PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Databases, Bibliographic”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed2001

Noninvasive techniques to detect fetal anemia due to red blood cell alloimmunization: a systematic review.

OBJECTIVE: To estimate, in maternal red blood cell alloimmunization, the diagnostic value of fetal ultrasonography and Doppler blood flow velocity in the evaluation and prediction of fetal anemia. METHODS: Literature from 1970 to 2000 was identified using general bibliographic databases (MEDLINE and EMBASE), the Cochrane Library and relevant specialist register of the Cochrane Collaboration, and by checking reference lists of known primary and review articles. Studies were selected if the accuracy of the fetal ultrasound parameters or Doppler studies of blood flow in the fetal vessels was estimated compared with a reference standard (fetal hemoglobin). The diagnostic tests evaluated were ultrasound measurement of the fetal spleen perimeter and Doppler studies of blood velocity estimates in the umbilical vein, ductus venosus, middle cerebral artery, thoracic aorta, and umbilical vessel combined with the thoracic aorta. Study selection, quality assessment, and data abstraction were performed independently and in duplicate. Data from the selected studies were abstracted as 2 x 2 tables comparing the diagnostic test result with the reference standard. Diagnostic accuracy was expressed as likelihood ratios. RESULTS: The review included eight primary studies with 362 pregnancies affected by red cell alloimmunization. Prospective patient recruitment and complete population details were reported in half of the selected studies (four of eight). Only one study reported masking the diagnostic test results to clinicians. The diagnostic test performance varied widely according to the type of the test evaluated and the cutoff level used to define fetal anemia, which varied from study to study. The diagnostic test study of highest methodological quality reported a positive likelihood ratio of 8.45 (95% confidence interval 4.69, 15.56) and negative likelihood ratio of 0.02 (95% confidence interval 0.001, 0.25) for maximum middle cerebral artery Doppler velocity. CONCLUSION: The literature reporting noninvasive techniques to predict fetal anemia is methodologically poor and a standard approach to the evaluation of these techniques is lacking. A recommendation for practice cannot be generated without further rigorous research.

Blood Flow Velocity↗
PubMed1995

Botanical lipids: effects on inflammation, immune responses, and rheumatoid arthritis.

OBJECTIVE: This review discusses the rationale and experimental data that led to clinical trials of certain botanical lipids, mainly gammalinolenic acid (GLA), for the treatment of rheumatoid arthritis (RA). DATA SOURCES: Pertinent articles and reviews, and a bibliographic database in English using the following indexing terms: rheumatoid arthritis, fatty acids, gammalinolenic acid, lymphocytes, and monocytes, were used. STUDY SELECTION: All clinical trials in which GLA was used to treat arthritis are included in this review. Data from appropriately peer reviewed in vitro and animal experiments evaluating the effects of botanical lipids as regulators of cell activation and immune responses are also reviewed. DATA SYNTHESIS: GLA treatment is associated with clinical improvement in patients with RA, as evaluated by duration of morning stiffness, joint pain and swelling, and ability to reduce other medications. However, studies vary in terms of duration, GLA dose, whether or not they were placebo controlled, and, if so, what placebo was used, criteria for evaluation, and use of concomitant medication. Studies done in vitro generally indicated that GLA reduces lymphocyte activation and production of mediators of inflammation. CONCLUSIONS: A small number of studies suggest that GLA is effective treatment for RA patients. Further controlled studies of its use in RA seem warranted.

Animals↗
PubMed1995

Adrenal insufficiency in the antiphospholipid antibody syndrome.

OBJECTIVE: Adrenal insufficiency (AI) is a rare complication of the antiphospholipid antibody syndrome (APS). The objective of this report is to describe a case and review the published literature to enhance recognition of this potentially fatal disorder by emphasizing its course, diagnosis, and cause. DATA SOURCES: A bibliographic database with the indexing terms adrenal insufficiency, adrenal hemorrhage, adrenal thrombosis, APS, systemic lupus erythematosus, with the constraints of human subjects only, was used. STUDY SELECTION: All 27 reports meeting the indexing terms were selected for review. DATA EXTRACTION: The specific criteria used for data extraction articles included course of the disease, causation, clinical and laboratory diagnostic criteria, and therapeutic intervention. DATA SYNTHESIS: Our patient is a previously health woman who developed a respiratory tract infection, followed by a prolonged illness with fever, hypotension, nausea, depression, and venous thromboses. She was found to have AI and APS that was alleviated with hydrocortisone and anticoagulation. Initially, her adrenal glands were normal on CT scan but subsequently became enlarged and later atrophic. Of the 27 previous case reports, a majority had thromboses and typical clinical and laboratory manifestations of AI. Hemorrhagic infarction of the adrenal gland appears to be the mechanism for AI in the APS. IgG and IgM anticardiolipin antibodies are most commonly reported in association with AI in APS. CONCLUSIONS: The hypercoagulable state in the APS may lead to adrenal vein thrombosis and subsequently to hemorrhagic necrosis of the adrenal gland. This complication of APS is important to recognize because it may be fatal if untreated.

Adrenal Glands↗
PubMed2003

Confirmation of research publications reported by neurological surgery residency applicants.

OBJECTIVE: Previous studies have reported that as many as 30% of resident and fellow applicants misrepresent their publication record on their residency and fellowship applications. To determine if neurologic surgery residency applicants were guilty of similar rates of misrepresentation, we reviewed the applications submitted to our institution in the year 2001-2002. METHODS: There were 102 applications submitted to our neurologic surgery residency program for the 2001-2002 academic year. All publications listed by applicants on the Central Application Service for Neurologic Surgery were verified using various online bibliographic databases including MEDLINE and an interlibrary search. Manuscripts listed as being "in press" were authenticated by contacting the journals' editorial office while those listed as either "in preparation" or "submitted for publication" were excluded. RESULTS: Seventy-three (71.6%) candidates reported 212 published citations, including 129 (61%) journal articles, 13 (6%) book chapters, and 70 (33%) printed abstracts. Twelve of these applicants also listed 13 papers as being "in press." Overall, among the entire applicant pool, there were nine examples of possible misrepresentation in six applicants (6%). One applicant provided inadequate information to verify a book chapter. Another candidate cited four journal articles with the authors' names, even though his name was not listed among them. Two applicants included one citation each without listing any of the authors' names. Verification of these citations revealed that neither of them was a coauthor, although one was acknowledged. Among the articles listed as "in press," one was still under consideration for publication, and one could not be verified because of the journal's discontinuation. CONCLUSIONS: We confirmed that applicants who reported their names along with their published citations did so honestly and accurately. In our study, misrepresentation of published manuscripts among neurologic surgery residency applicants was rare when compared to candidates in other specialties.

Humans↗
PubMedDate not supplied

Risk of cardiovascular events and rofecoxib: cumulative meta-analysis.

BACKGROUND: The cyclo-oxygenase 2 inhibitor rofecoxib was recently withdrawn because of cardiovascular adverse effects. An increased risk of myocardial infarction had been observed in 2000 in the Vioxx Gastrointestinal Outcomes Research study (VIGOR), but was attributed to cardioprotection of naproxen rather than a cardiotoxic effect of rofecoxib. We used standard and cumulative random-effects meta-analyses of randomised controlled trials and observational studies to establish whether robust evidence on the adverse effects of rofecoxib was available before September, 2004. METHODS: We searched bibliographic databases and relevant files of the US Food and Drug Administration. We included all randomised controlled trials in patients with chronic musculoskeletal disorders that compared rofecoxib with other non-steroidal anti-inflammatory drugs (NSAIDs) or placebo, and cohort and case-control studies of cardiovascular risk and naproxen. Myocardial infarction was the primary endpoint. FINDINGS: We identified 18 randomised controlled trials and 11 observational studies. By the end of 2000 (52 myocardial infarctions, 20742 patients) the relative risk from randomised controlled trials was 2.30 (95% CI 1.22-4.33, p=0.010), and 1 year later (64 events, 21432 patients) it was 2.24 (1.24-4.02, p=0.007). There was little evidence that the relative risk differed depending on the control group (placebo, non-naproxen NSAID, or naproxen; p=0.41) or trial duration (p=0.82). In observational studies, the cardioprotective effect of naproxen was small (combined estimate 0.86 [95% CI 0.75-0.99]) and could not have explained the findings of the VIGOR trial. INTERPRETATION: Our findings indicate that rofecoxib should have been withdrawn several years earlier. The reasons why manufacturer and drug licensing authorities did not continuously monitor and summarise the accumulating evidence need to be clarified.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

The limbic system: a review of its empirical foundation.

The concept of the limbic system is highly influential in many areas of the neurosciences and in their applications to clinical medicine. The value of this concept has been questioned, denied, and defended several times in the past but a comprehensive critical evaluation has never been published. In this article we take several approaches to analyse empirical data of relevance to the limbic system. First we delineate its factual application in different areas. The limbic system has a very wide scope and divergent use. Secondly we extract criteria for its definition from research literature using the bibliographic database Medline. The limbic system has been defined variously on a number of different descriptive levels from morphology to behaviour. Thirdly we review its empirical foundations comparing evidence from different sources. The limbic system lacks an adequate empirical definition in spite of numerous efforts. Last we evaluate its construction as a scientific concept from empirical facts. The limbic system is a non-empirical explanatory concept for poorly understood brain functions. We conclude that the concept of the limbic system cannot be accepted on empirical grounds. However, it is a very attractive concept in the search for explanation of brain function. The non-empirical contents of the limbic system remains largely unexplored.

Animals↗
PubMed2003

Organising access to Evidence-Based Medicine resources on the Web.

The continuing education is a challenge for health care professionals, considering the growing amount and variable quality of information in this field. In this context, we developed a method allowing clinicians to have a centralised access to the best current medical evidence supporting medical decision-making. Relevant data has been gathered according to the rules stated for Evidence-Based Medicine (EBM) and organised in a free-of-charge Web site, created by using common software applications. The general aim of our study was to encourage individual practice of EBM by providing tutorials as well as a selection of free access tools for searching medical information on the Web. In addition to the education part, we provided clinicians, through a Web interface, with up-to-date, accurate and quality data obtained from heterogeneous sources and presented in a full text format when available. The developed methodology has been applied to human prostate cancer. URL address: http://www.ebm.lib.ulg.ac.be/prostate/index.htm.

Artificial Intelligence↗
PubMedDate not supplied

[Use of internet and electronic resources among Spanish intensivist physicians. First national survey].

OBJECTIVE: Estimate knowledge and use habits of different electronic resources in a sample of Spanish intensivists: Internet, E-mail, distribution lists, and use of portable electronic devices. DESIGN: Self-applied questionnaire. METHODS: A 50-question questionnaire was distributed among Spanish intensivists through the hospital marketing delegates of a pharmaceutical company and of electronic forums. RESULTS: A total of 682 questionnaires were analyzed (participation: 74%). Ninety six percent of those surveyed used Internet individually: 67% admitted training gap. Internet was the second source of clinical consultations most used (61%), slightly behind consultation to colleagues (65%). The pages consulted most were bibliographic databases (65%) and electronic professional journals (63%), with limited use of Evidence Based Medicine pages (19%). Ninety percent of those surveyed used e-mail regularly in the practice of their profession, although 25% admitted that were not aware of its possibilities. The use of E-mail decreased significantly with increase in age. A total of 62% of the intensivists used distribution lists. Of the rest, 42% were not aware of its existence and 32% admitted they had insufficient training to handle them. Twenty percent of those surveyed had portable electronic devices and 64% considered it useful, basically due to its rapid consultation at bedside. Female gender was a negative predictive factor of its use (OR 0.35; 95% CI 0.2-0.63; p=0.0002). CONCLUSIONS: A large majority of the Spanish intensivists use Internet and E-mail. E-mail lists and use of portable devices are still underused resources. There are important gaps in training and infrequent use of essential pages. There are specific groups that require directed educational policies.

Adult↗
PubMed2004

[Qualitative research: a valid alternative].

OBJECTIVE: To describe the main qualitative research techniques through systematic review of Spanish studies published during the previous 5 years. DESIGN: Systematic review. DATA SOURCES: The Indice Médico Español (bibliographic database of items published in Spanish health sciences journals) was searched, and systematic searches of the journals Atención Primaria, Gaceta Sanitaria, and Revista de Calidad Asistencial were done. Study selection. We included studies carried out with any type of qualitative research technique. Also included were studies that reviewed qualitative research techniques. We excluded studies that used a qualitative technique but were based mainly on quantitative research techniques. The review was done during the period from April 1997 to April 2002. RESULTS: Most of the studies we reviewed used only one technique (80.5%). When more than one technique was used in combination (19.5% of the articles we reviewed), focus groups and interviews were usually used. The techniques identified were focus group (used in 34% of the articles reviewed), interview (24%), the Delphi technique (10%), content analysis (8%), nominal group (8%), metaplan (2%), and Philips 6/6 (2%). CONCLUSIONS: Qualitative research is a valid alternative, and if used with appropriate methodological rigor it can be of considerable use to health care professionals.

Biomedical Research↗
PubMed1998

Informed consent for clinical trials: in search of the "best" method.

OBJECTIVE: To review the literature on comparisons between different methods of obtaining informed consent for clinical trials. DESIGN: Eight hundred and twelve articles were traced, in the process of conducting a systematic review of the ethics of clinical trials, by searching a number of sources: bibliographic databases (Medline, Psychlit and BIDS science and social science indices), hand searches, personal contacts, an original collection and a systematic follow-up of reference lists. Fourteen research reports were found which provided comparative data on different methods of obtaining informed consent. Eleven of these used a randomised design. Studies were classified according to three outcome measures (anxiety, consent rate and understanding). RESULTS: The results of the various studies suggest that giving people more information and more time to reflect tends to be associated with a lower consent rate. There seems to be an optimal level of information about side-effects such that patients are not overburdened by detail, while grasping the most important risks. More information in general is associated with greater awareness of the research nature of the trial, voluntariness of participation, right to withdraw and (available) alternative treatments. This result does not, however, extend to explanations of the concept of randomisation on which the literature is contradictory--sometimes more information is associated with increased understanding of the concept and sometimes it is not. Although divulging less information seems to be associated with less anxiety, there is evidence of an interaction with knowledge--high levels of knowledge are significantly associated with less anxiety, irrespective of consent method. The more that patients know before they are invited to participate in a trial, the better equipped they are to cope with the informed consent procedure. CONCLUSION: There is some evidence to suggest that there is an optimal amount of information which enhances patient understanding and which might, in turn, reduce anxiety. However. the studies were not altogether conclusive. More work needs to be carried out, especially on public understanding of science and on how different ways of explaining scientific concepts affect that understanding.

Clinical Trials as Topic↗
PubMed2000

Teasing apart quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain.

The objectives of the study were (1) to carry out a systematic review to assess the analgesic efficacy and the adverse effects of acupuncture compared with placebo for back and neck pain and (2) to develop a new tool, the Oxford Pain Validity Scale (OPVS), to measure validity of findings from randomized controlled trials (RCTs), and to enable ranking of trial findings according to validity within qualitative reviews. Published RCTs (of acupuncture at both traditional and non-traditional points) were identified from systematic searching of bibliographic databases (e.g. MEDLINE) and reference lists of retrieved reports. Pain outcome data were extracted with preference given to standardized outcomes such as pain intensity. Information on adverse effects was also extracted. All included trials were scored using a five-item 0-16 point validity scale (OPVS). The individual RCTs were ranked according to their OPVS score to enable more weight to be placed on the trials of greater validity when drawing an overall conclusion about the efficacy of acupuncture for relieving neck and back pain. Statistical analyses were carried out on the OPVS scores to assess the relationship between trial finding (positive or negative) and validity. Thirteen RCTs met the inclusion criteria. Five trials concluded that acupuncture was effective, and eight concluded that it was not effective for relieving back or neck pain. There was no obvious difference between the findings of trials using traditional and non-traditional points. Using the new OPVS scale, the validity scores of the included trials ranged from 4 to 14. There was no significant relationship between OPVS score and trial finding (positive versus negative). Authors' conclusions did not always agree with their data. We drew our own conclusions (positive/negative) based on the data presented in the reports. Re-analysis using our conclusions showed a significant relationship between OPVS score and trial finding, with higher validity scores associated with negative findings. OPVS is a useful tool for assessing the validity of trials in qualitative reviews. With acupuncture for chronic back and neck pain, we found that the most valid trials tended to be negative. There is no convincing evidence for the analgesic efficacy of acupuncture for back or neck pain.

Acupuncture Therapy↗
PubMed2002

Pharmacological treatments for acute migraine: quantitative systematic review.

We wanted to compare the analgesic efficacy and adverse effects of pharmacological treatments for acute migraine through a systematic review of randomised controlled trials in patients with acute migraine pain of moderate to severe intensity. Trials were identified from systematic searching of bibliographic databases. For eletriptan information from all trials was supplied by Pfizer Inc. Outcomes sought were headache relief at 1 and 2h, patients pain free at 2h and sustained relief over 24h for treatments compared with placebo. Numbers-needed-to-treat (NNTs) were calculated, together with relative benefit. Information on adverse effects was also collected. Comparisons of relative efficacy used the same definition of headache, the same degree of pain at the start of treatment and the same definitions of outcomes, and always compared with placebo. Forty-eight publications reporting on 54 trials were included in the meta-analyses, with 79 placebo comparisons for the primary outcome of headache relief at 2h. Information on any outcome was available for nine oral medications, two intranasal medications and subcutaneous sumatriptan in 21,022 patients. For headache relief at 2h NNTs ranged from 2.0 for subcutaneous sumatriptan 6mg to 5.4 for naratriptan 2.5mg. For patients pain free at 2h NNTs ranged from 2.1 for subcutaneous sumatriptan 6mg to 8.6 for aspirin 900mg plus metoclopramide 10mg. For sustained relief over 24h NNTs ranged from 2.8 for eletriptan 80mg to 8.3 for rizatriptan 5mg. It was not possible to systematically review adverse effects data. Most interventions are effective. There is considerable information on relative efficacy for a number of outcomes.

Acute Disease↗
PubMed1999

Oral aspirin in postoperative pain: a quantitative systematic review.

OBJECTIVES: A systematic review of the analgesic efficacy and adverse effects of single-dose aspirin compared with placebo in postoperative pain. DESIGN: Published studies were identified from systematic searching of bibliographic databases and reference lists of retrieved reports. Summed pain intensity and pain relief data were extracted and converted into dichotomous information to yield the number of patients with at least 50% pain relief. This was used to calculate the relative benefit and number-needed-to-treat for one patient to achieve at least 50% pain relief. For adverse effects, relative risk and number-needed-to-harm were calculated. Sensitivity analyses were planned to test the impact of different pain models, pain measurements, sample sizes, quality of study design, and study duration on the results. RESULTS: Seventy-two randomized single-dose trials met our inclusion criteria, with 3253 patients given aspirin, and 3297 placebo. Significant benefit of aspirin over placebo was shown for aspirin 600/650 mg, 1000 mg and 1200 mg, with numbers-needed-to-treat for at least 50% pain relief of 4.4 (4.0-4.9), 4.0 (3.2-5.4) and 2.4 (1.9-3.2) respectively. Single-dose aspirin 600/650 mg produced significantly more drowsiness and gastric irritation than placebo, with numbers-needed-to-harm of 28 (19-52) and 38 (22-174) respectively. Type of pain model, pain measurement, sample size, quality of study design, and study duration had no significant impact on the results. CONCLUSIONS: There was a clear dose-response for pain relief with aspirin, even though these were single dose studies. Adverse effects, drowsiness and gastric irritation were also evident in the single dose studies. The pain relief achieved with aspirin was very similar milligram for milligram to that seen with paracetamol.

Administration, Oral↗
PubMedDate not supplied

Is somnambulism a distinct disorder of humans and not seen in non-human primates?

Though somnambulism (sleepwalking) is a well-recognized sleep disorder in humans, a biomedical literature search in Medline and Primate Literature bibliographic databases showed no publications on sleepwalking in non-human primates. From this finding, two inferences can be made. First is that somnambulism may be present in non-human primates; but due to limitations in expertise and methodological resources as well as narrow focus of research interest, until now researchers have not detected it in wild and/or captive conditions. Second, somnambulism does not exist in non-human primates including apes (chimpanzee, gorilla, orang-utan and gibbon); and thus, it is a unique behavioral disorder present only in humans. It is premature to conclude which of these two inferences is correct. In Jane Goodall's view, sleepwalking behavior is absent in chimpanzees. If further field observations can confirm Goodall's assertion that somnambulism is indeed absent in chimpanzees, it will be of evolutionary and medical interest to know why this parasomnic behavior became established in humans during the past 5.5 million years or so.

Animals↗
PubMed2003

Smoking cessation interventions for adolescents: a systematic review.

OBJECTIVE: To conduct a systematic review of controlled trials for adolescent smoking cessation. METHODS: Online bibliographic databases were searched as of June 2002, and reference lists from review articles and the selected articles were also reviewed for potential studies. The methodology and findings of all retrieved articles were critically evaluated. Data were extracted from each article regarding study methods, intervention studied, outcomes measured, and results. RESULTS: The abstracts or full-text articles of 281 relevant studies were examined, of which six met the selection criteria. Included were three school-based studies, a study in pregnant adolescent girls, a hospital-based study, and a trial of laser acupuncture. All three of the school-based studies reported significant impacts on cessation rates, although only one of these was a randomized trial. None of the studies had follow-up times of >5.2 months. CONCLUSIONS: There is very limited evidence demonstrating efficacy of smoking-cessation interventions in adolescents, and no evidence on the long-term effectiveness of such interventions. Smoking-cessation interventions that have proven most effective in adults, such as nicotine replacement and antidepressant use, have not been studied in adolescents in a controlled manner.

Adolescent↗