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At least 1,711 records · Page 95Linked to original sources
PubMed2002

Can patients taking opioids drive safely? A structured evidence-based review.

A structured evidence-based literature review was completed to determine if there was epidemiological evidence of an association of opioid use and intoxicated driving, motor vehicle accidents (MVA) and MVA fatalities; to rate the quality of this research evidence according to Agency for Health Care Policy and Research (AHCPR) type of evidence and strength and consistency of the evidence rating scales; and according to this evidence determine whether patients taking opioids can drive safely. Relevant references were located from Medline, Psychological Abstracts, Science Citation Index and the National Library of Medicine Data Query databases by appropriate subject headings. A manual search was also performed utilizing the reference lists of the retrieved articles. All references relating to intoxicated driving, MVA and MVA fatalities were retrieved and reviewed in detail. Of these, references addressing opioid use were isolated and research information from these references was placed into tabular form under three major headings: Intoxicated driving and opioids; MVA and opioids; and MVA fatalities and opioids. Data were extracted from these references according to the following format: research question addressed, sample size, statistical analysis and results. The type of evidence each study represented was rated according to the AHCPR type of evidence rating scale. Each research area (intoxicated driving, MVA, MVA fatalities) represented by all the studies in each table was then rated utilizing the strength and consistency of the evidence AHCPR rating scale. Of the 6 reports addressing intoxicated driving, 5 were well designed non-experimental studies and one was a well designed experimental study. All studies in this group reported a prevalence for opioid use which was approximately 1/10 that of the point prevalence use for opioids in the general population. This evidence indicated that opioids probably are not associated with intoxicated driving. Overall, the evidence indicates that opioids are not associated with MVA. Of the 9 studies addressing MVA, 5 were well designed quasi-experimental studies and 4 were well designed experimental studies. All reports in this group except one indicated that opioids are not associated with MVA. Of the 10 studies addressing MVA fatalities, 10 represented Type IV studies. For the vast majority of the studies, the prevalence percentages for an opioid association with MVA fatalities was 1/5 that of the point prevalence percentage for opioid use reported in the general population. Only 1 study reported a possible association between opioid use and MVA fatalities. The evidence in this review indicates that opioids do not appear to be associated with intoxicated driving, MVA and MVA fatalities, and consistently indicated that opioids are not associated with MVA. Although the comparison of point prevalence rates to the point prevalence may be problematic, the results of this systematic review support the contention that patients taking opioids may be allowed to drive. As in all clinical decisions, this determination should be individualized according to clinical factors.

Accidents, Traffic↗
PubMed2003

Legal regulation of the Croatian Medical Journal: model for small academic journals.

During the last few years, the questions of editorial independence and journal governance have come into the focus of scholarly journals. There is little data on the legal regulation of journals outside mainstream science, although they constitute the largest body of biomedical literature. The Croatian Medical Journal functioned for more than 10 years without much legal regulation but with lot of enthusiasm and hard work. This Editorial presents our attempt to make legal provisions for the current status of the Journal and its future work. We defined our owners, main participants in making of the journal, and their responsibilities and benefits. The Agreement will be signed by all four medical schools in Croatia, which will become owners of the Journal. We hope that our experiences and solutions for strengthening the legal status of the Journal will help other editors from small scientific communities to think about their journal and its governance.

Administrative Personnel↗
PubMed2004

Emergency contraception: knowledge and attitudes of family medicine providers.

BACKGROUND AND OBJECTIVES: Emergency contraception (EC) is an underutilized method of preventing unplanned pregnancy. This study assessed family physicians' and nurse providers' knowledge, attitudes, and beliefs about EC. METHODS: A cross-sectional survey was distributed to faculty, residents, and clinic nurses in a Midwestern department of family medicine. Data were analyzed using Statistical Package for the Social Sciences. Statistical significance was tested by chi-square test, Student's t test, and Mann-Whitney U test where appropriate. RESULTS: Seventy-eight providers participated (response rate 81%). Seventy-four percent of physicians have prescribed EC in the past, with an average of 3.2 (range 0-10) times in the last year. The majority of providers reported that they were familiar with indications (96%) and protocols (78%) for prescribing EC, yet knowledge inaccuracies were identified. Overall attitudes regarding EC were positive. CONCLUSIONS: Although the majority of participating providers were willing to prescribe EC and had generally favorable attitudes toward it, rates of providing this therapy were low. There was a discrepancy between providers' perceived and actual knowledge about EC. Interventions targeting misunderstandings might help reduce missed opportunities to provide EC.

Attitude of Health Personnel↗
PubMed2004

[Functional genomics and its impact on the future medicine].

The sequencing of the human genome was completed in 2003. These data will affect all aspects of biological and medical sciences. Since almost all the genes of the genome are known, the diagnosis and therapy of the future is expected to evolve towards more personalized and efficient methods. Before these medical advancements become applicable, functional genomics must successfully determine the cellular role all the genes in the genome. Comprehensive functional studies will require suitable animal models. Although many mammalian species are used in biological and medical experiments, the mouse emerges as a key model organism in studies of human genes. The power of the mouse model system comes from its extensive physiological and pathological similarities to humans and from technological advancements offered by mouse genetics. Recently, a project called ENCODE was launched to accelerate this monumental effort of gene analysis. Once gene analysis is completed, the face of medicine will change markedly. The greatest impact is expected on the front of individual diagnosis of disease genes and personalized treatments of patients.

Animals↗
PubMed1992

Imperatives for continuing research education: results of a Medical Library Association survey.

This paper reports the results of a survey assessing the interest of Medical Library Association (MLA) members in acquiring or improving research skills through continuing education (CE). It describes respondents' educational preparation for research and selected research activities, reviews MLA's experiences with offering CE courses on research topics, and discusses MLA's role in providing education to prepare members for research. The paper includes recommendations for improving research skills through CE and other professional activities. Topics of greatest interest to MLA members were survey development, problem identification, evaluation and cost studies, survey methodology, and methods of data collection. Many respondents preferred local courses. Academic health sciences librarians, as a group, were found to be more productive publishers than hospital librarians. Many respondents reported the availability of free or subsidized research-support services, but more than half did not. More than 90% of respondents indicated that MLA should actively encourage, require, or offer research education. A comprehensive plan for obtaining research skills through CE, along with individual self-assessment and counseling, is recommended.

Education, Continuing↗
PubMed2004

Salmonella Brandenburg: changing patterns of disease in Southland Province, New Zealand.

BACKGROUND: Salmonella Brandenburg has previously been an infrequent human pathogen in New Zealand, however a marked increase in human isolates has been noted since 1996. AIM: To research the incidence and pattern of Salmonella Brandenburg infection in New Zealand and specifically the characteristics of human isolates seen at Southland Hospital, Invercargill, Southland Province, New Zealand. METHODS: A literature review was performed, and statistical data from the Enteric Reference Laboratory, Institute of Environmental Science and Research Limited (ESR) was reviewed. A retrospective case series was performed, collecting demographic and clinical information for all patients with salmonellosis seen at Southland Hospital between September 1997 and May 2002. RESULTS: Salmonella Brandenburg is shown to have become the predominant human isolate seen at Southland Hospital from 1997 to 2001. Of a total of 62 cases of salmonellosis, 30 were culture-positive for S. Brandenburg (48%). Of these cases, 13 (43%) were from extra-intestinal sites. Eleven of these 13 (85%) cases did not have any risk factors for invasive disease. During the study period, the incidence of S. Brandenburg infection increased, as did the incidence of invasive disease. CONCLUSION: The incidence and invasive potential of S. Brandenburg seems to be increasing, particularly in Southland, with peak infection rates corresponding to the lambing and calving season (September to November). S. Brandenburg seen in immunocompetent hosts may be a more invasive organism, and present with a wider spectrum of disease than has been previously considered.

Adolescent↗
PubMed2006

Cardiovascular disease risk factors in patients with confirmed cardiovascular disease.

OBJECTIVE: To assess the magnitude of the problem of cardiovascular risk factors in hospitalized patients, and to establish cardiovascular disease (CVD) risk factor profiles. METHODS: The study included 476 confirmed CVD patients selected by a multi stage stratified cluster random sampling technique in Tabriz Heart Center (Shaheed Madani Hospital), Tabriz, Iran from February 2004 to May 2005. After obtaining demographic information and performing physical examination, biochemical parameters were measured. Data was analyzed using the Statistical Package for Social Science version 10.05, where p value of <0.05 was considered significant. RESULTS: Obesity was the most common abnormality (93.5%) followed by diabetes mellitus (58.4%), low high-density lipoprotein cholesterol (HDL-c) (45.4%), low physical activity (41.6%), high total cholesterol (40.1%), high triglyceride (37.2%), high low-density lipoprotein cholesterol (30.7%), diastolic hypertension (28.4%), high systolic blood pressure (24.8%) and smoking (20%). Of the total number of patients, 93% had one risk factors for CVD, 43% had 2, 16% had 3, and 5% had 4 risk factors. The prevalence of lipid disorders in females was more than males except for low HDL-c (p<0.05). Between lipid profiles, only TG showed a correlation between age (p<0.05). It was noticed that obesity accompanied by lipid profile abnormalities as low serum levels of HDL-c and high level of TG, TC, and LDL-c were more seen in obese patients (p<0.05). CONCLUSION: This study revealed a high prevalence of risk factors in CVD patients; thus, urgent lifestyle modification is recommended.

Adolescent↗
PubMed2006

A study of knowledge and attitudes towards the use of evidence-based medicine among primary health care physicians in Bahrain.

OBJECTIVE: A study of perceptions and attitudes towards the use of evidence-based medicine (EBM) among family physicians in Bahrain. METHODS: A systematically developed, anonymous, self administered 13 item questionnaire was mailed to 124 Bahraini family physicians in the Ministry of Health, Bahrain between January and April 2004. The response rate was 65%. Data were analyzed using the Statistical Package for Social Sciences (Windows version 11.00). RESULTS: The respondents (n=81) were mainly female (65.4%) with a mean age of 40 (SD 7.7) years, with 12.7 (SD 8.3) years since graduation. Forty-two percent had attended EBM workshops and 61% claimed to use EBM in their practice. Those who had attended a workshop were more likely to assert that they were practicing EBM (82% versus 47%; p=0.001). Less than 10% selected patient s choice as a component of EBM. The 81.5% of respondents agreed their patients were willing to participate in decision making but 50% felt that only 10-25% of their patients were capable. No time (53.1%) and no ready access to resources (73.5%) were the most cited barriers, 32% of respondents agreed that EBM is not applicable to their culture. CONCLUSION: Most family physicians in Bahrain claimed to use EBM in their practice, particularly if they had attended an EBM workshop. However, most of them did not consider patients values as a component of EBM. A substantial minority considered that EBM is inapplicable to their culture.

Adult↗
PubMed1990

[Laufberger's excitation theory].

The author gives an account of V. Laufberger's Excitation theory at the occasion of the 100th anniversary of his birthday. This work was published as a monograph in 1947 and contains many data which foresee the further development of neuro-sciences and other scientific disciplines. From a certain aspect it is more cybernetic than Wiener's "Cybernetics" published one year later. It applies in a genial way the principle of logical elements made up of binary functional elements, backfeeds, parallel organization of neuron networks, and memories based on so-called spinning excitations. It is the first modern model of cerebral activity. It combines within one system the neuron and psychic level of organization of the brain.

Cybernetics↗
PubMed1988

[Neurobiologic aspects of coping behavior].

Psychosomatic thinking in medicine is emphasized by progressive integration of neurobiologic and psychologic (psychoanalytic) results. In recent years data pertaining to the interface between neurosciences and behavioral sciences had been presented. Some of the results in the fields of neuroanatomy, neurobiochemistry, endocrinology and psychoneuroimmunology corresponding to coping-processes are presented.

Adaptation, Psychological↗
PubMed1986

[Flow cytometry: a multiparameter cytological analysis technic].

Cytometry is a cell analysis technique which owns its effectiveness to advances in immunology, chemistry, data processing, electronics and optics. Taken together, all these sciences have led to the development of the cytometer, an instrument which analyzes and sorts the cells with the help of structural and/or functional parameters determined on each individual cell. Because of the diversity of cell parameters which can be quantified by cytometry, this technique is now widely used in oncology, immunology and pharmacology.

Flow Cytometry↗
PubMed1988

Teaching periodontics. Past patterns and future prospects.

The article presents a brief history of the development of periodontal concepts and their data base. Because of the rapid change in periodontal science and knowledge, the author pleads for periodontal education based on "show, deliberate, choose, and do" in our dental curricula.

Curriculum↗
PubMed1987

Mortality in systemic lupus erythematosus.

Many factors influence survival in systemic lupus erythematosus (SLE). Earlier diagnosis and advances in treatment have led to improved survival. In an attempt to establish meaningful survival statistics for patients with SLE, a group of 9 medical institutions formed the Lupus Survival Study Group. We review their data and particularly the data from the State University of New York Health Science Center at Brooklyn, NY.

Follow-Up Studies↗
PubMed1971

Planning and designing hospital health science libraries.

The people who plan and design hospital libraries must be aware of the environment in which the library functions. The hospital health science library operates under a different set of values and priorities from an academic library. Three methodologic studies are reported to determine hospital health science functions with comments on the significance of the data for designing: (i) the extent and possible use of books and journal collections makes it evident a hospital must act as an access point to the scholarly record; (ii) a survey of 41 hospitals shows a wide variety and combination of 33 user services; obviously what services are to be given should be decided before design; (iii) observing how different areas are used by a library's clientele shows that groups use the library differently and within certain time patterns; the arrangement of the functional areas can be better designed if quantitative data on the use of space are available.

Architecture↗
PubMed1982

Contribution of familial factors to the occurrence of cancer before old age in twin veterans.

In an earlier report, we evaluated familial factors in deaths from all causes before age 62 among the 31,848 white male twin veterans who were followed during 1946-1978 through the National Academy of Sciences-National Research Council Twin Registry. We now report data for this group on twin concordances and heritabilities of cancer recorded on the death certificate as an underlying or associated cause. The study subjects have a mortality from cancer 0.88 times, and one from all causes 0.84 times, that of U.S. white males [12], but this is very similar to the mortality of other U.S. veterans [9]. Among 11,350 monozygotic (MZ) and 14,450 dizygotic (DZ) individuals in twin pairs alive on January 1, 1946, 1,162 MZ and 1,646 DZ individuals died before January 1, 1979. Cancer was diagnosed for 223 MZ and 323 DZ twins as an underlying or associated cause of death. Among the latter were 176 MZ and 274 DZ pairs with the only death in the pair a cancer death, 10 MZ and eight DZ pairs concordant for cancer, and 12 MZ and 14 DZ pairs in which the first death in the pair from cancer was followed by death of the other twin from another cause. When account is taken of the three MZ and two DZ pairs concordant for lung cancer, most likely related to cigarette smoking, the twin cancer death concordance rates are very low, and they are not appreciably different between the two zygosity groups. Genetic factors may be important in some specific forms of cancer. However, these data suggest that genetic factors and early familial environment, generally shared by twin-pair members, do not contribute much to mortality from most cancers between 30 and 60 years of age.

Adult↗
PubMed1981

Predicting academic performance in medical technology: a university-based program in retrospect.

In a study of the relative contribution of two achievement measures and five aptitude measures in determining three measures of academic performance, an achievement measure in combination with an aptitude measure provided the most efficient explanations. Stepwise multiple regressions were performed on data from 112 medical technology graduates to determine that science grade point average (GPA) and Nelson-Denny Combination sub-score significantly predicted professional GPA. Additionally, science GPA and the Otis Test score explained the variations in both certification examination performance and comprehensive examination performance.

Achievement↗
PubMed1996

State of the art. Antiviral treatment of HIV infection.

Antiretroviral drugs have been the mainstay of treatment for HIV infection. New categories of antiretrovirals and recommendations for treatment have emerged as a result of basic science research, new understandings of the infectious process, and data from clinical studies. This article summarizes the currently available drugs for nurses who act as educators and advocates in helping HIV-infected persons explore their treatment options.

Antiviral Agents↗
PubMed1996

The Danish Conscription Registry: a resource for epidemiological research.

According to the Danish constitution all Danish male citizens must appear before a Conscript Board for assessment prior to military or civil service. Conscript Board examinations have followed the same standardized procedures over many decades, and the Danish Conscript Registry represents a valuable resource for epidemiological research in Denmark. During the last two decades investigations based on information in the registry have produced significant contributions to many areas of medical science. Within the last decade new procedures and electronic data processing and storage have resulted in restricted possibilities concerning current and future utilization of the Danish Conscript Registry for epidemiological purposes. To improve this it is recommended to maintain all codes describing present illnesses and conditions together with the civic registration numbers in the computerized archive of all subjects assessed by the Conscript Board.

Adolescent↗