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At least 1,027 records · Page 57Linked to original sources
PubMed1989

Hypermedia techniques for diagnostic imaging instruction: videodisk echocardiography encyclopedia.

Because of the visual complexity of medical images and the intensive tutorial experience required to develop image recognition expertise, professional training programs have concentrated on educating limited numbers of experts. Videodisk and CD-ROM (compact disk read only memory) image storage media now make it possible for a microcomputer workstation to provide a learning environment substantially equivalent to that of conventional time-consuming tutorial methods. A demonstration hypermedia program on echocardiography was constructed that provides a user-controlled learning environment with instant access to 54,000 video frames encompassing 1,200 clinical items. The instructional module is controlled by a microcomputer, which provides electronic linkage to relevant graphics, animations, text, categorized data bases, and digitized sound. The system has been successfully used in a residency program as the primary instructional tool for achieving an intermediate level of clinical expertise. Hypermedia offer substantial advantages over conventional books as a clinical reference source.

Computer-Assisted Instruction↗
PubMed2005

Effectiveness of different databases in identifying studies for systematic reviews: experience from the WHO systematic review of maternal morbidity and mortality.

BACKGROUND: Failure to be comprehensive can distort the results of a systematic review. Conversely, extensive searches may yield unmanageable number of citations of which only few may be relevant. Knowledge of usefulness of each source of information may help to tailor search strategies in systematic reviews. METHODS: We conducted a systematic review of prevalence/incidence of maternal mortality and morbidities from 1997 to 2002. The search strategy included electronic databases, hand searching, screening of reference lists, congress abstract books, contacting experts active in the field and web sites from less developed countries. We evaluated the effectiveness of each source of data and discuss limitations and implications for future research on this topic. RESULTS: Electronic databases identified 64098 different citations of which 2093 were included. Additionally 487 citations were included from other sources. MEDLINE had the highest yield identifying about 62% of the included citations. BIOSIS was the most precise with 13.2% of screened citations included. Considering electronic citations alone (2093), almost 20% were identified uniquely by MEDLINE (400), 7.4% uniquely by EMBASE (154), and 5.6% uniquely by LILACS (117). About 60% of the electronic citations included were identified by two or more databases. CONCLUSIONS: This analysis confirms the need for extending the search to other sources beyond well-known electronic databases in systematic reviews of maternal mortality and morbidity prevalence/incidence. These include regional databases such as LILACS and other topic specific sources such as hand searching of relevant journals not indexed in electronic databases. Guidelines for search strategies for prevalence/incidence studies need to be developed.

Female↗
PubMed2006

A comparative study on the cost of new antibiotics and drugs of other therapeutic categories.

BACKGROUND: Drug treatment is becoming more expensive due to the increased cost for the introduction of new drugs, and there seems to be an uneven distribution of medication cost for different therapeutic categories. We hypothesized that the cost of new antimicrobial agents may differ from that of other therapeutic categories and this may play a role in the stagnation of development of new antibiotics. METHODOLOGY/PRINCIPAL FINDINGS: We performed a pharmaco-economical comparative analysis of the drug cost of treatment for new agents introduced in the United States drug market in various therapeutic categories. We calculated the drug cost (in US dollars) of a ten-day treatment of all new drugs approved by the FDA during the period between January 1997 and July 2003, according to the 2004 Red Book Pharmacy's Fundamental Reference. New anti-neoplastic agents were found to be the most expensive drugs in comparison to all other therapeutic categories, with a median ten-day drug-treatment cost of US$848 compared to the median ten-day drug-treatment costs of all other categories ranging from US$29 to US$301. On the other hand, new antimicrobial drugs were found to be much less expensive, with a median ten-day drug-treatment cost of US$137 and $US85 for all anti-microbial agents and for anti-microbial agents excluding anti-HIV medications, respectively. CONCLUSIONS/SIGNIFICANCE: The drug-treatment cost of new medications varies considerably by different therapeutic categories. This fact may influence industry decisions regarding the development of new drugs and may play a role in the shortage of new antimicrobial agents in the fight against the serious problem of antimicrobial resistance.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Elizabeth Fee: a historian reaching out to wider audiences].

To what activities and topics does a historian in health and medicine, whose articles and books have become fundamental references for scholars of the area, devote her time? Feminism, counter-culture, medical education, global health, the role of international health organizations, and knowledge sharing in the health history are some of the subjects Elizabeth Fee addresses in this interview given at Fiocruz in April where she presented the 2006 inaugural class to the Graduate Program in History of Health Sciences at Casa de Oswaldo Cruz. The topic of her lecture was "The World Health Organization and AIDS: what can we learn from history?"

Community-Institutional Relations↗
PubMed1995

Apoptosis overview emphasizing the role of oxidative stress, DNA damage and signal-transduction pathways.

Apoptosis (programmed cell death) is a central protective response to excess oxidative damage (especially DNA damage), and is also essential to embryogenesis, morphogenesis and normal immune function. An understanding of the cellular events leading to apoptosis is important for the design of new chemotherapeutic agents directed against the types of leukemias and lymphomas that are resistant to currently used chemotherapeutic protocols. We present here a review of the characteristic features of apoptosis, the cell types and situations in which it occurs, the types of oxidative stress that induce apoptosis, the signal-transduction pathways that either induce or prevent apoptosis, the biologic significance of apoptosis, the role of apoptosis in cancer, and an evaluation of the methodologies used to identify apoptotic cells. Two accompanying articles, demonstrating classic apoptosis and non-classic apoptosis in the same Epstein-Barr virus-transformed lymphoid cell line, are used to illustrate the value of employing multiple criteria to determine the type of cell death occurring in a given experimental system. Aspects of apoptosis and programmed cell death that are not covered in this review include histochemistry, details of cell deletion processes in the sculpting of tissues and organs in embryogenesis and morphogenesis, and the specific pathways leading to apoptosis in specific cell types. The readers should refer to the excellent books and reviews on the morphology, biochemistry and molecular biology of apoptosis already published on these topics. Emphasis is placed, in this review, on a proposed common pathway of apoptosis that may be relevant to all cell types.

Animals↗
PubMedDate not supplied

Tracing our roots: origins of clinical laboratory science.

OBJECTIVE: To trace the roots of clinical laboratory science by explaining how women initially gained access to scientific work and to describe the emergence of clinical laboratories. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: The origin of the field of clinical laboratory science can be traced to the early 1900s. Between 1890 and 1910, women were able, for the first time, to pursue careers in scientific professions, clinical laboratories became established in hospitals, and the clinical utility of laboratory tests became more widely recognized by physicians.

Clinical Laboratory Techniques↗
PubMedDate not supplied

Tracing our roots: the first clinical laboratory scientist.

OBJECTIVE: To trace the roots of clinical laboratory science by discussing the development of the role of the "laboratory technician", and describing selected early training programs for clinical laboratory personnel. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: The first clinical laboratory scientists began working in clinical laboratories shortly before World War I. During the war, and in the years that followed, a critical shortage of trained laboratory personnel developed. To alleviate this shortage, pathologists began to hire young women, training them on the job to perform simple laboratory tests. However, there were no established training standards, and few institutions offered a systematic method for instruction. During this same period, three educational programs were established that did offer high quality training that provided systematic instruction to their students.

History, 20th Century↗
PubMedDate not supplied

Tracing our roots: the beginnings of a profession.

OBJECTIVE: To examine the role of the American Society of Clinical Pathology and the Board of Registry in shaping the field of clinical laboratory science during its formative years. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: The Board of Registry played a significant role in the early development of clinical laboratory science. The Board established standards of competence for entry-level practitioners and a mechanism for assessing competence and developed an accreditation process for educational programs.

Adult↗
PubMedDate not supplied

Tracing our roots: early clinical laboratory scientists and their work--myth and reality.

OBJECTIVE: To describe the 'real' and 'ideal' clinical laboratory scientist according to the perceptions of pathologists, clinical laboratory scientists, and the public during the early years of the profession (1918 to 1942). DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: As early as 1920, young women learned, through career guides, that they were particularly well-suited for performing laboratory work because they possessed a unique set of attributes which were considered to be desirable qualities in a clinical laboratory scientist. In addition, magazine articles published in the popular press in the 1930s and 1940s romanticized laboratory technicians. Although later articles did present a more realistic description of the work of the laboratory technician, they continued to portray the occupation in idealistic terms. Pathologists and laboratory technicians also described the ideal laboratory technician in professional journals, citing those qualities that were essential or especially desirable in a competent laboratory technician. The relationship between the clinical pathologists and the laboratory technician was described as one of mutual interdependence and integration of responsibilities. In reality, pathologists maintained strict supervision and control over the work of laboratory technicians. The 'real' laboratory technician differed markedly from the 'ideal' prototype created by the public, pathologists, and by laboratory technicians, themselves.

Clinical Laboratory Techniques↗
PubMedDate not supplied

Tracing our roots: a professional identity emerges: 1928 to 1945.

OBJECTIVE: To describe the early years of the American Society of Medical Technology and discuss major issues that led to contention between the American Society of Medical Technology and the Board of Registry. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: Clinical laboratory science began to develop a professional identity of its own, distinct from that of pathology, with the establishment of the American Society of Medical Technology and the publication of the American Journal of Medical Technology. These achievements illustrate clinical laboratory scientists' commitment to developing formal mechanisms to serve their specific interests and needs, independent of pathologists and the Board of Registry. Pathologists were successful, however, in maintaining control over other aspects of clinical laboratory scientists' professional identity, such as certification, accreditation, scope of practice, and code of ethics.

Certification↗
PubMedDate not supplied

Tracing our roots: the broadening horizons of clinical laboratory practice (1945-62).

OBJECTIVE: To describe how the field of clinical laboratory science responded to the shortage of qualified laboratory personnel in the 1950s, and to review educators' responses to the changes in clinical laboratory practice. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: Between 1945 and 1962, the demand for certified medical technologists grew as a result of public demand for more health services, including laboratory testing. The shortage of qualified laboratory personnel, coupled with the introduction of new, more complex methods of analysis and the addition of different types of tests gave rise to specialization in each of the clinical laboratory disciplines. These developments also stimulated a renewed interest in creating another class of laboratory worker, the laboratory assistant, who could be assigned to perform simple procedures under the supervision of a certified medical technologist. The broadening horizons of clinical laboratory practice created new opportunities and new challenges for medical technologist educators.

Chemistry, Clinical↗
PubMedDate not supplied

Tracing our roots: a new era in clinical laboratory science education.

OBJECTIVE: To describe the emergence of laboratory personnel at the technician and assistant levels and discuss educational issues that arose between 1962 and 1977. DESIGN: A survey of literature on the history of clinical laboratory science (CLS) was conducted. References consulted include various books and professional journals. CONCLUSION: Advances in scientific and medical knowledge and the development of new technologies created new roles and responsibilities for medical technologists (MTs) in the areas of education, research, and laboratory management. At the same time, the certified laboratory assistant (CLA) category was established as a means of providing competent personnel to work in physician office laboratories and small community hospitals in lieu of a certified MT. The growth in popularity of two-year colleges and the availability of federal funding for the development of allied health programs led to the establishment of yet another category of laboratory personnel: the medical laboratory technician (MLT). These developments prompted educators to modify their CLS curricula, develop educational programs at the CLA and MLT levels, and provide opportunities to CLAs, and MLTs for upward mobility. Furthermore, once the Board of Registry (BOR) established the baccalaureate degree as the prerequisite for MT certification, educators also began to restructure and more closely integrate the academic and clinical components of MT programs.

Education, Professional↗
PubMedDate not supplied

The isolated leader: extraverted and introverted styles.

When an executive moves up the hierarchal ladder in the organization, the promotion is often accompanied by an increasing sense of isolation and loneliness. Goleman, Boyatzis and McKee coined the phrase "CEO disease" to describe the isolation of top executives in their book Primal Leadership. It refers to an information vacuum around leaders, created when people withhold important and sometimes unpleasant information.

Chief Executive Officers, Hospital↗
PubMed2000

Tracing our roots: the rocky road toward recognition of clinical laboratory science's professional status (1962-1977).

OBJECTIVE: To discuss the progress clinical laboratory science made between 1962 and 1977 toward developing and acquiring characteristics associated with the traditional professions of medicine and law. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted included various books and professional journals. CONCLUSION: Between 1962 and 1977, the field of clinical laboratory science experienced many changes. Medical technologists in supervisory positions became more involved in higher management functions, such as organizing and directing laboratory operations. Clinical laboratory science educators developed graduate programs that would prepare faculty for positions in two- and four-year colleges and in hospital-based programs.

Clinical Laboratory Techniques↗
PubMed2001

Tracing our roots: new opportunities and new challenges in clinical laboratory science (1977-1992).

OBJECTIVE: To describe new opportunities and challenges facing clinical laboratory science between 1977 and 1992. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: Between 1977 and 1992 the role of clinical laboratory scientist continued to evolve and expand as new tests and instruments were introduced. Over time, they began to assume greater responsibilities for analyzing and interpreting test results, evaluating and implementing quality assurance programs and new methodologies, and became involved, to a greater extent, in laboratory management and supervision, education, and research. A wide variety of career opportunities were opened to clinical laboratory scientists, providing them with employment opportunities beyond the milieu of the clinical laboratory. Federal regulations aimed at controlling cost of healthcare had a significant effect on the clinical laboratory and clinical laboratory personnel. Stricter guidelines for reimbursement of laboratory services by third-party payees and private insurers forced laboratories to scrutinize their costs and develop creative strategies to attract clients. Attrition, job satisfaction, salaries, and personnel shortages grew in importance during this period as well, prompting research in these areas.

Clinical Laboratory Techniques↗
PubMed1991

[The development of anesthesia in german-speaking regions in the 19th century].

Following the first public demonstration of ether anaesthesia by W.T.G. Morton on October 16, 1846, the pioneers to perform ether anaesthesia in German speaking countries were H. A. Demme, surgeon at the University Hospital Bern, Switzerland, on January 23, 1847, the German surgeon J. F. Heyfelder at Erlangen on January 24, and the Austrian surgeon F. Schuh in Vienna on January 27, 1847. The first books in German language referring to clinical experience with and experimental research on sulphuric ether were published in March/April 1847. After the introduction of chloroform the use of ether anaesthesia rapidly decreased. Chloroform administration was smoother and much more easier not requiring any special apparatus. Chloroform remained the preferred anaesthetic till the end of the century although there happened significantly more deaths due to this agent than to ether. Since 1863 nitrous oxide again was propagated for pain relief in dental practice. German investigators provided pioneering contributions to the development of local and regional anaesthesia. C. Koller, Vienna, was the first to operate on a patient in local anaesthesia with cocaine. The next steps were the introduction of infiltration anaesthesia by C. L. Schleich in 1892/1894 and of spinal anaesthesia by A. Bier in 1899. The ultimate success of local and regional anaesthesia was made possible by using adrenaline with the local anaesthetic (1901) and by the introduction of novocaine in 1905.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗
PubMed1990

[Analysis of hospital morbidity as another tool in the diagnosis of health status].

A descriptive analysis of hospital morbidity generated in our health center during one year was carried out. To this end, the official hospital registry books of the three reference hospitals of our area were used. Overall 1,114 hospital admissions were analyzed; most of them (59.3%) corresponded to young adults (25-44 years). The hospital frequentation rate was 85.8, and it was higher in the district with the lowest socioeconomic status. Mean hospital stay was 8.28 days (range 1 to 120 days). It was higher for individuals over 65 years, in males and in patients with respiratory diseases. The most common causes for admission in diagnostic groups were those related with pregnancy and delivery, followed by respiratory, gastrointestinal and genitourinary disorders. We conclude that the analysis of hospital morbidity is important as an indispensable complement of the diagnosis of the health status of the community, as it discloses several diseases which, despite their frequency and relevance, are often missed to be recorded in daily practice.

Adolescent↗
PubMed1979

Genetic counseling in primary obstetric care.

Of all health professionals the obstetrician is by far the best-equipped to integrate genetic counseling into health care delivery. As with most aspects of the practice of medicine, genetic information increases daily. The practicing obstetrician, by learning the fundamentals of genetics, can at least delineate at-risk situations. When a new situation arises he can either consult an up-to-date article or book 185--190 or refer the patient to the local genetic counseling clinic for further appraisal. By incorporating prospective counseling and in some cases retrospective counseling into his daily practice, the obstetrician can contribute greatly to the ideals of obstetrics, namely producing healthy children for his patients.

Age Factors↗