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PubMed1994

[Ophthalmology in Leipzig and Dresden 100 years ago].

BACKGROUND: Based on a rich ophthalmologic tradition in Saxony--for example Georg Bartisch (1536-1606) and his "ophthalmoduleia" furthermore the anatomist and surgeon of the university of Leipzig Justus Gottfried Guenz (1714-1754), working about the staphyloma and criticizing the notorious oculist John Taylor (1703-1772)--the situation at Dresden and Leipzig is described. The development was dynamical, scientifical and in the end independent of surgical specialty. Physiology (Purkinje, Helmholtz), obstetric (Credé) and other medical specialties had a great influence on the ophthalmology too. MATERIAL AND METHODS: The investigation predominantly is determined by the "Staatshandbuch für das Königreich Sachsen" and by the also important address-books of Dresden and Leipzig. In this material are to find the number of ophthalmologists, of clinics and practices as well as the kinds of work. RESULTS: The ophthalmology in Saxony 100 years ago, especially in the university of Leipzig and in the capital of this country, Dresden, may be mirror of the development in whole Germany. As well in the academic field as in the ophthalmology the specialty was very spreaded and accepted. CONCLUSIONS: In the focus of the ophthalmological picture the extent and the level or the quality of this medical specialty stands. We can say, that the oculists at that time are versed in concerning the operative and conservative therapy. The social welfare played a part in the supply of the blind and in the prescription of glasses. With reference to the chairs and many personalities Saxony was a centre of ophthalmology in Germany.

Germany↗
PubMed1991

Investigations on the circulation of anesthetized dogs.

In the present experiments arterial blood pressure, cardiac output, heart rate, oxygen consumption, AVO2 difference values and their changes were investigated in 64 anesthetized dogs in four periods for altogether 60 min. Blood flows of the renal, commune carotid and femoral arteries were measured in parallel and the changes were recorded throughout the 60 min of the experimental period. Urine was collected separately from both kidneys, in order to determine whether the measurement of the blood flow of the renal artery disturbed renal functions. Total peripheral vascular resistance and the vascular resistance of the territories of the commune carotid and femoral arteries were calculated from the parameters measured. In the present experiments the equation of the regression line between cardiac output and body weight was y = 0.102x + 0.9411. The equation of the regression line between cardiac output an body surface proved to be y = 2.996x + 0.653. The relationship between total oxygen consumption and body weight could be characterized by the y = 5.815x + 24.227 equation. Our data were in accordance with data of the Biology Data Book obtained in dogs anesthetized by pentobarbital. Our present data can be found but partially in the Biology Data Book, so the results obtained in the present study may serve as basis of future comparisons. In this work proper care was taken to maintain the same conditions and, thus ruling out possible artefacts. The experiments were carried out on mongrel dogs of different sexes; nevertheless, the animals were attempted to be kept under the same conditions for the 14 days preceding the experiments.

Anesthesia↗
PubMed2004

Re-audit of radiotherapy waiting times 2003.

AIMS: There has been increasing concern, by clinical oncologists in the UK, about the continuing long waiting times for radiotherapy treatment. An audit of patients starting treatment in 1 week in 2003 was carried out to determine waiting times and to compare current results with those obtained from a similar audit in 1998. MATERIALS AND METHODS: All centres in the UK completed the audit, which recorded waiting-list status and treatment intent for all new treatments started in 1 week, date of booking form completion and fractionation scheme used. RESULTS: Waiting times have lengthened in most centres for all categories of patients although, for palliative treatments, there was no additional increase in median waiting time compared with the last audit. Fewer patients in all categories are being treated within the Joint Collegiate Council for Oncology (JCCO) guidelines. Single-fraction treatments are now common for palliation. Most adjuvant treatment uses one of three prescriptions. In each Strategic Health Authority (StHA), the same proportion of the total number of patients with cancer seemed to be given radiotherapy. There was no obvious simple correlation of radiographer, physicist or treatment machine numbers with waiting times. CONCLUSION: The results of this survey suggest a continuing mismatch between capacity and demand. Increased complexity of radical treatments, and possibly more patients being referred for treatment, may have been offset in part by reduced fractionation for palliation.

Chemotherapy, Adjuvant↗
PubMed2004

Fertility options in young breast cancer survivors: a review of the literature.

PURPOSE/OBJECTIVES: To describe the impact of treatment on fertility, discuss fertility-sparing options available for women with breast cancer, and explore pregnancy subsequent to breast cancer. DATA SOURCES: Published research, clinical articles, book chapters, and abstracts. DATA SYNTHESIS: The risk of amenorrhea associated with alkylating agents in breast cancer survivors is well known. Fertility-sparing options before, during, and after treatment are possible with the use of assistive reproductive technology. Young breast cancer survivors are concerned about stimulating recurrence with subsequent pregnancy, health during pregnancy, and family matters. CONCLUSIONS: Current data about the effects of treatment on amenorrhea, subsequent pregnancy after treatment, preservation of ovarian function during adjuvant therapy, and management of ovarian failure in young women with breast cancer are important to include in discussions and counseling. IMPLICATIONS FOR NURSING: Young women deserve a thoughtful discussion about their concerns among their multidisciplinary team, including oncology nurses, oncologists, and social workers. Effects of treatment on fertility are well known. Women with fertility concerns should be referred to a reproductive endocrinology team at the time of diagnosis rather than after treatment has ended.

Adult↗
PubMedDate not supplied

[Spanish wines in the Liber de arte medendi (1564) by Cristóbal de Vega (1510-1573)].

OBJECTIVE: The Liber de arte medendi (Lyon, 1564) is the most relevant book of Prima Professor of The Faculty of Medicine of Universidad de Alcalá, doctor Cristóbal de Vega (1510-1573). It is a treatise--674 pages in folio--of theoretical and practical medicine. This doctrinal expose, scholar and bookisk, changes its tone in the second of the three parts, the liber II, that deals with "no natural things" of galenism, which necessarily affect the organism and that, depending on how they are used, they may strengthen or weaken its health: air, physical activity, foods and drinks, sleep, evacuations and passions of the soul. SCOPE: Within the section dedicated to foods and drinks, we have studied the interesting chapter about wines, where the author makes a hygienic assessment about wine. MATERIAL: The chapter on spanish wines consigned at the Liber de arte medendi and some other references about the therapeutic capabilities of some of the wines described by the author. INTERVENTIONS: He we undertaken a critical analysis of that chapter, glossing the most significant texts about spanish wines mentioned by the author. RESULTS: In this chapter vega praises the class and hygienic applications of white Alcarrian wines from Yepes, Lillo and Santorcaz, of the Galician from Rivadavia, from Cantalapiedra in the Salamanca region, and the Andalusians from Jerez, Cazalla and Alanís. He also extols the smooth reds from Santorcaz; though the best in this category would be, for the adaptation of its temperament to the human nature, the Illana wine. DISCUSSION: at Liber de arte medendi, wines from Cantalapiedra (Ded Castille), Rivadavia (Galicia), Jerez, Ca- zalla and Alanís (Andalusia), Santorcaz, Corpa, Yepes, San Martín de Valdeiglesias, Villalbilla, Illana and Lillo (New Castille) are mentioned.

History, 16th Century↗
PubMedDate not supplied

A new method for representing the human anatomy.

In current practice, anatomical atlases are based on a collection of planar images presented in a book or, recently, stored on digital media. We present a new method for generating interactive true three-dimensional (3D) anatomical atlases based on a volume model derived from MRI and CT. The model has a two layer structure. The lower level is a volume model with a set of semantic attributes connected to each voxel. The semantic attributes are assigned by an anatomist using a volume editor. The upper level is a set of relations between these attributes. Interactive visualization tools such as multiple surface display, transparent rendering, and cutting are provided. It is shown that the combination of this data structure with advanced volume visualization tools provides the "look and feel" of real dissection. First tests show that the atlas system cannot only be used successfully for anatomy teaching, but also as a reference for radiologists or surgeons. As a replacement of classical atlases, however, the spatial resolution has still to be improved.

Anatomy↗
PubMed1983

[Symbolic representations of the eye in an ars memorandi of the 16th century].

Four illustrations containing various eye symbols are discussed. They appear in an early 16th-century mnemonic textbook of the Ars memorandi genre, called Rationarium evangelistarum. It was intended to help students to memorize the New Testament. The eye symbols in it refer twice to the healing of the blind, and once to the proverbial beam in the eye. Furthermore, a precursor of the later and very popular motif of the eye of God can also be found. It is easy to recognize eye symbols--even when they are simply depicted--since the eyes not only of human beings, but of all vertebrates are similar in their external appearance. This may help to explain why the eye is a common symbol in art, magic, ornamental decoration, and many other areas.

Books, Illustrated↗
PubMedDate not supplied

Informatics in Radiology (infoRAD): album of radiologic signs: a useful tool for training in radiologic semiology.

The importance of radiologic semiology can be seen from the large number of articles, books, and Web pages dealing with radiologic signs. Recognition of these signs forms an important part of the training process for radiologists. Computer-assisted instruction complements traditional techniques for teaching radiology and provides an appropriate method of collecting, organizing, and presenting radiologic signs. A computer application that includes more than 350 radiologic signs has been created with Microsoft PowerPoint (version 2002 for Windows). The user can navigate freely to see the signs from a menu that provides access according to anatomic region or from an interactive dictionary that includes 779 terms. From the presentation of each sign, the user can access one or more representative images, information about the examination wherein the sign appears, an explanation of the meaning of the sign and the corresponding diagnosis, additional comparative images (pathologic or normal), and relevant references. This album of radiologic signs is a useful tool for training in radiologic semiology and also allows a quick consultation based on the name of the sign. Although designed for interns and residents, it will also be useful in pregraduate teaching of radiology, as a reference, and in continuing medical education.

Databases, Factual↗
PubMed2001

[Pott triad and Schmorl nodules. A historical overview of kyphosis with special reference to tuberculous spondylitis and Scheuermann disease].

This report provides an overview of the history of the different types of kyphosis (arcuated and angulated forms). Especially tuberculous spondylitis and Scheuermann's disease are pointed out from among the large group of kyphotic diseases. Therefore, Beckhterew's disease, the combination of rickets and kyphosis as well as the dysraphic diseases and constitutional kyphosis caused by faulty posture are only mentioned. These two special types of kyphosis (Scheuermann's disease and tuberculous spondylitis) are presented from the first description with diagnostic findings, the ideas of pathogenesis and aspects of treatment through to the different periods of medical history. This article describes the way of thinking and discussing of opinion leaders at the beginning of the century and the influence of new techniques and developments (asepsis, antisepsis, anesthesia, bacteriology, X-ray, antibiotics) on the differential diagnosis and therapy. It is impossible to give a complete overview of all aspects during the centuries concerning tuberculous spondylitis or arcuated kyphosis. The authors of this article have focussed their studies on developments from the first descriptions until World War II, based mainly on literature from German journals and historical books from the library of the German Museum for Orthopedic History and Science.

Eponyms↗
PubMed2000

Operational performance of an STD control programme in Mwanza Region, Tanzania.

OBJECTIVES: To describe important details of the design and operational features of the Mwanza sexually transmitted diseases (STD) control programme. To assess the feasibility of the intervention, the distribution of STD syndromes observed, the clinical effectiveness of syndromic STD case management, the utilisation of STD services by the population, and the quality of syndromic STD services delivered at rural health units. METHODS: The intervention was integrated into rural primary healthcare (PHC) units. It comprised improved STD case management using the syndromic approach, facilitated by a regional programme office which ensured the training of health workers, a reliable supply of effective drugs, and regular support supervision. Five studies were performed to evaluate operational performance: (i) a survey of register books to collect data on patients presenting with STDs and reproductive tract infections (RTIs) to rural health units with improved STD services, (ii) a survey of register books from health units in communities without improved services, (iii) a survey of register books from referral clinics, (iv) a home based cross sectional study of STD patients who did not return to the intervention health units for follow up, (v) a cross sectional survey of reported STD treatment seeking behaviour in a random cohort of 8845 adults served by rural health units. RESULTS: During the 2 years of the Mwanza trial, 12,895 STD syndromes were treated at the 25 intervention health units. The most common syndromes were urethral discharge (67%) and genital ulcers (26%) in men and vaginal discharge (50%), lower abdominal tenderness (33%), and genital ulcers (13%) in women. Clinical treatment effectiveness was high in patients from whom complete follow up data were available, reaching between 81% and 98% after first line treatment and 97%-99% after first, second, and third line treatment. Only 26% of patients referred to higher levels of health care had presented to their referral institutions. During the trial period, data from the cohort showed that 12.8% of men and 8.6% of women in the intervention communities experienced at least one STD syndrome. Based on various approaches, utilisation of the improved health units by symptomatic STD patients in these communities was estimated at between 50% and 75%. During the first 6 months of intervention attendance at intervention units increased by 53%. Thereafter, the average attendance rate was about 25% higher than in comparison communities. Home visits to 367 non-returners revealed that 89% had been free of symptoms after treatment, but 28% became symptomatic again within 3 months of treatment. 100% of these patients reported that they had received treatment, but only 74% had been examined, only 57% had been given health education, and only 30% were offered condoms. Patients did not fully recall which treatment they had been given, but possibly only 63% had been treated exactly according to guidelines. CONCLUSIONS: This study demonstrated that it is feasible to integrate effective STD services into the existing PHC structure of a developing country. Improved services attract more patients, but additional educational efforts are needed to further improve treatment seeking behaviour. Furthermore, clear treatment guidelines, a reliable drug supply system, and regular supervision are critical. All efforts should be made to treat patients on the spot, without delay, as referral to higher levels of care led to a high number of dropouts. The syndromic approach to STD control should be supported by at least one reference clinic and laboratory per country to ensure monitoring of prevalent aetiologies, of the development of bacterial resistance, and of the effectiveness of the syndromic algorithms in use.

Adolescent↗
PubMed2005

Screening of copy number polymorphisms in human beta-defensin genes using modified real-time quantitative PCR.

Defensins are cationic antimicrobial peptides, which play an important role in host immune defense to some infectious diseases as well as immune disease and skin disease. Recent studies identified that the genes coding for human beta-defensin 2 (DEFB4), human beta-defensin 3 (DEFB103) and human beta-defensin 4 (DEFB104) showed variation in copy numbers. This variation may have an impact on gene expression levels. Here, we have demonstrated a real-time PCR-based method to measure beta-defensin gene copy number. Using this relative real-time quantitative PCR, we developed a new rapid and reliable approach, which involves amplification of the target locus (DEFB4 or DEFB103 or DEFB104) and the single-copy reference locus (human serum albumin, ALB) in a single PCR reaction. A calibrator was prepared by recombining one copy of the target gene and one copy of the reference gene into a plasmid. After correcting the PCR amplification efficiency, which differed between the defensin gene and ALB gene, and normalization by the calibrator, the ratio of the copy number of the target gene to that of the reference gene in an unknown sample was determined. This normalized ratio directly related to the gene copy number. The assay was validated using previously genotyped samples, which demonstrated high accuracy and reliability of the method. Furthermore, this method was used to screen the copy number variations of these three beta-defensin genes in healthy blood donors. This method proved to be a reliable and fast tool to genotype gene copy number variations in projects associating genomic variations with gene expression or with population phenotypes in epidemiologic studies.

Base Sequence↗
PubMed2005

Ricin poisoning: a comprehensive review.

CONTEXT: The recent discoveries of ricin, a deadly biologic toxin, at a South Carolina postal facility, a White House mail facility, and a US senator's office has raised concerns among public health officials, physicians, and citizens. Ricin is one of the most potent and lethal substances known, particularly when inhaled. The ease with which the native plant (Ricinus communis) can be obtained and the toxin extracted makes ricin an attractive weapon. OBJECTIVES: To summarize the literature on ricin poisoning and provide recommendations based on our best professional judgment for clinicians and public health officials that are faced with deliberate release of ricin into the environment. LITERATURE ACQUISITION: Using PubMed, we searched MEDLINE and OLDMEDLINE databases (January 1950-August 2005). The Chemical and Biological Information Analysis Center database was searched for historical and military literature related to ricin toxicity. Book chapters, unpublished reports, monographs, relevant news reports, and Web material were also reviewed to find nonindexed articles. RESULTS: Most literature on ricin poisoning involves castor bean ingestion and experimental animal research. Aerosol release of ricin into the environment or adulteration of food and beverages are pathways to exposure likely to be exploited. Symptoms after ingestion (onset within 12 hours) are nonspecific and may include nausea, vomiting, diarrhea, and abdominal pain and may progress to hypotension, liver failure, renal dysfunction, and death due to multiorgan failure or cardiovascular collapse. Inhalation (onset of symptoms is likely within 8 hours) of ricin is expected to produce cough, dyspnea, arthralgias, and fever and may progress to respiratory distress and death, with few other organ system manifestations. Biological analytic methods for detecting ricin exposure are undergoing investigation and may soon be available through reference laboratories. Testing of environmental samples is available through federal reference laboratories. Currently, no antidote, vaccine, or other specific effective therapy is available for ricin poisoning or prevention. Prompt treatment with supportive care is necessary to limit morbidity and mortality. CONCLUSION: Health care workers and public health officials should consider ricin poisoning in patients with gastrointestinal or respiratory tract illness in the setting a credible threat. Poison control centers and public health authorities should be notified of any known illness associated with ricin exposure.

Animals↗
PubMed1990

Evaluation of a Diagnostic Encyclopedia Workstation for ovarian pathology.

The Diagnostic Encyclopedia Workstation (DEW) is a computer system that provides completely integrated pictorial and textual information as reference knowledge in the field of ovarian pathology. The textual component comprises information per diagnosis such as descriptions of macroscopic and microscopic images, clinical signs, and prognosis. In addition, the system offers lists of differential diagnoses and criteria to differentiate among lists of differential diagnoses and criteria to differentiate among them. The present study evaluates to what extent the system influences the diagnostic process in efficiency and outcome. Therefore, two groups of six pathologists each, covering a wide spectrum of experience in ovarian pathology, participated in the evaluation of the DEW. The quality of the resulting diagnoses was statistically analyzed with the Wilcoxon rank sum test with respect to five different viewpoints: classification, morphology, clinical consequences, duration of diagnostic process, and consensus among the participants. The results are discussed and it is concluded that classification and morphology showed better results when books were used. The evaluation experiment was, however, very rigid and negatively biased with respect to the DEW system. Positive aspects of the encyclopedia are the easy access to diagnostic and differential diagnostic information and the large set of illustrations. Insight is acquired with respect to existing bottlenecks and how they may be overcome.

Computer Systems↗
PubMed2005

The "Wall of Fear": the bridge between the traumatic event and trauma resolution therapy for childhood sexual abuse survivors.

A multitude of published books and papers on child sexual abuse (CSA) describe symptoms, long-term effects, and therapy for survivors of abuse. However, the parallels between the nature of the sexual trauma event(s) as originally experienced by the victim and the therapeutic process into which the survivor later becomes engaged have not been reported. This paper attempts to fill that gap and proposes that the concept of a Wall of Fear is the bridge connecting the two. In the first part of the paper, a model of the CSA experience based upon Furniss (1991) will be explained in order to point out the basis for the dissociation and other symptomatology demonstrated by the CSA victim. Following that, the stages of therapy will be mapped out, with special attention to the concept of the Wall of Fear (Oz, 1999) and traumatic memory resolution (abreactions) and with reference to the experience of the original traumatic events. Therapist fear of decompensation will be addressed.

Child↗
PubMed2005

No reconciliation, but self-searching in the sense of rapprochement: Hillel Klein's Holocaust research in Germany 40 years after.

The paper is written from a personal perspective and in conjunction with the author's participation in editing Hillel Klein's book Uberleben und Versuche der Wiederbelebung-Psychoanalytische Studien mit Uberlebenden der Shoah und mit ihren Familien in Israel und in der Diaspora [Survival and trials of revival--Psychodynamic studies of Holocaust survivors and their families in Israel and the diaspora] which appeared posthumously in 2003. The manuscript was originally written in English during the first half of the 1980s. It consists of a revised version of his contributions to psychoanalytic Holocaust research, as well as further observations and a number of autobiographical features. It suggests that we see the symptom which relates to the traumatic past less as the sign of a pathology, and instead, through the linking of drives and objects, more as a sign of hope. The hope is that revival begins in recovering the world that was lost in the Holocaust, the world from before, which, as torn as it was, he still referred to as the 'intact world'. He regarded rapprochement as one of the main therapeutic tools. Rapprochement does not build up absolutes, but leaves from the quantitative point of view room for encounter.

Adaptation, Psychological↗
PubMed2005

A decision-making framework for sediment contamination.

A decision-making framework for determining whether or not contaminated sediments are polluted is described. This framework is intended to be sufficiently prescriptive to standardize the decision-making process but without using "cook book" assessments. It emphasizes 4 guidance "rules": (1) sediment chemistry data are only to be used alone for remediation decisions when the costs of further investigation outweigh the costs of remediation and there is agreement among all stakeholders to act; (2) remediation decisions are based primarily on biology; (3) lines of evidence (LOE), such as laboratory toxicity tests and models that contradict the results of properly conducted field surveys, are assumed incorrect; and (4) if the impacts of a remedial alternative will cause more environmental harm than good, then it should not be implemented. Sediments with contaminant concentrations below sediment quality guidelines (SQGs) that predict toxicity toless than 5% of sediment-dwelling infauna and that contain no quantifiable concentrations of substances capable of biomagnifying are excluded from further consideration, as are sediments that do not meet these criteria but have contaminant concentrations equal to or below reference concentrations. Biomagnification potential is initially addressed by conservative (worst case) modeling based on benthos and sediments and, subsequently, by additional food chain data and more realistic assumptions. Toxicity (acute and chronic) and alterations to resident communities are addressed by, respectively, laboratory studies and field observations. The integrative decision point for sediments is a weight of evidence (WOE) matrix combining up to 4 main LOE: chemistry, toxicity, community alteration, and biomagnification potential. Of 16 possible WOE scenarios, 6 result in definite decisions, and 10 require additional assessment. Typically, this framework will be applied to surficial sediments. The possibility that deeper sediments may be uncovered as a result of natural or other processes must also be investigated and may require similar assessment.

Animals↗
PubMed2004

[Assessment of mothers' knowledge about breastfeeding].

OBJECTIVES: The aim of this study was to assess the level of knowledge of problems referring to breastfeeding among women in childbirth. MATERIALS AND METHODS: The study was based on a questionnaire, which consisted of 20 questions with multiple choice answers. 108 women in puerperium were surveyed-54 in the Obstetrical Ward in Puck and the same number in the I Clinic of Obstetrics and Gynaecology in Warsaw. The results were analysed according to age, education and attendance to labour school. Statistical analysis was performed afterwards. RESULTS: For all the surveyed women, breastfeeding is a natural need and an important element of the emotional bond with a newborn. For 78.7% of the women questioned, the priority of breastfeeding was the health of their baby, 16.7% point to the advantages of the optimal composition of human milk, 37% of mothers found breastfeeding convenient. On the other hand, 37% consider artificial milk only a substitute. For 60% of women magazines were the source of education, books 53.7%, acquaintances and family 32.4%. Only a small percentage (24.1%) of women took advantage of labour classes, although it is an extremely successful method of teaching. 17.6% of women were not looking for any information about breastfeeding during the pregnancy. CONCLUSIONS: Differences in preferences and level of knowledge between women from big and small centre were shown, although there was no difference in access to it. Magazines and books, not medical staff, were the most popular source of information. The level of knowledge depends on education and labour class attendance. It seems that the system of lactational guidance should be extended on obstetrical wards, concentrating especially on women with poorest education.

Adult↗
PubMed1980

A structured approach to the integration of the clinical and didactic components of health career programs.

This paper presents a tested approach to a systematic progression of learning from the classroom to the clinical internship. The approach uses workbooks to integrate all facets of the training continuum. The basic model is training continuum. The basic model is called TAR. T refers to theory or teaching; A to application, which occurs during the clinical component; and R to reinforcement provided through seminars scheduled concurrently with fieldwork. The entire concept is introduced to students during a required weekly fieldwork preparation component scheduled prior to the first theory course. Clinicians and academicians participated in all phases of the three-year, HEW-funded project, which included development of interrelated performance objectives for the teaching, application and reinforcement components. Analysis of data from clinicians, students and faculty indicated that the TAR model provides a needed integrating structure.

Books↗