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PubMed2002

When is an epidemic an epidemic?

BACKGROUND: The large number of cases of West Nile fever diagnosed in Israel in 2000 once again brought into focus the confusion that frequently accompanies the use of the term "epidemic." OBJECTIVES: To examine the different definitions of the term "epidemic" and to propose ways in which it can be used to both improve communication among professionals and provide the public with a better sense of the associated risks. METHODS: The literature was reviewed for the various definitions of the terms "epidemic" and "outbreak." Sources included popular and medical dictionaries, ancient documents, epidemiology texts, legal texts, and the medical literature. RESULTS: The term epidemic is variously defined. The broad definition given by epidemiologists--namely, more disease than is anticipated by previous experience--is less meaningful to the general public. In some ways it conflicts with the definitions found in the popular literature, which generally imply danger to the public and a very large number of victims. CONCLUSIONS: The interpretation of the term epidemic may vary according to the context in which it is used. For risk communication, we suggest that every effort be made to add descriptive terms that characterize the epidemic.

Communication↗
PubMed2001

Representing and querying conceptual graphs with relational database management systems is possible.

This is an experimental study on the feasibility of maintaining medical concept dictionaries in production grade relational database management systems (RDBMS.) In the past, RDBMS did not support transitive relational structures and had therefore been unsuitable for managing knowledge bases. The revised SQL-99 standard, however, may change this. In this paper we show that modern RDBMS that support recursive queries are capable of querying transitive relationships in a generic data model. We show a simple but efficient indexed representation of transitive closure. We could confirm that even challenging combined transitive relationships can be queried in SQL.

Artificial Intelligence↗
PubMedDate not supplied

[Gout in the past and uric arthritis today in Croatia] ].

In the past, gout was well known in these places, from Istria to Dubrovnik. Our very first dictionaries also witness about gout. Old doctors from Krapinske Toplice had also written about gout. Dr Edmund Mai, in his article published in "Lijecnicki vjesnik" in 1904 mentions "171 cases of uric arthritis". But, after that, for long 60 years there wasn't even a word about our patients, except surprise on very high incidence of the disease in the past. Even our handbooks had claimed that uric arthritis is not common in our country. In 1964 after 60 years of silence, the first article about our patients with uric arthritis, was published in "Lijecnicki vjesnik". These patients were medically treated for average of 13 years, and still were misdiagnosed. After that article, the numbers of patients with gout and articles on uric arthritis permanently rise. Today, the incidence of gout in Croatia is similar to that in other European countries.

Arthritis, Gouty↗
PubMedDate not supplied

The relationship between nurses' personality and stress levels reported when caring for interpersonally difficult patients.

The aim of this study was to investigate the self-reported stress in a group of nurses caring for patients with interpersonally difficult behaviours at four Melbourne hospitals. An examination was undertaken of the role played by the personality construct known as Lifestyle, in nurses' cognitive appraisal of interpersonal stressors. One hundred and ten nurses completed the Basic Adlerian Scales for Interpersonal Success, Adult Version (BASIS-A) personality inventory and the Difficult Patient Questionnaire (DPQ) and a subgroup of 40 nurses were subsequently interviewed. The interviews were analysed with the Alexis lexical thematic content analysis computer program using the Harvard III Psychosociological Dictionary. The results revealed no significant correlations between stress and the nurses' demographic or professional backgrounds. However, very specific and significant correlations between certain personality profiles and stress levels were detected. Lexical thematic content analysis indicated that nurses who reported high stress differed significantly from those reporting low stress in the psychological processes they used when caring for interpersonally difficult patients. These findings suggest that the personality construct of Lifestyle plays an important role in regard to the stress response of these nurses. The implications of the findings include the possibility of structuring interventions based on Individual Psychology that may assist nurses to better deal with interpersonal conflict in patient care, and hence to reduce their own stress levels.

Adaptation, Psychological↗
PubMed2002

Structure-based comparison of four eukaryotic genomes.

The field of comparative genomics allows us to elucidate the molecular mechanisms necessary for the machinery of an organism by contrasting its genome against those of other organisms. In this paper, we contrast the genome of homo sapiens against C. Elegans, Drosophila melanogaster, and S. cerevisiae to gain insights on what structural domains are present in each organism. Previous work has assessed this using sequence-based homology recognition systems such as Pfam [1] and Interpro [2]. Here, we pursue a structure-based assessment, analyzing genomes according to domains in the SCOP structural domain dictionary. Compared to other eukaryotic genomes, we observe additional domains in the human genome relating to signal transduction, immune response, transport, and certain enzymes. Compared to the metazoan genomes, the yeast genome shows an absence of domains relating to immune response, cell-cell interactions, and cell signaling.

Animals↗
PubMed2002

A hedging point strategy--balancing effluent quality, economy and robustness in the control of wastewater treatment plants.

An operational space map is an efficient tool to compare a large number of operational strategies to find an optimal choice of setpoints based on a multicriterion. Typically, such a multicriterion includes a weighted sum of cost of operation and effluent quality. Due to the relative high cost of aeration such a definition of optimality result in a relatively high fraction of the effluent total nitrogen in the form of ammonium. Such a strategy may however introduce a risk into operation because a low degree of ammonium removal leads to a low amount of nitrifiers. This in turn leads to a reduced ability to reject event disturbances, such as large variations in the ammonium load, drop in temperature, the presence of toxic/inhibitory compounds in the influent etc. Hedging is a risk minimisation tool, with the aim to "reduce one's risk of loss on a bet or speculation by compensating transactions on the other side" (The Concise Oxford Dictionary (1995)). In wastewater treatment plant operation hedging can be applied by choosing a higher level of ammonium removal to increase the amount of nitrifiers. This is a sensible way to introduce disturbance rejection ability into the multi criterion. In practice, this is done by deciding upon an internal effluent ammonium criterion. In some countries such as Germany, a separate criterion already applies to the level of ammonium in the effluent. However, in most countries the effluent criterion applies to total nitrogen only. In these cases, an internal effluent ammonium criterion should be selected in order to secure proper disturbance rejection ability.

Automation↗
PubMed2001

Fenfluramines, idiopathic pulmonary primary hypertension and cardiac valve disorders: facts and artifacts.

The fenfluramines saga began in 1963 and ended in 1997. Fenfluramines are anorexigenic agents recommended, in April 1996, for the long-term treatment of obesity in USA, before being suddenly withdrawn from the market in September 1997. Over 34 years, about 60 million people were exposed to these drugs worldwide, mainly in Europe. The aim of this critical review is not to attempt to rehabilitate these appetite suppressants but to launch a plea for a more rational and rigorous approach to what might be called objective medical knowledge. Idiopathic primary pulmonary hypertension and cardiac valve disorders which have been both associated with fenfluramines have in common many puzzling features. The metamorphosis of facts into artifacts is only a hypothesis, but seems conceivable from a scientific point of view. Medicine is not only an art, it is also a science, which, like the others, implies adhesion to certain fundamental rules, such as refutation or verification of all experimental results by rigorous and standardized methods, before considering them as established facts. Firstly, a single study, moreover a case-control study like the International Primary Pulmonary Hypertension Study, is not sufficient to establish a causal relationship between exposure to appetite-suppressants and idiopathic pulmonary hypertension, because of the numerous biases which characterize even the best analytical research. Secondly, Doppler-echocardiography cannot be considered as a laboratory test, because of the poor interoperator reproducibility observed in obese patients. The use of this technique in pharmaco-epidemiology implies standardized procedures concerning not only reading data, but also their acquisition, because of possible uncontrolled interactions between sonographers, patients and sophisticated machines. In the case of the fenfluramines saga, numerous methodological artifacts concerning acquisition, processing and interpretation of epidemiologic and echocardiographic data might have contributed to distortion of reality. Let us recall how Webster's dictionary defines artifact: "a spurious observation or result arising from preparatory or investigative procedures or any feature that is not naturally present but is a product of an extrinsic agent, method, or the like".

Appetite Depressants↗
PubMed2002

[Drugs and closed-angle glaucoma risk].

Closed-angle glaucomas arise among predisposed patients (narrow iridocorneal angle) in response to various stimuli. Most of the attacks are of iatrogenic origin: all the topical and systemic mydriatic drugs can provoke an angle closure glaucoma attack. Dangerous active ingredients with closed-angle glaucoma are active substances with anticholinergic activity (peripheral action, central action, with anticholinergic side-effects), active ingredients with sympathomimetic alpha activity (alpha 1, alpha and beta with indirect effects), and the active ingredients with parasympathomimetic activity (anticholinesterases). The proprietary medicine, whether or not they are included in the French dictionary Vidal((R)), are classified according to the administration route and their different indications. The closed-angle glaucoma risk after administration of these drugs is noted in the items'contraindications and precautions in the summary of the product characteristics enclosed in the marketing authorization.

Glaucoma, Angle-Closure↗
PubMed2001

[The Sarqī medical school (11th-14th centuries): society and medicine in al-Andalus Levante].

Most of the information about medical science in al-Andalus is associated with its leading figures and their work in the capital cities of the time: Cordoba, Seville, Granada, and the Taifal cities. This study presents the medicine of the Levantine or Sarqī al-Andalus region (10th-14th centuries). To this end, we have gathered reports on physicians that worked in the different Levantine capitals and have investigated key data in the biographical dictionaries, sources that have been little-used to study medical practice. We especially studied the Takmila by Ibn al-Abbār from Valencia.

Arab World↗
PubMed2001

[The diseases ŷudām and baras (leprosy) in treatises of Islamic Law (Malikí Doctrine)].

Two diseases that appear in the legal treatises, ŷudām and baras, are semantically ambiguous and present difficulties when it comes to establishing their meaning. However, comparison of lexicographical and medical sources with modern bilingual and monolingual Arabic dictionaries bring us closer to the real meanings of the terms within the spacial and temporal contexts of the Maliki legal treatises. In these treatises, they appear as vitia redhibitoria in certain types of contract and also as diseases subject to regulations for the prevention of infection.

Books↗
PubMed2002

[On the problem of genome redundancy in viruses and prokaryotes].

A specific index of nucleotide sequence redundancy, the specific restriction length of a finite frequency dictionary, was determined for a complete set of genes in some viral genomes and a genome of a bacterium, Bacillus subtilis. The distribution of the gene number over the specific restriction length was shown to be bimodal for viral genomes and unimodal for the Bac. subtilis genome. These results agree with earlier data.

Bacillus subtilis↗
PubMed2002

[Colonic necrosis caused by sodium polystyrene (kayexalate) in hemodialysis: myth or reality? Two case reports].

Among gastro-intestinal complications reported in uremic or transplanted patients, colonic necrosis due to Kayexalate and sorbitol is not so unusual for english authors. This iatrogenic event is probably underestimated by physicians and pathologists. In France, neither literature nor pharmacovigilance refer this complication but Vidal dictionary advises against such association. We thought of interest to report 2 representative observations and, after reviewing literature, to discuss diagnostics circumstances and etiopathogenic hypothesis and then to give some advices.

Cation Exchange Resins↗
PubMed1999

[One hundred years' history of public health activities in Korea].

In a dictionary of epidemiology, recently edited by John Last, public health was defined as one of the efforts organized by society to protest, promote, and restore the peoples' health. It is the combination of sciences, skills, and beliefs that is directed to the maintenance and improvement of the health of all the people through collective or social action. In most countries, the efforts to protect, promote, and restore the peoples' health are mostly organized by the government, and therefore, the history of public health in the respective countries is closely related to the state of government and its administrative structures. In this article, the history of public health activities in Korea during the last 100 years has been reviewed in four consecutive time periods from the end of Li Dynasty till now. The public health during the first some 50 years from 1897 when the Dae Han Empire began to 1945 when the Japanese colonial period ended can be characterized by enforcement of personal and environmental hygiene by the police. In those days, communicable disease control was the main purpose of such public health measures. Second phase of Korean public health from 1945 to the time of military coup in 1961 is characterized by enactment of various public health laws and the related public health practices. Major health related laws are communicable disease control law, environmental hygiene act, industrial safety and health law, and so on. Important public health practice in this time period was family planning. Third phase of public health history from 1962 to 1992 can be recorded as the time when the actual public health practices were fully developed. Because of well established health center activities throughout the country, basic public health services were provided together with primary medical care services to the people in rural areas. Since 1993, two civilian governments have been trying to change the concept of their health administration from providing public health services to improve welfare of the whole population. Emphasis was put on health promotion, and for this, the government enacted a health promotion law. Based on this law, even special funds for various health promotion activities are now available by taxing on tobacco sales.

History, 19th Century↗
PubMed1993

Excellent population research prize to be awarded.

In order to promote the development of population science in China, mobilize the initiativeness of demographers and more effectively serve the purpose of controlling population growth and improving the quality of human resources, the Population Association of China has sponsored an Excellent Population Research Award to encourage the demographers with outstanding achievements within the term (January 1991-June 30, 1993) of the Association. All the research staff and family planning workers with the membership of the Population Association of China as well as research institutes with notable achievements are eligible to the application for the award. The research achievements include monographs (or teaching materials), papers, survey reports, translated works, dictionaries or reference books, and softwares. For each category, 2 classes of prizes have been set, and winners are to be awarded with diplomas and money. The evaluation work will be started in September and October and concluded by the end of November 1993.

Asia↗
PubMed2001

Optometry and ophthalmology: the Internet connection--assessing consumer health web sites.

BACKGROUND: The Internet is a major conduit of health information. Consumers frequently rely on it without verifying its validity. The purpose of this study was to assess the accuracy and currency of Internet-based information on the roles and practice of optometrists, which has been found to be misleading, inaccurate, and often outdated. METHODS: Using search engines and ranking directories, 16 popular health Web sites were examined for differentiation between optometry and ophthalmology. Each site's eye care content was reviewed for syndication, definitions, provider directories, linkages to eye organizations, and provider recommendations in treatment of certain conditions. RESULTS: Many Web sites use a syndicated source for their health content and several use Merriam-Webster as their primary dictionary. A majority of sites provided poor definitions for optometry. Most Web sites were biased in recommending ophthalmologists and do not include optometrists as licensed providers in treatment of certain eye diseases. For example, Intelihealth, Aetnaushc, and Noah-Health recommend only ophthalmologists for the treatment of conjunctivitis. CONCLUSIONS: Inaccuracies and misleading information about optometry do exist and undermine the role of optometrists in delivery of eye care. When alerted, several Web sites were receptive to proposed changes. While some efforts have been undertaken to monitor Web sites, the profession must develop a concrete effort to ensure that it is correctly represented on the Internet.

Health Education↗
PubMed2002

[The acute toxic effects of microcystin LR in SD rats].

OBJECTIVE: To assess Microcystin LR (MCLR)-induced acute toxic effects in male Sprague-Dawley rats. METHODS: The rats were injected with MCLR intraperitoneally in different doses for different days. The organs and serum with rats were collected at 1 and 7 days after injection, and 7 days after the final injection (total 14 days). Pathological and enzymatic changes were observed. RESULTS: The rats injected with 122 microg/kg MCLR showed myocardial cells damage including pyknosis, plasma dissolve and myofibrilla (pls check with dictionary) necrosis in the heart muscles after 24 hours. At the same time, the activities of serum glutamate-oxaloacetate transaminase (GOT), lactate dehydrogenase (LDH) and creatine phosphonase (CPK) were higher than these in the other groups (P < 0.01). The kidney was also damaged, kidney cell degeneration, and the increase of blood creatine (BCr) and blood urea nitrogen (BUN) were also seen. In liver pathological study, liver cell hemorrhage, degeneration and/or necrosis was observed. In serum the activities of glutamate-pyruvate transaminase (GPT), alkaline phosphatase (LDH) and GOT were higher than these in the other groups (P < 0.01). CONCLUSION: These results suggested that MCLR can injure the heart, kidney and the liver in SD rats, and there is a dose-response relationship between MCLR and the toxic effect.

Alanine Transaminase↗
PubMedDate not supplied

[Circulation of pharmaceutical information among general practitioners in the region of Sousse (Tunisia)].

The general practitioner plays an essential role in the rational strategy of drug-use by the quality of his prescription which translates the validity and the relevance of his pharmaceutical information. The objective of this work is to study the different means of pharmaceutical information used by general practitioners in the region of Sousse (Tunisia). We conducted a transversal, descriptive, exhaustive survey of 140 general practitioners in private (68) and public (72) practice during 1999. Data were collected through a questionnaire. This study, with a participation rate of 78%, showed that pharmaceutical dictionaries are the major source of information for 86% of general practitioners, that medical delegates have a positive image for 84% of them and that 36% of general practitioners do not subscribe to any medical journal. Thus, general practitioners are exposed to relatively unreliable pharmaceutical information coming generally from the pharmaceutical industry.

Communication↗
PubMed2000

A criterion-referenced multidimensional job-related model prediction capability to perform occupations among persons with chronic pain.

OBJECTIVE: The purpose of this prospective study was an exploration of the construct of the criterion-referenced multidimensional job-related model (CMVA) aimed for predicting patients' with chronic pain capability to perform occupations. METHODS: The study samples were 1) participants (n=84) who at present were not performing employed work (median sick-listing period 12 months) because of chronic pain and 2) participants (n = 104) who at present were performing employed work at least 20 hours of a workweek. The participants had experiences of 40 different occupations classified into five of the occupational categories of Jist's Enhanced Dictionary of Occupational Titles. Data were collected through ten assessment instruments and a structured interview, comprising 54 variables and 465 items. Data were analyzed using multiple regression with forward entering of variables. RESULTS: The CMVA model (Adjusted R^2 0.777, F (4, 183) = 164.067; p<0.001) was able to explain 78% of the variance. CMVA contained the aspects; "the work demands-variable, the person-variable of work life values, the environment-variable of social support and the two occupational performances-variables; self-perceived capability to perform work tasks/the simulated work tasks". CONCLUSIONS: The construct of CMVA was robust suggesting that among persons with chronic pain, the predictors focusing on their capability to perform occupations are of great importance.

Journal Article↗