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A mediated health search portal for trusted medical content.

The Internet has become an important source of medical information for both patients and providers. However, it is increasingly difficult to properly access and evaluate the information obtained on the Internet. Search engines are frequently used to find information but suffer either from lack of specificity, or cumbersome requirements for use. Mediated search services have been suggested as a possible alternative. This paper describes one such mediated medical information search service called IMO Health Search.

Humans↗

Mammary cancer in humans and mice: a tutorial for comparative pathology. The CD-ROM.

This article introduces a CD-ROM containing whole-mount and histological images of normal growth and development of both the mouse mammary gland and the human breast. It also covers nonneoplastic lesions and neoplasias in both species including a catalog of lesions in genetically engineered mice. Instructions, with examples, on techniques such as whole-mount preparation, immunohistochemistry, in situ hybridization, and common histological stains are provided. The images are based on full-scale 1996 x 1640 pixel images at 300 pixels/ inch and are annotated. Every genetically engineered model has one or more accompanying citations. Tables are provided for orientation and organization. The CD includes zoom capabilities, a search engine, and a help mode.

Animals↗

How internet users find, evaluate, and use online health information: a cross-cultural review.

The Internet has become a favored source to find health information. Worldwide, about 4.5% of all Internet searches are for health-related information. However, research has found that the quality of online health information is mixed, which raises serious concerns about the impact of this information. This paper reviews relevant research to understand how health information on the Internet is retrieved, evaluated, and used. Most users of online health information are looking for information about specific health conditions because they or someone they know was diagnosed with a medical condition. They typically use general search engines to find online health information and enter short phrases, often misspelled. They seldom go beyond the first page of a search. Both their search and evaluation skills are limited although they are concerned about the quality of online health information. They avoid sites with overt commercialism, but often do not pay attention to indicators of credibility. Online health information is used to fill an information void which can enhance coping and self efficacy, affects health-related decisions and behavior of users and their friends and family, and is often discussed with health care providers. There are cross-cultural differences in the types of sites used as well as how online information is used. Based on the research reviewed in this paper, three major recommendations are suggested. Professionals should recommend sites. Professionals should promote more effective search and evaluation techniques. Professionals should be involved in developing and promoting uniform standards for health and mental health sites.

Cross-Cultural Comparison↗

Horizontal wires replace the vertical files.

Traditionally, clippings of newspaper articles, pictures from magazines, pamphlets, charts, graphs, posters, proceedings, or copies thereof, and other miscellaneous information sources have been stored in vertical files in libraries. The practice of creating and maintaining vertical files is extremely time consuming. In a medical library, in particular, old information about diagnosis, treatment, and prognosis can quickly become incorrect, misleading, and possibly harmful. Adequately tending to the vertical files can require a librarian to create a balancing act between properly maintaining vertical files and meeting the needs of the users in other areas of the library. The maintenance of vertical files is, by nature, highly consumptive of paper and space consuming. A reasonable alternative to the traditional vertical files is the World-Wide Web. Search engines exist for locating specific information, and bookmarks and/or links which point users to particularly useful sites can be set in search software. Some methods for searching are discussed, and a variety of World-Wide Web information sources are offered.

Computer Communication Networks↗

Portal vein thrombosis in children and adolescents.

OBJECTIVE: To review the literature on portal vein thrombosis in children and adolescents, focusing on its diagnosis, complications and treatment. SOURCES OF DATA: The medical literature of the past 10 years was reviewed using the PubMed and MEDLINE search engines, with major focus on portal vein thrombosis and its clinical outcomes. The following keywords or expressions were used for the web search: portal vein thrombosis, extra-hepatic portal vein obstruction, prognosis, children, portal hypertension, esophagogastric varices. Additionally, we also reviewed the articles cited in the references of the initially selected papers, as well as relevant textbooks. SUMMARY OF THE FINDINGS: Portal vein thrombosis is one of the most common causes of portal hypertension among children. The initial clinical manifestation is characterized either by episodes of upper gastrointestinal bleeding or by splenomegaly on routine clinical examination. The major complications include upper gastrointestinal bleeding, hypersplenism secondary to splenomegaly, growth retardation, and portal biliopathy. The diagnosis is made by abdominal Doppler ultrasonography. Treatment is targeted at the complications and includes primary and secondary prophylaxis against upper gastrointestinal bleeding (which results from the rupture of esophageal varices), and portosystemic shunting in selected cases. CONCLUSIONS: Portal vein thrombosis is one of the major triggers of upper gastrointestinal bleeding in children. Bleeding episodes have a remarkable effect on the quality of life of affected patients. Thus, appropriate diagnosis and treatment are needed in order to reduce morbidity and mortality.

Adolescent↗

[The importance of Internet in medical education].

Internet is more and more involved in medical education in many countries including Bosnia and Herzegovina. Not only medical student but also physicians are using Internet to find out the latest information in specific field of medicine. Some sites are specially designed to be used for medical education. Information about some programs or courses of medical education can be found here. Improvements of network resources and multimedia technologies have made it possible to satisfy needs for medical Education. Multimedia approach offer possibility to show text, picture, sound or movie considering specific need. All of that is available on Internet. Many search engine are available in the world and student can use all of them when they have access to Internet. The more precise search can be done on specific sites that include information about medical conditions and medical education. The most important is MEDLINE. MEDLINE is bibliographic database of National Library Of Medicine in USA. This database can be explored from several sites. All relevant information about article can be find here including abstract and service to obtain full text of specific article. Database can be searched using specific keywords that can be find in text or in MESH thesaurus. Data about authors, their addresses and title of article can be found, too. The possibility of using Internet in medical education are considered in this article. Some of Internet sites are described, too.

Education, Medical↗

[Headache as a chief subject in the Hungarian medical literature].

BACKGROUND: Less than 1.2% of papers published in the first 50 volumes of the journal Clinical Neuroscience/Ideggyógyászati Szemle--the major official journal of Hungarian neurologists--focused on headache despite the fact that headache is among the most frequent complaints in neurological consultations. In the current study the authors evaluated the presence of headache as the main topic in articles of the Hungarian medical literature. METHODS: They identified full publications on headache by handsearching all volumes of the journal Clinical Neuroscience/Ideggyógyászati Szemle from 1950 till the end of 2003. Electronic searches were performed to find Hungarian papers focusing on headache using the bibliographic databases of the Hungarian National Library of Healthcare (Hungarian Medical Bibliography, HMB) and the American National Library of Medicine of the National Institutes of Health (Medline and Oldmedline). Results of handsearch and electronic searches were cross checked for the journal Clinical Neuroscience/Ideggyógyászati Szemle. RESULTS: Of the 2618 full papers published in Clinical Neuroscience/Ideggyógyászati Szemle headache was the main topic in 32 articles (1.2%), most of them published after 1985. The electronic search of the HMB resulted in 132 documents in 41 journals, whereas using the PubMed search engine, they identified 66 Hungarian papers on headache. Migraine was the most frequent topic of interest in papers found by all three searches. The HMB search identified all headache articles published after 1990 in Clinical Neuroscience/Ideggyógyászati Szemle which were identified by handsearch. The Oldmedline, database contained four of the seven papers identified by handsearch from 1954-1964. After 2002, the start of indexing Clinical Neuroscience/Ideggyógyászati Szemle in the Medline, the only article identified by handsearch was also found by the electronic search. CONCLUSION: After the lack of interest until the mid-1980-ies, headache became a frequent topic in the Hungarian medical literature. Bibliographical data of articles on headache published after 1990 can be identified by electronic searches of the Hungarian and international bibliographic databases using carefully constructed but simple search strategies. An increasing presence of Hungarian headache research was found in international journals in the last two decades.

Bibliometrics↗

Fragment Finder: a web-based software to identify similar three-dimensional structural motif.

FF (Fragment Finder) is a web-based interactive search engine developed to retrieve the user-desired similar 3D structural fragments from the selected subset of 25 or 90% non-homologous protein chains. The search is based on the comparison of the main chain backbone conformational angles (phi and ). Additionally, the queried motifs can be superimposed to find out how similar the structural fragments are, so that the information can be effectively used in molecular modeling. The engine has facilities to view the resultant superposed or individual 3D structure(s) on the client machine. The proposed web server is made freely accessible at the following URL: http://cluster.physics.iisc.ernet.in/ff/ or http://144.16.71.148/ff/.

Amino Acid Motifs↗

Pharmacy-managed anticoagulation: assessment of in-hospital efficacy and evaluation of financial impact and community acceptance.

BACKGROUND: The dangers of thrombosis are well known and yet current therapy presents a paradox; effective methods of pharmacological anticoagulation are available, but underemployed. The risks associated with the use of anticoagulants, especially warfarin, and the requirement of meticulous dosing with subsequent vigilant monitoring provides some explanation for this discrepancy. Efforts have been made to address this incongruity and increase anticoagulation treatment while mitigating complications; these include the development of dosing nomograms, patient self-monitoring of anticoagulation status, and increased pharmacist participation in anticoagulation management. Although the latter option has proven effective in outpatient clinics, its in-hospital application has received less attention. Therefore, our primary goal was to review the published literature to evaluate the efficacy of in-hospital, pharmacy-managed anticoagulation. In addition, our secondary goals were to assess the potential financial benefit and community acceptance of such pharmacist management. METHODS: Potentially relevant studies were identified by searching PubMed; however, because some pharmacy journals are not included in this database, we also used internet search engines to locate articles. We subsequently employed the Science Citation Index to find additional papers that had referenced articles identified by our initial searches. RESULTS: Several pilot studies, focusing primarily on adherence to warfarin dosing guidelines, found general equivalence between pharmacist and physician management and specifically illustrated the potential benefit gained simply through adherence to protocols. Nevertheless, these studies frequently lacked appropriate statistical analysis and examined small, and often heterogeneous, patient groups. Larger comparative studies also possessed some of the same flaws; however, taken together the equivalence and, in some cases improvement, in patient outcomes (e.g., greater control of International Normalized Ratios and decreased length of hospital stay) that they demonstrated suggest the value of increased pharmacist participation in anticoagulation therapy. Studies using heparin-based anticoagulation reported similar positive findings and hence support the warfarin results. Both published studies examining financial implications of in-hospital pharmacy management indicated potential for considerable savings. Finally, although we identified no in-hospital studies of community acceptance, positive survey results indicted that the majority of physicians and patients accepted pharmacy-managed outpatient anticoagulation. CONCLUSIONS: The reported outcomes of pharmacy-managed in-hospital anticoagulation therapy appear at least equal, and sometimes superior, to those obtained through standard care; however, the lack of large well-designed trials prevents drawing definitive conclusions. Nevertheless, the continued and likely increased future need for anticoagulation in general and warfarin therapy in particular suggests that increased pharmacist involvement could enhance the quality of patient care.

Anticoagulants↗

Discovering known and unanticipated protein modifications using MS/MS database searching.

We present an MS/MS database search algorithm with the following novel features: (1) a novel protein database structure containing extensive preindexing and (2) zone modification searching, which enables the rapid discovery of protein modifications of known (i.e., user-specified) and unanticipated delta masses. All of these features are implemented in Interrogator, the search engine that runs behind the Pro ID, Pro ICAT, and Pro QUANT software products. Speed benchmarks demonstrate that our modification-tolerant database search algorithm is 100-fold faster than traditional database search algorithms when used for comprehensive searches for a broad variety of modification species. The ability to rapidly search for a large variety of known as well as unanticipated modifications allows a significantly greater percentage of MS/MS scans to be identified. We demonstrate this with an example in which, out of a total of 473 identified MS/MS scans, 315 of these scans correspond to unmodified peptides, while 158 scans correspond to a wide variety of modified peptides. In addition, we provide specific examples where the ability to search for unanticipated modifications allows the scientist to discover: unexpected modifications that have biological significance; amino acid mutations; salt-adducted peptides in a sample that has nominally been desalted; peptides arising from nontryptic cleavage in a sample that has nominally been digested using trypsin; other unintended consequences of sample handling procedures.

Algorithms↗

A tutorial on information retrieval: basic terms and concepts.

This informal tutorial is intended for investigators and students who would like to understand the workings of information retrieval systems, including the most frequently used search engines: PubMed and Google. Having a basic knowledge of the terms and concepts of information retrieval should improve the efficiency and productivity of searches. As well, this knowledge is needed in order to follow current research efforts in biomedical information retrieval and text mining that are developing new systems not only for finding documents on a given topic, but extracting and integrating knowledge across documents.

Journal Article↗

Safety and anti-inflammatory activity of curcumin: a component of tumeric (Curcuma longa).

INTRODUCTION: Tumeric is a spice that comes from the root Curcuma longa, a member of the ginger family, Zingaberaceae. In Ayurveda (Indian traditional medicine), tumeric has been used for its medicinal properties for various indications and through different routes of administration, including topically, orally, and by inhalation. Curcuminoids are components of tumeric, which include mainly curcumin (diferuloyl methane), demethoxycurcumin, and bisdemethoxycurcmin. OBJECTIVES: The goal of this systematic review of the literature was to summarize the literature on the safety and anti-inflammatory activity of curcumin. METHODS: A search of the computerized database MEDLINE (1966 to January 2002), a manual search of bibliographies of papers identified through MEDLINE, and an Internet search using multiple search engines for references on this topic was conducted. The PDR for Herbal Medicines, and four textbooks on herbal medicine and their bibliographies were also searched. RESULTS: A large number of studies on curcumin were identified. These included studies on the antioxidant, anti-inflammatory, antiviral, and antifungal properties of curcuminoids. Studies on the toxicity and anti-inflammatory properties of curcumin have included in vitro, animal, and human studies. A phase 1 human trial with 25 subjects using up to 8000 mg of curcumin per day for 3 months found no toxicity from curcumin. Five other human trials using 1125-2500 mg of curcumin per day have also found it to be safe. These human studies have found some evidence of anti-inflammatory activity of curcumin. The laboratory studies have identified a number of different molecules involved in inflammation that are inhibited by curcumin including phospholipase, lipooxygenase, cyclooxygenase 2, leukotrienes, thromboxane, prostaglandins, nitric oxide, collagenase, elastase, hyaluronidase, monocyte chemoattractant protein-1 (MCP-1), interferon-inducible protein, tumor necrosis factor (TNF), and interleukin-12 (IL-12). CONCLUSIONS: Curcumin has been demonstrated to be safe in six human trials and has demonstrated anti-inflammatory activity. It may exert its anti-inflammatory activity by inhibition of a number of different molecules that play a role in inflammation.

Anti-Inflammatory Agents, Non-Steroidal↗

Protein Information Resource: a community resource for expert annotation of protein data.

The Protein Information Resource, in collaboration with the Munich Information Center for Protein Sequences (MIPS) and the Japan International Protein Information Database (JIPID), produces the most comprehensive and expertly annotated protein sequence database in the public domain, the PIR-International Protein Sequence Database. To provide timely and high quality annotation and promote database interoperability, the PIR-International employs rule-based and classification-driven procedures based on controlled vocabulary and standard nomenclature and includes status tags to distinguish experimentally determined from predicted protein features. The database contains about 200,000 non-redundant protein sequences, which are classified into families and superfamilies and their domains and motifs identified. Entries are extensively cross-referenced to other sequence, classification, genome, structure and activity databases. The PIR web site features search engines that use sequence similarity and database annotation to facilitate the analysis and functional identification of proteins. The PIR-Inter-national databases and search tools are accessible on the PIR web site at http://pir.georgetown.edu/ and at the MIPS web site at http://www.mips.biochem.mpg.de. The PIR-International Protein Sequence Database and other files are also available by FTP.

Computational Biology↗

A concept analysis of malnutrition in the elderly.

PURPOSE: Malnutrition is a frequent and serious problem in the elderly. Today there is no doubt that malnutrition contributes significantly to morbidity and mortality in the elderly. Unfortunately, the concept of malnutrition in the elderly is poorly defined. The purpose of this paper is to clarify the meaning of malnutrition in the elderly and to develop the theoretical underpinnings, thereby facilitating communication regarding the phenomenon and enhancing research efforts. SCOPE, SOURCES USED: Critical review of literature is the approach used to systematically build and develop the theoretical propositions. Conventional search engines such as Medline, PsyINFO, and CINAHL were used. The bibliography of obtained articles was also reviewed and additional articles identified. Key wards used for searching included malnutrition, geriatric nutrition, nutritional status, nutrition assessment, elderly, ageing, and weight loss. CONCLUSIONS: The definition of malnutrition in the elderly is defined as following: faulty or inadequate nutritional status; undernourishment characterized by insufficient dietary intake, poor appetite, muscle wasting and weight loss. In the elderly, malnutrition is an ominous sign. Without intervention, it presents as a downward trajectory leading to poor health and decreased quality of life. Malnutrition in the elderly is a multidimensional concept encompassing physical and psychological elements. It is precipitated by loss, dependency, loneliness and chronic illness and potentially impacts morbidity, mortality and quality of life.

Aged↗

GABAagent: a system for integrating data on GABA receptors.

MOTIVATION: Scientific data pertaining to GABA receptors, which are of medical importance, are widely scattered throughout numerous heterogeneous Internet resources. This situation has made the integrated acquisition of such data difficult and substantially time consuming even for researchers who are Internet aficionados. Thus, there exists a genuine need for the development of Internet applications, such as GABAagent, which provide efficient and timely access to concise and integrated information. RESULTS: We report here the establishment of a novel server (GABAagent) which has been written in Perl script, and which is freely accessible through the Internet. GABAagent is designed to assist researchers in retrieving focused and integrated information related to GABA receptors from various public domain databases. GABAagent relies on server-side flat-file databases that have been created through data mining from Internet sources such as the PubMed, DDBJ, SWISS-PROT and TrEMBL, in addition to the many World Wide Web (Web) sites which are accessible through Excite (E-Web). These warehouse databases are regularly updated and contain among other things, information concerning: (i) GABA receptor publications, (ii) DNA and protein sequences and (iii) the contents of related E-Web sites along with their addresses. Our system also provides hard links to the above-mentioned Web sites and E-Web sites; the feature which adds to it the character of virtual federation type of database. The current version of GABAagent provides two user-friendly services. The first is a search engine possessing intelligent query reformulation support (GABAengine), the second an elaborate email alert service was designed into the system (GABAalert). The GABAengine allows the user to search server-side databases exclusively for GABA receptor-related queries. Whereas, GABAalert allows the user, by means of subscription, to receive immediate and/or monthly updates automatically. AVAILABILITY: GABAagent is freely accessible at the following Web address http://www.ust.hk/gaba.

Databases, Factual↗

PAST: fast structure-based searching in the PDB.

PAST is a new web service providing fast structural queries of the Protein Data Bank. The search engine is based on an adaptation of the generalized suffix tree and relies on a translation- and rotation-invariant representation of the protein backbone. The search procedure is completely independent of the amino acid sequence of the polypeptide chains. The web service works best with, but is not necessarily limited to, shorter fragments such as functional motifs-a task that most other tools do not perform well. Usual query times are in the order of seconds, allowing a truly interactive use. Unlike most established tools, PAST does not prefilter the dataset or exclude parts of the search space based on statistical reasoning. The server is freely available at http://past.in.tum.de/.

Databases, Protein↗

Font adaptive word indexing of modern printed documents.

We propose an approach for the word-level indexing of modern printed documents which are difficult to recognize using current OCR engines. By means of word-level indexing, it is possible to retrieve the position of words in a document, enabling queries involving proximity of terms. Web search engines implement this kind of indexing, allowing users to retrieve Web pages on the basis of their textual content. Nowadays, digital libraries hold collections of digitized documents that can be retrieved either by browsing the document images or relying on appropriate metadata assembled by domain experts. Word indexing tools would therefore increase the access to these collections. The proposed system is designed to index homogeneous document collections by automatically adapting to different languages and font styles without relying on OCR engines for character recognition. The approach is based on three main ideas: the use of Self Organizing Maps (SOM) to perform unsupervised character clustering, the definition of one suitable vector-based word representation whose size depends on the word aspect-ratio, and the run-time alignment of the query word with indexed words to deal with broken and touching characters. The most appropriate applications are for processing modern printed documents (17th to 19th centuries) where current OCR engines are less accurate. Our experimental analysis addresses six data sets containing documents ranging from books of the 17th century to contemporary journals.

Abstracting and Indexing↗

Reformulation of consumer health queries with professional terminology: a pilot study.

BACKGROUND: The Internet is becoming an increasingly important resource for health-information seekers. However, consumers often do not use effective search strategies. Query reformulation is one potential intervention to improve the effectiveness of consumer searches. OBJECTIVE: We endeavored to answer the research question: "Does reformulating original consumer queries with preferred terminology from the Unified Medical Language System (UMLS) Metathesaurus lead to better search returns?" METHODS: Consumer-generated queries with known goals (n=16) that could be mapped to UMLS Metathesaurus terminology were used as test samples. Reformulated queries were generated by replacing user terms with Metathesaurus-preferred synonyms (n=18). Searches (n=36) were performed using both a consumer information site and a general search engine. Top 30 precision was used as a performance indicator to compare the performance of the original and reformulated queries. RESULTS: Forty-two percent of the searches utilizing reformulated queries yielded better search returns than their associated original queries, 19% yielded worse results, and the results for the remaining 39% did not change. We identified ambiguous lay terms, expansion of acronyms, and arcane professional terms as causes for changes in performance. CONCLUSIONS: We noted a trend towards increased precision when providing substitutions for lay terms, abbreviations, and acronyms. We have found qualitative evidence that reformulating queries with professional terminology may be a promising strategy to improve consumer health-information searches, although we caution that automated reformulation could in fact worsen search performance when the terminology is ill-fitted or arcane.

Consumer Behavior↗