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PubMed1996

Suggestions for the construction, analysis and use of descriptive epidemiological models for the modernization of meat inspection.

There is consensus that scientifically validated, quantitative assessments of actual public health risks are a prerequisite for any sound modernization of current meat inspection procedures. This article outlines how such analyses could be conducted. Approaches that rely heavily upon extrapolations from theoretical dose-effect relationships are inadequate for the assessment of microbiological health risks associated with the production and consumption of meat. The use of highly structured and very elaborate descriptive epidemiological models covering the entire period from stable to table can be considered a promising solution. Health risks can be quantified by means of incidence rates and the influence of risk factors by means of odds ratios and (population) attributable fractions. A great advantage is that when it is not possible to quantify risks exactly, the descriptive models are detailed enough to be used in a hazard analysis critical control point (HACCP)-like approach and for writing validated codes of good manufacturing practice (GMP). There are, however, several conditions which have to be met before risk assessment can become the foundation of safety assurances for meat, such as active legislative support and the setting up of monitoring systems for zoonoses and other health hazards in animals and humans.

Data Collection↗
PubMed1991

Modern strategies in the prevention of polymer-associated infections.

Foreign body infections continue to present a challenge to modern medicine. New aspects for the prevention of such infections are presented on the basis of modifying medical devices or implant materials (synthetic polymers). Physicochemical treatment of polymer surfaces is a possible tool to create anti-adhesive and thus anti-infective surfaces. Coupling or incorporation of antimicrobial substances to or into polymers is another way to prevent bacterial colonization and subsequently the development of polymer-associated infections.

Anti-Bacterial Agents↗
PubMedDate not supplied

Bioassays in modern peptide research.

Bioassays have been used in pharmacology since its beginning, nearly one hundred years ago. With the recent development of new techniques such as radioreceptor assays, radioimmunoassays, high pressure liquid chromatography (HPLC) and recombinant DNA technology, it might be asked if bioassays are still up-to-date in a fast moving field like peptide research? This brief review describes the possible uses of bioassays as well as the basic criteria used to characterize a bioassay. Recent results obtained with bioassays for various peptides will demonstrate the importance of this technique in modern peptide research.

Animals↗
PubMed1984

The versatility of modern therapy in mid-facial trauma.

Modern trends in the therapy of mid-facial trauma, which include the use of miniplates, wire osteosynthesis, and suspension wiring, bone transplantation from the contra-lateral canine fossa for orbital floor reconstruction, as well as the use of lyophilised dura placed over bony defects, are briefly discussed. The versatility of the combined techniques used in therapy has been illustrated by a case.

Adult↗
PubMed1991

Modern chemotherapeutic regimens in the management of aggressive non-Hodgkin lymphoma: can they be improved?

Major advances in the treatment of aggressive NHL have occurred in the last 20 years. Modern combination chemotherapy provides a complete remission in a majority of patients and cures a significant number of these patients. Treatment failures are a consequence of the existence or development of resistant disease and regimen related toxicity. Identification of mechanisms of tumour resistance and prognostic factors, together with consideration of regimen related toxicity, should aid in the optimal application of currently available agents and regimens and guide the development of future regimens. Novel delivery systems may allow more tumour specific therapy in the future.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

The relevance of traditional medical cultures to modern primary health care.

This paper attempts to identify forms of traditional medicine which have the greatest potential for advancing primary health care goals. It begins by differentiating traditional medical systems into types, according to the kinds of medical knowledge which they depend on for preventing, diagnosing, and treating sickness. Emphasis is given to the facts that some traditional systems concentrate on producing varieties of pathophysiological knowledge, while others focus on forms of etiological knowledge; and that some traditional systems accumulate the medical knowledge which they produce, while others diffuse and fragment it. These differences give clues to a medical tradition's abstract potential for achieving three distinct, and only sometimes linked, ends: curing disease, healing illness, and enhancing the productivity of official primary health care programs. To make these clues concrete, it is also necessary to know something about the different ways in which traditional medical beliefs and practices are embedded, together with modern (cosmopolitan) medicine, in actual patterns of resort. The remainder of the paper assesses the relevance, for advancing primary health care goals, of particular classes of traditional healers--e.g. herbalists, midwives, bonesetters--and technologies within different types of medical systems. Four possibilities are described; integration, complementarity, rivalry and intercalation.

Diagnosis↗
PubMed1984

Traditional healers in Swaziland: toward improved cooperation between the traditional and modern health sectors.

The paper describes applied research efforts, requested by the Swaziland Ministry of Health and funded by U.S. AID, aimed at providing an information base for new government policies regarding traditional healers in Swaziland. Information reported relates to: health care manpower in the traditional sector; treatment seeking behavior in a pluralistic medical setting; traditional health beliefs and practices; payment practices; patterns of patient referral; attempts to establish an association of healers; attitudes of healers toward paraprofessional training; and possibilities for specific types of cooperation between modern and traditional health sectors.

Allied Health Personnel↗
PubMed1984

Dilemmas of modernization in primary health care in Western Samoa.

This paper examines the historical development of rural women's associations (komiti tumama) in Western Samoa under New Zealand's colonial administration. These associations came to be the backbone of public health programmes and played a crucial role in preventive medicine at the village level: they embodied all the principles now subsumed under the rubric 'primary health care'. The successful growth of a rural, self-help system of primary health care in Samoa resulted from the use of traditional institutions to promote new practices in sanitation and health care. The system rewarded and fostered village autonomy and enhanced the status of married women. This paper argues that a stagnation in community-based health programmes linked in part to an increasing unwillingness of rural women's associations to support such programmes has occurred most particularly in the past decade. It is proposed that this stagnation may be related to overall problems of modernization in the Western Samoan economy, professionalization and bureaucratization of the national health services, and the ritualization of certain key practices (such as the inspection of village sanitation) in preventive medicine by rural women. The consequences of the stagnation for rural people have been a greater dependence upon curative medical services, and a loss of clearly defined roles for women's institutions in primary health care. The historical drift has been away from rather than towards the PHC model as espoused today by the World Health Organization and as initiated by the New Zealand administration in colonial times.

Cultural Characteristics↗
PubMed1985

Holistic medicine and technology: a modern dialectic.

This is an attempt to present a comprehensive overview of two major trends in American medicine which suggests significant evolutionary biopsychosocial developments in the remaining decades of the 20th century. Comments have been confined to the U.S. because it is the geographical country of residence and practice of the authors, and because the U.S. appears to be the locus of two contemporaneous and seemingly antithetical popular movements: quantum leaps in the development and use of medical technology and a groundswell of interest and enthusiasm for health enhancement or wellness which advocates a natural approach to health and emphasizes the central role of the individual in the preservation of health and the prevention of illness. The dynamics of this modern dialectic in American medicine have generated important qualitative consequences in the nature of the doctor-patient relationship and the delivery of health care. They have also, it is submitted, generated the search for a new paradigm which will permit a workable equilibrium between the disparate imperatives of both movements. The delicate process of developing that equilibrium is made more difficult by the co-existence of a host of complex factors, many of which are inextricably interwoven with one or the other of these two major trends.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1991

A model for diurnal patterns of carbon fixation in a Precambrian microbial mat based on a modern analog.

Microbial mat communities are one of the first and most prevalent biological communities known from the Precambrian fossil record. These fossil mat communities are found as laminated sedimentary rock structures called stromatolites. Using a modern microbial mat as an analog for Precambrian stromatolites, a study of carbon fixation during a diurnal cycle under ambient conditions was undertaken. The rate of carbon fixation depends primarily on the availability of light (consistent with photosynthetic carbon fixation) and inorganic carbon, and not nitrogen or phosphorus. Atmospheric PCO2 is thought to have decreased from 10 bars at 4 Ga (10(9) years before present) to approximately 10(-4) bars today, implying a change in the availability of inorganic carbon for carbon fixation. Experimental manipulation of levels of inorganic carbon to levels that may have been available to Precambrian mat communities resulted in increased levels of carbon fixation during daylight hours. Combining these data with models of daylength during the Precambrian, models are derived for diurnal patterns of photosynthetic carbon fixation in a Precambrian microbial mat community. The models suggest that, even in the face of shorter daylengths during the Precambrian, total daily carbon fixation has been declining over geological time, with most of the decrease having occurred during the Precambrian.

Bacteria↗
PubMed1991

Analysis of 105 patients admitted over a 2-year period to a modern burns unit in Saudi Arabia.

This is an epidemiological survey of 105 burned patients treated between May 1986 and May 1988 in a modern Burns Unit in Saudi Arabia. Hospitalization time ranged from 1 to 100 days with a mean of 17 days. The mean age of the patients was 9 years. Sixty (57 per cent) of the patients were males and 45 (43 per cent) were females. The main causes of injury were hot liquids (57.7 per cent) and fire (33 per cent). The mean extent of injury was 19 per cent TBSA. Burns covered less than 40 per cent TBSA in 91 out of 105 patients (87 per cent). Deep burns did not exceed 100 units of burned skin in 48 out of 55 patients (87 per cent). Urgent escharotomy was done in 14 patients. Early excision and skin grafting was carried out in 34 patients. Complications included six cases (5.7 per cent) with septicaemia, one (0.9 per cent) with disseminated intravascular coagulopathy, three (2.9 per cent) with amputation and one (0.9 per cent) with stress gastric ulcer. Seven patients discharged themselves against medical advice. Five patients died. The favourable results in this series were attributed mainly to the low severity of burns and partially to the short delay between injury and admission, early surgery and remarkably good facilities. Childhood scalds in this region of the world could possibly be reduced by changing the family habit of having tea at floor level and recommending wide-based tea-pots.

Adolescent↗
PubMed1993

Light variability in the modern neonatal nursery: chronobiologic issues.

The role that nursery light variability may play in modulating infant biological rhythms is being studied in Stanford Medical Center's Neonatal Intensive Care (NICU) and Intermediate Care (IN) Nurseries. In this investigation, spatial and temporal variability in illuminance was determined at 20 sites within each nursery over a 5-day period. The analysis of 240 measurements at 30 min intervals from each site revealed marked variability in illumination with respect to both time and position in the nursery. These aperiodic lighting patterns differed greatly from the published characterization of NICUs as having 'constant' illumination. Light pulses of variable frequency, intensity, and duration were common at each of the 40 bedsites studied. Given the powerful impact of light on circadian rhythmicity and sleep in adults, the results from this study suggest that modern NICU lighting, while implemented to facilitate intensive care, may have adverse effects on infant development. Future studies on the influence of light on biological rhythmicity and sleep are essential to provide a framework for clinical and environmental interventions, which may play a significant role in improving developmental outcome in hospitalized preterm or term infants.

California↗
PubMed1994

From the common cold to cancer: how evolution and the modern lifestyle appear to have contributed to such eventualities.

This hypothesis suggests that psychosocial stress is the pivotal determinator of many modern day disorders in consequence to consuming today's nutritional intakes of ascorbic acid and sodium. For it seems, as a result of our tropical African evolution, present day intakes of these essential nutrients are incompatible with the maintenance of bodily homeostasis when the body is subjected to any form of stress. In addition, the climatic conditions under which most of us live are seemingly ill-suited to experiencing stress, since it appears that a constituent part of the bodily stress response remains exclusively designed to be effective in a hot tropical environment, where the stress can be expected to be accompanied by thermoregulation sweating and an overheated body. For without such an occurrence coinciding with stress, the stress response itself appears to have been transposed into a reaction that inhibits the body's ability to resist infection and disease.

Ascorbic Acid↗
PubMed1994

Is weekly port filming adequate for verifying patient position in modern radiation therapy?

PURPOSE: The objective of this study is to use daily electronic portal imaging to evaluate weekly port filming in detecting patient set-up position. METHODS AND MATERIALS: A computer-based portal alignment method was used to quantify the field displacements on 191 digitized weekly port films and 848 daily electronic portal images in 21 radiation therapy patients. An electronic portal image data set as a control for actual daily treatment position was used to evaluate weekly port films with respect to same-day field displacement, rate of field placement error detection, and prediction of subsequent daily field displacements. RESULTS: The field displacements measured on a port film frequently deviated from the corresponding field displacements on the electronic portal image obtained in the same treatment set-up. A linear regression analysis showed that the curves fitted to the same-day field displacements had slopes that differed significantly from unity (p < 0.001). Overall, the respective frequencies of field placement error, beyond clinical tolerance limits of 5, 7, and 10 mm (corresponding to head and neck, thoracic, and pelvic sites) for port filming and electronic portal imaging were 11% and 14% (p = 0.4) in the X-direction (lateral or anteroposterior) and 24% and 13% (p = .0001) in the Y-direction (caphalad-caudad). When the data were broken down by anatomical region, this discrepancy was found to be mainly due to the differences in the thorax, and head and neck image data sets. For thoracic fields, error in Y-shifts was 28% by port filming, but only 9% by portal imaging (p = 0.01). In the head and neck region, 18% of the port films exceeded tolerance, whereas only 6% of the electronic portal images did (p = 0.0001). Field displacements on the treatment set-ups between the acquisition of port films were not predicted by those films. CONCLUSION: There are discrepancies between the field displacements and field placement errors detected by weekly port films and daily electronic portal images. This study suggests that improved methods of treatment verification may be necessary in modern radiation therapy.

Diagnostic Imaging↗
PubMed1996

Analysis of non-linear cochlear mechanics in the marsupial Monodelphis domestica: ancestral and modern mammalian features.

The acoustic distortion product 2f1-f2 was measured in the ear canal of the gray short-tailed opossum. Monodelphis domestica, during stimulation with two pure tone stimuli of the frequencies f1 and f2 (f1 < f2). From 2f1-2f growth functions for different primary frequencies from 4 to 85 kHz, a distortion threshold curve was obtained describing the relative threshold of non-linear mechanical processes in the cochlea. Distortion products could be measured over the entire investigated frequency range and the distortion audiogram proved sensitive (thresholds < 20 dB SPL) over a wide range from 8 to 55 kHz with a broad minimum around 17.5 kHz. Thresholds steeply increased for frequencies below 8 kHz which can be regarded as an original mammalian feature (Heffner and Masterton, 1980). To assess the tuning characteristics of the cochlea, suppression tuning curves of 2f1-2f were measured. The shape and tuning sharpness of these curves resembled that of modern eutherian mammals with a shallower low-frequency and a steeper high-frequency flank and Q10dB values between 2.4 and 7.12. The optimum primary ratio f2/f1 (best-ratio) was on average 1.172. For f2 frequencies between 20 and 30 kHz the ration curves displayed multiple peaks in periodic intervals. The same peaks were also evident for higher-order distortions (3f1-2f2, 4f1-3f2). It is discussed to which extent this finding is consistent with the second filter theory of Brown et al. (1992) and Allen and Fahey (1993) and how in Monodelphis domestica this filter could work differently, possibly representing a less evolved stage, than in eutherian mammals.

Acoustic Stimulation↗
PubMed1984

Pharmacognosy: the oldest modern science.

The use of drugs goes back to time immemorial, ever since primitive man resorted to the world around him to derive remedies which could alleviate pain and cure illnesses. The knowledge of drugs has developed together with the evolution of scientific and social progress. After a rapid historical review on the use of medicinal drugs in the diverse civilizations and on the origin and introduction of the term Pharmacognosy, the acquisitions of modern experimental Pharmacognosy in different countries of the world, and its contribution to therapy are briefly discussed.

China↗
PubMed1986

The Aloe vera phenomenon: a review of the properties and modern uses of the leaf parenchyma gel.

The mucilaginous gel from the parenchymatous cells in the leaf pulp of Aloe vera has been used since early times for a host of curative purposes. This gel should be distinguished clearly from the bitter yellow exudate originating from the bundle sheath cells, which is used for its purgative effects. Aloe vera gel has come to play a prominent role as a contemporary folk remedy, and numerous optimistic, and in some cases extravagant, claims have been made for its medicinal properties. Modern clinical use of the gel began in the 1930s, with reports of successful treatment of X-ray and radium burns, which led to further experimental studies using laboratory animals in the following decades. The reports of these experiments and the numerous favourable case histories did not give conclusive evidence, since although positive results were usually described, much of the work suffered from poor experimental design and insufficiently large test samples. In addition some conflicting or inconsistent results were obtained. With the recent resurgence of interest in Aloe vera gel, however, new experimental work has indicated the possibility of distinct physiological effects. Chemical analysis has shown the gel to contain various carbohydrate polymers, notably either glucomannans or pectic acid, along with a range of other organic and inorganic components. Although many physiological properties of the gel have been described, there is no certain correlation between these and the identified gel components.

Aloe↗