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This article provides an overview of the articles published on locoregional staging of stomach cancer by endoscopic ultrasonography. For an analysis of the clinical value of EUS in the diagnosis and treatment, the reader is referred to the review books, articles, and consensus statements that are cited.
The Hungarian geographer, archaeologist, and ethnographer Kánitz Félix, great friend and admirer of the Bulgarian people has left valuable and comprehensive information about North Bulgaria and the Balkan Mountain by the end of the Ottoman oppression in his work La Bulgarie Danubienne et le Balkan (1882). The book contains also valuable references concerning the animal breeding activities within the 1860-1880 period in this part of the world. In the mountainous region in Bulgaria sheep- and goat-breeding were well developed, and this accounted to a large extent for the destruction of forests. Numerous and large flocks of sheep were raised in Dobrouja, a portion of which belonged to the famous shepherds of the town of Kotel. During the winter season a great number of flocks from Transylvania were also kept in this region. The breeding of sheep was the main source of meat supply both for North Bulgaria and the Balkan Mount region and for the markets of the Ottoman Empire. It also yielded a total of 120,000 okas of wool (78 okas = 100 kg) annually to meet the needs of the Empire manufacture as centered at that time in the town of Sliven for the production of textiles for the army. The raising of cattle was also prosperous during the same time. On the other hand, stock breeding was unfavourably influenced by heavy taxing in the form of both cash payment and remuneration in kind, by requisitioning (especially in war time) and the endless thefts and robberies done by tatars and cherkesses that had moved to this country from Caucasus. This exploitation concerned equally Bulgarian and Turkish animal breeders.
Multiple sclerosis (MS) is an incurable neurological illness that frequently causes chronic disability. Neurologists broach the diagnosis with dread. "I'll end up in a wheel chair" is the anguished cry of the newly diagnosed and mostly young patients. The past decade has improved our understanding of the immunopathogenesis of MS enormously. This has led to a plethora of clinical trials and the resultant emergence of several new drugs in various stages of development. In 1993, Food and Drug Administration (FDA) approved Betaseron for the treatment of MS. Todate, this is the only drug approved by the FDA, specifically for the treatment of MS. However, it would not be too long before several other drugs are approved, leaving the neurologist bewildered having gone from a state of practically little to offer to a state of several options to choose from. This review discusses the status of current and future therapy in the treatment of MS. Multiple sclerosis (MS) is the most common demyelinating disease of the human central nervous system (CNS). Medline includes over 13000 articles on MS since 1966 that exclude book chapters and other references. MS typically affects the youth and women more than men, between the ages of twenty and forty. Clinically, the illness is characterized into a relapsing-remitting (RR) or chronic progressive (CP) stage although more precisely defined stages exist for research purposes. It tends to follow a highly unpredictable course leading to chronic and sometimes devastating disability. More recently, follow up data suggested that the disease may fall into a pattern after several years. Despite decades of hectic research and better understanding of immunological mechanisms involving human CNS disease, the cause of MS remains unknown. However, it is widely believed that MS is the result of an autoimmune disorder in a genetically susceptible individual, mediated by autoreactive T cells that migrate into the CNS and initiate the inflammatory demyelinating lesion. Regardless of the plausibility of this theory and without going into details, several aspects of immune mediated pathology of MS remain unexplained. This is an attempt to review the status of current therapy and future prospects in the treatment of MS.
PURPOSE: This study is an analysis of Mosby Year Book citations from Ovid Online's Comprehensive Core Medical Library (CCML). The purpose of this study was twofold: (1) to determine whether Year Book citations were more likely to be judged "key" than non-Year Book citations by clinicians; and (2) to determine whether the MEDLINE record of Year Book citations evaluated as key contained objective quality indicators that searchers might use to target key articles. BACKGROUND: As part of the MEDLINE/Full-Text Research Project, health care professionals evaluated search output from CCML on a five-point scale. The scale included the choice "key" for those items which the evaluator would not want to miss. Because the output contained items from the Year Book series, it was possible to determine whether the Year Book items were evaluated as key more frequently than expected. METHODS: This study analyzes the MEDLINE records corresponding to 110 references from the Mosby Year Book series evaluated as key by clinicians receiving search output from CCML. The records were examined for the presence of such searchable elements as Medical Subject Headings (MeSH) terms and publication types related to study design, evidence of research support, inclusion in the Abridged Index Medicus (AIM) subset, and a comments field. Also noted were the presence of a structured abstract, study design details in the author abstract, and inclusion in more than one Year Book. RESULTS: A chi-square test (p < .001 indicated that the proportion (33%) of Year Book citations marked key on the searches was significantly higher than that of non-Year Book citations (18%). When the occurrence of the searchable elements was compared to MEDLINE as a whole, the following access points appeared more frequently in the key Year Book records: study design terms categorized under epidemiologic methods in the MeSH Tree Structures; the checktag comparative study; AIM subset; comments field; and, publication types (pt) clinical trial, randomized controlled trial, multicenter study, and meta-analysis. CONCLUSIONS: These searchable elements should be helpful in targeting some, but not all, key articles in MEDLINE.
Children with ADHD have difficulty understanding causal connections and goal plans within stories. This study examined mediators of group differences in story narrations between children ages 7-9 with and without ADHD, including as potential mediators both the core deficits of ADHD (i.e., inattention, disinhibition, planning/working memory) as well measures of phonological processing and verbal skills. Forty-nine children with ADHD and 67 non-referred children narrated a wordless book and completed tasks assessing the core deficits of ADHD, phonological processing, and verbal skills. Results revealed that, although no shorter than those of non-referred children, the narratives of children with ADHD contained fewer elements relating to the story's causal structure and goal plan. Deficits in sustained attention accounted for the most variance in these differences. Results have implications for understanding and ameliorating the academic problems experienced by children with ADHD.
In the absence of Spanish journals and publications with a high impact factor and since one of the primary reasons to obtain such an impact is the frequency with which the publication is referenced, we wanted to check the general belief by which even in the Spanish journals the proportion of national articles that get referenced is very small. We reviewed all articles published by Actas Urológicas Españolas during 1989 and 1990 (12 issues, 246 articles with 4,549 references), and found that only 14.42% of references were from publications or books edited in Spain or at congresses held within Spain. After excluding books and communications originates in congresses, the figure is 10.9%. On the other hand, we noticed that over 25% articles do not include one single Spanish reference. Finally, the publication most often consulted is the USA Journal of Urology, which approaches some 20% of all mentions.
The amount of Norwegian specialist literature for general practice is increasing. In this article we discuss 16 requirements that should be considered when producing new books for general practice. These requirements refer to four main areas: --We should prove that the general practitioner needs the book --The book should develop the theoretical and professional basis of general practice --The book should develop the practical and concrete contents of general practice --The book should have a presentation which makes the information easily accessible to a busy general practitioner.
The Biblical Book of Job is a wisdom book. Wisdom, in this context, refers to the intellectual discipline taught by the sages of ancient Isreael to provide professionals with a realistic approach to the problems of life. Chapter 30 of the Book of Job is a key-index of ideas that, if followed through the book, discloses a modern scientifically accurate description of a depression that, at times, was life-threatening. There are practical clinical clues to distinguish between normal mourning and depression, as well as aids to the differential diagnosis of somatic symptoms that may arise from depression. A timeless model of the scope and limitations of the professional relation between patient and comforter is also presented. Part of the wisdom of the Book of Job is to use depression as an example of a life-threatening illness to provide an unexcelled standard of clinical observation and medical intervention.
BACKGROUND: Hip fracture is a major cause of morbidity in older people and its impact, both on the individual and to society, is substantial. OBJECTIVES: To examine the effects of co-ordinated multidisciplinary inpatient rehabilitation, compared with usual orthopaedic care, for older patients with hip fracture. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group trials register, Medline (up to April 1998), and reference lists of published papers and books. We also contacted colleagues and trialists. SELECTION CRITERIA: Randomised and quasi-randomised trials of postsurgical care using specialised rehabilitation of mainly older patients (aged 65 years or over) with hip fracture. DATA COLLECTION AND ANALYSIS: Trial assignment to included, excluded and awaiting assessment categories, was by consensus. Two reviewers independently assessed trial quality and extracted data. Limited additional information was sought from most trialists. As well as pooling of data from primary outcomes, supplementary analyses were performed to combine clinically relevant outcomes and investigate possible explanatory factors. MAIN RESULTS: In this minor update, one new trial is identified and has been placed in "studies awaiting assessment". Of another three trials previously pending assessment, one has now been excluded. The five included trials involved 1068 patients. The combined outcomes of death or requiring institutional care at final follow-up showed no significant difference between intervention and control groups (Peto odds ratio 0.92; 95% confidence interval 0.71 to 1.18). There was considerable heterogeneity in length of stay and cost data. Using death and deterioration in function as a further combined outcome variable yielded a Peto odds ratio of 0.83 (95% confidence interval 0.64 to 1. 07). This should be interpreted with caution due to heterogeneity. No quality of life measures were reported and the two trials investigating carer burden showed no detrimental effect from the intervention. The review update did not result in any new data for these outcomes. REVIEWER'S CONCLUSIONS: The trials reviewed had different aims, interventions and outcomes. As a consequence, results were heterogeneous and the question of effectiveness of different types of co-ordinated inpatient rehabilitation after hip fracture cannot be answered conclusively. There is a trend to effectiveness when combined outcome variables (death and institutional care, death and deterioration in function) are considered. Future trials of postsurgical care involving inpatient rehabilitation, or other models such as 'early supported discharge' and 'hospital at home' schemes, should aim to establish both effectiveness and cost effectiveness of multidisciplinary rehabilitation overall, rather than attempt to evaluate its components.
A cross-sectional survey of U.S. Army primary care physicians was done to answer two questions: (1) which medical reference materials are Army primary care physicians currently using when deployed to a field environment? and (2) what would they like to have for medical reference in a field environment? Of 740 surveys delivered to their intended recipients, 445 (60%) were returned. Currently, 96% of primary care physicians use books, 37% use journals, and 11% use computer software in their medical reference database. Of those now using books, 72% were satisfied with them, compared with 61% of those using journals and 45% of those using software. The most common book used was the Merck Manual. The most important characteristics desired in a field medical database were broad coverage, ease of use, and light weight. The majority of respondents believe that a good medial reference database is important but that current medical databases limit the quality of the medicine they practice in the field.
Selected outstanding books from the older literature on gynecologic pathology are reviewed with emphasis on drawing attention to the abundant helpful information and often outstanding illustrations that are worthy of review by present-day pathologists. This represents a follow up to a previous similar essay that appeared in Volume 19:67-84, 2000. The first three books cover general gynecological pathology: Gynecological Pathology by Carl Abel; Gynecological and Obstetrical Pathology by Robert T. Frank; and Haines and Taylor's Gynaecological Pathology by Magnus Haines and Claud W. Taylor. Each of them emphasizes the time-honored problem of mimicry of malignancy by diverse benign lesions or even aspects of normal histology. Awareness of the clinical background and cooperation between the clinician and pathologist are emphasized. The other three books considered are all devoted largely or exclusively to the ovary: Ovarian Tumors by Hans Selye, Ovarian Neoplasms, Morphology, and Classification by Karel Motlik, and Special Tumors of Ovary and Testis and Related Extragonadal Lesions by Gunnar Teilum. The book of Selye has a truly remarkable encyclopedic coverage of the older literature, the references being so comprehensive that they are presented in a separate volume. A number of aspects of the histopathology of ovarian tumors that have been emphasized in recent years are noted in Selye's book. Dr. Motlik's book presents a very high quality consideration of the differential diagnosis of ovarian tumors. Teilum's book contains a masterful account of the histopathology of germ cell tumors emphasizing a neoplasm with which his name will always be associated, the yolk sac tumor (endodermal sinus tumor). Numerous beautiful and refreshingly large illustrations are provided, and Dr. Teilum's interest in comparative pathology is evident in the pages, his linking of the famous Schiller-Duval bodies with the endodermal sinuses of the rat placenta, being the most notable example.
Few works serve as solid a framework for the field of health sciences librarianship or provide as many insights and detailed knowledge as Introduction to Reference Sources in the Health Sciences. Now in its fourth edition, the book's editors and contributors represent an impressive range of experience, expertise, and subject knowledge appreciated by practicing librarians in a variety of settings and by students of health sciences librarianship. Jo Anne Boorkman, Jeffrey T. Huber, and Fred W. Roper answered a series of questions about the latest edition of this seminal work, and offered opinions about reference works, services, and librarians.
PURPOSE: The aim of the present study was to elucidate the trends in drug interactions for pharmaceutical products in Japan by examining safety profile updates. METHODS: All 12 422 prescription drugs currently on the Japanese market were included in the study. Revisions to their product information (or package insert: PI) were investigated from January 2000 to December 2003. The publication 'Drug Safety Update,' which is a summary of the revisions made to the precautions in PIs and is issued by The Society of Japanese Pharmacopoeia and The Federation of Pharmaceutical Manufacturers' Associations of Japan under the supervision of the Ministry of Health, Labour and Welfare (MHLW), was used as a data source. The revised drug interactions were categorized according to measures, mechanisms, and evidence from published references. RESULTS AND CONCLUSIONS: The results revealed 426 new interactions, including 75 contraindicative combinations, during the survey period. About 45% and 27% of the new interactions involved metabolic and pharmacological processes, respectively, with metabolic interactions involving cytochrome P450 3A4 being the dominant reason for the revision of PIs. Only 37% of the new interactions cited scientific journals and/or books, and 58% of these references cited were published more than 5 years prior to the date of revision. In conclusion, metabolic interactions were the major reasons for the update of safety information after 2000. Published references should be provided in order to assist with clinical management and avoid the undesirable effects of new drug interactions.
All new patients attending a Dublin Hospital's Accident and Emergency (A&E) Department were surveyed to document their reasons for attending and to make comparisons between self-referred and GP referred groups. Of the 557 responders 395 (70.9%) were self-referred. Four-fifths of this group said they had a GP but only 6.6 per cent attempted to contact the GP before attending. Compared with GP referred patients the self-referred group were more likely to be under 45 (74.6 per cent v 59.8 per cent, P < 0.01) and have soft tissue injuries (57 per cent v 32.9 per cent, P < 0.01). They were less likely to require laboratory investigation or to be admitted to hospital (11 per cent v 31.2 per cent, P < 0.01). It is likely many of the self-referred patients could have been managed by a GP. However, A & E departments remain popular sources of treatment for patients with a wide variety of conditions. Current methods of delivering health care to patients with minor conditions require assessment so that patient demands for both a responsive minor injury and emergency service can be met. Almost 70 per cent of all hospital admissions originated from the A&E department. This makes rational planning and management of booked admissions difficult. GPs who refer patients for admission should have an alternative route to hospital beds besides the A&E department.
BACKGROUND: The profile of HIV infection is constantly changing. Although once viewed as an illness progressing to death, HIV infection now presents as a chronic infection characterized by unpredictable cycles of wellness and illness. Thus, the needs of this population have increasingly included management of impairments, disabilities and handicaps. Exercise is a key management strategy employed by rehabilitation professionals to address these issues. Exercise has been shown to improve strength, cardiovascular function, and psychological status in seronegative populations (see Eds., Bouchard, C., Shephard, R.J., & Stephens, T. (1993). Physical Activity, Fitness, and Health. Champaign, IL: Human Kinetics Publishers.) But what are the effects of exercise for people living with HIV infection? If the risks and benefits of exercise for people living with HIV infection are better understood, appropriate exercise prescription may be practiced by health care providers. Improved exercise prescription may enhance the effectiveness of HIV management, thus improving overall outcomes for people living with HIV infection. OBJECTIVES: To examine the effect of aerobic exercise interventions on cardiopulmonary, immunologic and psychological parameters in adults living with HIV infection. SEARCH STRATEGY: Studies were identified using MEDLINE, EMBASE, SCIENCE CITATION INDEX, AIDSLINE CINAHL, HEALTHSTAR, PSYCHLIT, SOCIOFILE, SCI, SSCI, ERIC, DIA and abstracts from international AIDS meetings, ICAAC, and other major meetings. Reference lists from pertinent articles and books and personal contact with authors were also used, as were Collaborative Review Group databases and results of hand searching of targeted journals. All languages were included. Searches covered the period from 1980 to July 1999. SELECTION CRITERIA: For inclusion, studies had to be randomized control trials involving HIV+ adults 18 years of age or older and had to include at least one group randomized to receive aerobic exercise performed at least three times/week for at least four weeks. DATA COLLECTION AND ANALYSIS: Data on study design, participants, interventions, and outcomes were extracted from the reports onto specifically designed data collection forms by at least two reviewers. MAIN RESULTS: Six studies satisfied the eligibility criteria. The main results indicated that performing constant or interval aerobic exercise for at least 20 minutes, at least three times per week for four weeks may lead to increased CD4 count, improved cardiopulmonary fitness, and improved psychological status. These findings are limited to those who continued to exercise and for whom there was adequate follow-up data. REVIEWER'S CONCLUSIONS: Aerobic exercise appears to be safe and may be beneficial for adults living with HIV/AIDS. These findings are limited by the small sample sizes and large drop-out rates of the included studies. Further research is required to determine the optimal parameters of aerobic exercise and stage of disease in which aerobic exercise may be most beneficial for adults living with HIV infection.
About one-third of published nursing articles have some type of error in the references. Authors need to ensure that references are accurate before submitting the manuscript to the journal or book publisher. This author who has conducted research on reference errors and is an experienced author gives you practical steps to prevent errors in your manuscript.
The main goal of this descriptive exploratory study with a quantitative approach is to present the number of patients severely burned in alcohol plastic bottle explosions that have been cared for between 2000 and 2002 by the nursing staff of a Rio de Janeiro hospital that is a reference for the treatment of this kind of accident. The data was gathered from the nursing note book. The authors emphasize that the media refers to these victims as "burned by alcohol" rather than "burned by a bomb", since alcohol plastic bottles are potential bombs. The authors conclude that much suffering could be avoided through an effective, clear, and above all responsible communication.
Clinical research databases can meet both research and clinical needs, but this ideal is seldom achieved. Priorities often differ for those who collect and ultimately use the data and those who develop data systems. Traditional database designs also create logistical barriers that hamper communication. The Michigan Alzheimer's Disease Research Center has developed a secure, distributed data system with centralized data entry that provides an intuitive, individually customized interface for investigators in their clinics, laboratories and offices. Data are kept in a form that can be readily understood without reference to a code-book. Investigators can modify and query their own copies of the database without knowledge of programming languages. Balancing centralized and distributed designs for research databases enhance the accuracy and completeness of data collection and increases the use of data for research and clinical care.