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PubMed1992

An epidemiologic study of neural tube defects: Delta County, Michigan, 1969-1988.

We determined the incidence of neural tube defects (anencephaly, spina bifida, hydrocephalus) in a rural county in the Upper Peninsula of Michigan because several local physicians perceived that the incidence in this area might be high. To assure that all neural tube defects that occurred were noted, data for the study were collected from hospital birth-log books, patient records of all neural tube defect births, all stillbirth records, and from records of babies transferred to other regional hospitals. A reference group consisting of 10% of all nonneural tube defect births during the 20 years of the study was selected at random and used to make comparisons to the case group. During the twenty-year period 1969-1988, the incidence of neural tube defects (NTDs) was found to be 2.09 per 1000 total births. The incidence of anencephaly was 1.05/1000; of spina bifida, 0.56/1000; and for hydrocephalus, 0.48/1000. Seasonal variations by month of conception were noted for anencephaly and spina bifida, confirming previous findings in the literature. Study results showed that between 1972 and 1976 there was a cluster of NTDs, but the NTD incidence was not statistically different from what might be expected over a twenty-year period. The incidence of NTDs in Delta County was found to be normal for this part of North America. The results of this study indicate that physicians should be cautious when attempting to interpret rare events, which often occur in clusters, leaving the impression that their incidence is excessive.

Adult↗

PubMed2004

A list of photosynthesis conferences and of edited books in photosynthesis.

This paper is a general appendix to the three parts of 'Celebrating the millennium - historical highlights of photosynthesis research' (Photosynthesis Research, Vols~73(2002), 76(2003), 80(2004)). The major part of this paper includes a comprehensive list of most of the edited volumes on research in the area of photosynthesis. However, I begin this paper by describing selected conferences, related to photosynthesis, held in USA, during 1935-1965, followed by the 1963 International Colloquim held in Gif-sur-Yvette, France (René Wurmser (1890-1993), President); and the 2nd Western European Congress (1965), held in the Netherlands, under the leadership of Jan B. Thomas (1907-1991), both these European conferences being the precursors of the first International Congress on Photosynthesis (1968), organized by Helmut Metzner (1925-1999) at Freudenstadt, Germany. A list of the subsequent international photosynthesis congresses is available in Govindjee and David Krogmann (this issue).

Journal Article↗

PubMed2001

The effects of physical therapy in Parkinson's disease: a research synthesis.

OBJECTIVE: To present a critical review and meta-analysis of studies evaluating the effects of physical therapy in patients suffering from Parkinson's disease (PD), in terms of neurologic signs, activities of daily living (ADLs), and walking ability. DATA SOURCES: Articles published from 1966 to May 1999 were compiled by means of MEDLINE, Cochrane register of controlled trials, and CINAHL using combinations of the key words Parkinson's disease, exercise, exercise therapy, physical therapy, and group training. References presented in relevant publications were also examined. Articles written in English, German, or Dutch were included. STUDY SELECTION: Studies had to meet the following selection criteria: (1) patients with PD were included in the intervention study, (2) the effects of physical therapy (PT) were evaluated, (3) the study could be classified as true or quasi-experiment, and (4) the study was published in a journal or book. DATA EXTRACTION: Two reviewers assessed independently the methodologic quality of the data of each included study. One reviewer extracted relevant meta-analysis data. DATA SYNTHESIS: For each outcome measure the estimated effect size and the summary effect size (SES) were calculated, using fixed (ie, Hedges's g) and random effects models. The meta-analysis resulted in a significant homogeneous SES with regard to ADLs (.40; confidence interval [CI] = .17-.64) and stride length (.46; CI = .12-.82). The SES with regard to walking speed showed a significant heterogeneous SES, which remained significant after applying a random effects model (.49; CI = .21-.77). The SES with regard to neurologic signs was not significant (.22; CI = -.08 to .52). The small number of studies included and the shortcomings of the methodologic quality of these studies, however, bias the results of the present study. CONCLUSIONS: The results of the present research synthesis support the hypothesis that Parkinson patients benefit from PT added to their standard medication.

Activities of Daily Living↗

PubMed2005

Medical textbook summarization and guided navigation using statistical sentence extraction.

We present a method for automated medical textbook and encyclopedia summarization. Using statistical sentence extraction and semantic relationships, we extract sentences from text returned as part of an existing textbook search (similar to a book index). Our system guides users to the information they desire by summarizing the content of each relevant chapter or section returned in the search. The summary is tailored to contain sentences that specifically address the user's search terms. Our clustering method selects sentences that contain concepts specifically addressing the context of the query term in each of the returned sections. Our method examines conceptual relationships from the UMLS and selects clusters of concepts using Expectation Maximization (EM). Sentences associated with the concept clusters are shown to the user. We evaluated whether our extracted summary provides a suitable answer to the user's question.

Abstracting and Indexing↗

PubMed2006

Juvenile maladaptive aggression: a review of prevention, treatment, and service configuration and a proposed research agenda.

OBJECTIVE: To review prevention programs, psychosocial and psychopharmacologic treatments, and service delivery configurations for children and adolescents with maladaptive aggression. To propose a research agenda for disorders of aggression in child and adolescent psychiatry. DATA SOURCES: Recent empirical studies were reviewed using searches of MEDLINE and PsycINFO (text terms: aggression, antisocial, violence, conduct, oppositional, psychosocial treatment, psychopharmacology, and prevention), relevant books, review articles, and bibliographies. DATA EXTRACTION: Articles met the following criteria: published in an English-language, peer-reviewed journal between 1980 and 2005, included a focus on individuals < 18 years old, and included an outcome measure of relevant significance. STUDY SELECTION: Results of 154 randomized, controlled psychosocial treatment trials, 20 controlled psychopharmacology studies, 4 open-label medication studies, and 2 psychopharmacology meta-analyses were reviewed. RESULTS: Prevention programs show promise for reducing future aggression in at-risk populations. Empirical support is available for the effectiveness of multifocused psychosocial treatments in reducing aggression in children and adolescents. Atypical antipsychotics, lithium, divalproex sodium, and stimulants for conduct problems associated with attention-deficit/hyperactivity disorder have empirical support for reducing aggression in selected patient populations. CONCLUSIONS: Therapeutic nihilism in the treatment of aggressive children and adolescents with conduct problems is no longer warranted. Multifocused psychosocial interventions given early in life to at-risk children have the most support for effectiveness. However, treatments for children who routinely present to the child psychiatrist with already well-established disorders of aggression are neither robust nor well-established. Further research into maladaptive aggression in referred children and adolescents within and across psychiatric diagnoses is important for the field of child and adolescent psychiatry.

Adolescent↗

PubMed2006

Contributions of Muhadhdhab Al-Deen Al-Baghdadi to the progress of medicine and urology. A study and translations from his book Al-Mukhtar.

This study of the Arabic 4-volume book of Al-Mukhtar Fi Al-Tibb (Choice Book on Medicine) written by the Muslim physician Muhadhdhab Al-Deen Al-Baghdadi (515-610 H, 1117-1213 AD) aimed at evaluating his contributions to the progress of medicine and urology along with providing English translations of relevant excerpts. Al-Baghdadi laid emphasis on the morals of medical practice and the principles of medical education describing how to select medical students and how to evaluate graduates. He stressed on the need for a long training program directly supervised by skilled expert doctors both in hospitals (Al-Bimaristanat) and during home visits. A good part of volume 1 was allocated to preventive medicine and the whole of volume 2 was devoted to the pharmacy section, which he restricted to what was proven by the experience of his teacher and by his own experiments. Same as all his predecessors in the Islamic era, Al-Baghdadi stressed the importance of clinical medicine and gave more details related to history taking, physical examination, differential diagnosis and prognosis. Similar to them, he also, emphasized that a doctor should be quite knowledgeable in anatomy. Furthermore, the presence of anatomical drawings in Kitab Al-Mukhtar Fi Al-Tibb is a further step forward in illustrating medical text books; a trend that flourished in the Islamic era reflecting the role of direct observations and experience. The detailed description of the functional anatomy of the uretero-vesical junction and the antireflux and micturition mechanisms given by Al-Baghdadi is contrary to that of Galen (130-200 AD) but conforms well to our contemporary understanding. In the conservative management of urinary stones, he described 70 simple and 13 compound drugs while those described by Pulus of Aegina (625-690 AD) were only 20 simple and 3 compound drugs. Furthermore, Al-Baghdadi's description of the instruments and techniques of urethral catheterization, perineal cystolithotomy and perineal cystolithotripsy using Al-Zahrawi's lithotrite is meticulous and reveals originality, dexterity and experience.

Anatomy↗

PubMed1974

Library lists: core or apple?

Core lists for medical libraries are intended to offer a minimal coverage of the medical literature. But they have grave drawbacks: (1) The coverage of some specialties is so minimal in several well-known lists as to be misleading. (2) A small hospital lacking a specialist in a particular branch of medicine does not need a specialist journal in that branch. Such a journal is better borrowed from a neighbouring hospital where the appropriate specialist can also be consulted. (3) Many hospitals will stick only to the core list, leading to excessive uniformity across the country. What librarians should be offered is a list of about 300-400 journals from which to make a selection on the following criteria: (1) The preference of the doctors who use the library. (2) The availability of journals in neighbouring libraries. (3) The budget.

Book Collecting↗

PubMed2006

Fundamentals of neurogastroenterology: basic science.

The focus of neurogastroenterology in Rome II was the enteric nervous system (ENS). To avoid duplication with Rome II, only advances in ENS neurobiology after Rome II are reviewed together with stronger emphasis on interactions of the brain, spinal cord, and the gut in terms of relevance for abdominal pain and disordered gastrointestinal function. A committee with expertise in selective aspects of neurogastroenterology was invited to evaluate the literature and provide a consensus overview of the Fundamentals of Neurogastroenterology textbook as they relate to functional gastrointestinal disorders (FGIDs). This review is an abbreviated version of a fuller account that appears in the forthcoming book, Rome III. This report reviews current basic science understanding of visceral sensation and its modulation by inflammation and stress and advances in the neurophysiology of the ENS. Many of the concepts are derived from animal studies in which the physiologic mechanisms underlying visceral sensitivity and neural control of motility, secretion, and blood flow are examined. Impact of inflammation and stress in experimental models relative to FGIDs is reviewed as is human brain imaging, which provides a means for translating basic science to understanding FGID symptoms. Investigative evidence and emerging concepts implicate dysfunction in the nervous system as a significant factor underlying patient symptoms in FGIDs. Continued focus on neurogastroenterologic factors that underlie the development of symptoms will lead to mechanistic understanding that is expected to directly benefit the large contingent of patients and care-givers who deal with FGIDs.

Adenosine Triphosphate↗

PubMed1984

Socioeconomic resources in medicine: review of the literature.

In this era of intense competition in medicine, it is essential for health sciences librarians to keep abreast of the new and varied socioeconomic influences in the medical environment. A list of socioeconomic resources is provided to help meet this objective. A citation analysis of the Socioeconomic Bibliographic Information (SIB) database was used as a selection criterion. An annotated list of ninety journals, newspapers, and newsletters is included, which provides title of publication, publisher, cost, index information, and special characteristics. In addition, publishers and associations that provide socioeconomic information are listed, and an annotated list of standard statistical resource books is given.

Bibliographies as Topic↗

PubMed1996

A guide to the understanding and use of tricyclic antidepressants in the overall management of fibromyalgia and other chronic pain syndromes.

The purpose of this review is to present relatively detailed information on the characteristics of tricyclic antidepressants, mainly amitriptyline hydrochloride and doxepin hydrochloride, for use as an integral part of the safe and effective management of fibromyalgia and, to a lesser extent, other chronic pain syndromes. Data sources include MEDLINE searches in English, relevant reference books and textbooks, my personal database and library, as well as personal clinical experience. I discuss these data with regard to the pharmacologic characteristics, mechanisms of action, adverse effects, and precautions involved with the use of tricyclic antidepressants. Additional information is given on drug selection and dosage titration. Much emphasis is placed on the fact that while tricyclic antidepressants play a major role in the management of fibromyalgia and other chronic pain syndromes, lifestyle alterations (eg. physical reconditioning and exercise), as well as behavior modification, are also vital to a successful outcome in management.

Amitriptyline↗

PubMedDate not supplied

ECG boy: low-cost medical instrumentation using mass-produced, hand-held entertainment computers. A preliminary report.

A prototype low-cost, portable ECG monitor, the "ECG Boy," is described. A mass produced hand-held video game platform is the basis for a complete three-lead, driven right-leg electrocardiogram (ECG). The ECG circuitry is planned to fit in a standard modular cartridge that is inserted in a production Nintendo "Gameboy." The combination is slightly smaller than a paperback book and weighs less than 500 g. The unit contains essential safety features such as optical isolation and is powered by 9-V and AA batteries. Functionally, the ECG Boy permits viewing ECG recordings in real time on the integrated screen. The user can select both the lead displayed on the screen and the time scale used. A 1-mV reference allows for calibration. Other ECG enhancements such as data transmission via telephone can be easily and inexpensively added to this system. The ECG Boy is intended as a proof of concept for a new class of low-cost biomedical instruments. Rising health care costs coupled with tightened funding have created an acute demand for low-cost medical equipment that satisfies safety and quality standards. A mass-produced microprocessor-based platform designed for the entertainment market can keep costs low while providing a functional basis for a biomedical instrument.

Analog-Digital Conversion↗

PubMed1976

The impact of federal funding. Long-term dialysis programs: new selection criteria, new problems.

The following transcript is adapted from a case conference held in the Barnes and Wohl Hospitals, St. Louis, Missouri. The participants are members of the Departments of Internal Medicine and Pathology of the Washington University School of Medicine. Dr. Renée Fox, professor and chairman of the Department of Sociology at the University of Pennsylvania and co-author of the book The Courage to Fail, was a guest at the conference.

Adult↗

PubMed2000

Dietary interventions for phenylketonuria.

BACKGROUND: Phenylketonuria is an inherited disease for which the main treatment is the dietary restriction of the amino acid phenylalanine. The diet has to be initiated in the neonatal period to prevent or reduce mental handicap however the diet is very restrictive and unpalatable and can be difficult to follow. Whether the diet can be relaxed or discontinued during adolescence or should be continued for life remains a contraversial issue which we aim to address in this review. OBJECTIVES: To assess the effects of a phenylalanine restricted diet commenced early in life for patients with phenylketonuria. To assess the possible adverse effects of relaxation or termination of the diet on intelligence, neuropsychological outcomes and mortality, and to assess the effect on growth, nutritional status and eating behaviour and quality of life. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Trials Register which is a specialist trials register which comprises references identified from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. Additional studies were identified from handsearching the Journal of Inherited Metabolic Disease (from inception, 1978 to 1998). The manufacturers of dietary products for phenylketonuria were also contacted. Date of the most recent search of the Group's specialised register: November 1999. SELECTION CRITERIA: All randomised or pseudorandomised controlled trials comparing a phenylalanine restricted diet to either relaxation or termination of dietary restrictions in patients with phenylketonuria. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed the trial eligibility, methodological quality and extracted the data. MAIN RESULTS: Four studies were included in this review including a total of 251 patients. Few statistically significant differences were found between treatment and comparison groups for any of the outcomes apart from for blood phenylalanine level and intelligence quotient. Blood phenylalanine levels were significantly lower in those subjects with phenylketonuria following a phenylalanine restricted diet compared to those on a less restricted or relaxed diet (weighted mean difference at three months -672.203, 95% Confidence interval (CI) -813.799 to - 530.608). Intelligence quotient was significantly higher in subjects who continued on the phenylalanine restricted diet compared to those who terminated the diet (weighted mean difference after 12 months -5.00, 95% CI -9.595 to -0.405). However this is based on the results of only one study. REVIEWER'S CONCLUSIONS: The results of non-randomised studies have concluded that a phenylalanine restricted diet is effective in reducing blood phenylalanine levels and improving intelligence quotient and neuropsychological outcome. No randomised controlled trials have assessed the effect of a phenylalanine restricted diet versus no dietary restrictions from diagnosis. In view of evidence from non-randomised studies, such a trial would now be unethical and it is recommended that phenylalanine restricted diet should be commenced at the time of diagnosis. There is uncertainty about the precise level of phenylalanine restriction and when, if ever, the diet should be relaxed. These questions should be addressed by randomised controlled trials with careful consideration given to which patients to include.

Humans↗

PubMedDate not supplied

Solving the surgical waiting list problem? New Zealand's 'booking system'.

This article discusses the development and implementation of New Zealand's booking system for publicly funded non-urgent surgical and medical procedures. The 'booking system' emerged out of New Zealand's core services debate and the government's desire to remove waiting lists. It was targeted for implementation by mid-1998. However, the booking system remains in an unsatisfactory state and a variety of problems have plagued its introduction. These include a lack of national consistency in the priority access criteria, failure to pilot the system and a shortfall in the levels of funding available to treat the numbers of patients whose priority criteria 'scores' deem them clinically eligible for surgery. The article discusses endeavours to address these problems. In conclusion, based on the New Zealand experience, the article provides lessons for policy-makers interested in introducing surgical booking systems.

Appointments and Schedules↗

PubMed2001

3D modelling of gene expression patterns.

The current genome-sequencing projects provide "word indices" of the book of life. A central post-genomic question will be how these words are three-dimensionally deployed in the generation of organism form. Gene expression studies of developing organisms contribute an increasing wealth of snapshot data on the activation of individual genes at selected locations and single moments in the developmental process. However, a comprehensive understanding of the dynamic activation of multiple genes and their functional role in controlling the 3D processes of collective cell behaviour, pattern formation and morphogenesis, requires special tools for a systematic description of spatio-temporal patterns of gene activation and the ensuing phenotypic effects. This article concentrates on new, computer-based tools for the 3D analysis of gene expression patterns in embryonic development and their use for the systematic establishment of comprehensive gene expression maps.

Animals↗

PubMed2003

Molecular targets in cancer therapy.

OBJECTIVES: To review selected pharmacologic agents that target key cellular processes along with their mechanisms of action and adverse events. Nursing implications including what patients and families need to know, administration issues, and management of common toxicities will be reviewed. DATA SOURCES: Research articles, clinical trials, abstracts, and book chapters. CONCLUSION: Knowledge of complex biology and biochemistry regulating normal and abnormal cellular function obtained over the past 30 years is starting to be used clinically for new therapies to treat cancer. By targeting what makes cancer unique, these therapies are able to spare more healthy or normal cells than the standard treatments, such as radiation and chemotherapy. Several molecular targeting agents are now in use and even more are under study as cancer treatments. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses must understand the principles underlying targeted treatments and their potential benefits to provide adequate patient education and care.

Antineoplastic Protocols↗

PubMed1993

British gastroenterologists' care profile for patients with inflammatory bowel disease: the need for a patients' charter.

The follow-up of patients with inflammatory bowel disease (IBD) was investigated using a postal questionnaire sent to 359 members of the British Society of Gastroenterology (BSG), of whom 235 replied. Of patients with IBD, 96% were weighed on each out-patient clinic review and over 60% had their full blood count checked. Although few centres (20%) have computerized recall of their patients for cancer surveillance, 96% did perform such surveillance on patients with ulcerative colitis. The mean duration of disease before surveillance was initiated was 9.6 years. Most clinicians (80%) only surveyed patients with disease extending beyond the transverse colon. Despite recent work on cancer risk age is relatively unimportant to 76% of clinicians in their decision to screen or not. Only 24% of clinicians undertake cancer surveillance in patients with Crohn's disease but these use similar criteria in their selection of patients. Few other tests were performed regularly. Clinic services vary considerably from centre to centre, 62% offer open access to patients with IBD, 8% have a stoma nurse in clinic and 17% a dietitian. Eighty-four per cent of respondents provide educational books and 22% videos. Forty-four per cent of clinicians refer patients for advice to fellow sufferers. We believe there should be a uniform minimum standard of care and services available in clinics throughout the United Kingdom and propose a patients' charter to ensure that this occurs. Such care profiles provide guidelines to those who need to develop standards for resource management.

Adolescent↗

PubMed2006

Determination of the genetic structure of remnant Morus boninensis Koidz. trees to establish a conservation program on the Bonin Islands, Japan.

BACKGROUND: Morus boninensis, is an endemic plant of the Bonin (Ogasawara) Islands of Japan and is categorized as "critically endangered" in the Japanese red data book. However, little information is available about its ecological, evolutionary and genetic status, despite the urgent need for guidelines for the conservation of the species. Therefore, we adopted Moritz's MU concept, based on the species' current genetic structure, to define management units and to select mother tree candidates for seed orchards. RESULTS: Nearly all individuals of the species were genotyped on the basis of seven microsatellite markers. Genetic diversity levels in putative natural populations were higher than in putative man-made populations with the exception of those on Otouto-jima Island. This is because a limited number of maternal trees are likely to have been used for seed collection to establish the man-made populations. A model-based clustering analysis clearly distinguished individuals into nine clusters, with a large difference in genetic composition between the population on Otouto-jima Island, the putative natural populations and the putative man-made populations. The Otouto-jima population appeared to be genetically differentiated from the others; a finding that was also supported by pairwise FST and RST analysis. Although multiple clusters were detected in the putative man-made populations, the pattern of genetic diversity was monotonous in comparison to the natural populations. CONCLUSION: The genotyping by microsatellite markers revealed strong genetic structures. Typically, artificial propagation of this species has ignored the genetic structure, relying only on seeds from Otouto-jima for replanting on other islands, because of a problem with inter-specific hybridization on Chichi-jima and Haha-jima Islands. However, this study demonstrates that we should be taking into consideration the genetic structure of the species when designing a propagation program for the conservation of this species.

Conservation of Natural Resources↗