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PubMed1994

The association between cholesterol and death from injury.

PURPOSE: To review the association between low serum cholesterol and death from injury. DATA SOURCES: Relevant English-language papers identified through MEDLINE and Current Contents searches and bibliographies of identified articles. STUDY SELECTION: More than 150 articles were reviewed to identify data, meta-analyses, or important reviews of the association between low cholesterol and injuries. DATA EXTRACTION: Estimates of the association between cholesterol and death from injury were extracted from published reports. DATA SYNTHESIS: Animal studies and descriptive studies have provided little information about serum cholesterol and injuries. The Conference on Low Blood Cholesterol pooled results from 14 cohort studies in men and found a relative risk of 1.4 for death from injury in men whose cholesterol levels were lower than 4.14 mmol/L (160 mg/dL) compared with men whose cholesterol levels were 4.14 to 5.15 mmol/L (P = 0.003). Most cohort studies support this finding. The strongest evidence that cholesterol and death from injury are related comes from a meta-analysis of six randomized cardiac primary prevention trials of cholesterol reduction; the relative risk for death from injury for treated men compared with controls was 1.42 (95% Cl, 0.94 to 2.15). CONCLUSIONS: In cohort studies, the strength of the association between low serum cholesterol levels and subsequent death from injury is weak and may be caused by confounding factors such as socioeconomic status. The modestly elevated risk ratio found in a meta-analysis of trials of cholesterol reduction in men is of borderline statistical significance. This association may be related to efforts to lower cholesterol rather than to low absolute levels of serum cholesterol. Until more data are available, the hypothesized relation between low cholesterol and injuries remains unsettled.

Animals↗

PubMed1997

Anterior vaginal prolapse: review of anatomy and techniques of surgical repair.

OBJECTIVE: To summarize the literature on anterior vaginal prolapse, focusing on vaginal anatomy, etiologic theories, and comparison of anterior colporrhaphy and paravaginal repair. DATA SOURCES: We identified articles related to anterior vaginal prolapse through a MEDLINE search of English-language literature published from January 1966 through December 1995 and in bibliographies in gynecologic textbooks. METHODS OF STUDY SELECTION: We reviewed 80 articles published in peer-reviewed journals or textbooks and related to anterior vaginal prolapse. In addition, ten articles on operative procedures for urinary incontinence were studied. TABULATION, INTEGRATION, AND RESULTS: We abstracted and synthesized information from 31 papers that contained descriptions of and opinions on vaginal anatomy and etiology of vaginal prolapse. The vagina has three layers-mucosa, muscularis, and adventitia; there is no vaginal "fascia." Vaginal support is provided by the underlying levator ani muscles and by lateral connective-tissue attachments at the arcus tendineus fasciae pelvis or "white line." Anterior vaginal prolapse results from direct or indirect damage to the pelvic muscles or connective tissue or both. Forty-nine articles described surgical techniques for the correction of anterior vaginal prolapse, and 24 of them reported postoperative outcomes. Reported failure rates ranged from 0-20% for anterior colporrhaphy and 3-14% for paravaginal repair. No controlled studies compared different procedures performed primarily for correction of anterior vaginal prolapse. CONCLUSIONS: Dissection during anterior colporrhaphy splits vaginal muscularis, and repair involves plication of the muscularis and adventitia (not vaginal "fascia") in the midline, which may pull the lateral attachments further from the pelvic sidewall. Paravaginal repair restores the lateral attachments to the pelvic sidewall at the white line. Controlled studies that compare directly these two procedures for anterior vaginal prolapse repair are necessary to determine their relative effectiveness.

Female↗

PubMed2000

Antibiotics for acute maxillary sinusitis.

OBJECTIVES: For adults seeking care in ambulatory practices, sinusitis is the most common diagnosis treated with antibiotics. We examined whether antibiotics are indicated for acute sinusitis, and if so, which antibiotic classes are most effective. SEARCH STRATEGY: Relevant studies were identified from searches of MEDLINE and EMBASE in October 1998, contacts with pharmaceutical companies and bibliographies of included studies. SELECTION CRITERIA: Randomized trials were eligible that compared antibiotic to control or antibiotics from different classes for acute maxillary sinusitis. Additional criteria were diagnostic confirmation by radiograph or sinus aspiration, outcomes that included clinical cure or improvement and a sample size of 30 or more adults. Of 1784 potentially relevant studies, two or more reviewers identified 32 studies meeting selection criteria. DATA COLLECTION AND ANALYSIS: Data were abstracted independently by 2 persons and synthesized descriptively. Some data were analyzed quantitatively using a random effects model. Primary outcomes were a) clinical cure and b) clinical cure or improvement. Secondary outcomes were radiographic improvement, relapse rates, and dropouts due to adverse effects. MAIN RESULTS: Thirty-two trials, involving 7,330 subjects evaluated antibiotic treatment for acute maxillary sinusitis. Major comparisons were antibiotic vs. control (n=5); newer, non-penicillin antibiotic vs. penicillin class (n=10); and amoxicillin-clavulanate vs. other extended spectrum antibiotics (n=10). Most trials were conducted in otolaryngology settings. Only 5 trials described adequate allocation and concealment procedures; 10 were double-blind. Compared to control, penicillin improved clinical cures [relative risk (RR) 1.72, 95% CI 1.00 to 2.96]. Treatment with amoxicillin did not significantly improve cure rates (RR 2.06; 95% CI 0.65 to 6.53), but there was significant variability between studies. Radiographic outcomes were improved by antibiotic treatment. Comparisons between classes of antibiotics showed no significant differences: newer non-penicillins vs. penicillins (RR for cure 1.07; 95% CI 0.99 to 1.17); newer non-penicillins vs. amoxicillin-clavulanate (RR for cure 1.01, 95% CI 0.97 to 1.04). Compared to amoxicillin-clavulanate, dropouts due to adverse effects were significantly lower for cephalosporin antibiotics. Relapse rates within one month of successful therapy were 5%. REVIEWER'S CONCLUSIONS: For acute maxillary sinusitis confirmed radiographically or by aspiration, current evidence is limited but supports penicillin or amoxicillin for 7 to 14 days. Clinicians should weigh the moderate benefits of antibiotic treatment against the potential for adverse effects.

Acute Disease↗

PubMed2003

Radon therapy for the treatment of rheumatic diseases--review and meta-analysis of controlled clinical trials.

OBJECTIVE: The aim of this study was to analyze the effect of radon therapy on pain in rheumatic diseases. METHODS: MEDLINE and MedKur databases were searched for the terms radon plus therapy, rheum, arthritis, and osteo. Radon therapy centers and experts in the field were contacted, proceedings hand-searched, and bibliographies checked for references of potential importance. Included were all prospective randomized controlled clinical trials that compared clinical effects of radon therapy with other interventions in patients with rheumatic diseases and studied pain intensity. Information concerning patients, interventions, results, and methodology were extracted in a standardized manner by all authors independently and summarized descriptively. Reports on pain reduction were pooled for meta-analysis. RESULTS: Five clinical trials with a total of 338 patients and comparing the effect on pain of radon baths (three trials) or radon speleotherapy (two trials) with control intervention in degenerative spinal disease (two trials), rheumatoid arthritis (one trial) and ankylosing spondylitis (two trials) met the inclusion criteria. In meta-analysis, the pooled data showed no difference immediately after treatment (P=0.13) but significantly better pain reduction in the radon group than the control group at 3 months (P=0.02) and 6 months (P=0.002) after treatment. CONCLUSIONS: The existing trials suggest a positive effect of radon therapy on pain in rheumatic diseases. With respect to the potential clinical effect and given the increasing public interest in radon therapy, there is an urgent need for further randomized controlled clinical investigations with long-term follow-up.

Arthritis, Rheumatoid↗

PubMed2001

Systematic reviews of complementary therapies - an annotated bibliography. Part 2: herbal medicine.

BACKGROUND: Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with herbal medicine. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of herbal medicines; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pre-tested form and summarized descriptively. RESULTS: From a total of 79 potentially relevant reviews pre-selected in the screening process 58 met the inclusion criteria. Thirty of the reports reviewed ginkgo (for dementia, intermittent claudication, tinnitus, and macular degeneration), hypericum (for depression) or garlic preparations (for cardiovascular risk factors and lower limb atherosclerosis). The quality of primary studies was criticized in the majority of the reviews. Most reviews judged the available evidence as promising but definitive conclusions were rarely possible. CONCLUSIONS: Systematic reviews are available on a broad range of herbal preparations prescribed for defined conditions. There is very little evidence on the effectiveness of herbalism as practised by specialist herbalists who combine herbs and use unconventional diagnosis.

Herbal Medicine↗

PubMed1975

Drug interactions: the effects of alcohol and meprobamate applied singly and jointly in human subjects. I. Theoretical considerations and literature review.

The considerations necessary to describe the effects of combinations of drugs in a biological system are reviewed. The terms which express these effects-additive, potentiative, antagonistic, synergistic-have not had specific operations applied to them and mathematical models have been sought to define these operations. The models should (1) describe the nature of the action of single drugs, (2) classify the results of drug combinations, (3) provide a set of operations for deciding the outcome of combinations, and (4) predict all possible results of a combination from a knowledge of each drug acting alone. Research on the effects of alcohol and meprobamate and their interactions is reviewed, including behavioral and pharmacological studies and also some studies of the interaction of alcohol with other drugs. The task of characterizing the relation between the drug and response is formidable because complex physiological and biochemical processes determine the relationship between administered and effective dose and are further complicated by route of drug administration and various time relations. The descriptions of biochemical and physiological events seem well advanced; those of behavior are not. Much of the behavioral research assumes that a single dose is representative of all doses of the drug, and that combinations of the drugs and additivity of effects can be determined without a rigorous definition or means of application. [Bibliography of 249 items.]

Animals↗

PubMed1996

Benefits of parenteral deferoxamine for acute iron poisoning.

OBJECTIVE: To review the benefits of deferoxamine for the treatment of iron poisoning. METHODS: Both the basic science and clinical literature on deferoxamine were reviewed by comprehensive computer literature search. This was supplemented by references identified from bibliographies of pertinent articles and books. RESULTS: The basic science literature supports deferoxamine as an attractive antidote for iron poisoning. There were no dose response studies in the human or animal literature. There were no randomized controlled trials or case controlled studies of patients with toxicity (serum iron concentration > 500 micrograms/dL). All data were descriptive and anecdotal. Therefore fundamental parameters such as indications for administration, dose, route and duration of therapy are unclear and efficacy is unproven. CONCLUSION: Deferoxamine is attractive for the treatment of iron poisoning despite the lack of knowledge for its optimal use and remains the drug of choice for the treatment of significant iron poisoning.

Administration, Oral↗

PubMed1996

Antenatal psychosocial risk factors associated with adverse postpartum family outcomes.

OBJECTIVE: To determine the strength of the association between antenatal psychosocial risk factors and adverse postpartum outcomes in the family, such as assault of women by their partner, child abuse, postpartum depression, marital dysfunction and physical illness. DATA SOURCES: MEDLINE, Cinahl, Famli, Psych Abstracts and the Oxford Database of Perinatal Trials were searched from relevant articles published from Jan. 1, 1980, to Dec. 31, 1993, with the use of MeSH terms "depression, involutional," "child abuse," "child neglect," "domestic violence," "family," "marital adjustment," "family health," "newborn health," "child health," "physical illness," "social support," "psychosocial risk," "prediction," "risk factors," "obstetrics" and "prenatal care." Further articles were identified from bibliographies. STUDY SELECTION: Of the 370 articles identified through the search, 118 were included for review. Studies were included if they examined the association between psychosocial risk factors and the outcomes of interest. Articles were excluded if they were reviews of poor quality or they had one or more of the following features: insufficient description of the sample, a high attrition rate, a lack of standardized outcome measures, outcomes other than the ones of interest or results that had already been reported in a previous study. DATA EXTRACTION: The strength of evidence of each study was evaluated. On the basis of the evidence, each risk factor was assigned a rating of the strength of its association with each of the postpartum outcomes. The ratings were class A (good evidence of association), class B (fair evidence) and class C (no clear evidence). Of the 129 antenatal psychosocial risk factors studied, 15 were found to have a class A association with at least one of the postpartum outcomes. DATA SYNTHESIS: Child abuse and abuse of the mother by her partner were most strongly correlated (class A evidence) with a history of lack of social support, recent life stressors, psychiatric disturbance in the mother and an unwanted pregnancy. Child abuse was also strongly associated with a history of childhood violence in the mother or her partner, previous child abuse by the mother's partner, a poor relationship between the mother and her parents, low self-esteem in the mother and lack of attendance at prenatal classes. Postpartum abuse of the mother was also associated with a history of abuse of the mother, prenatal care not started until the third trimester and alcohol or drug abuse by the mother or her partner (class A evidence). Child abuse had a fair (class B) association with poor marital adjustment or satisfaction, current or past abuse of the mother and alcohol or drug abuse by the mother or her partner. There was class B evidence supporting an association between abuse of the mother and poor marital adjustment, traditional sex-role expectations, a history of childhood violence in the mother or her partner and low self-esteem in the mother. Postpartum depression was most strongly associated with poor marital adjustment, recent life stressors, antepartum depression (class A evidence), but was also associated with lack of social support, abuse of the mother and a history of psychiatric disorder in the mother (class B evidence). Marital dysfunction was associated with poor marital adjustment before the birth and traditional sex-role expectations (class A evidence), and physical illness was correlated with recent life stressors (class B evidence). CONCLUSIONS: Psychosocial risk factors during the antenatal period may herald postpartum morbidity. Research is required to determine whether detection of these risk factors may lead to interventions that improve postpartum family outcomes.

Child↗

PubMed2002

A women's health track for internal medicine residents using evidence-based medicine.

OBJECTIVES: Evidenced-based medicine has established itself as an integral part of medical education and practice. The explosion of new knowledge in women's health and the need to teach this to internal medicine residents in an evidence-based fashion have presented a challenge to medical educators. To address this need, we developed and implemented an evidence-based women's health curriculum to be used in addition to clinical training in a women's health center for internal medicine residents. The objectives of the curriculum are to (1) define and utilize basic evidence-based medicine concepts to critically analyze women's health literature, (2) understand recent innovations in women's health from an evidence-based viewpoint, (3) gain clinical experience in women's health, and (4) apply evidence-based medicine to the clinical practice of women's health. DESCRIPTION: We designed our curriculum based on recommendations from the National Academy of Women's Health Medical Education, the American Board of Internal Medicine, the Fifth Report of the Council on Graduate Medical Education, and the results of needs assessments of internal medicine residents at our institution. Using Medline to create a women's health bibliography, an extensive literature search was performed on the following topics: osteoporosis, breast cancer, hormone replacement therapy, domestic violence, coronary artery disease in women, menopause, headaches, substance abuse in women, urinary incontinence, dementia, sexual dysfunction, and evidence-based medicine. Peer-reviewed journal articles were compiled by subject matter for placement in our clinic's resource center and were entered into a computerized database that will link with online journals and be available for electronic access. Most articles were selected based on the criteria of data published since 1990, and randomized, double-blinded, placebo-controlled studies were given preference. Weekly 45-minute sessions preceding the resident clinic in the women's health center are held in a journal-club format to review literature in a systematic fashion. Faculty and residents review and analyze one to two articles weekly. Content experts provide context and clinical expertise to resident discussions. Clinical questions, such as "Should I prescribe hormone replacement therapy to my postmenopausal patient?" are addressed in each session. Evidence-based medicine core concepts are reviewed and applied; these core concepts include the number needed to treat, absolute risk reduction, and relative risk. DISCUSSION: The women's health curriculum, weekly conferences, and clinical experience serve to update residents and clinicians in women's health literature, to exchange ideas for the improvement of women's health as it is taught in internal medicine, and to further elucidate the evidence behind what we practice and teach. The curriculum equips physicians to provide patients with solid, evidence-based interpretations of new scientific knowledge to discern truth from fallacy.

Curriculum↗

PubMed1993

125I-fibrinogen leg scanning: reassessment of its role for the diagnosis of venous thrombosis in post-operative patients.

OBJECTIVE: To determine the reasons why 125I-fibrinogen leg scanning, a screening test which was reported to be very sensitive for the detection of post-operative thrombosis, has shown poor sensitivity in contemporary studies. STUDY IDENTIFICATION: English-language reports were identified through a Medline computer search (1965-1991), Current Contents, and an extensive manual search of the bibliographies in identified articles. STUDY SELECTION: Studies in orthopaedic or general surgical patients were reviewed that compared 125I-fibrinogen leg scanning with venography in all patients (accuracy studies) or in patients in whom 125I-fibrinogen leg scanning became positive (positive predictive value studies). DATA EXTRACTION: A systematic appraisal of study design and specific descriptive information concerning the selection of patients. RESULTS OF DATA SYNTHESIS: Six of the 15 studies which compared 125I-fibrinogen leg scanning with venography were level 1 studies (potential for bias minimized) and nine were classified as level 2 studies (potential for bias not minimized). In orthopaedic surgical patients, the pooled sensitivity of leg scanning for isolated calf vein thrombosis, for all venous thrombosis, and the pooled specificity were 55%, 45%, and 92% for the level 1 studies, respectively. These indices were 88%, 82%, and 79%, respectively for the level 2 studies (P < 0.001). Only two (level 2) studies were found that evaluated the accuracy of leg scanning for venous thrombosis in general surgical patients. CONCLUSION: We conclude that leg scanning is an insensitive method for the screening of post-operative venous thrombosis in orthopaedic patients. Our findings call into question the validity of the many studies (including meta-analyses) evaluating prophylactic agents for venous thrombosis which used leg scanning as the only test for the assessment of efficacy.

Fibrinogen↗

PubMed1999

[Some bibliographies of pestilences. Johannes Jacobi in Antwerp (circa 1484-circa 1491)].

One of the many works on the plague is by the Frenchman Johannes Jacobi. It dates from the 14th century and has been passed down in numerous manuscripts, and from the last quarter of the 15th century, also in many printed documents. Curiously, the latter are in the name of Canutus, Kami(n)tus, and the like. Virtually all the prints are undated, and were usually published without an indication of the place of publication or the name of the printer. The editions from the Southern Netherlands are no exception to this general rule. After a very brief description of the author and the contents, some attention is paid to the distribution of the publication in Europe, followed by a more detailed discussion of the different editions in Antwerp, published by Mathias van der Goes and Gheraert Leeu. The bibliographical analysis of these prints made wide use of the results of bibliographical research, and of the incomparable aid of the IISTC, the bibliographical data bank of incunabula. Thus the presumed dates can be compared with the latest results, and in this way be confirmed, altered or stated more precisely. Finally, following this bibliographical exercise, the author examines whether these dates could conflict with what we know about the plague epidemic in our country from other sources.

Disease Outbreaks↗

PubMed2004

Descriptive review of the literature on breast cancer outcomes: 1990 through 2000.

BACKGROUND: There is increasing interest in the incorporation of nonbiomedical outcomes into cancer research. OBJECTIVE: Our goal was to review the use of nonbiomedical outcomes in research on breast cancer care. DATA SOURCES: We conducted a MEDLINE search of all studies on breast cancer quality of life, preferences, satisfaction, and economics that were published during the period from January 1, 1990, through December 31, 2000. We also searched bibliographies of published articles. STUDY SELECTION: We included original primary research and excluded reviews, methods papers, studies conducted outside the United States and Western Europe, or studies with fewer than 100 subjects. DATA ABSTRACTION: Data were abstracted by using a structured tool. DATA SYNTHESIS: There were 1089 articles identified; 230 were included. The greatest proportion of research focused on survivorship followed by screening. The most frequently reported outcomes were health-related quality of life (54%) followed by economic analyses (38%) and patient satisfaction (14%); only 9% measured patient preferences. Few studies included more than 10% nonwhite populations or focused on the elderly. No single instrument was used in more than 10% of the studies, and many authors developed de novo tools for use in their study. Methodologic flaws were prevalent and included use of nonstandard economic methods, insufficient power, low or differential response rates, and lack of control for baseline status. CONCLUSION: At present, outcomes measurement is variable in its approach and application to breast cancer care. More research is needed to develop practical approaches that are reliable, valid, and feasible in routine practice, that are applicable to diverse populations, and that can inform interventions to improve the quality of care across the full spectrum of services.

Breast Neoplasms↗

PubMed1996

Intravenous amiodarone: pharmacology, pharmacokinetics, and clinical use.

OBJECTIVE: To review the clinical pharmacology, pharmacokinetics, and clinical efficacy and safety of intravenous amiodarone. DATA IDENTIFICATION: Articles were identified through a computer search of the English-language literature using MEDLINE (KR Information OnDisc) and the search term amiodarone. Additional articles were identified through examination of the bibliographies of the articles initially retrieved. STUDY SELECTION: Relevant or representative animal studies, clinical trials, and case reports were selected for evaluation. Particular emphasis was placed on studies pertaining to the use of intravenous amiodarone in treatment-refractory ventricular fibrillation (VF) and hemodynamically unstable ventricular tachycardia (VT). DATA EXTRACTION: The literature was assessed for adequate description of patients, study methodologies (e.g., study design, number of patients), and outcomes. DATA SYNTHESIS: Amiodarone is an unusual class III antiarrhythmic that produces each of the four main types of antiarrhythmic action in addition to other effects, such as vasodilatory, selective antithyroid, and other activities that may be therapeutically relevant. Amiodarone pharmacokinetics demonstrate extensive interpatient variability and are characterized by wide tissue distribution (steady-state volume of distribution 40-84 L/kg), slow total body clearance (90-158 mL/h/kg), long terminal elimination half-life (20-47 d), and extensive hepatic metabolism. The onset of maximal antiarrhythmic effect is a function of both amiodarone dosage and time. The high plasma concentrations achieved with intravenous dosing do not fully replicate the electrophysiologic effects observed following long-term oral administration, particularly with respect to class III activity. Available data suggest that intravenous amiodarone is associated with an efficacy rate of 50% or more in treatment-refractory VT/VF, and has a relatively rapid (2-24 h) onset of action. The drug is relatively well tolerated, but close hemodynamic, electrocardiographic, and hepatic function monitoring are required. The value of using amiodarone serum concentrations to guide therapy remains uncertain. CONCLUSIONS: Intravenous amiodarone is an effective, relatively safe antiarrhythmic for the treatment of recurrent, hemodynamically unstable VT/VF refractory to other drug therapy in the acute care setting.

Amiodarone↗

PubMedDate not supplied

Corticosteroid injection for treatment of de Quervain's tenosynovitis: a pooled quantitative literature evaluation.

BACKGROUND: There have been many approaches described to treat de Quervain's tenosynovitis, but no definite consensus emerges in the literature. We conducted a pooled quantitative literature evaluation to review the therapeutic studies in the English language to determine the various reported cure rates. METHODS: All citations in the MEDLINE and Ovid databases that addressed de Quervain's tenosynovitis were independently reviewed. Appropriate studies from the bibliographies of these articles were then obtained. Of the 35 articles on de Quervain's temosynovitis that were found in the modern literature, only seven allowed for comparison among potentially effective treatments. Studies were included if they evaluated or compared treatment options among patients and had defined criteria for diagnosis and successful treatment. These seven studies were descriptive, not comparative. In other words, each study reported the proportion of successful outcomes with different treatments, without a comparison to a specified control group. Four hundred fifty-nine wrists were subjected to one of several therapeutic modalities. RESULTS: There was an 83% cure rate with injection alone. This rate was much higher than any other therapeutic modality (61% for injection and splint, 14% for splint alone, 0% for rest or nonsteroidal anti-inflammatory drugs). CONCLUSION: It seems that injection alone is the best therapeutic approach to de Quervain's tenosynovitis.

Adrenal Cortex Hormones↗

PubMed2004

The Molecular Pages of the mesotelencephalic dopamine consortium (DopaNet).

BACKGROUND: DopaNet http://www.dopanet.org is a Systems Biology initiative that aims to investigate precisely and quantitatively all the aspects of neurotransmission in a specific neuronal system, the mesotelencephalic dopamine system. The project should lead to large-scale models of molecular and cellular processes involved in neuronal signaling. A prerequisite is the proper storage of knowledge coming from the literature. METHODS: DopaNet Molecular Pages are highly structured descriptions of quantitative parameters related to a specific molecular complex involved in neuronal signal processing. A Molecular Page is built by maintainers who are experts in the field, and responsible for the quality of the page content. Each piece of data is identified by a specific ontology code, annotated (method of acquisition, species, etc.) and linked to the relevant bibliography. The Molecular Pages are stored as XML files, and processed through the DopaNet Web Service, which provides functionalities to edit the Molecular Pages, to cross-link the Pages and generate the public display, and to search them. CONCLUSIONS: DopaNet Molecular Pages are one of the core resources of the DopaNet project but should be of widespread utility in the field of Systems Neurobiology.

Animals↗

PubMedDate not supplied

Antibiotics in chronic obstructive pulmonary disease exacerbations. A meta-analysis.

OBJECTIVE: A meta-analysis of randomized trials was performed to estimate the effectiveness of antibiotics in treating exacerbations of chronic obstructive pulmonary disease (COPD). DATA SOURCES: English-language studies published from 1955 through 1994 were retrieved using MEDLINE, Index Medicus, bibliographies, and consultation with experts. MEDLINE search terms included "COPD," "chronic bronchitis," and "antibiotic(s)." STUDY SELECTION: Only randomized trials that enrolled patients having an exacerbation of COPD, used an antibiotic in the treatment group and placebo in the control group, and provided sufficient data to calculate an effect size were included in the meta-analysis. DATA EXTRACTION: Descriptive and outcome data from each study were independently in the meta-analysis. DATA SYNTHESIS: Overall summary effect size of the nine trials satisfying all inclusion criteria was 0.22 (95% confidence interval [CI], 0.10 to 0.34), indicating a small benefit in the antibiotic-treated group. Similar analysis of the six studies that provided data on peak expiratory flow rate changes revealed a summary effect size of 0.19 (95% CI, 0.03 to 0.35) and a summary change in peak expiratory flow rate of 10.75 L/min (95% CI, 4.96 to 16.54 L/min) in favor of the antibiotic-treated group. Sensitivity analyses did not significantly affect these results. CONCLUSIONS: These analyses suggest a small but statistically significant improvement due to antibiotic therapy in patients with exacerbations of COPD. This antibiotic-associated improvement may be clinically significant, especially in patients with low baseline flow rates.

Anti-Bacterial Agents↗

PubMed2003

The adoption history project: A new on-line resource.

The author offers a brief description of The Adoption History Project, a Web site launched on June 1, 2003, that covers the people and organizations, issues, and studies, that shaped adoption in theory and practice throughout the 20th century. The Adoption History Project offers many brief biographical and topical sketches, a wealth of primary texts (excerpted from published and unpublished sources), numerous images, a timeline, bibliography, and a search engine. Historians of psychology will be especially interested in how the consolidation of professional communities (in psychology, social work, and medicine) influenced family formation and in the history of the adoption research industry.

Adoption↗

PubMed1997

Maternal cigarette smoking and oral clefts: a meta-analysis.

OBJECTIVE: A meta-analysis was performed to estimate the association between maternal cigarette smoking and the risk of having a child with a nonsyndromic oral cleft (NSOC). DESIGN: Studies published from 1966 through 1996 were retrieved using MEDLINE, Current Contents, bibliographies, and other sources. MEDLINE and Current Contents search terms included "oral clefts," "cigarette smoking," "birth defects," and "congenital malformations." Cohort and case-control studies that enrolled oral cleft patients [cleft lip with or without cleft palate (CL/P), cleft palate (CP), or both] and controls, and presented information on maternal cigarette exposure during pregnancy were included in the analysis. Descriptive and outcome data from each study were independently abstracted by two authors. RESULTS: The overall odds ratio of the 11 studies satisfying criteria was 1.29 [95% confidence interval (CI), 1.18 to 1.42] for CL/P and 1.32 (95% CI: 1.10 to 1.62) for CP, indicating a small increase risk of having a child with either a CL/P or a CP for mothers who smoke during the first trimester of the pregnancy. CONCLUSIONS: These analyses suggest a small but statistically significant association between maternal cigarette smoking during the first trimester of gestation and increased risk of having a child with a CL/P or CP.

Cleft Lip↗