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At least 973 records · Page 54Linked to original sources
PubMed1992

A trial of health education aimed to reduce cigarette smoking among pregnant women.

Three hundred and forty-six women who reported smoking one or more cigarettes per day prior to the 20th week of gestation were recruited into a trial of health educational counselling to stop or reduce cigarette smoking. Counselling was begun at the first prenatal visit and then continued subsequently in the home. Among the 319 women included in analysis, at first follow-up visit those who received counselling smoked 1.7 fewer cigarettes a day than control women (P less than 0.05) and 10.4% had stopped smoking, compared to 5.4% in the control group (NS). Similar but not significant differences were noted at the end of pregnancy. Study effects were limited to the 284 women smoking five or more cigarettes a day at booking. This report refers primarily to them. At first follow-up visit the proportion of such women in the counselled group who ceased smoking (9.3%) was significantly greater than in the control group (2.6%; P less than 0.05). The magnitude of this difference persisted through late pregnancy (11.8% vs. 4.3%; NS) and delivery (10.6% vs. 4.7%; NS). The differences between counselled women and controls in numbers of cigarettes reported smoked at first and last prenatal follow-up visits (2.4 and 2.1) and at delivery (2.0) were all statistically significant. While there was no effect of counselling on either serum thiocyanate or end expiratory carbon monoxide, the counselled group gained slightly more weight than controls during the study (0.47 vs. 0.44 kg per week among controls; NS), and their infants had modestly higher birthweight (44 g; NS).

Breath Tests↗
PubMed1986

The realities of screening for the small for dates fetus using ultrasound measurement.

Screening for the small for dates fetus using ultrasound measurement of the fetal abdominal circumference resulted in a significantly increased rate of diagnosis compared with clinical examination. However, when the perinatal mortality and morbidity amongst infants with a birthweight less than the 10th percentile for gestation in the screened group was compared with that of similar infants in a nonscreened groups who attended the same antenatal clinic but who either booked or were referred late, there was no significant difference.

Birth Weight↗
PubMed1993

Commemorating the Fabrica of Vesalius.

It is an appropriate time to commemorate the Fabrica of Andreas Vesalius, which was published in Basel 450 years ago. In addition, a dozen key references in English (books and articles) are listed for those who wish to learn more about Vesalius and particularly concerning the wonderful woodcuts in the Fabrica.

Anatomy↗
PubMed1993

Ceftriaxone distribution and protein binding between maternal blood and milk postpartum.

OBJECTIVE: To study postpartum distribution and protein binding of ceftriaxone (CTX) between maternal blood and milk and to discuss risk factors and possible impact for the neonate. DATA SOURCES: Reference articles and books are identified in the text. DATA SYNTHESIS: CTX distribution and protein binding between maternal blood and milk postpartum were studied in a patient at term presenting with acute pyelonephritis caused by Escherichia coli. The antibiotic therapy prescribed pending bacteriology results consisted of CTX 2 g/d, ornidazole 1 g/d, and tobramycin 3 mg/kg/d. Pharmacokinetics of total CTX were studied after the first 2-g infusion. At plateau (i.e., two days after delivery; seventh infusion), pharmacokinetics and milk distribution of total and free CTX also were studied. No accumulation of CTX was noted in the plasma at plateau. When high dosages of CTX are used (approximately 2 g), its penetration into the milk is important (i.e., protein binding capacity is overwhelmed). No notable adverse reactions occurred in mother or child. Thus, an important diffusion into the milk (4.4 percent of the dose) appears not to be clinically important. Our knowledge of both metabolism and milk distribution of drugs with high protein binding (> or = 95 percent) and an acid characteristic should be expanded to better understand their use during both the pregnancy and postpartum periods. Finally, the child of the patient described here has normal initial growth and development at the present time. CONCLUSIONS: Caution should be taken when drugs such as CTX, which have both high protein binding (> or = 95 percent) and an acid characteristic are administered to breastfeeding women. Drugs of this type should be systematically investigated to better understand their use during pregnancy and postpartum.

Adult↗
PubMed1994

Flecainide distribution, transplacental passage, and accumulation in the amniotic fluid during the third trimester of pregnancy.

OBJECTIVE: To study the disposition of flecainide acetate and its transplacental passage (both into the fetus and in the amniotic fluid) during the third trimester of pregnancy. DATA SOURCES: Reference articles and books are identified in the text. A literature review is presented. CASE SUMMARY: Flecainide distribution, transplacental passage, and accumulation into the amniotic fluid were studied in a patient at term presenting with a fetal supraventricular tachycardia diagnosed at 33 4/7 weeks of gestation. The fetal tachycardia was accompanied by cardiac failure with placental anasarca and hydramnios. Flecainide 100 mg po bid was prescribed initially; by the time of delivery, the dosage had been decreased to 50 mg bid. At delivery day (39 5/7 weeks), the pharmacokinetics of total flecainide were studied at plateau. DATA SYNTHESIS: The concentrations of flecainide at birth in fetal and maternal blood and in amniotic fluid were 235.4, 241.2, and 6426.5 micrograms/L, respectively. Calculation of a fetomaternal blood accumulation ratio of 0.97 showed that, at this gestational age, flecainide penetrates the placental membrane easily without accumulation in fetal blood. In contrast, the concentration of flecainide in amniotic fluid was approximately 27-fold that measured in maternal peripheral blood. Our results suggest the following: (1) close to term, the metabolic clearance (fetal hepatic clearance) of flecainide offers a high yield and its excretion by the fetal kidney is efficient; (2) given that amniotic fluid is constantly swallowed, it seems that, in contrast to what is seen in adults (relative oral bioavailability > or = 95 percent), the oral bioavailability of flecainide is possibly low in the fetus at term or close to term; under such circumstances, the drug would accumulate passively within the gestational sac; and (3) an alternative explanation is that the concentration in the fetus is, in part, the result of both transplacental crossing of the drug and reabsorption orally from the amniotic fluid. CONCLUSIONS: The regular therapeutic monitoring of flecainide is necessary and sufficient in the mother as the concentrations found appear to accurately reflect the degree of fetal accumulation. Because previous studies in infants and children have indicated few toxic adverse effects attributed to flecainide, it appears that the risk to a sucking infant of ingesting toxic amounts of flecainide in human breast milk is very low. Finally, the child of the patient described here has normal initial growth and development at the present time. The transplacental penetration of a drug can be considered, according to gestational age and the disorder being treated, as being of no consequence, dangerous, or desirable. Flecainide appears to fall into this last category.

Adult↗
PubMed2002

A criterion audit of women's awareness of blood transfusion in pregnancy.

BACKGROUND: In the Confidential Enquiry into Maternal Deaths (CEMD) Report, the very high risk of mortality in women who refuse blood transfusions is highlighted. The objectives were to establish current knowledge about, and views of transfusion in our pregnant population and to establish the level of compliance with the set audit standard. METHOD: Questionnaire survey of 228 women, including both high and low risk pregnancies, attending ante-natal clinic between 2-9 May 2000 at the North Staffordshire Maternity Hospital, Stoke on Trent. RESULTS: The response rate was 100%. Only 43% were aware of the possible need for blood transfusion in pregnancy. If a blood transfusion was required, 92% stated that they would accept a blood transfusion in pregnancy. Four percent stated that they would not accept a transfusion because of religious reasons and risk of infection and the remaining four percent did not declare a reason. CONCLUSIONS: This short survey identified that 57% of women were not aware of the possible need for blood transfusion during pregnancy. There is a need for more information to be shared on this subject with all antenatal women. Women who would refuse a transfusion need to be identified at booking and be referred for counselling and a management plan made for pregnancy, labour and delivery.

Journal Article↗
PubMed2003

[Well-child care today: an evidence-based view].

OBJECTIVES: Health promotion is one of the chief activities of pediatricians, although still lacking enough scientific bases. This article reviews the scientific support for the main preventive interventions, as well as who should make them, when and how they should be made. SOURCES: Systematic review of recent literature, through the search of Medline and Lilacs databases, using the terms well-child care, health supervision and health promotion (both in English and Portuguese); non-systematic review of reference lists of book chapters; non-systematic Internet search of organizations that make recommendations on health supervision; selection of classic articles within this field. SUMMARY OF THE FINDINGS: Pediatricians must seek integration with other professionals in providing preventive services, as well as in establishing effective partnerships with all community sectors. It is essential to improve communication skills. The ideal number of health supervision visits has never been established; interventions must be individually adapted according to family and community contextual risk factors. There is scientific evidence of the effectiveness of prenatal visits, preventive guidance, metabolic screening, immunization, and vision and hearing screening. Growth monitoring and development screening must be rationalized. The systematic repetition of complete physical examinations and laboratory tests is not warranted. CONCLUSIONS: Pediatricians play a fundamental role in child and adolescent health promotion, but their actions regarding well-child care must no longer be totally empirical. There are innumerous evidence-based resources to guide pediatricians as to the most effective interventions.

Child↗
PubMedDate not supplied

Tracing our roots: years of turmoil (1962-1977).

OBJECTIVE: To describe the activities of the American Society of Clinical Pathologists and the sequence of events leading to the establishment of the National Accrediting Agency for Clinical Laboratory Science and Medical Laboratory Personnel. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted various books and professional journals. CONCLUSIONS: By virtue of its close association with ASCP, ASMT became drawn into a series of legal actions between 1962 and 1977. Although ASMT was eventually dropped from all law-suits, the association's leadership recognized the need for greater autonomy and independence from ASCP. Clinical laboratory science achieved several victories during this period with respect to certification and mandatory re-registration by the BOR. Responsibility for accreditation of educational programs was shifted from the BOS to NAACLS and the establishment of the National Certification Agency for Medical Laboratory Personnel signified ASMT's commitment to certification by the profession for the profession.

Accreditation↗
PubMed1975

Role and functions of the Nordic Pharmacopoeia.

It was proposed as early as in 1860 that a common pharmacopoeia should be worked out in the Nordic countries but it took more than a hundred years before such a pharmacopoeia was published and put into force. Ever since that early date the Nordic countries have, however, been striving for common regulations in the drug field with more or less intensity. The accomplishment of the common pharmacopoeia is therefore to be regarded only as a milestone on the long way to complete conformity of the different national drug regulations. The Nordic Pharmacopoeia has definitely broken through the borderlines of the earlier national pharmacopoeias, which were designed for the activities of the pharmacies, and has obtained recognition as a work on drug standards possible to apply in the manufacture and control of drugs no matter where they are produced or controlled. The Nordic Pharmacopoeia thus has wider functions and a greater responsibility than the earlier pharmacopoeias. This depends partly on the pharmacopoeia itself, partly on the development in the field of drug control. On the other hand the Nordic Pharmacopoeia has left some of the tasks of the earlier pharmacopoeias to different national formularies, manuals and other sources of information. This applies especially to galenical preparations. As expected the Nordic Pharmacopoeia has facilitated drug trade in the Nordic countries to a certain extent and it is no doubt of greatest value in the different control activities of the national health authorities. It is also a guide-book and a reference work for manufacturers and control laboratories of different kinds. But this is what it should be, what it is intended to serve as. In addition to that the Nordic Pharmacopoeia has played an essential role in many other respects; not least as initiator of different progressive work and drawer of guide-lines for future development in the drug field.

Pharmacopoeias as Topic↗
PubMed2001

[Comparison observation on the mature alveolar of Echinococcus sibiricensis and Echinococcus multilocularis in the experimentally infected white mice].

The alveolar echinococcus is one of the most dangerous worm parasites in man. Rausch and Schiller reported a new species, Echinococcus sibiricensis n. sp. from arctic fox, Alpex logopus, on St. Lawrence Island of Alaska, USA. According to the view of Vogel, the sibiricensis form is only a geographical race or subspecies of Europe Echinococcus multilocularis. So far, the two names, Echinococcus multiocularis multilocularis and Echinococcus multilocularis sibiricensis, existed in many references and text books. We have found the adults of Echinococcus sibiricensis and Echinococcus multilocularis from sand foxes, Vulpes corsac and their larval stages (alveolar echinococcus) from field voles, Microtus brandti in the Hulunbeier Pasture of Inner Mongolia, northeastern China in 1985 and 1998-1999. Two types of metacestodes with quite different styles of early development of E. sibiricensis and E. multilocularis were found from field voles and laboratory experimental white mice. As one characteristic of alveolar E. multilocularis, the capsules are produced by the exogenous budding of germinal cell layer together with cyst wall. The protoscoleces grow from germinal cells on germinal cell layer. The peduncles of early protoscoleces attached to the germinal cell layer on the inner surface of capsule wall(Plate I, Figs. 1-2). Some protoscoleces in reticular structure were linked with the inner surface of capsule wall (Plate I, Fig. 3) in livers of mice in 9.5th month postinfection. In 14th month old alveolar multilocularis, large number of mature protoscoleces in reticular structure were still linked to the inner surface of capsule wall (Plate I, Figs. 4-8). The cavities of some capsules were filled with protoscoleces in meshes of reticular structure which were also linked around with the inner surface of capsule wall (Plate I, Fig. 9). The superficial surface of livers of positive field voles and experimental mice never showed any hyperemic phenomenon. The superficial surfaces of livers and lungs of positive field voles and experimental mice infected with alveolar E. sibiricensis were highly hyperemic. The metacestodes of E. sibiricensis composed of mother cyst, undifferentiated embryonic cysts and small brood capsules. Cavities of all cysts were fully filled with germinal cell masses. Host reaction appeared to be very strong, all cysts were surrounded by thick connective tissue and dense leukocytes (Plate II, Fig. 10). All alveolar vesicles were found located in lungs tissue of experimental mice. Large germinal cell masses metastasized out from undifferentiated embryonic cysts into host lung tissue, where germinal cell masses developed into accumulation of early protoscoleces (Plate II, Figs. 11-12). Early protoscoleces of alveolar E. sibiricensis were seen earliest in mice lung tissues on 101-104th days after infection. Many small capsules in different sizes and different shapes containing mature protoscoleces and reticular structure (Plate II, Figs. 13-15) were found in lungs of mice in 9th month after infection. Only in one experimental mouse infected with alveolar E. sibiricensis in 8.5th month postinfection, both its lung and liver existed alveolar cysts; the capsules in liver were surrounded by very thick connective tissue of the host, and there were some protoscoleces in their cavities (Plate II, Figs. 16-18).

Animals↗
PubMed1992

[Władysław Ołtuszewski--organizer of the first Polish phoniatrics institute (in it's 100 year anniversary)].

On the occasion of 100's anniversary of first phoniatrics' department foundation in Poland--"The Warsaw Institute of Speech Deviation", the activity of dr med. Władysław Ołtuszewski its organizer and the pioneer of Polish phoniatrics is described. The main topics of his activities are referred in his book "About speech and its disorders" (1906). Dr Ołtuszewski's achievements in the popularization of the knowledge about speech disorders were strongly pointed out. His lectures were given not only for medical societies but also for the pedagogic ones.

Academies and Institutes↗
PubMed2003

[Postnatal care in a cross-cultural and historical perspective].

BACKGROUND: In most societies, birth and the immediate postpartum period are considered a time of vulnerability for mother and child. Rituals for major changes in the life cycle are common in most societies. The aim of this study was to present some examples of postpartum customs in a cross-cultural and historical perspective. We also present research on associations between postnatal care and mental health. MATERIAL AND METHODS: A systematic search was performed in Medline and the Science Citation Index Expanded (ISI) from 1966 until March 2003. Reference lists in books about pregnancy and birth from the library of the University of Oslo were used to get additional information. RESULTS: The postnatal period is defined as approximately 40 days in most cultures; most societies have special postnatal customs that include special diet, isolation, rest and help in the household. The resemblance between different cultures is striking. Many postnatal customs from rural societies that were common before 1950 have disappeared. The focus on rest and help in the household for the mother after delivery has been reduced. INTERPRETATION: We need more knowledge about the impact of different kinds of postnatal care on the mother's wellbeing.

Anthropology↗
PubMed2002

[The Mandragore].

The medicine of today has been evaluated as the inheritance of the Mediterranean civilization of which fundamental sources date back even to the Sumerian and the Mesopotamian medicine. It is necessary to start with those ancient cultures for researching historically the adventure of medicinal drugs utilized in medicine at present. As a matter of fact, on the basis of the pharmaceutical books it was referred to, the research of mandragore's use in medicine throughout the history serves as a good example to that aim.

History, 15th Century↗
PubMedDate not supplied

Out of the blue and into the pink. Is it so rosy for the cardiologist?

There is a stage in one's career when one is mature enough to be invited to give named lectures. Usually, one has never heard of the 'named' person. This occasion is different because I know Dr Keith. (Dr John Keith died February 8, 1989, aged 80 years. Obituary in Can J Cardiol 1989;5[3]:XI). His book was my reference when I became excited by congenital heart disease and two days ago I had the pleasure of speaking to him, explaining the title which he said was "quaint and interesting." He reminded me that when he started the Canadian Cardiovascular Society with Dr Harold Segall there were only a handful of people who came together to discuss mutual problems in cardiology. Looking at the remarkable list of distinguished physicians and surgeons who have come before me to give this important lecture, I hope that I can do justice to the honour that you have given in asking me to be the John Keith Lecturer in 1988. The title of this lecture was born when I received a blue anniversary card covered with pink hearts from a once deeply cyanosed, chairbound girl with Ebstein's anomaly, 20 years after she had reparative surgery and lived a normal life, for which she thanked me. I passed the message to Donald Ross, with whom I have been privileged to work with for 25 years in the National Heart Hospital in London, United Kingdom and whose courageous innovations have created so much good life for many with complex congenital heart disease.

Adolescent↗
PubMed1979

[Specific position of physical therapy in psychiatry].

It is pointed out that in modern psychiatry physical therapy has to be integrated as therapeutic tool beside psychopharmacology, verbal psychotherapy and occupational therapy. The expression physical therapy is used here in a large sense. As an example endogenous depression is chosen to show which conditions are necessary when using physical therapy in a rational way. Concerning the other groups of psychiatric disorders it was referred in the book "Physikalische Therapie in der Psychiatrie" ("physical therapy in psychiatry").

Breathing Exercises↗
PubMed1979

Continuing medical education.

1. Continuing medical education is unquestionably a worthwhile goal. Knowledge or exposure to information, however, does not ensure competence in medical care; nevertheless, without knowledge there is no possibility of true competence. 2. Continuing medical education should not be judged by recall knowledge but should ensure exposure to current and acceptable medical knowledge. 3. Because all licensed physicians have unrestricted licenses regardless of their specialty, they all should benefit from a comprehensive type of CME. 4. An open-book examination with reference sources appended to the questions would expose the physician to current and acceptable medical knowledge. 5. Recall types of examinations have no place in practical CME.

Education, Medical, Continuing↗
PubMedDate not supplied

[Hyperthymic disorders].

Hyperthymia, as referring to the book by J. Delay: "les dérèglements de l'humeur" (1946), means from a clinical point of view, an exaggeration of the level of mood, as well on the one hand, expansive and joyful, as, on the other hand, distressing, within a withdrawn self. K. Schneider had described an hyperthymic personality in 1923: optimist, dynamic, taking initiatives, or more simply hypomanic. He opposed this type of personality to depressive personality types. Delay unified these two pathologic evolutions within a physiopathological and psychopathological unique concept. Conversely, H. Ey denied this unique affective conceptualization of the disease. From his physiopathologic jacksonian point of view, a certain level of destruction of consciousness explains, solely, both affective and noetic disorganization of these so called hyperthymias. Since the early eighties, Angst, Akiskal, Cassano, brought up to date the adjective hyperthymic. They assessed the correlation between premorbid personality disorder and mood disorder: a number of bipolar disorders are linked with premorbid hyperthymic disorders. This was the K. Schneider' position who linked traits and states, as Kraepelin did for the manic premorbid disposition. Choosing a dimensional approach, one question has to be asked: can hyperthymia be found as a previous personality trait of different other diseases? An anxious hyperthymia can be found linked to some panic attacks and other neurotic symptoms. A delusional hyperthymia is described by Janzarik who thinks that delusional ideas are linked to a kind of delusional mood. G. Petit, in 1933, subsumed the existence of a paranoid hyperthymia within the more general concept of the passional psychoses described by de Clérambault, Delmas and Borel.

Anxiety Disorders↗
PubMed1993

Radiology of arthritis.

The radiographic evaluation of the arthritides still relies primarily on the plain films that are readily available to every practicing clinician. The radiographic examination serves primarily to confirm the clinician's diagnosis based on the history, clinical findings, and laboratory studies and to document the severity of the arthritic changes. On occasion, the radiographic studies will be diagnostic when other findings are equivocal and the diagnosis is in question. The radiographic studies, in association with the other data, should result in a firm diagnosis greater than 90% of the time. This review article has outlined the basic features of the common arthritides and hopefully will serve as a handy reference in office practice for the evaluation of a patient with arthritis. There will always be unusual or perplexing cases that may require reference to text books devoted exclusively to the radiology of arthritis and bone disease. Of course, you can always get some excellent help by consulting with your local radiologist.

Arthritis↗