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Mapping the literature of case management nursing.
OBJECTIVES: Nursing case management provides a continuum of health care services for defined groups of patients. Its literature is multidisciplinary, emphasizing clinical specialties, case management methodology, and the health care system. This study is part of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association. The study identifies core journals cited in case management literature and indexing services that access those journals. METHODS: Three source journals were identified based on established criteria, and cited references from each article published from 1997 to 1999 were analyzed. RESULTS: Nearly two-thirds of the cited references were from journals; others were from books, monographs, reports, government documents, and the Internet. Cited journal references were ranked in descending order, and Bradford's Law of Scattering was applied. The many journals constituting the top two zones reflect the diversity of this field. Zone 1 included journals from nursing administration, case management, general medicine, medical specialties, and social work. Two databases, PubMed/MEDLINE and OCLC ArticleFirst, provided the best indexing coverage. CONCLUSION: Collections that support case management require a relatively small group of core journals. Students and health care professionals will need to search across disciplines to identify appropriate literature.
Abstracting and Indexing↗
Design of a diagnostic encyclopaedia using AIDA.
Diagnostic Encyclopaedia Workstation (DEW) is the name of a digital encyclopaedia constructed to contain reference knowledge with respect to the pathology of the ovary. Comparing DEW with the common sources of reference knowledge (i.e. books) leads to the following advantages of DEW: it contains more verbal knowledge, pictures and case histories, and it offers information adjusted to the needs of the user. Based on an analysis of the structure of this reference knowledge we have chosen AIDA to develop a relational database and we use a video-disc player to contain the pictorial part of the database. The system consists of a database input version and a read-only run version. The design of the database input version is discussed. Reference knowledge for ovary pathology requires 1-3 Mbytes of memory. At present 15% of this amount is available. The design of the run version is based on an analysis of which information must necessarily be specified to the system by the user to access a desired item of information. Finally, the use of AIDA in constructing DEW is evaluated.
Computer Systems↗
Ethnobotanical review of medicinal plants from Thai traditional books, Part II: Plants with antidiarrheal, laxative and carminative properties.
A survey of medicinal plants used in Thailand has been made from Thai books on traditional herbal medicine. In this part of the survey, 326 plants with antidiarrheal, laxative and/or carminative properties are described. Information provided for each species includes plant part used, methods of preparation and administration and literature references to Thai books, together with indications of usage in other Southeast Asian countries and of phytochemical work which has been performed.
Antidiarrheals↗
A comparison of two microcomputer-based programs for bibliographic retrieval and formatting.
We evaluated two representative microcomputer-based programs for organizing a biomedical literature filing system. With a bibliography of 100 anesthetic references, a series of benchmark tests was developed to measure the speed and accuracy of typical searching, sorting, and formatting tasks. Each program performed the searching tasks accurately and at about the same speed. One program performed sorting without errors, provided the field order of the template used to enter references was unchanged. Both programs used "punctuation files," that is, templates for controlling author presentation; punctuation to suit style requirements of individual journals; and order of particular fields, such as publisher and year of publication. Each program was able to format journal, book, and chapter references correctly, but the resulting output required some refining in a word processor. Both require a major time commitment to learn and to create custom punctuation files for journals not included in the predesigned punctuation files. Once mastered, both programs are quite competent at organizing reprints and formatting journal references.
Humans↗
[The periphery of the iris in glaucoma].
The author surveys, on the basis of some personal observations, the bibliographic data referring to the role of the iris in excretion of the aqueous humor. The second part of the paper reports on the authors clinical material, with emphasis on the great number of cases of atrophy of the iris periphery in the simple glaucoma and that appearing in the advanced age. The book concludes with references on the etiopathogenic correlations between the structural modifications of the iris root and the changes of intraocular tension.
Adult↗
Lecithin for dementia and cognitive impairment.
BACKGROUND: People with Alzheimer's disease have been found to have a relative lack of the enzyme responsible for converting choline into acetylcholine within the brain. Lecithin is a major dietary source of choline, so extra consumption may assist in the production of acetylcholine and reduce some of the symptoms of dementia. OBJECTIVES: To determine the efficacy of lecithin in the treatment of dementia or cognitive impairment. SEARCH STRATEGY: The Cochrane Dementia and Cognitive Impairment Group Register of Clinical Trials has been searched, as have the electronic databases MEDLINE, EMBASE, Psychlit, ISI and Current Contents. Reference lists and relevant books have been examined. SELECTION CRITERIA: All unconfounded, randomised trials comparing lecithin with placebo in a treatment period longer than one day, in patients with dementia of the Alzheimer type, vascular dementia, mixed vascular and Alzheimer's disease, unclassified or other dementia or unclassified cognitive impairment not fulfilling the criteria for dementia are eligible for inclusion. DATA COLLECTION AND ANALYSIS: Data are extracted by two independent reviewers and cross checked. Meta-analyses are performed when more than one trial provide data on a comparable outcome on sufficiently similar patients. Random effects analyses are performed whenever heterogeneity between results appears to be present. Standardised mean difference are used due do the use of different scales and periods of treatment. Odds ratios for dichotomous data are pooled using the Mantel-Haenszel or DerSimonian and Laird methods. MAIN RESULTS: Eleven randomised trials have been identified involving patients with Alzheimer's disease (265 patients) and Parkinsonian dementia (21 patients). No trials reported any clear clinical benefit of lecithin. Few trials contributed data to meta-analyses. The only statistically significant result was in favour of placebo for adverse events, based on one trial, which appears likely to be a spurious result. REVIEWER'S CONCLUSIONS: Evidence from randomised trials does not support the use of lecithin in the treatment of patients with dementia or cognitive impairment. A moderate effect cannot be ruled out, but results from the small trials to date do not indicate priority for a large randomised trial.
Alzheimer Disease↗
Behavior problems and mental health referrals of international adoptees: a meta-analysis.
CONTEXT: International adoption involves more than 40,000 children a year moving among more than 100 countries. Before adoption, international adoptees often experience insufficient medical care, malnutrition, maternal separation, and neglect and abuse in orphanages. OBJECTIVE: To estimate the effects of international adoption on behavioral problems and mental health referrals. DATA SOURCES: We searched MEDLINE, PsychLit, and ERIC from 1950 to January 2005 using the terms adopt* combined with (behavior) problem, disorder, (mal)adjustment, (behavioral) development, clinical or psychiatric (referral), or mental health; conducted a manual search of the references of articles, books, book chapters, and reports; and consulted experts for relevant studies. The search was not limited to English-language publications. STUDY SELECTION: Studies that provided sufficient data to compute differences between adoptees (in all age ranges) and nonadopted controls were selected, resulting in 34 articles on mental health referrals and 64 articles on behavior problems. DATA EXTRACTION: Data on international adoption, preadoption adversity, and other moderators were extracted from each study and inserted in the program Comprehensive Meta-analysis (CMA). Effect sizes (d) for the overall differences between adoptees and controls regarding internalizing, externalizing, total behavior problems, and use of mental health services were computed. Homogeneity across studies was tested with the Q statistic. DATA SYNTHESIS: Among 25,281 cases and 80,260 controls, adoptees (both within and between countries) presented more behavior problems, but effect sizes were small (d, 0.16-0.24). Adoptees (5092 cases) were overrepresented in mental health services and this effect size was large (d, 0.72). Among 15,790 cases and 30,450 controls, international adoptees showed more behavior problems than nonadopted controls, but effect sizes were small (d, 0.07-0.11). International adoptees showed fewer total, externalizing and internalizing behavior problems than domestic adoptees. Also, international adoptees were less often referred to mental health services (d, 0.37) than domestic adoptees (d, 0.81). International adoptees with preadoption adversity showed more total problems and externalizing problems than international adoptees without evidence of extreme deprivation. CONCLUSIONS: Most international adoptees are well-adjusted although they are referred to mental health services more often than nonadopted controls. However, international adoptees present fewer behavior problems and are less often referred to mental health services than domestic adoptees.
Adolescent↗
Bayesian statistics in medicine: a 25 year review.
This review examines the state of Bayesian thinking as Statistics in Medicine was launched in 1982, reflecting particularly on its applicability and uses in medical research. It then looks at each subsequent five-year epoch, with a focus on papers appearing in Statistics in Medicine, putting these in the context of major developments in Bayesian thinking and computation with reference to important books, landmark meetings and seminal papers. It charts the growth of Bayesian statistics as it is applied to medicine and makes predictions for the future. From sparse beginnings, where Bayesian statistics was barely mentioned, Bayesian statistics has now permeated all the major areas of medical statistics, including clinical trials, epidemiology, meta-analyses and evidence synthesis, spatial modelling, longitudinal modelling, survival modelling, molecular genetics and decision-making in respect of new technologies.
Bayes Theorem↗
Effectiveness of steroid therapy in acute exacerbations of asthma: a meta-analysis.
The objective of this study was to determine the effect of steroid therapy on pulmonary function, admission rates, and relapse rates in patients presenting with acute exacerbations of asthma. Computerized MEDLINE and SCIENCE CITATION searches were combined with review of reference lists from book chapters and articles to identify published randomized trials on steroid interventions. Over 700 articles were reviewed by two independent reviewers who identified 30 relevant randomized controlled trials for analysis. Study validity was independently assessed by two reviewers and information regarding populations, interventions, and outcomes was abstracted. Binary outcomes were combined and reported as odds ratios (OR), using the Mantel-Haenszel method. Individual and pooled effect sizes (ES) were determined for pulmonary function data. The authors found that the use of steroids early in the treatment of asthmatic exacerbations reduces admissions in adults (common OR 0.47; 95% confidence interval (CI) 0.27, 0.79) and children (OR 0.06-0.42). They found steroids effective in preventing relapse in the outpatient treatment of asthmatic exacerbations (OR 0.15; CI 0.05, 0.44). Oral and intravenous steroids appear to have equivalent effects on pulmonary function in acute exacerbations (ES -0.07; CI -0.39, 0.25). The authors conclude that overall, steroid therapy provides important benefits to patients presenting to emergency departments with acute exacerbations of asthma. Further research into dosage, alternative routes of administration, and alternative outcome measures is needed.
Asthma↗
From animal models to human genetics: research on the induction and pathogenicity of autoantibodies.
The revolutionary techniques of modern molecular and cellular biology enhance almost daily our knowledge of immunity and autoimmunity in men and experimental animals. Our fragmentary puzzle of the immune system is going to form a fascinating picture of a masterpiece of evolution. Although many of these aspects were achieved by analysis of human body fluids and tissues, the etiopathogenesis of autoimmune diseases cannot readily be analyzed without appropriate animal models. Therefore, the 7th Dresden Symposium on Autoantibodies has focused on experimental autoimmune models. The 295 attendants of the symposium listened to and discussed about the pathogenesis and therapy of autoimmunity in experimental mouse models, natural and pathogenic autoantibodies, molecular mechanisms of xenobiotic-induced autoimmunity, the genetic background of autoimmune diseases, novel autoantibodies and their pathogenic and/or clinical relevance, autoantibodies in systemic and neurological diseases, the occurrence and measurement of therapy-induced antibodies and methodical aspects as well as novel diagnostic strategies including multiplex assays for autoantibody profiling. Those who are interested to read the full length articles are referred to the book published in parallel to this meeting ([Conrad K, Bachmann MP, Chan EKL, Fritzler MJ, Humbel RL, Sack U, Shoenfeld Y, editors. From animal models to human genetics: research on the induction and pathogenicity of autoantibodies, Report on the 7th Dresden Symposium on Autoantibodies held in Dresden on September 1-4, 2004. Germany: Pabst Science Publishers; 2004.]; www.pabst-publishers.de).
Animals↗
Structural and functional aspects of acetylcholine peptide coexistence in the autonomic nervous system.
The present article is an attempt to briefly review acetylcholine and peptide coexistence in the ANS. For more detailed information the reader is referred to the book by Furness and Costa (1987) and books edited by Elfvin (1983) and Björklund et al. (1988). Acetylcholine is the "classical" transmitter substance between preganglionic and post-ganglionic neurons in both the sympathetic and parasympathetic nervous system but also between postganglionic parasympathetic neurons and effector cells. ENK and NT were early on shown to be present in preganglionic sympathetic neurons whereas SP and SOM have more recently been associated with these cells. Physiological experiments have shown that ENK may presynaptically inhibit cholinergic transmission in sympathetic ganglia. The cholinergic postganglionic parasympathetic neurons contain VIP/PHI. These peptides may be responsible for the atropine-resistant vasodilation seen after stimulation of parasympathetic nerves. In salivary glands VIP has been shown to potentiate the salivatory volume response to ACh. A number of postganglionic sympathetic neurons innervating exocrine sweat glands in the skin are also cholinergic. In addition to VIP/PHI, these neurons contain CGRP and probably also SP. The functional significance of acetylcholine coexisting with four vasodilatory peptides in this cell population is at present unclear. In the enteric ganglia the coexistence situation is very complex. Thus, in the myenteric plexus cholinergic SP-containing excitatory motor neurons seem to be present. In the myenteric plexus other cholinergic neurons may contain at least six different neuronal peptides. These latter neurons seem to be part of the peripheral intestino-intestinal reflex arc which is involved in regulation of gastrointestinal motility and mucosal functions. In the submucous plexus three populations of cholinergic neurons are present, one of which has secretomotor properties and contains CGRP, CCK, GAL, NPY and SOM. In vivo and in vitro studies have shown that developing sympathetic neurons can "change" the "classical" transmitter they-use and alter their neuropeptide expression. If dissociated sympathetic neurons are grown in cultures without any non-neuronal elements they differentiate into a noradrenergic phenotype. However, if the cultures also contain non-neuronal cells, both noradrenergic and cholinergic properties will develop. These changes may also by induced by a conditioned medium, containing a diffusible factor secreted from the non-neuronal cells. In conclusion, the present article underlines the complexity of the chemical neuroanatomy of the ANS and emphasizes the abundance of the peptides in both noradrenergic and cholinergic neurons. Although these peptides can be shown to exert a number of interesting effects in various experimental paradigms, much work is needed to define their exact role in nervous system function.
Acetylcholine↗
Neurosurgical management of patients with central nervous system malignancies.
OBJECTIVES: To provide an introduction to and description of the neurosurgical technologies used for the diagnosis and treatment of central nervous system (CNS) malignancies. DATA SOURCES: Published articles, books, and other reference materials. CONCLUSIONS: Recent advances in the development of assessment tools and surgical techniques have improved the outcome and quality of life for patients with brain and spinal cord tumors. Further improvements in intraoperative instrumentation and postoperative adjuvant therapy are expected to increase the safety and effectiveness of treatments for CNS malignancies. IMPLICATIONS FOR NURSING PRACTICE: Preoperative education for the patient with a CNS malignancy is a special challenge to nurses. Management of these aggressive tumors requires multiple treatment modalities and continued vigilance to detect and palliate recurrent tumors.
Brain Neoplasms↗
A primer on molecular biology for imagers: II. Transcription and gene expression.
The process of gene expression is complex and highly regulated to ensure that the right gene is expressed at the right place, at the right time, and in regulated amounts. The cell has multiple levels at which it controls the expression of a transcript including gene expression, alternate splicing, and stability of the transcript. Alternate splicing to generate different RNA species from a given gene and DNA rearrangements where genes are rearranged during cellular differentiation (eg, immunoglobulin genes) are additional mechanisms used to generate diversity in complex organisms. Epigenetic mechanisms such as methylation where CpG-rich islands in the promoter region depending on their methylation status can also modulate gene expression. The reader is requested to refer to the books, review articles, and web sites for additional information.
Alternative Splicing↗
High-dose progestins for the treatment of cancer anorexia-cachexia syndrome: a systematic review of randomised clinical trials.
BACKGROUND: The aim of the present study was to summarise evidence from scientific studies on cancer anorexia-cachexia syndrome in order to assess and highlight the efficacy of high-dose progestins (megestrol acetate and medroxyprogesterone acetate) compared with placebo in patients with hormone-independent tumors. MATERIALS AND METHODS: A systematic review of published randomised clinical trials was carried out by an extensive electronic and hand search through databases, relevant journals and books, congress, proceedings, reference lists, without any language or year of publication restriction. The research was conducted by two independent operators who collected the data in a form specifically designed for this review. Among the several possible outcomes, appetite and body weight were chosen. RESULTS: Fifteen randomised clinical trials (more than 2000 patients) were retrieved for the review. There was a statistically significant advantage for high-dose progestins as regards improved appetite: pooled odds ratio (OR) = 4.23, 95% confidence interval (CI): 2.53-7.04. Although the effect of high-dose progestins on body weight was less impressive, statistical significance was also reached for this outcome: pooled OR = 2.66, 95% CI: 1.80-3.92. Treatment morbidity was very low, due to the brief period of the treatment in most of the studies. CONCLUSIONS: The effects of high-dose progestins on appetite and body weight were clearly demonstrated. However, further studies are undoubtedly warranted to investigate other aspects of progestin activity, especially as regards dosage, duration and timing with best therapeutic index.
Anorexia↗
Dental transfigurements in Borneo.
Dental transfigurement, formerly termed dental mutilation, has been practised by many societies worldwide. This article gives many of the forms that have been attributed to the indigenes of the island of Borneo. The method has been performed by review of anthropological books, sparse dental references, Borneo research literature, and popular writing.
Borneo↗
Estimation of energy intake in clinical practice: a comparison between a food record protocol and a precoded food record book.
The aim of this study was to compare energy intake estimated from a clinical food record protocol (CFRP) with that from a precoded food record book (PFRB) as reference method. Food and fluid consumption were recorded in 10 older patients using a CFRP in parallel with a PFRB during a 6-day period. The results showed that there were no significant differences in mean energy intake estimated from the CFRP as compared with that estimated from the PFRB. The correlation coefficient between the calculated daily energy intake from the CFRP and PFRB was 0.96. The differences in energy intake (kcal/day) between the CFRP and PFRB, plotted against their mean value for 10 patients, showed that results were within the limits of agreement (mean +/- 2SD) for nine patients. The differences in each day's energy intake between the two methods plotted against their mean value showed that 97% of the estimated daily energy intake was within the limits of agreement. The weighted kappa between the two methods was 0.76. The CFRP would seem to be acceptable for the estimation of mean energy intake in the hospital setting.
Aged↗
Breast cancer risk following irradiation for Hodgkin's disease.
Radiation is commonly used to treat early-stage Hodgkin's disease. As the risk of recurrent Hodgkin's disease decreases as time from treatment elapses, the risk of radiation-induced breast cancer rises. Women irradiated between the time of puberty and the age of 30 are at the highest risk. The median time to breast cancer following radiation in this age group is approximately 15 years, usually when women are aged between 30 and 40, and often before regular breast screening is implemented. Risk factors associated with breast cancer development include age at irradiation, time since treatment and the radiation dose received. Current screening for breast cancer after Hodgkin's disease is inconsistent. In this article we review breast development, mechanisms of radiation-induced carcinogenesis, and findings from retrospective studies on Hodgkin's disease and breast cancer. We also review future considerations of management, including assessment of risk awareness in these women, guidelines for follow-up and screening, and chemoprevention both during and after treatment of Hodgkin's disease. The literature reviewed was obtained from Medline using the key words: breast cancer, Hodgkin's disease and radiation-induced cancer. The search was limited to English language literature. Other sources include reference lists in books and published papers.
Adult↗