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PubMed1999

The 1999 Crafoord Prize lectures. The Tithonus error in modern gerontology.

Tithonus asked Aurora for eternal life, when he meant eternal youth. Modern gerontological research makes the same mistake in its preoccupation with death, as if it were a programmed event in an organism's life history. Gerontology ought instead to investigate senescence, the decreasing effectiveness of mechanisms by which adult organisms avoid death or loss of fitness. Such studies should measure rates of decline in a diversity of adaptations and compare them within and between individuals and relate these rates and their correlations to genetic and environmental factors. The death of a studied organism must necessarily end its usefulness in providing valuable data. It is of little scientific significance.

Aging↗
PubMed2005

Explosive radiation of Malpighiales supports a mid-cretaceous origin of modern tropical rain forests.

Fossil data have been interpreted as indicating that Late Cretaceous tropical forests were open and dry adapted and that modern closed-canopy rain forest did not originate until after the Cretaceous-Tertiary (K/T) boundary. However, some mid-Cretaceous leaf floras have been interpreted as rain forest. Molecular divergence-time estimates within the clade Malpighiales, which constitute a large percentage of species in the shaded, shrub, and small tree layer in tropical rain forests worldwide, provide new tests of these hypotheses. We estimate that all 28 major lineages (i.e., traditionally recognized families) within this clade originated in tropical rain forest well before the Tertiary, mostly during the Albian and Cenomanian (112-94 Ma). Their rapid rise in the mid-Cretaceous may have resulted from the origin of adaptations to survive and reproduce under a closed forest canopy. This pattern may also be paralleled by other similarly diverse lineages and supports fossil indications that closed-canopy tropical rain forests existed well before the K/T boundary. This case illustrates that dated phylogenies can provide an important new source of evidence bearing on the timing of major environmental changes, which may be especially useful when fossil evidence is limited or controversial.

Biological Evolution↗
PubMed2005

Recurrent exposure to Histoplasma capsulatum in modern air-conditioned buildings.

BACKGROUND: Between 1989 and 1996, an epidemic of histoplasmosis occurred on a medical school campus. There had been numerous construction projects on the campus that involved previously wooded land and were adjacent to a large bird sanctuary. METHODS: We investigated the epidemic with active surveillance to detect cases, a histoplasmin skin-test survey, inspection of the air-filtration systems of the involved buildings, and cultures of soil samples. The investigation also included a simulation of entry into air-intakes of the buildings from spore sources by means of a wind-tunnel analysis of a model of the campus that used inert gas. After control procedures were instituted, sentinel population groups had follow-up with yearly serological tests. RESULTS: From 1989 through 1996, there were 29 cases of histoplasmosis that occurred among school employees. All cases with a defined onset began during periods of ongoing campus construction. Positivity rates for histoplasmin skin testing were higher among on-campus personnel (47%) than among off-campus employee control subjects (28%) (P<.001); the rates were highest in employees who worked on the upper floors of 2 research buildings. The air-handling units on the roofs of these buildings were not designed to exclude Histoplasma spores. The wind-tunnel experiment indicated that spores aerosolized in the bird sanctuary were not taken into campus buildings. CONCLUSIONS: The major sources of employee exposure to H. capsulatum spores were the construction sites. Low-level, recurrent exposures occurred over several years inside modern research buildings. This phenomenon, which has not been previously described, may play a role in the epidemiology of spore-transmitted diseases in urban settings.

Air Conditioning↗
PubMed2002

The face(t)s of biotech in the nineties: how the German press framed modern biotechnology.

The following article deals with the different images of modern biotechnology created by the German press in the last decade of the twentieth century. To describe these images we have chosen the theoretical concept of framing, which in general denotes the idea that the media deal with certain issues in different ways and that therefore the coverage offers different perspectives to the reader. We understand a frame as a certain pattern of a text that is composed of several different text elements. We assume that some of these text elements group together systematically in a specific way, thereby forming a certain pattern that can be identified across several texts in a sample. These patterns we call frames. By means of cluster analysis we are able to identify not only predefined but also newly emerging frames and the way framing of an issue changes over time. This methodological approach allows us to give a dynamic overview of how the German press dealt with biotechnology in the early and late nineties.

Biotechnology↗
PubMed1996

Bumetha Rukararwe: integrating modern and traditional health care in southwest Uganda.

Rukararwe-Bumetha in southwest Uganda is a community-based program which combines the services of traditional medical practitioners with modern medical services in providing sustainable rural health care. In five years, approximately 50,000 patients have been seen. The clinic is staffed by a trained nurse and a pharmaceutical technician, and visited by doctors from nearby Mbarara University Medical School, all of whom work with traditional herbalists in diagnosing, standardizing dosage and consistency of medicines, and dispensing herbal mixtures, many of which are cultivated in Rukararwe's medicinal plant garden. Conservation of medicinal plants and education are central to the integrated health care services at Bumetha. Community health education emphasizes hygiene and the appropriate use of local medicinal resources. Traditional health practitioners care for the emotional and spiritual, as well as the physical, well-being of their patients.

Ambulatory Care Facilities↗
PubMed2005

The effects of skin temperature and testing site on blood glucose measurements taken by a modern blood glucose monitoring device.

BACKGROUND: Modern blood glucose (BG) monitoring devices (e.g., InDuo [LifeScan, Inc., Milpitas, CA]) require very low blood volumes, allowing for testing at sites other than the traditional fingertip, but the reliability of such testing has not been fully elucidated. The aim of this randomized study was to compare the effects of cold/warm skin temperature combined with alternative site (forearm) testing versus conventional fingertip measurements on fasting and postprandial conditions. MATERIALS AND METHODS: The study population consisted of 19 patients who had previously used InDuo for 6 weeks. Four simultaneous (within 1 min) BG readings (left and right forearm and fingertips) were obtained from each patient 15, 10, and 5 min before eating. Ten minutes before eating, the patient immersed one arm in cold water (15.5 degrees C) and the other in warm water (35 degrees C). At time 0 min arms were removed from water baths, and the patient was offered a standard meal (duration 15 min). Arms were again immersed in water baths, and BG was measured from the same locations 20 min after eating and at subsequent 15-min intervals for 185 min. The effects of site testing and temperature were assessed in this period by identifying maximum BG concentrations (C (max)) and time to C (max) (T (max)). RESULTS: Significantly lower Cmax values were observed for (1) cold forearm versus cold fingertip (mean Delta 28.6 mg/dL, P < 0.001), (2) warm forearm versus warm fingertip (mean Delta 12 mg/dL, P = 0.028), (3) cold fingertip versus warm fingertip (mean Delta 17.2 mg/dL, P = 0.002), and (4) cold forearm versus warm forearm (mean Delta 33.7 mg/dL, P < 0.001). Significantly longer Tmax values were reported for cold forearm versus warm forearm (mean Delta 22.4 min, P < 0.001) and cold forearm versus cold fingertip (mean Delta 20 min, P < 0.001). CONCLUSIONS: These results demonstrate that cold skin and forearm conditions significantly underestimate BG concentrations and delay T(max) compared with warm skin and fingertip measurements.

Blood Glucose↗
PubMed1984

The value of modern non-invasive imaging techniques in the elderly.

Computerized tomography, isotope imaging and ultrasonography are available for the investigation of elderly patients at the Middlesex Hospital. Over a six-month period there were 360 acute admissions to the Geriatric Department and 100 specialist imaging techniques were used in their investigation. The pattern of presentation of these patients and results of specialist techniques are presented. Sick elderly patients should have ready access to modern non-invasive imaging techniques.

Aged↗
PubMed1979

Blood levels of selected nutritional status indicators in young men from a rapidly modernizing society in Abu Dhabi, United Arab Emirates.

Some blood levels of selected indicators of nutritional status were assessed in young adult males among the rapidly modernizing bedouin society of Abu Dhabi. Blood specimens from 30 indigenous army recruits were tested for the following: packed cell volume, total serum proteins, albumin, globulins, serum transferrin, serum calcium (total and ionized), serum iron, and total folates in serum and in red blood cells. A control group consisted of 10 male expatriate laboratory personnel of similar age. Except for iron and folates, all parameters were within normal range. Although the average serum iron was normal, 13.3% of the army recruits were serum iron deficient. The mean serum folate in both groups fell within the indeterminate range with two deficient recruits. The mean red blood cell folate was in the low normal value in the local people with one-third of them in the borderline range, and two deficiencies with no pathological effects. The control group was well within the acceptable normal range of red blood cell folate and the difference between the means of both samples was significant. Inappropriate amounts of vegetables in the diet and prolonged cooking may be the cause of such folate inadequacy.

Adolescent↗
PubMed2004

World Health Organization equations have shortcomings for predicting resting energy expenditure in persons from a modern, affluent population: generation of a new reference standard from a retrospective analysis of a German database of resting energy expenditure.

BACKGROUND: Reference standards for resting energy expenditure (REE) are widely used. Current standards are based on measurements made in the first part of the past century in various races and locations. OBJECTIVE: The aim of the present study was to investigate the application of the World Health Organization (WHO) equations from 1985 in healthy subjects living in a modern, affluent society in Germany and to generate a new formula for predicting REE. DESIGN: The study was a cross-sectional and retrospective analysis of data on REE and body composition obtained from 2528 subjects aged 5-91 y in 7 different centers between 1985 and 2002. RESULTS: Mean REE varied between 5.63 and 8.07 MJ/d in males and between 5.35 and 6.46 MJ/d in females. WHO prediction equations systematically overestimated REE at low REE values but underestimated REE at high REE values. There were significant and independent effects of sex, age, body mass or fat-free mass, and fat mass on REE. Multivariate regression analysis explained up to 75% of the variance in REE. Two prediction formulas including weight, sex, and age or fat-free mass, fat mass, sex, and age, respectively, were generated in a subpopulation and cross-validated in another subpopulation. Significant deviations were still observed for underweight and normal-weight subjects. REE prediction formulas for specific body mass index groups reduced the deviations. The normative data for REE from the Institute of Medicine underestimated our data by 0.3 MJ/d. CONCLUSIONS: REE prediction by WHO formulas systematically over- and underestimates REE. REE prediction from a weight group-specific formula is recommended in underweight subjects.

Adolescent↗
PubMed2002

Traditional versus modern anticoagulant strategies: summary of the literature.

Traditional and modern anticoagulant therapies for the management, prophylaxis, and treatment of venous thromboembolism (VTE) and acute coronary syndrome (ACS) and key findings of primary studies are summarized. Significant advances have been made during the past decade in the prevention and treatment of VTE and the treatment of ACS. Numerous trials have demonstrated that low-molecular-weight heparins (LMWHs) are at least as effective as and have challenged unfractionated heparins (UFHs) as the standard of care for the treatment of VTE and ACS. For VTE, a number of new antithrombotic agents have been developed and are currently under development, including oral direct thrombin inhibitors and synthetic pentasaccharides, such as fondaparinux, in addition to LMWHs. For ACS, various new treatment modalities, such as the broader use of percutaneous transluminal coronary angioplasty and stents, are available, in addition to new pharmacologic agents, such as glycoprotein IIb/IIIa inhibitors and innovative thrombolytics. Most of these agents and treatment modalities require the use of an anticoagulant as adjuvant therapy. Evidence suggests that LMWHs can be used safely and, in addition to being more practical, have been shown to improve outcomes compared with traditional anticoagulants in certain patient populations. LMWHs demonstrate superior clinical outcomes over traditional anticoagulants for VTE prophylaxis and treatment and ACS treatment. Primary studies of new agents, including oral direct thrombin inhibitors and synthetic pentasaccharides for the treatment of ACS are promising; however, more data are needed on their safety and efficacy.

Anticoagulants↗
PubMedDate not supplied

Three days in October of 1630: detailed examination of mortality during an early modern plague epidemic in Venice.

The epidemiology of medieval and early modern European plague remains highly controversial. It now seems likely that the epidemiology was not uniform throughout either the geographic or temporal boundaries of the plague in Western Europe. The Venetian plague of 1630 was extensively documented; day-by-day records were kept, and each mortality in the city was recorded in a set format. The days 23-25 October 1630, representing a period when mortality was beginning to increase sharply, are examined. In all, 1,163 deaths were recorded. They show a large preponderance of women; a mean age of 28, but a majority of cases clumped between ages 0 and 25 years; and an unequal sex ratio among children. Further, there was an identifiable smallpox epidemic raging simultaneously with plague, and more than one-quarter of all the deaths in this period of high mortality were clearly due to nonplague causes. Deaths due to wounds and associated with violence were prominent in one parish, which suggests that in times of plague the breakdown in the normal machinery of government, in everyday patterns of life, and possibly of mental well being resulted in an even more exaggerated death toll. These factors--violence, accidents, and other epidemics--have never been so definitively tied to a European plague epidemic. In addition, there are hints that plague has a marked proclivity to kill pregnant women--their deaths far outnumber those anticipated--and that plague was very localized at a given moment within Venice itself, even during times of peak mortality.

Female↗
PubMed1995

Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era.

Pylephlebitis usually occurs secondary to infection in the region drained by the portal venous system. We describe a case of pylephlebitis at our institution and examine 18 other cases culled from the literature since 1979, reviewing diagnostic and management issues. A precipitating focus of infection (most commonly diverticulitis) was identified in 13 (68%) of the cases. Bacteremia (often polymicrobial) was present in 88% of the patients. The most common blood isolate was Bacteroides fragilis. Overall mortality was 32%, but most of the patients who died had severe sepsis prior to the initiation of antibiotic therapy. In no case was improvement in a patient's clinical status clearly attributable to the use of heparin, but some beneficial effect of anticoagulation could not be ruled out. This report is the first to examine the published experience with pylephlebitis during the era of antibiotics and modern imaging and is also the first to review critically the role of anticoagulation in the management of this disease.

Anti-Bacterial Agents↗
PubMed1989

Modern trends in monitoring in anaesthesia: its benefits and costs.

Many monitoring devices, including peripheral arterial catheters, multichannel electrocardiographs, pulmonary artery catheters, capnographs, and pulse oximeters, have vied for acceptance in modern operating rooms. Considerable costs are associated with the use of these monitors. These costs are not limited to the purchase price of the equipment, but extend to the cost of any complications. The use of new equipment is fostered by the belief that new monitors improve the care of patients. However, for some invasive monitoring modalities, it is difficult to demonstrate clinical benefit.

Anesthesia↗
PubMed2006

Life-years-gained from population risk factor changes and modern cardiology treatments in Ireland.

BACKGROUND: Coronary heart disease (CHD) mortality rates in Ireland have halved since the mid-1980s, and adult life expectancy has also steadily improved. This study estimated the life-years-gained by CHD treatments and by changes in cardiovascular risk factor levels. METHODS: A previously validated Irish IMPACT CHD mortality model was used to integrate large amounts of data on (i) patient numbers, (ii) treatment uptake, (iii) risk factor trends, (iv) effectiveness of cardiology treatments and risk factor reductions, and (v) median survival in patients with and without CHD, all stratified by age and sex. Results were tested in rigorous sensitivity analyses. RESULTS: There were 3763 fewer CHD deaths than expected in 2000 compared with the base year, 1985. This resulted in approximately 44,060 life-years-gained among people aged 25-84. Specific medical and surgical treatments given in 2000 for CHD patients together gained approximately 14,505 life-years. Population changes in cholesterol and smoking levels accounted for some 32,705 life-years-gained, 66% from reductions in cholesterol alone. Adverse changes in obesity and diabetes resulted in a loss of approximately 3670 life-years. CONCLUSIONS: Use of modern cardiology treatments in Ireland from 1985 to 2000 gained many thousands of life-years. However, twice as many life-years were generated by relatively modest reductions in major risk factors. Effective policies, such as the promotion of healthy diets, and weight reduction, together with the recent nationwide workplace smoking ban, will be essential to maintain and further enhance health gain.

Adult↗
PubMed2000

Archaic lineages in the history of modern humans.

An important question in the ongoing debate on the origin of Homo sapiens is whether modern human populations issued from a single lineage or whether several, independently evolving lineages contributed to their genetic makeup. We analyzed haplotypes composed of 35 polymorphisms from a segment of the dystrophin gene. We find that the bulk of a worldwide sample of 868 chromosomes represents haplotypes shared by different continental groups. The remaining chromosomes carry haplotypes specific for the continents or for local populations. The haplotypes specific for non-Africans can be derived from the most frequent ones through simple recombination or a mutation. In contrast, chromosomes specific for sub-Saharan Africans represent a distinct group, as shown by principal component analysis, maximum likelihood tree, structural comparison, and summary statistics. We propose that African chromosomes descend from at least two lineages that have been evolving separately for a period of time. One of them underwent range expansion colonizing different continents, including Africa, where it mixed with another, local lineage represented today by a large fraction of African-specific haplotypes. Genetic admixture involving archaic lineages appears therefore to have occurred within Africa rather than outside this continent, explaining greater diversity of sub-Saharan populations observed in a variety of genetic systems.

Africa↗
PubMedDate not supplied

Attitudes towards reproduction in Latin America. Teachings from the use of modern reproductive technologies.

The use of modern reproductive technology, such as in-vitro fertilization and its related procedures, has opened new areas of legal, religious and public concern. Thirty years ago, the development of effective methods to control procreation generated a debate on whether couples had the right to enjoy sex in the absence of its procreative effect. Today, assisted reproductive technology (ART) allows couples to have their own children in the absence of a direct intermediation of sex. The Catholic Church has reacted against both contraception and ART, and specific instructions have been directed to the public, the medical profession and legislators. In a recent survey, 88.4% of the population in Latin America claims to be Catholic; therefore, bioethical considerations and legal implications concerning intervention in reproduction are strongly permeated by the moral teachings of Catholicism. In 1996, 83 medical doctors and scientists, participating in the Latin American Network of Assisted Reproduction, produced a consensus document on ethical aspects and legal implications of ART. The document contains minimal ethical guidelines that Latin American professionals have decided to adhere to, even in the absence of legal regulations. This article examines how the medical profession, legislators and the public react to religious influence when confronted by difficult bioethical decisions such as the right to procreate.

Catholicism↗
PubMed1976

William Farr: founder of modern concepts of surveillance.

Considerable confusion surrounds the use of the term surveillance in the context of public health but the principles underlying all uses are as old as epidemiology itself. William Farr has contributed more than anyone else to the development of these principles and to the demonstration of their value in practice on a large scale. This paper re-examines the basic tenets which guided him and the methods and techniques which he developed in the hope of reviving insights and resetting standards that modern epidemiologists might, with benefit, strive to emulate.

Adolescent↗
PubMed2003

Two medieval plague treatises and their afterlife in early modern England.

This study of an adaptation of the popular John of Burgundy plague treatise by Thomas Moulton, a Dominican friar, ca. 1475, and a translation of the so-called Canutus plague treatise by Thomas Paynell, printed 1534, shows how the medieval traditions they represent were carried forward, well into the sixteenth century, and also subjected to change in light of religious, moral, and medical concerns of early modern England. The former had a long life in print, ca. 1530-1580, whereas Paynell's translation exists in one printed version. Moulton's adaptation differs from its original and from the Canutus treatise in putting great emphasis on the idea that onsets of plague were acts of divine retribution for human sinfulness. In this respect, Moulton reshaped the tradition of the medieval plague treatise and anticipated the religious and social construction of plague that would take shape in the first half of the sixteenth century. Its long history in print indicates that Moulton's treatise expressed the spirit of that construction and probably influenced the construction as well. The contrasting histories of the two treatises attest not only to the dramatic change brought about by religious and social forces in the sixteenth century, but to a growing recognition of the value of the printing press for disseminating medical information-in forms that served social and ideological ends.

Astrology↗