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[MEDLARS. A biomedical retrieval system].
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A quantitative ranking of Canada's research output of original human studies for the decade 1989 to 1998.
BACKGROUND: Since 1987 research articles have been catalogued with the author's affiliation address in the 40 databases of the Medical Literature Analysis and Retrieval System (MEDLARS) of the National Library of Medicine, Bethesda, Md. The present study was conducted to examine the Canadian entries in MEDLARS to interpret past and future trends and to combine the MEDLARS demographic data with data from other sources to rank Canadian research output of human studies both nationally and internationally. METHODS: The PubMed Web site of the National Library of Medicine was used to count medical articles archived in MEDLARS and published from Jan. 1, 1989, through Dec. 31, 1998. The articles attributed to Canadian authors were compared by country, province, city, medical school, hospital, article type, journal and medical specialty. RESULTS: During the study period Canadian authors contributed on average 3% (standard deviation [SD] 0.2%) of the worldwide MEDLARS content each year, which translated to a mean of 11,067 (SD 1037) articles per year; 49% were human studies, of which 13% were clinical or controlled trials, and 55% involved people aged 18 years or less. In total, 68% of the articles were by authors affiliated with Canadian medical schools; those affiliated with the University of Toronto accounted for the greatest number (8604), whereas authors affiliated with McGill University had the greatest rate of annual increase in the quantity published (8%). Over one-third (38%) of the articles appeared in Canadian journals. When counted by specialty, 17% of the articles were by authors with clinical specialties, 5% by those with surgical specialties and 3% by those with laboratory specialties. INTERPRETATION: The annual rate of increase in research output for Canada was more than 3 times higher than that seen world wide. Canada is now ranked seventh among countries contributing human studies to MEDLARS. The increase indicates that Canada's medical schools are productive, competitive in making contributions to medical science and are supporting Canadian journals.
Sensitivity of frozen section examination of pelvic lymph nodes for metastatic prostate carcinoma.
BACKGROUND: A Total Quality Improvement review of frozen section diagnoses yielded four sequential false-negative frozen section diagnoses in lymph nodes in the evaluation of metastases from prostate carcinoma. Because these results appeared to differ from the department's overall frozen section experience, frozen section diagnoses of pelvic lymph nodes in patients with prostate carcinoma were reviewed to benchmark the department's performance. METHODS: All 220 pelvic lymph node frozen section samples from 110 patients with prostate carcinoma from January, 1986 to July, 1993 at Bridgeport Hospital (BH) were reviewed, and the department's frozen section diagnostic efficiency was compared with: (1) all BH frozen section procedures performed during the same period; (2) pelvic lymph node frozen section analysis and (3) imaging techniques for prostate carcinoma from other institutions found in MEDLARS literature searches from 1973 to 1993. RESULTS: Frozen section diagnostic efficiency for patients with prostate carcinoma from BH was 93.6% (sensitivity 63.2%, specificity 100%) compared with (1) 98% for all BH frozen section analyses (sensitivity 99%, specificity 98%); (2) 90.1% for MEDLARS search pelvic lymph node frozen section prostate carcinoma analyses (sensitivity 66.5%, specificity 100%); and (3) 88% for MEDLARS search magnetic resonance imaging (MRI) pelvic lymph node prostate carcinoma (sensitivity 41%, specificity 97%). CONCLUSIONS: Frozen section diagnosis of pelvic lymph nodes approaches the overall diagnostic efficiency of frozen section analysis and is more sensitive for the diagnosis of prostate carcinoma in pelvic lymph nodes than is MRI because more than half of the metastases are smaller than the 1.0-cm resolution limit of the MRI. False-negative frozen section diagnoses (67% sensitivity) occur because of errors in sampling microscopic metastases.
Development of a medical specialty recurring bibliography--Index of Rheumatology.
The Index of Rheumatology is a newly-developed, recurring bibliography produced by the Medical Literature Analysis and Retrieval System (MEDLARS) of the National Library of Medicine. It is published semimonthly by the American Rheumatism Association. This report describes preliminary testing of MEDLARS output, modification of MEDLARS Medical Subject Headings (MeSH), and the computer formulation for retrieval of the bibliographic citations comprising the Index.
An inventory of Canadian anesthesiology. Human research from 1995 through 1999.
PURPOSE: The year 2000 provides a symbolic opportunity to assess the past initiatives in anesthesia research. As in many other fields, medical research has benefited from utilizing computerized data bases to facilitate enumerating areas of interest. We have created a baseline survey of past research in the fields of anesthesia, anesthetics, analgesia, and analgesics to highlight Canadian studies. METHODS: The survey was undertaken using the Medical Literature Analysis and Retrieval System (MEDLARS) medical literature archive for the years 1995 through 1999. The principal categories and sub-categories of MEDLARS' anesthesia classifications were counted for 70 countries contributing to the archive. RESULTS: Canadian contributions ranged from 141 (1992) to 185 (1999) and represented annually 3% of the world total in the anesthesia categories. The greatest number of studies (30-38%) were about adults aged 19 to 44 yr, and there were between 4% and 14% more studies of females than males. "Pharmacology" and "therapeutic use" were the most frequent topics, lidocaine, fentanyl, and propofol were the most studied anesthetics, and non-steroidal anti-inflammatories, opium, morphine, and fentanyl were the most studied analgesics. Among the types of studies, those classified as "quality of health care" occurred most frequently (16%). Canadian trends closely follow world trends. CONCLUSION: The collected counts provide a comprehensive overview of research trends for the past five years.
Index to Dental Literature and MEDLINE: a guide to searching the dental literature.
The Index to Dental Literature is generated from the MEDLARS data tapes. The dental file, a subset of MEDLARs, is available for online searching. One of the major problems encountered when searching for dental literature in the predominately medical file is the specificity of the dental vocabulary. Six suggestions are given to help the user find the closest MeSH equivalent for the dental concept. Examples are provided to illustrate retrospective searching of the BACKfiles and the uses of journal titles lists, dental terms, subheadings, Text Words, and pre-explosions when searching MEDLINE for dental and related literature.
MEDLINE searching and retrieval.
The development of MEDLINE searching philosophy and methodology is described. Searcher requirements and capabilities in moving from a batch-mode linear operation to the iterative searching and retrieval provided by the random access mode of MEDLARS II are discussed. A detailed tutorial on searching methodology for individual queries is covered. Elements of search formulation include requestor interview, query analysis, presearching, technics of selecting terminology, formulation logic, adapting indexing protocol in the search, on-line man-machine interface, and retrieval analysis. Similar searching technics are utilized in producing the two basic types of MEDLINE publications, recurring bibliographies (RBs) and literature searches (LSs). RBs are co-operative ventures between the NLM and professional organizations or other government agencies. LSs are NLM sponsored non-recurring bibliographies on a topic of current but also general interest to the medical community. All publications are produced through the retrieval and publication systems of MEDLARS II and graphic arts composing equipment. At the beginning of the 1978 publication year there were 27 RBs in routine production including Index Medicus. Through 1977, over 375 LSs had been produced.
The United States National Library of Medicine's international relationships.
The US National Library of Medicine (NLM) is a Federal institution which serves as a national resource with international impact. The global biomedical literature and that selected for Index Medicus is characterized by numbers of journals, country of origin, and language of publication. NLM's domestic responsibilities and international programmes are described. NLM's international relationships consist of MEDLARS co-operation, exchange programmes, services, a special foreign currency programme, technical consultation, co-operation with the World Health Organization (WHO) and the Pan American Health Organization (PAHO) and some special programmes vis-á-vis formal governmental bilateral agreements. A regional approach to the provision of medical library and health-information services is illustrated by the PAHO Regional Library of Medicine. The principles for the availability of MEDLARS internationally and the nature of the quid pro quo arrangements are presented.
Addressing the issue of cataloging and making chiropractic literature accessible: Part I: Defining the problem.
Health science journals are a principle source of new knowledge for chiropractors, chiropractic faculty and students. Regrettably, clinically or educationally relevant articles (appearing in the nearly 20,000 journals annually) are often overlooked due to access difficulties. Innovations are needed to assist the reader to select articles relevant to chiropractic and reduce the time spent sorting through the volumes of literature. A review of the literature shows there is a trend toward database management for cataloging and accessibility of other, nonchiropractic, literature. Most notable of these is an endeavor by National Technical Information Service, commonly referred to as MEDLARS (Medline). It is interesting to note that a computer-assisted library database program does not exist on any chiropractic campus. This is in contrast with the trend on campuses of other health care fields. Manual search strategies within the chiropractic literature are time consuming, subject to a high failure rate, and even if the search produces citations, there is no assurance the journal can be accessed unless a chiropractic campus is nearby. Furthermore, difficulties exist when a chiropractic literature search is attempted in any computerized database, e.g., MEDLARS (Medline). Journals/articles that are unique to chiropractic (national, international or on the state level) are not specifically included in these computerized databases. Aside from these difficulties, there exists the problem of finding those articles that contain valid and relevant information from among those that are less valid or informative.
Exporting the American (information) revolution: the international impact of the National Library of Medicine.
The National Library of Medicine has had an enormous impact on health information services all over the world. Although NLM is primarily a national institution, it has become an important international resource by responding to requests from the international community. NLM has been influential in three major ways. First, NLM has provided a model for other national and regional health information services. Second, it has been a catalyst, in that MEDLARS and other services it provides formed the nucleus of many regional networks. NLM helped such networks get started by giving advice on how to set up services and build collections and by "training the trainers" on the MEDLARS system. Third, NLM has supported national and regional operations by providing the additional training and materials needed for day-to-day service.
The National Library of Medicine and medical informatics.
Medical informatics attempts to provide the theoretic and scientific basis for the use of automated information systems in biomedicine. Even though a new field, its roots are in the 19th century. The National Library of Medicine (NLM) began classifying the medical literature and publishing the Index Medicus in 1897; in the early 1960s, the growth of the index gave rise to MEDLARS, the first successful, large-scale, computerized bibliographic system. In 1971, about the time MEDLARS evolved into a nationwide on-line retrieval system known as MEDLINE, a committee of the Association of American Medical Colleges published a report calling for the NLM to exert strong leadership in developing computer applications for information transfer in medicine. The NLM has sponsored several training and research programs in this area and is now developing the concept of "centers of excellence" in medical informatics. In addition, there are a number of current research and development activities within the NLM internal and extramural programs that may influence the progress of medical informatics.
Screening of new sorbent materials for cadmium removal from aqueous solutions.
This study compares the abilities of four low-cost materials: peels of peas, broad bean, and medlar, respectively and fig leaves, to remove cadmium from aqueous solutions. Kinetic data and equilibrium sorption isotherms were measured in batch conditions. Kinetics of cadmium sorption was contact time, initial cadmium concentration and sorbent type dependent. The results also showed that the kinetics of cadmium sorption were described by a pseudo second-order rate model. The cadmium uptake of these low-cost materials was quantitatively evaluated using sorption isotherms. Results indicated that Langmuir model gave an acceptable fit to the experimental data. A high cadmium sorption was observed by these materials. The broad bean peel was the most effective to remove cadmium ions with a maximum sorption capacity about 147.71 mg/g followed by peas peel (118.91 mg/g), fig leaves (103.09 mg/g), and medlar peel (98.14 mg/g).
True multifood allergy in a 4-year-old child: a case study.
BACKGROUND: Food allergy is quite common in children, but it usually trends to improve with ageing. When an individual has specific IgE to a large variety of foods (multifood allergy) the clinical picture may be of remarkable severity and the avoidance of the offending foods may lead to severe dietary impairment. We describe a case of a child with ascertained multifood allergy. METHODS: The prick-by-prick testing with fresh foods and serum IgE tests were used to evaluate the patient's sensitivity to food allergens. The clinical effect of sensitizations were evaluated by DBPCFC which was carried out for egg, fish, peanuts, walnut, fig, asparagus, orange, chicory, medlar, peach, strawberry and cherry. Each challenge was performed on a separate day. Medical assistance and resuscitation facilities were available during the whole challenge procedures. RESULTS: SPT with fresh food gave a 4 mm wheal for fig, asparagus, cherry and walnut; a 5 mm wheal for medlar and orange; a 6 mm wheal for chicory and strawberry; a 7 mm wheal for fish and peanuts; an 8 mm wheal for peach and a 9 mm wheal for egg. The RAST assay confirmed the presence of specific IgE to egg, fish, peanuts, walnut, fig, orange, strawberry, peach, and cherry. The total serum IgE was 730,6 kU/l.The DBPCFC was positive, at various degrees, for all foods tested according to skin sensitizations. CONCLUSIONS: The case herein described is a true multifood allergy, as confirmed by the DBPCFC. Multifood allergy is not common, but when present it can lead to severe dietary limitation.
Expression of heat shock protein 27 in chromomycosis.
We report on a 58-year-old woman with long-lasting (36 years) chromomycosis on the foot and secondary self-inoculation from foot to hand 4 years ago. Mycological classification was performed after culture on Sabouraud glucose agar. We used haematoxylin and eosin and Giemsa staining and an antibody to heat shock protein (HSP) 27 (Stress Gen, Clone G3.1) on paraffin-embedded and cryostat specimens of chromomycosis. The mycological culture revealed the fungus Fonsecaea pedosoi. Histopathology revealed dermal fibrosis with persistent fungi (Medlar bodies), numerous mast cells and pseudoepitheliomatous hyperplasia. Immunohistochemically, HSP 27 was positively identified in F. pedrosoi. Moreover, in differentiating keratinocytes in the pseudoepitheliomatous lesions of chromomycosis, HSP 27 was increasingly expressed from basal layers to stratum spinosum in the epidermis but not in keratinocytes directly bordering Medlar bodies. In chromomycosis, HSP 27 is expressed, in accordance with its role as a marker of differentiation and proliferation, in keratinocytes and also in F. pedrosoi. It remains unknown if these results might explain the therapeutic efficacy of hyperthermic treatment.
The availability of health information in South Africa.
The South African Medical Research Council (MRC) has provided access to on-line health and biomedical information since 1976, when the MRC became an international partner of NLM. This was done to support research and health care when the Institute of Biomedical Communication was established. The institute has since reorganized and is now the Information Systems Division in the Research Systems Support Group MRC. he MRC and medical libraries in South Africa are able to access various automated services via telecommunication. The major systems available are MEDLARS, DIALOG, DATASTAR and BRS, with ECRI being the latest addition; most used are MEDLARS and DIALOG. New technologies (e.g., CD-ROM) have given more people access. This technology is not available to many people working in Primary Health Care (PHC), as they do not have access to computer networks. Beyond on-line is statistical and printed information, called "Gray Literature," not accessible through on-line systems as it is not published in conventional sources used to build databases. With a shift to Essential National Health Research and the focus on PHC and preventative medicine, demand for health information and "gray literature" is growing. The MRC collects and produces this material and has its own database called SAMED, which is to be made available to others as our contribution to health. It is hoped to make this available for inclusion in the proposed African Index Medicus presently investigated by the World Health Organization. Africa as a continent, and South Africa as a country, are experiencing major changes in health care and medical practice, and inevitably, provision of health information services. With South Africa's re-entry into the global village and its acceptance by the rest of Africa, it can be a key player in information provision to the rest of the continent. The MRC, as a major provider of Health information, can play a vital role in the information flow throughout Africa by continuously improving and expanding its services. A large proportion of South Africans live in rural areas where health care is provided by clinics not linked to information networks. This does not mean these clinics are excluded from the use of information. The major challenge is to find the ways and means of getting the relevant information to these clinics. Information is needed to help with patient care and continuing education. With this in mind, the MRC is evaluating different formats in which information can be supplied. Due to the lack of computer literacy, facilities, and financial constraints, it is better to supply printed information. With the spread of technology through the country and continent, it can be assumed that information flow and transfer will be more rapid. Repackaging of information means that it is possible to get the relevant information to the right people at the right time. The first such package developed is for hospital managers. With the help from experts in the field of PHC, it is hoped to develop packages aimed specifically at the CHWs and other workers in the field. All packages developed by the MRC are backed by a document provision service, using the most cost-effective route to obtain documents. A printed product must comply with certain criteria; these are: 1) purpose for which the information is needed; 2) kind of information needed and the format in which it is needed; 3) when the information is needed; 4) is the information to be supplied on an ongoing basis i.e., updated with latest information; 5) cost involved; and 6) how to get the information to the relevant user.
Primary journal selection using citations from an indexing service journal: a method and example from nursing literature.
Although serial literature is extremely important to a library collection, it is also the source of many problems. Specialty journal selection is difficult, particularly for the librarian of a small or intermediate-size library that is not in a position to develop or maintain an exhaustive or inclusive collection in a particular field or discipline. Steadily increasing journal costs and recent economic trends necessitate establishment or reexamination of a periodical collection policy. In this investigation, the technique used analyzes citations assigned to medical subject headings (MeSH) and subheadings by indexers who prepare the MEDLARS data base. Citations have been retrieved by exploiting the on-line nature of the MEDLARS data base. A four-year time period is used to identify specialty journals in the area of nursing. Results given include a separate rank-order listing arranged by decreasing frequency of productivity for each MeSH term searched. A composite listing is given for the 16,355 unique citations retrieved. The approach illustrated and data presented may be useful in establishing library policy for questions of periodical subscription and setting of priorities for binding and microform purchases. The purpose of the approach described is to predict collection demand with efficiency and economy.