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PubMed2006

The nervous system in colours: the tabulae pictae of G.F. d'Acquapendente (ca. 1533-1619).

Girolamo Fabrici d'Acquapendente (ca.1533-1619), in his olograph will donated to the Signoria of Venice a rich collection of anatomical paintings, which are today preserved in the Marciana Library. The third volume of these tabulae pictae, entitled De Anatomia Capitis Cerebri Nervorum, deals with the nervous system and contains the only known illustrations by Fabrici regarding neuroanatomy. Despite the realisation of this splendid collection of 21 coloured paintings, neither a systematic description nor an iconographic record regarding nervous structures were found to be published by Fabrici. For this reason, a thorough study of these plates is pivotal to a better understanding of the contribution made by d'Acquapendente to the knowledge of the nervous system. Besides their aesthetic quality, Fabrici's tabulae pictae appear as a unique document of exceptional scientific value, thanks to the unprecedented realism given to the anatomical structures by the innovative use of colours. These pictures represent the highest point reached by the 16th-century Paduan Medical School well demonstrating its aim for a sound naturalistic approach.

History, 16th Century↗
PubMed2000

[Internet--an introduction].

The internet is an excellent medium for storing and quickly disseminating large amounts of information on a global basis. Modern medicine requires a rapid access to information including clinical data from medical records, bibliographic databases, knowledge bases and nomenclature databases. This is especially true for university hospitals and medical schools for training as well as for fundamental and clinical research for diagnosis and therapeutic purposes. Therefore, the internet with its constantly increasing offers plays a more and more important role in scientific research. This review focuses on how developments of this communication technology have become a useful educational resource in medicine, and describes modest ideas in computer network use. Internet basic resources are electronic mailing (e-mail), discussion groups, file transfer, and browsing the World Wide Web (WWW).

Databases, Bibliographic↗
PubMed2002

The Dutch system of external quality assessment: description and experiences.

CONTEXT: Generally speaking, quality assurance in Dutch higher education consists of four parts: a self-evaluation, written by the faculty, a review committee, consisting of experts, the site visit, and a public report of the assessment outcomes. TASK OF THE REVIEW COMMITTEE: The organization, in which all universities are united, appoints a review committee for each educational program. Most educational programs are taught at different universities. Consequently, the review committee visits several universities. The task of the review committee is: to assess the overall quality of these educational programs in The Netherlands; and to assess the quality of each school separately. METHOD: The members of the review committee start their activities by formulating the evaluation criteria (standards) for the content of an educational program and for the educational process. This ends with a paper that will be used as a reference for the assessment. Then the review committee studies the self-evaluation reports. The faculties write these reports along established guidelines. In cases where the self-evaluation is not completely clear, or not sufficient, the committee formulates questions and asks for additional information. Then the committee visits the faculties. These visits take usually two days each. During these visits, the committee gets information from the dean of the faculty, the program committee, teachers, students, and from other employees of the faculty. In addition, the members of the committee inspect the facilities of the faculty, e.g. the library. RESULT: Directly after the visit, the chair of the committee gives, orally, a first impression of the findings. After visiting all faculties, the committee starts their deliberations, which result in a report of the assessment of the overall quality of the educational programs. The committee also assesses the quality of each faculty separately, often ending with recommendations. CONCLUSION: The Dutch system of quality assurance in higher education is much copied by other countries. The essence is the self-evaluation on one hand, and the site visit on the other. Committees try to act as consultants, and not as executioners. Therefore, the way the members of the committee play their role is very important.

Journal Article↗
PubMed2005

[G. A. van Rijnberk (1875-1953): key figure in Dutch medicine in the interbellum period].

G. A. van Rijnberk (1875-1953) was Dutch by birth but attended school in Italy and studied medicine there. He received his training as a scientific researcher in Rome from the famous physiologist Luciani. During the time that he spent at Luciani's Institute, he managed to gain attention for himself through his scientific work. In 1909 the University of Amsterdam appointed Van Rijnberk as a professor of physiology. He continued to produce scientific work during the first decade of his professorship but later focused on writing textbooks and his responsibilities as managing editor of The Nederlandsch Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) (1913-1946). In this role and over the course of the years he acquired the reputation of an autocrat who left his mark on the Journal's policies. This was apparent in his attention to correct language use, interest in the history of medicine and the construction of a library. Thanks to his efforts, the weekly clinical lesson has been a regular feature since 1928. The property on Jan Luykenstraat acquired under Van Rijnberk's management would remain the headquarters of the Journal for more than half a century. Van Rijnberk was also active as a columnist in the lay press and as an author of books on occultism.

History, 19th Century↗
PubMed1994

The campus at the University of Maryland at Baltimore.

The University of Maryland at Baltimore (UMAB) is an urban professional school campus. Its 36 acres include 39 buildings, both historic and new. The campus fabric is marked by diversity. The new facilities master plan was developed to reflect the strategic planning process for the campus. Design guidelines are intended to create a common theme while still encouraging each building to have a unique identity. The new Health Sciences Library/Information Services building will sit diagonally from Davidge Hall, built in 1812 and the symbolic center of the campus.

Academic Medical Centers↗
PubMed1991

Bringing the medical library to the office desktop.

This demonstration illustrates LRC Remote Computer Services- a dual operating system, multi-protocol system for delivering medical library services to the medical professional's desktop. A working model draws resources from CD-ROM and magnetic media file services, Novell and AppleTalk network protocol suites and gating, LAN and asynchronous (dial-in) access strategies, commercial applications for MS-DOS and Macintosh workstations and custom user interfaces. The demonstration includes a discussion of issues relevant to the delivery of said services, particularly with respect to maintenance, security, training/support, staffing, software licensing and costs.

CD-ROM↗
PubMed1988

Teaching pathology in the 21st century. An experimental automated curriculum delivery system for basic pathology.

In late 1984, the "General Professional Education of the Physician" (GPEP) report recommended, among other things, that medical curricula be revised to rely less on lectures and more on independent study and problem solving. We seem to have anticipated, in 1980, the findings of the GPEP panel by formulating and starting to test the hypothesis that certain "core" information in medical curricula can be as effectively delivered by technology-based self-study means as by lecture or formal laboratory. We began, at that time, to prepare a series of self-study materials using, at first, videotape and then computer-controlled optical videodiscs. The content area selected for study was basic microscopic pathology. The series was planned to cover the following areas of study: cellular alterations and adaptations, cell injury, acute inflammation, chronic inflammation and wound healing, cellular accumulations, circulatory disturbances, necrosis, and neoplasia. All are intended to provide learning experiences in basic pathology. The first two programs were released for testing in 1983 as a two-sided videodisc accompanied by computer-driven pretests, study modules, and posttests that used Apple computers and Pioneer (DiscoVision) videodisc players. An MS DOS (eg, IBM) version of the computer programs was released in 1984. The first two programs are now used in 57 US, Canadian, European, and Philippine health professions schools, and over 1300 student and faculty evaluations have been received. Student and faculty evaluations of these first two programs were very positive, and, as a result, the others are in production and will be completed in 1988. Only when a critical mass of curriculum is available can we really test our stated hypothesis. In the meantime, it is worthwhile to report the evaluation of the first two programs.

Audiovisual Aids↗
PubMed2002

Socio-economic and schooling status of dental undergraduates from six French universities.

OBJECTIVES: The aim of this study was to evaluate the socio-economic status of French undergraduate dental students. METHODS: A 46-item questionnaire was completed by the dental students of six universities between 1992 and 1995. Subjects related to family background, housing, schooling, income, expenditure and participation in student life were investigated. RESULTS: A total of 1192 out of 1207 questionnaires were returned. Both genders had equal access to dental training. The average overall cost of the four last years of the dental course was 30,302 French francs and varied greatly between faculties, as did the number of hours spent at the faculty for lectures, tutorials and practicals, and clinical work. Overall, the majority of students came from a well off social background, and had a relatively high quality of life while a small minority received no support from their families. Thirty-four per cent of students had never worked. One third of students smoked and one third regularly consumed medication of some sort. A third did not participate in any sport. Only 25% students bought dental text books and 42% of the students reported using the library regularly. CONCLUSIONS: This study offers an accurate description of the socio-economic status of French dental students that could be used as a reference for comparable studies in other European countries.

Adult↗
PubMed2005

[Growth and developmental outcomes of the extremely preterm infant].

OBJECTIVE: To provide information for pediatricians and neonatologists to create realistic outcome expectations and thus help plan their actions. SOURCES OF DATA: Searches were made of the Cochrane Library, MEDLINE, and Lilacs databases. SUMMARY OF THE FINDINGS: The assessment of growth and development over the first 2-3 years must adjust chronological age with respect of the degree of prematurity. There is special concern regarding the prognoses of small for gestational age preterm infants, and for those with bronchopulmonary dysplasia. Attention must be directed towards improving the nutrition of extremely low birth weight infants during their first years of life; these infants have high prevalence levels of failure to catch-up on growth, diseases and rehospitalizations during their first 2 years. They are frequently underweight and shorter than expected during early childhood, but delayed catch-up growth may occur between 8 and 14 years. Extremely low birth weight infants are at increased risk of neurological abnormalities and developmental delays during their first years of life. Educational, psychological, and behavioral problems are frequent during school years. Teenage and adult outcomes show that although some performance differences persist, social integration is not impaired. CONCLUSIONS: The growth and neurodevelopment of all ELBW infants must be carefully monitored after discharge, to ensure that children and their families receive adequate support and intervention to optimize prognoses.

Child Development↗
PubMedDate not supplied

Galeno's De Pulsis et Urinis from the Casinensis Codex 97.

Between the end of the 9th and the first decade of the 10th century, two medical codes were produced in the Cassino area: The Pluteo 73.41 manuscript of the Laurenziana library in Florence and the Casinensis Codex 97 kept in the archives of the abbey. They are written in Beneventano-Cassinese language and are enriched with drawings of plants and animals. They were most certainly used for the teaching and learning of medicine. On pages 26-31, there is Galeno's De Pulsis et Urinis, that is presented in the form of "Epistola", containing 30 chapters in which the characteristics and variations of pulse, fever and urine are described in different illnesses, thus influencing the prognosis. Galeno's manuscript De Pulsis et Urinis, as well as his other manuscripts contained in Code 97, have an important role in emphasizing the writings of one of the greatest and prolific doctors of ancient times who laid the basis for medicine in the East and in the West. The source is most likely Sergio's which belong to the medical school of Costantinople (his death is known to be in 536); he translated all of Galeno's known writings in the 6th century.

Fever↗
PubMed2004

Vitamin C for preventing and treating the common cold.

BACKGROUND: The role of oral vitamin C (ascorbic acid) in the prevention and treatment of the common cold has been a subject of controversy for at least sixty years. Public interest in the topic continues to be high and vitamin C continues to be widely sold and used as a preventive and therapeutic agent for this common ailment. OBJECTIVES: To discover whether oral vitamin C in doses of 200 mg or more daily, reduces the incidence, duration or severity of the common cold when used either as continuous prophylaxis or after the onset of cold symptoms. SEARCH STRATEGY: This updated review added to earlier searches, a full search of the following electronic databases: the Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2004); MEDLINE (January 1966 to June 2004); and EMBASE (1990 to June 2004). SELECTION CRITERIA: Papers were excluded if a dose less than 200 mg daily of vitamin C was used; if there was no placebo comparison; if methods of outcome assessment were inadequately described; and if the report did not record any of the three study outcomes (incidence, duration or severity) in sufficient detail to enter into the meta-analysis. Three criteria of study quality were assessed: Jadad scores, placebo distinguish-ability, and allocation concealment. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. 'Incidence' of colds during prophylaxis was assessed as the proportion of participants experiencing one or more colds during the study period. 'Duration' was the mean days of illness of cold episodes and 'severity' of these episodes was assessed by days confined indoors, off work or school. or by symptom severity scores. MAIN RESULTS: Twenty-nine trial comparisons involving 11,077 study participants contributed to the meta-analysis on the relative risk (RR) of developing a cold while taking prophylaxis. The pooled RR was 0.96 (95% CI 0.92 to 1.00). A subgroup of six trials that involved a total of 642 marathon runners, skiers, and soldiers on sub-arctic exercises reported a pooled RR of 0.50 (95%CI 0.38 to 0.66). Thirty comparisons that involved 9,676 respiratory episodes contributed to the meta-analysis on common cold duration during prophylaxis . A consistent benefit was observed, representing a reduction in cold duration of 8% (95% CI 3% to 13%) for adult participants and 13.5% (95% CI 5% to 21%) for child participants. Fifteen trial comparisons that involved 7,045 respiratory episodes contributed to the meta-analysis of severity of episodes experienced while on prophylaxis. The pooled results revealed a difference favouring those on vitamin C when days confined to home and off work or school were taken as a measure of severity (p = 0.02), and when restricting to studies which used symptom severity scores (p = 0.16), and for the both measures of severity combined (p = 0.004). Seven trial comparisons that involved 3,294 respiratory episodes contributed to the meta-analysis of cold duration during therapy with vitamin C that was initiated after the onset of cold symptoms, and no significant difference from placebo was seen. Four trial comparisons that involved 2,753 respiratory episodes, contributed to the meta-analysis of cold severity during therapy and no significant difference from placebo was seen.In laboratory studies, differing methods of artificial transmission of virus to vitamin C or placebo treated volunteers in residential experiments gave different results. Volunteers infected by nasal installation showed small or no benefit from vitamin C, whereas a group who were infected more naturally, reported less severe symptom severity scores (p = 0.04). REVIEWERS' CONCLUSIONS: The failure of vitamin C supplementation to reduce the incidence of colds in the normal population indicates that routine mega-dose prophylaxis is not rationally justified for community use. But evidence shows that it could be justified in persons exposed to brief periods of severe physical exercise and/or cold environments. Also, the consistent and statistically significant small benefits on duration and severity for those using regular vitamin C prophylaxis indicates that vitamin C plays some role in respiratory defence mechanisms. The trials in which vitamin C was introduced at the onset of colds as therapy did not show any benefit in doses up to 4 grams daily, but one large trial reported equivocal benefit from an 8 gram therapeutic dose at onset of symptoms.

Administration, Oral↗
PubMed1988

A Virtual Notebook for biomedical work groups.

During the past several years, Baylor College of Medicine has made a substantial commitment to the use of information technology in support of its corporate and academic programs. The concept of an Integrated Academic Information Management System (IAIMS) has proved central in our planning, and the IAIMS activities that we have undertaken with funding from the National Library of Medicine have proved to be important extensions of our technology development. Here we describe our Virtual Notebook system, a conceptual and technologic framework for task coordination and information management in biomedical work groups. When fully developed and deployed, the Virtual Notebook will improve the functioning of basic and clinical research groups in the college, and it currently serves as a model for the longer-term development of our entire information management environment.

Computer Communication Networks↗
PubMed2002

Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain.

BACKGROUND: Chronic low back pain is, in many countries, the main cause of long term disability in middle age. Patients with chronic low back pain are often referred for multidisciplinary treatment. Previous published systematic reviews on this topic included no randomised controlled trials and pooled together controlled and non-controlled studies. OBJECTIVES: To assess the effect of multidisciplinary bio-psycho-social rehabilitation on pain, function, employment, quality of life and global assessment outcomes in subjects with chronic disabling low back pain. SEARCH STRATEGY: We searched MEDLINE, EMBASE, PsychLIT, CINAHL, Health STAR, and The Cochrane Library from the beginning of the database to June 1998 using the comprehensive search strategy recommended by the Back Review Group of the Cochrane Collaboration. INTERVENTION specific key words for this review were: patient care team, patient care management, multidisciplinary, interdisciplinary, multiprofessional, multimodal, pain clinic and functional restoration. We also reviewed reference lists and consulted the editors of the Back Review Group of the Cochrane Collaboration. SELECTION CRITERIA DESIGN: randomised controlled trials comparing multidisciplinary bio-psycho-social rehabilitation with a non-multidisciplinary control intervention. POPULATION: Adults with disabling low back pain of more than three months in duration. INTERVENTION: Patients had to be assessed and treated by qualified professionals according to a plan that addresses physical and at least one of psychological, or social/occupational dimensions. OUTCOMES: Only trials which reported treatment effect in at least one of pain, function, employment status, quality of life or global improvement. Exclusion: Pure educational interventions (back schools) and pure physical interventions were excluded. DATA COLLECTION AND ANALYSIS: Selection, data extraction and quality grading of studies was done by two independent reviewers using pre-tested data forms. Study quality was assessed according to the scheme recommended by the Back Review Group of the Cochrane Collaboration. Trials with internal validity scores of five or more in a ten point scale were considered high quality. Discrepancies between reviewers were resolved by consensus or by a third reviewer. Given the marked heterogeneity in study settings, interventions and control groups we decided not to pool trial results in a meta-analysis. Instead, we summarized findings by strength of evidence and nature of intervention and control treatments. The evidence was judged to be strong when multiple high quality trials produced generally consistent findings. It was judged to be moderate when multiple low quality or one high quality and one or more low quality trials produced generally consistent findings. Evidence was considered to be limited when only one randomised trial existed or if findings of existing trials were inconsistent. MAIN RESULTS: Ten trials (12 randomised comparisons) were included. They randomised a total of 1964 patients with chronic low back pain. There was strong evidence that intensive multidisciplinary bio-psycho-social rehabilitation with a functional restoration approach improved function when compared with inpatient or outpatient non-multidisciplinary treatments. There was moderate evidence that intensive multidisciplinary bio-psycho-social rehabilitation with a functional restoration approach improved pain when compared with outpatient non-multidisciplinary rehabilitation or usual care. There was contradictory evidence regarding vocational outcomes of intensive multidisciplinary bio-psycho-social intervention. Some trials reported improvements in work readiness, but others showed no significant reduction in sickness leaves. Less intensive outpatient psycho-physical treatments did not improve pain, function or vocational outcomes when compared with non-multidisciplinary outpatient therapy or usual care. Few trials reported effects on quality of life or global assessments. REVIEWER'S CONCLUSIONS: The reviewed trials provide evidence that intensive multidisciplinary bio-psycho-social rehabilitation with a functional restoration approach improves pain and function. Less intensive interventions did not show improvements in clinically relevant outcomes.

Back Pain↗
PubMed1990

[Jirí Josef Camel, pharmacist and botanist].

Jirí Josef Camel (1661-1706), a pharmacist and botanist, was born in Brno, educated at a grammar school and then joined the Jesuit Order as a laic brother. He worked in the college pharmacies in Brno, Jindrichův Hradec and Ceský Krumlov. In 1687 he left for a religious mission to the Philippine Islands, where he worked for 17 years in a hospital as a pharmacist. He died in Manila in 1706. He wrote 19 treatises, in which he acquainted European medicine and pharmacy with the flora and fauna of the Philippines. Camel sent his papers to London to J. Ray, the then most distinguished authority in botany. Ray published them in the 3rd volume of Historia Plantarum in 1704. The most valuable part of his work are drawings of plants, published by Petiver in the journal Gazophylacei naturae et artis (1702-1709). More than 400 of them have survived till nowadays in the collection of the British Museum. Further 260 drawings were acquired in the course of years by the University Library in Louvain.

Botany↗
PubMed1991

Efficient MEDLINE searching of the radiologic literature.

The Radiology Information Service at the Bowman Gray School of Medicine of Wake Forest University performs a wide range of functions from physician continuing education to a photocopy service, including approximately 450 demand literature searches annually. The complexity of the field of radiology, the rapid advances in hardware and techniques, and the variety of interests on the part of radiologists and basic scientists requesting searches make online literature retrieval a challenge for even the expert radiology librarian. This paper presents up-to-date searching terminology, suggested search formulations, and bibliographic sources which have proved valuable in the functioning of the Radiology Information Service.

CD-ROM↗
PubMed2005

Family therapy for attention-deficit disorder or attention-deficit/hyperactivity disorder in children and adolescents.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is diagnosed in between 3% and 7% of school-age children and consists of the core symptoms of inattention, impulsivity and hyperactivity. Children are often treated with medication, usually stimulant medication such as methylphenidate. Stimulant medication has been found to be effective for alleviating ADHD symptoms, at least in the short term. ADHD is also treated with a variety of psychosocial and psychoeducational interventions for parents, children, and with multicomponent interventions combined with medication management. However, many patients (10 to 13% of patients) cannot or prefer not to take medication. Family therapy without medication may help to develop structure in the family, help to manage children's behaviour, and may help families cope with distress from the presence of the disorder. OBJECTIVES: This review seeks to address the question of whether family therapy without medication can reduce the core symptoms of ADHD as compared to no treatment or standard treatment. SEARCH STRATEGY: The following electronic databases were searched using a specific search strategy: The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2004), MEDLINE (1966 to April 2004), PsycINFO (1872 to April 2004), CINAHL (1982 to April 2004), Biosis (Biological Abstracts) (1985 to March 2004), Dissertation Abstracts (1980 to April 2004), and Sociological Abstracts (Sociofile) (1963 to April 2004). Hand searches of relevant journals and bibliographies were also conducted and experts in the field were contacted for further information. SELECTION CRITERIA: Included studies were randomised controlled trials investigating the efficacy of behavioural family therapy, cognitive behavioural family therapy, or functional family therapy for children with ADHD or ADD (Attention Deficit Disorder). DATA COLLECTION AND ANALYSIS: Studies were evaluated for methodological quality and to determine whether they met the inclusion criteria. MAIN RESULTS: This assessment yielded two studies. Data were extracted for both studies. The findings from Jensen 1999 (N=579) indicate that no difference can be detected between the efficacy of behavioural family therapy and treatment as usual in the community. The finding from the available data from Horn 1991 slightly favours treatment over medication placebo. AUTHORS' CONCLUSIONS: Further research examining the effectiveness of family therapy versus a no-treatment control condition is needed to determine whether family therapy is an effective intervention for children with ADHD. There were no results available from studies investigating forms of family therapy other than behavioural family therapy.

Adolescent↗
PubMed2001

Pediatric and adolescent bipolar disorder: medical resources.

An increasing body of research suggests the existence of early onset childhood bipolar disorder. The population of pediatric bipolar illness may be small, but current research points to early misdiagnosis of ADD/ADHD, and that attention deficit disorder may masquerade as a harbinger of the mania to come. Since ADD/ADHD estimates range up to 10% of the school population, the notion that ADD/ADHD precedes bipolar disorder leads to a significant increase in diagnosed depressives. This in turn produces an increase in information-seeking behaviors by parents, caregivers, and medical personnel. Variables hindering the information-seeking process include vocabulary, tool failure, co-morbidity, social prejudices, age issues, and environmental factors. This research provides reliable sources, Web sites, databases, key authors, electronic groups, and other accessible medical information in order to better serve the pediatric bipolar community.

Adolescent↗
PubMed1989

MEDLINE-for-Medics: an outline searching course for health-care professionals.

An online searching course for health professionals was initiated at a university medical school. A group of end users were taught to search the MEDLINE database on DATA-STAR and their subsequent online progress was monitored. The preliminary survey by questionnaire, pretraining interviews, the tutorial programme, course evaluation and end-user feedback were described. Logsheets showed that most end-user searches were for research purposes, although some were for patient care. The effects of CD-ROM on online end-user searching were discussed and it was suggested that direct online access to information might be a more appropriate medium for busy clinical and academic staff.

Academic Medical Centers↗