interpret lesions by serving as a second reader. In this study the authors developed and applied a CAD system to measure its ability to microcalcifications detect and compare its performance with that of a human observer. MATERIAL AND METHODS: The study was performed as part of the CALMA (computer-aided library for mammography) project of the Pisa section of the National Institute of Nuclear Physics. The aim of this project is to set up a large database of digital mammograms and to develop a CAD system. Our study series consisted of 802 mammograms - corresponding to 213 patients - digitalized between March and June 2000. We performed traditional mammography and then digitalized the mammograms using a CCD linear scanner (pixel size of 85 x 85 microm2, 12 bits). The images were evaluated by two radiologists with similar experience and then by the CAD system. This CAD system searches for microcalcifications by using ad hoc algorithms and an artificial neural network (Sanger type). RESULTS: The number of clusters in our database was 141 corresponding to 140 images; 692 images were non pathological. The CAD system identified a variable number of clusters depending on the threshold values. The threshold value is a number over which the probability of finding a lesion is highest. With thresholds of 0.13 and 0.14 the CAD system identified 140/141 clusters (99.3%); with a threshold of 0.15 it identified 139/141 clusters (98.6%); with a threshold of 0.16, 137/141 (97.2%); with a threshold of 0.18, 133/141 (94.3%); with thresholds of 0.18 and 0.20, 130/141 (92.2%). With threshold values of 0.13, 0.14, 0.15, 0.16 and 0.17 the system's sensitivity was greater than 82%, whereas with values of 0.18 and 0.20 it was greater than 80%. The number of false positive region of interest (ROI) / image was greater with low threshold values: in particular, thresholds of 0.13 and 0.14 yielded 16 false positives /image, thresholds of 0.15 and 0.16 yielded 9 and 7 false positives/image, and both 0.18 and 0.20 only 5/image. DISCUSSION: ROC curve shows how the use of high threshold values determined a very high specificity despite very low sensitivity rates. Conversely, low threshold values allowed to have a high sensitivity and a very low specificity. The best performance of our CAD system was obtained with threshold values at 0.15 and 0.16. In fact these thresholds resulted in a high sensitivity (greater than 82%) with an acceptable number of false positives/image, 9 and 7/image, respectively. It is not yet known how radiologists can deal with large numbers of false positives in screening programmes but in our opinion the most important feature of a good CAD system is a high sensitivity. CONCLUSIONS: In the near future the use of CAD systems will be widespread and easier to apply to everyday practice above all in centers where digital mammography is performed. Mammograms could be directly shown to radiologists after the CAD system has selected the ROI and analysed the images. Thanks to its high sensitivity and despite its low specificity CAD represents a concrete aid for radiologists.

Breast Diseases↗

PubMedDate not supplied

[Effectiveness of flunarizine in the prophylaxis of migraine: a meta-analytical review of the literature].

BACKGROUND: Migraine is a common and disabling health problem among young and middle aged adults. Flunarizine have been used as a prophylactic medication in its management for more than two decades. OBJECTIVE: The aim of the study is to systematically review the evidence obtained from randomized controlled trials about the efficacy and security of flunarizine versus placebo for the prevention of migraine in adults. MATERIALS AND METHODS: Electronic search were performed using the databases MEDLINE, EMBASE, Biosis, the Cochrane Library, Lilacs and others. Reference lists of retrieved studies, reviews and conference abstracts were used to found another articles. Additionally, the authors performed a handsearched in recognized journals related to migraine and neurological topics. Randomized, placebo controlled, double blind trials assessing the efficacy of flunarizine for preventing migraine were included. We evaluated the frequency of the attacks by comparing the mean frequency before and after the intervention for each group of treatment and then the two groups were compared. To evaluate the security of flunarizine we used included and excluded studies and open trials. RESULTS: Nine studies were obtained but only four met the inclusion criteria. The fixed effects model reported a reduction in the frequency of attacks by using flunarizine. The monthly difference was 0.55 attacks (CI 95%= 0.215 0.895; p= 0.002). Somnolence was the most frequent adverse effect in 20.5% of the subjects (n= 1,987). CONCLUSIONS: Based on a small number of trials, flunarizine, at a daily dose of 10 mg lightly reduces the frequency of migraine attacks.

Adolescent↗