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At least 217 records · Page 12Linked to original sources

PubMed2003

Accuracy of precision diagnostic blocks in the diagnosis of chronic spinal pain of facet or zygapophysial joint origin.

CONTEXT: Facet or zygapophysial joint blocks are used extensively in the evaluation of chronic spinal pain. However, there is a continuing debate about the value and validity of facet joint blocks in the diagnosis of chronic spinal pain. The value of diagnostic facet joint injections may have been overlooked in the medical literature. OBJECTIVES: To determine the accuracy of facet joint blocks in the diagnosis of chronic spinal pain of facet joint origin and also determine the rationale, principles, false-positive rate, and diagnostic utility of facet joint blocks as well as prevalence of facet joint pain. METHODS: Relevant literature was identified through searches of MEDLINE, EMBASE (Jan 1966- Mar 2003), manual searches of bibliographies of known primary and review articles, and abstracts from scientific meetings. Studies were selected if they were either placebo-controlled or comparative local anesthetic blocks and met 3 of the 5 criteria established by the Agency for Healthcare Research and Quality. Information extracted from each study included the details about the study, type, design, patient eligibility criteria, and statistical analysis. Studies were excluded from analysis if they were simply a review or descriptive or involved only a single-block. RESULTS: The data showed that there was conclusive evidence demonstrating that facet joints have a nerve supply and are capable of causing pain with provocation in normal volunteers that reproduces typical pain attribution clinically to facet joints. The studies demonstrated a prevalence of facet joint pain in chronic spinal pain patients of 15% to 45% in lumbar spine, up to 48% in thoracic spine, and 54% to 67% in the cervical spine. Single diagnostic blocks showed a false-positive rate of 27% to 63%. CONCLUSION: The diagnostic accuracy of controlled local anesthetic facet joint blocks is high in the diagnosis of chronic spinal pain.

Journal Article↗

PubMed1996

Routine diagnostic imaging for childhood urinary tract infections: a systematic overview.

OBJECTIVE: To assess the quality of the evidence on which current recommendations for routine diagnostic imaging for childhood urinary tract infection are based. METHODS: A systematic overview of the literature using the MEDLINE database (1966 to October 1994), article bibliographies, and a manual search of current publications using Current Contents, was undertaken. Preset criteria were used to categorize study sample and design, and interrater reliability was assessed with a random sample. RESULTS: A total of 434 publications were evaluated, and 63 studies met the criteria for inclusion. There was 100% interrater agreement on inclusion eligibility and design classification. No controlled trials or analytic studies evaluating routine diagnostic imaging were found. All 63 studies were descriptive, and only 10 were prospective. None of the studies provided evidence of the impact of routine imaging on the development of renal scars and clinical outcomes in children with their first urinary tract infection. CONCLUSION: Methodologically sound, prospective studies are needed to assess whether children with their first urinary tract infection who have routine diagnostic imaging are better off than children who have imaging for specific indications. We conclude that the current recommendations are not based on firm evidence.

Adolescent↗

PubMed2006

SOGC clinical practice guidelines. Ultrasound evaluation of first trimester pregnancy complications. Number 161, June 2005.

OBJECTIVES: First, to review normal embryonic development and the sonographic evidence of early pregnancy failure; second, to review sonographic evidence of ectopic pregnancy. OUTCOMES: First, prediction of pregnancy failure, second, sonographic identification of ectopic pregnancy. EVIDENCE: A MEDLINE search and review of bibliographies in identified articles was conducted. VALUES: The evidence was reviewed by the Diagnostic Imaging Committee along with the principal authors. A quality of evidence assessment was undertaken as outlined in the report of the Canadian Task Force on the Periodic Health Examination (Table 1). BENEFITS, HARMS, AND COSTS: Women presenting with first trimester bleeding may be incorrectly diagnosed with a missed abortion and (or) may be inappropriately reassured about viability. Transvaginal ultrasound provides improved resolution allowing description of early embryonic development characteristics. Improvement in the identification of the sonographic landmark of normal embryonic development and awareness of the sonographic risk factors of pregnancy failure may lead to more successful management strategies. Diagnosis of suspected ectopic pregnancy often involves an assessment of both hormonal markers and sonographic features. Maternal morbidity and mortality can be reduced with an early diagnosis of ectopic pregnancy. RECOMMENDATIONS: There is good (class A) evidence that current ultrasound technology can distinguish between normal and abnormal pregnancies in the first trimester. There is good (class A) evidence that transvaginal ultrasound in conjunction with quantitative-HCG can diagnose ectopic pregnancy.

Embryonic Development↗

PubMedDate not supplied

Vance Tartar: a unique biologist.

Vance Tartar (1911-1991) has made major discoveries concerning morphogenesis, patterning, and nucleocytoplasmic relations in the giant ciliate Stentor coeruleus, mostly by means of hand-grafting using glass microneedles. This article provides a chronological account of the major events of Vance Tartar's life, a brief description of some of his major scientific achievements, and a discussion of his distinctive personality and multifaceted interests. It concludes with a consideration of how his unique style of life and work contributed to his equally unique scientific contributions.

Animals↗

PubMed2002

Use of plasma aldosterone concentration-to-plasma renin activity ratio as a screening test for primary aldosteronism. A systematic review of the literature.

The aldosterone-renin ratio is widely used to screen for primary aldosteronism. We conducted a systematic review of the literature to establish the test characteristics (sensitivity, specificity, likelihood ratios at different cutoff values) of the aldosterone-renin ratio used in screening for primary aldosteronism in subjects with presumed essential hypertension. We searched Medline, EMBASE, and Current Contents databases, bibliographies of retrieved papers, and personal files for all reports published from January 1966 to October 2001. We consulted experts to identify additional published and unpublished reports. We included prospective studies of the ratio as a screening test for primary aldosteronism, without applying language or data availability restrictions. We excluded retrospective studies, case reports, and duplicate or preliminary reports. Working independently, we selected the articles, assessed their quality, and extracted their data. Data extracted included sample size and care setting, description of the testing conditions, description of the confirmatory tests, and the test characteristics of the ratio (sensitivity, specificity, likelihood ratios at different cutoff values). This review includes 16 studies with 3136 participants. None of the studies evaluated the aldosterone-renin ratio and the reference standard independently of each other; only two studies evaluated patients who had a "negative" ratio with the reference standard. Only 16.7% of the subjects had both the ratio and the confirmatory test performed. Ratio cutoff values ranged from 200 to 2774 pmol/L per ng/mL per hour. None of the studies provided valid estimates of the aldosterone-renin ratio test characteristics. There are no published valid estimates of the test characteristics of the aldosterone-renin ratio when used as a screening test for primary aldosteronism in patients with presumed essential hypertension.

Aldosterone↗

PubMed2001

Searching fee and non-fee toxicology information resources: an overview of selected databases.

Toxicology profiles organize information by broad subjects, the first of which affirms identity of the agent studied. Studies here show two non-fee databases (ChemFinder and ChemIDplus) verify the identity of compounds with high efficiency (63% and 73% respectively) with the fee-based Chemical Abstracts Registry file serving well to fill data gaps (100%). Continued searching proceeds using knowledge of structure, scope and content to select databases. Valuable sources for information are factual databases that collect data and facts in special subject areas organized in formats available for analysis or use. Some sources representative of factual files are RTECS, CCRIS, HSDB, GENE-TOX and IRIS. Numerous factual databases offer a wealth of reliable information; however, exhaustive searches probe information published in journal articles and/or technical reports with records residing in bibliographic databases such as BIOSIS, EMBASE, MEDLINE, TOXLINE and Web of Science. Listed with descriptions are numerous factual and bibliographic databases supplied by 11 producers. Given the multitude of options and resources, it is often necessary to seek service desk assistance. Questions were posed by telephone and e-mail to service desks at DIALOG, ISI, MEDLARS, Micromedex and STN International. Results of the survey are reported.

Bibliographies as Topic↗

PubMed1990

An update on the CHILDES/BIB (formerly ISU/CHILDES) database.

A description is given of the CHILDES/BIB database, its contents, and its relationship to the CHILDES database. CHILDES is a depository of child language corpora, and the publisher of CHAT (a transcription manual), and CLAN (an electronic package for child language research). CHILDES/BIB is an electronic bibliographic database that is an autonomous unit of CHILDES.

Bibliographies as Topic↗

PubMed2006

[Forensic psychiatric systems in the world].

OBJECTIVE: The study aims to approach forensic psychiatry within different contexts. It endeavors to show how this specific psychiatry science area is influenced by legal and cultural aspects. METHOD: The bibliography reviewed had in view understanding the different ways of how to deal with law within the psychiatric sphere, from a cultural point of view. RESULTS: there is a great heterogeneity, of different nature (legal, political, cultural, and religious) that enrich, but at the same time makes difficult, a debate about this issue. CONCLUSIONS: there are two great obstacles to achieve a good knowledge about the practice of forensic psychiatry all over the world. The first one is represented by a heterogeneity that makes difficult its description in a comprehensible way. The second is the lack of knowledge of the cultural diverse realities. These difficulties should be a stimulus for newer studies of this characteristic. Only in this way it becomes possible to gradually increase the comprehension of this issue.

Africa↗

PubMed2005

Palatal development of preterm and low birthweight infants compared to term infants - What do we know? Part 1: The palate of the term newborn.

BACKGROUND: The evidence on prematurity as 'a priori' a risk for palatal disturbances that increase the need for orthodontic or orthognathic treatment is still weak. Further well-designed clinical studies are needed. The objective of this review is to provide a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development. One focus of this review is the analysis of studies on the palate of the term newborn, since knowing what is 'normal' is a precondition of being able to assess abnormalities. METHODS: A search profile based on Cochrane search strategies applied to 10 medical databases was used to identify existing studies. Articles, mainly those published before 1960, were identified from hand searches in textbooks, encyclopedias, reference lists and bibliographies. Sources in English, German, and French of more than a century were included. Data for term infants were recalculated if particular information about weight, length, or maturity was given. The extracted values, especially those from non-English paper sources, were provided unfiltered for comparison. RESULTS: The search strategy yielded 182 articles, of which 155 articles remained for final analysis. Morphology of the term newborn's palate was of great interest in the first half of the last century. Two general methodologies were used to assess palatal morphology: visual and metrical descriptions. Most of the studies on term infants suffer from lack of reliability tests. The groove system was recognized as the distinctive feature of the infant palate. The shape of the palate of the term infant may vary considerably, both visually and metrically. Gender, race, mode of delivery, and nasal deformities were identified as causes contributing to altered palatal morphology. Until today, anatomical features of the newborn's palate are subject to a non-uniform nomenclature. CONCLUSION: Today's knowledge of a newborn's 'normal' palatal morphology is based on non-standardized and limited methodologies for measuring a three-dimensional shape. This shortcoming increases bias and is the reason for contradictory research results, especially if pathologic conditions like syndromes or prematurity are involved. Adequate measurement techniques are needed and the 'normal palatal morphology' should be defined prior to new clinical studies on palatal development.

Humans↗

PubMed1991

The Wilfred Fish memorial lecture. The Hunterian tradition in dentistry.

The influence of William and John Hunter upon the development of Medicine and Dentistry in Britain has endured for more than two centuries. John Hunter's first book set out the morphological details of the teeth and their associated structures. From this basis he sought to attain an understanding of physiological and pathological processes by studies of the entire animal kingdom and by experimentation. His foundations of scientific dentistry were built upon by John Tomes and Wilfred Fish in subsequent centuries, both invoking the use of microscopy to enhance Hunter's naked eye descriptions and to interpret the results of experiments. Both, too, are inseparably linked with the history of the Royal College of Surgeons of England by the parts they played in establishing and preserving the place of their profession in that great repository of Hunter's teachings.

History of Dentistry↗

PubMedDate not supplied

Midwifery care research: what questions are being asked? What lessons have been learned?

PURPOSE: To create and critically evaluate a research database about midwifery care that identifies topics studied, research methods, results, funding, publication data, and implications for a future midwifery research agenda. METHODS: Systematic literature review. Studies included were 1) data-based research; 2) about midwifery care or practice; 3) in the United States; and 4) published between 1984-1998. The CINAHL and MEDLINE electronic databases were searched using a defined strategy, and relevant journals and bibliographies were searched by hand. RESULTS: This 15-year review identified 140 studies of midwifery care published in 161 papers. A midwife was the lead author on 60%. Sixty percent were published in the Journal of Nurse-Midwifery. Six to 15 studies were published each year, and both the number of publications and funding increased over the time period. The six major areas of focus were: 1) midwifery management, 2) structure of care, 3) midwifery practice, 4) midwife-physician comparisons, 5) place of birth, and 6) care of vulnerable populations. DISCUSSION: Although retrospective descriptive studies still predominate, more prospective studies, randomized controlled trials, multi-site studies, and quasi-experimental designs are being conducted. Qualitative methods are helping to measure nontraditional outcomes. A research agenda should be established based on discussion and debate within the profession. Midwife investigators need to build research teams and collaborate with other disciplines. Key areas for future research include alternative therapies, breastfeeding, cost-effectiveness, cultural studies, gynecology, health policy, menopause, postpartum care, substance abuse interventions, and the woman's experience of birth and midwifery care.

Data Collection↗

PubMed1996

[Proximal spinal muscular atrophy in the adult].

Based on personal experience and recent advances in the molecular genetics of spinal muscular atrophies (SMA), the author reviews the main features of adult SMA predominantly affecting the proximal musculature. Hereditary SMA forms linked to characteristic chromosome abnormalities are distinguished from those that have not been linked to any known gene. Among the first type, recessive autosomal inherited forms linked to chromosome 5 are mentioned and the description is extended to progressive bulbar-spinal amyotrophy and Kennedy syndrome, linked to the X chromosome, whose gene also codifies androgenic receptors, constituting a syndrome with clear neuro-endocrine involvement. In dealing with SMA forms that have not been linked to a gene, the author details, always from personal experience, those with scapuloperoneal involvement, of which Stark-Kaeser syndrome is the prototype. Finally, the author discusses non hereditary types, covering current knowledge of chronic anterior poliomyelitis, the concept of monomelic spinal muscular atrophy and post-poliomyelitis muscle syndrome. The author's extensive personal bibliography completes the chapter.

Adult↗

PubMedDate not supplied

Considerations in the humane use of laboratory animals in radiology research.

Our institution has recognized both the scientific and ethical responsibilities for the humane treatment of laboratory animals in the Radiology Research Laboratory. The Laboratory Animal Resource Center is specific in its requirements for the procurement, housing, and general care given to those animals used in our laboratory. In accordance with NIH guidelines, Animal Care Committee rules require investigators to provide detailed descriptions of research protocols so that appropriate care can be assured. The investigator is responsible ultimately for the thoughtful treatment of the animals before, during, and after the investigation. In the forseeable future, the use of laboratory animals will continue to be of paramount importance to the advancement of biomedical and imaging technology.

Animal Care Committees↗

PubMed2003

Interventions to modify sexual risk behaviors for preventing HIV infection in men who have sex with men.

BACKGROUND: MSM remain at great risk for HIV infection. Program planners and policy makers need descriptions of interventions and quantitative estimates of intervention effects to make informed decisions concerning prevention efforts. OBJECTIVES: 1. To locate and describe outcome studies evaluating the effects of behavioral and social interventions targeting MSM. 2. To summarize the effectiveness of these interventions among MSM. 3. To stratify results by characteristics of interventions and participants. 4. To identify gaps and indicate future research, policy, and practice needs. SEARCH STRATEGY: We searched electronic databases (MedLine, PsycInfo, etc.); several current journals (e.g., AIDS, AIDS and Behavior, AIDS Education and Prevention, American Journal of Public Health, Journal of Acquired Immune Deficiency Syndromes, etc.); manuscripts submitted by researchers; bibliographies of relevant articles; and other published reviews, for published and unpublished reports from 1988 through 1997. SELECTION CRITERIA: Studies were considered in scope if they examined the effects of behavioral interventions to reduce risk for HIV or STD transmission. We reviewed studies in scope for criteria of outcome relevance (measurement of at least one of a list of behavioral or biologic outcomes, e.g., unprotected sex or incidence of HIV infections) and methodologic rigor (randomized controlled trials or certain strong quasi-experimental designs with comparison groups). DATA COLLECTION AND ANALYSIS: As of June 1998 we had identified 13 eligible studies. Twelve studies (7 trials of small group interventions, 3 community-level interventions, and 2 individual level interventions) reported intervention effects on unprotected sex. Because few studies reported effects on condom use (3 studies), number of sex partners without regard to condom use (4 studies), or HIV or STD incidence (1 study in which no infections occurred) we do not address these outcomes at this time. We present those analyses which can be performed in the current Cochrane RevMan software, followed by more complete analyses that permit inclusion of community-level studies, adjustment for baseline conditions, calculation of effect sizes from a wider variety of statistics (e.g., an F-statistic from a one-way ANOVA), and simultaneous meta-analysis of continuous and dichotomous outcomes (Johnson 2002b). We translate the summary effect to reduction in risk behavior based on the background prevalence of unprotected sex. Finally we provide analyses stratified by intervention content (interpersonal skills addressed or not), intervention format (community vs small group or individual) and mean age of participants (23 to 31 vs. 32 to 36). MAIN RESULTS: A summary measure of intervention effects on reducing unprotected sex was favorable (odds ratio = 0.73) and statistically significant (CI, 0.60 to 0.88), corresponding to a 23% reduction in the proportion of men engaging in unprotected sex. Effects were homogeneous among studies, but were slightly more favorable among community-level interventions, those that served populations in their 20s rather than their 30s, and those that promoted interpersonal skills. REVIEWER'S CONCLUSIONS: These studies demonstrate that interventions can promote risk reduction among MSM. Yet given the epidemiology of HIV in Pattern I countries, the small number of rigorous controlled intervention trials for this population is striking. Many more rigorous evaluations of HIV prevention efforts with MSM are needed to ascertain with confidence the effects of specific intervention components, population characteristics, and methodologic features.

HIV Infections↗

PubMed1995

Clinical manifestations of trisomy 4p syndrome.

UNLABELLED: Trisomy 4p syndrome is a distinct clinical entity which was noted almost a quarter century ago by Wilson et al. [71] and later was delineated by Gonzalez and colleagues [29]. The variation in the length of duplicated segment usually associated with monosomy of other genetic material which has resulted in confusion and as a result a so-called 4p syndrome could not be recognized without cytogenetic analysis. We wish to draw the attention of clinicians to this subject by presenting the description of over 75 cases including one from our clinic and stress the point that molecular approaches are imperative to characterize this anomaly. After extensive review, it appears that patients retaining at least the distal two-thirds to the entire short arm share an overlapping phenotypic expression that constitutes pure trisomy 4p syndrome which includes prominent glabella, bulbous nose with flat or depressed nasal bridge, retrognathia, pointed chin, short neck with low hairline, enlarged ears with abnormal helix and antihelix, rocker-bottom feet with prominent heel. Arachnodactyly and camptodactyly. Molecular characterization of 4p is imperative. We have also included an extensive bibliography for clinicians who may find it useful as a single reference source for evaluating their future cases. CONCLUSION: The 4p-syndrome is a distinct entity but without cytogenetic evaluation, the syndrome can not be recognized.

Abnormalities, Multiple↗

PubMed2005

A systematic review of interventions to improve outcomes for elders discharged from the emergency department.

OBJECTIVES: To evaluate the evidence for interventions designed to improve outcomes for elders discharged from the emergency department (ED). METHODS: The study was a systematic review of English-language articles indexed in MEDLINE and CINAHL (1966-2005) with 1) key words "geriatric," "older adults," or "seniors," or 2) Medical Subject Heading (MeSH) terms "Geriatrics" or "Health Services for the Aged" AND key word "emergency," or 3) MeSH terms "Emergencies," "Emergency Service, Hospital," or "Emergency Treatment." Bibliographies of the retrieved articles were reviewed for additional references, and the authors consulted with content experts to identify relevant unpublished work. Patients of interest were community-dwelling elder patients discharged home from the ED. Data were abstracted from selected articles by the authors. Studies with interventions limited to patients with a single presentation or diagnosis (falls, delirium, etc.) or delivered only to patients who would have otherwise been hospitalized were not included. RESULTS: Of 669 citations, 27 studies (reported in 33 articles) met study criteria and were reviewed; six randomized controlled trials (RCTs), two nonrandomized clinical trials, and 19 observational studies or program descriptions. Three of four RCTs designed to measure functional outcomes showed a reduction in functional decline in the intervention group. The trials that resulted in functional benefits enrolled high-risk patients and included geriatric nursing assessment and home-based services as part of the intervention. Results of trials to decrease health service utilization rates following an ED visit were mixed. CONCLUSIONS: A significant number of programs to improve outcomes for elders discharged from the ED exist, but few have been systematically examined. Development of interventions to improve the care of elder patients following ED visits requires further research into system and patient-centered factors that impact health care delivery in this situation.

Aged↗

PubMed2000

Bioinorganic motifs: towards functional classification of metalloproteins.

UNLABELLED: The habitat of bioinorganic motifs (BIMs) is at the interface of biological inorganic chemistry and bioinformatics. BIM is defined as a common structural feature shared by functionally related, but not necessarily homologous, proteins, and consisting of the metal atom(s) and first coordination shell ligands. BIMs appear to be suitable for classification of metal centres at any level, from groups of unrelated proteins with similar function to different functional states of the same protein, and for description of possible evolutionary relationships of metalloproteins. However, they have not attracted wide attention from the bioinformatics community. Although their presence is appreciated, they are difficult to predict-therefore the current 'high-throughput' initiatives are likely to miss or ignore them altogether. The protein sequence databases do not distinguish between proteins containing different prosthetic groups (unless they have different sequences) or between apo- and holoprotein. On the other hand, the protein structure databases include data on 'hetero compounds' of various origin but these data are often inconsistent. A number of specialized databases dealing with BIMs and attempts to classify them are reviewed. SUPPLEMENTARY INFORMATION: The additional bibliography and list of Internet resources on bioinorganic chemistry are available at http://www.ebi.ac.uk/ approximately kirill/biometal/

Amino Acid Motifs↗

PubMed2004

Propranolol for migraine prophylaxis.

BACKGROUND: Propranolol is one of the most commonly prescribed drugs for migraine prophylaxis. OBJECTIVES: We aimed to determine whether there is evidence that propranolol is more effective than placebo and as effective as other drugs for the interval (prophylactic) treatment of patients with migraine. SEARCH STRATEGY: Potentially eligible studies were identified by searching MEDLINE/PubMed (1966 to May 2003) and the Cochrane Central Register of Controlled Trials (Issue 2, 2003), and by screening bibliographies of reviews and identified articles. SELECTION CRITERIA: We included randomised and quasi-randomised clinical trials of at least 4 weeks duration comparing clinical effects of propranolol with placebo or another drug in adult migraine sufferers. DATA COLLECTION AND ANALYSIS: Two reviewers extracted information on patients, methods, interventions, outcomes measured, and results using a pre-tested form. Study quality was assessed using two checklists (Jadad scale and Delphi list). Due to the heterogeneity of outcome measures and insufficient reporting of the data, only selective quantitative meta-analyses were performed. As far as possible, effect size estimates were calculated for single trials. In addition, results were summarised descriptively and by a vote count among the reviewers. MAIN RESULTS: A total of 58 trials with 5072 participants met the inclusion criteria. The 58 selected trials included 26 comparisons with placebo and 47 comparisons with other drugs. The methodological quality of the majority of trials was unsatisfactory. The principal shortcomings were high dropout rates and insufficient reporting and handling of this problem in the analysis. Overall, the 26 placebo-controlled trials showed clear short-term effects of propranolol over placebo. Due to the lack of studies with long-term follow up, it is unclear whether these effects are stable after stopping propranolol. The 47 comparisons with calcium antagonists, other beta-blockers, and a variety of other drugs did not yield any clear-cut differences. Sample size was, however, insufficient in most trials to establish equivalence. REVIEWERS' CONCLUSIONS: Although many trials have relevant methodological shortcomings, there is clear evidence that propranolol is more effective than placebo in the short-term interval treatment of migraine. Evidence on long-term effects is lacking. Propranolol seems to be as effective and safe as a variety of other drugs used for migraine prophylaxis.

Adrenergic beta-Antagonists↗