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PubMedDate not supplied

Hysterectomy for treatment of pain associated with endometriosis.

The literature was searched for endometriosis and hysterectomy on PubMed and the individual search engines of the Journal of Minimally Invasive Surgery, Fertility and Sterility, BJOG, Obstetrics and Gynecology, the American Journal of Obstetrics and Gynecology, and Human Reproduction. Eighty references of interest were identified and included in this review. Analysis of hysterectomy for pain associated with endometriosis is difficult for many reasons. These include a lack of differentiation of various forms of cyclic pain from other forms of non-cyclic pain, the retrospective nature of much of the literature, and a low specificity for identifying pain. Hysterectomy for chronic non-specified pelvic pain associated with endometriosis is a successful approach in many women. It can not be determined whether this is due to intermingling of patients with and without cyclic pain or if both of these respond equally well. Focused prospective research is needed to determine whether symptoms, signs, or laboratory findings might be useful in determining more specific response patterns.

Contraceptive Agents, Female↗

PubMed2004

An evaluation of the contents and quality of menopause information on the World Wide Web.

OBJECTIVE: To evaluate the content and quality of currently available World Wide Web based information about menopause. DESIGN: A sample of the 100 top sites obtained with the search engine Google for the key word "menopause" was evaluated according to predefined general and specific criteria, content type, language, and quality. The Internet popularity was established by the number of links to each website. Using a systematic scoring tool each site was assessed on factual information provided and quality of site. RESULTS: The websites studied were heterogeneous in content and quality. The most frequent type of website has commercial content with low quality, biased or useless information. Few sites provided comprehensive medical information about menopause. The scientific societies not always provided complete information about the possible adverse events related with hormone replacement therapy. The results of the Women's Health Initiative (WHI) and the Million Women (MW) studies are discussed by very few websites. Internet popularity did not correlate with measures of quality such as display of authorship, attribution or references, currency of information, and disclosure. CONCLUSION: The content and quality of the websites concerning menopause are widely varied and sometimes biased to commercial goals. The dominant medical information is of low quality and do not comply with general quality scores although the most informative sites have comprehensive content about the menopause including the recent results of the WHI and MW studies.

Estrogen Replacement Therapy↗

PubMed2006

Neural networks in frontotemporal dementia--a meta-analysis.

OBJECTIVE: Frontotemporal dementia is the most common form of frontotemporal lobar degeneration. It is characterized by deep alterations in behavior and personality. We conducted a systematic and quantitative meta-analysis to examine its neural correlates and place the disease in a framework of cognitive neuropsychiatry. METHODS: MedLine and Current Contents search engines were used to identify imaging studies investigating frontotemporal dementia between 1980 and 2005. Nine studies were identified reporting either atrophy or decreases in glucose utilization. Finally, the analysis involved 132 patients and 166 controls. A quantitative meta-analysis was performed. Maxima of the studies resulted in activation likelihood estimates. RESULTS: The meta-analysis revealed a particularly frontomedian network impaired in frontotemporal dementia. Additionally, right anterior insula, and medial thalamus were identified. CONCLUSIONS: Our study specifies frontotemporal dementia as the frontomedian variant of frontotemporal lobar degeneration. The disease affects neural networks enabling self-monitoring, theory of mind capabilities, processing/evaluation of internal mental states, perception of pain and emotions, and sustaining personality and self. Our study contributes to placing frontotemporal dementia in cognitive neuropsychiatry.

Aged↗

PubMed2004

Redundant publications in scientific ophthalmologic journals: the tip of the iceberg?

OBJECTIVE: The number of scientific publications is often used to measure scientific achievement. This practice can motivate unethical conduct, such as redundant or duplicate publications, defined as publication of the same scientific contents in more than 1 journal. The aim of this study was to estimate the amount of redundant publications in ophthalmologic journals. DESIGN: Retrospective analysis of published literature. METHODS: We developed an electronic search engine for redundancies to estimate the amount of duplicate publications in scientific journals. When redundancies reached a given degree (matching score), the articles were screened manually based on authors, titles, and abstracts. We applied this method to the 22 433 articles that were published between 1997 and 2000 in 70 ophthalmologic journals indexed by MEDLINE. MAIN OUTCOME MEASURES: The number of duplicate publications with a matching score of 0.6 or more, the number of involved journals, and the number of authors. RESULTS: Redundancies reached a matching score of 0.6 or more in 13 967 pairs of articles. Out of them, a sample of 2210 was reviewed manually. We found 60 redundant articles and estimated that 1.39% of the publications were redundant. Thirty-two journals and an estimate of 1092 authors were involved. In 5% of cases, the scientific conclusions were modified. CONCLUSIONS: Because of the restrictive selection process, the impracticability of detecting all redundant publications, and the estimated amount of duplicates increases with lower matching scores, we regard our estimate to be the tip of the iceberg. Duplicate publications have several negative impacts, but neither peer reviewers nor editors can protect their journal from them completely. Several deterrents for duplicate publications are possible, but as long as publications remain the central requirement for academic advancement, a solution seems unlikely. Nevertheless, it is the responsibility of all those who care about objective research and evidence-based medicine to address this problem-not only in ophthalmology.

Algorithms↗

PubMed2004

Evaluation of the quality and contents of diabetes mellitus patient education on Internet.

Patient education is widely regarded as an essential component of chronic disease care and effective health promotion. Internet is extremely useful medium in this respect. Web-based information is seldom the subject of systematic investigation for its accuracy and appropriateness for patients. Objective of this study was to evaluate of web-based diabetes patient education material for well-accepted evaluation criteria and core education concepts. Out of 214 web-sites retrieved from meta search engine, 53 sites themselves provide patient information and so considered for evaluation. Data obtained was analyzed by cluster analysis and classified into four categories with respect to quality. Considerable variability in quality of diabetes patient education web-sites was found with respect to core educational concepts and HSWG criteria. Inclusion of evidence-based medicine concepts, role of family support, enhancement in customized content and easier feedback mechanism in the web-sites can be a significant development in the direction of patient-centered diabetes care.

Cluster Analysis↗

PubMed2004

The shortened dental arch: a review of the literature.

The functional demands of patients are highly variable and individual, requiring dental treatment to be tailored to the individual's needs and adaptive capability. The World Health Organization indicates that a functional, esthetic, natural dentition has at least 20 teeth, while the literature indicates that dental arches comprising the anterior and premolar regions meet the requirements of a functional dentition. The English-language peer-reviewed literature pertaining to the short dental arch (SDA) was identified through the Medline search engine covering the period between 1966 and the present and critically reviewed. This treatment option for the partially dentate patient may provide oral functionality, improved oral hygiene, comfort, and, possibly, reduced costs.

Dental Arch↗

PubMed2005

Bladder tumor markers beyond cytology: International Consensus Panel on bladder tumor markers.

This is the first of 2 articles that summarize the findings of the International Consensus Panel on cytology and bladder tumor markers. The objectives of our panel were to reach a consensus on the areas where markers are needed, to define the attributes of an ideal tumor marker, and to identify which marker(s) would be suitable for diagnosis and/or surveillance of bladder cancer. Our panel consisted of urologists and researchers from Europe, Asia, and the United States who reviewed original articles, reviews, and book chapters on individual bladder tumor markers published in the English language mainly using the PubMed search engine. Panel members also met during 3 international meetings to write recommendations regarding bladder tumor markers. The panel found that the most practical use of noninvasive tests is to monitor bladder cancer recurrence, thereby reducing the number of surveillance cystoscopies performed each year. Markers also may be useful in the screening of high-risk individuals for early detection of bladder cancer. However, more prospective studies are needed to strengthen this argument. Case-control and cohort studies show that several markers have a higher sensitivity to detect bladder cancer. However, cytology is the superior marker in terms of specificity, although some markers in limited numbers of studies have shown specificity equivalent to that of cytology. Our panel believes that several bladder tumor markers are more accurate in detecting bladder cancer than prostate-specific antigen (PSA) is in detecting prostate cancer. However, bladder tumor markers are held to a higher standard than PSA. Therefore, use of bladder tumor markers in the management of patients with bladder cancer will require the willingness of both urologists and clinicians to accept them.

Biomarkers, Tumor↗

PubMed2006

Simple case definition of clinical benign prostatic hyperplasia, based on International Prostate Symptom Score, predicts general practitioner consultation rates.

OBJECTIVES: To determine which case-definition of clinical benign prostatic hyperplasia (BPH) has the best predictive value for general practitioner visits for lower urinary tract symptoms (LUTS) suggestive of BPH. The incidence and prevalence rates of general practitioner visits for LUTS were also determined. METHODS: A longitudinal, population-based study from 1995 to 2003 was conducted among 1688 men aged 50 to 78 years old. Data were collected on physical urologic parameters, quality of life, and symptom severity as determined from the International Prostate Symptom Score. Information on health-care-seeking behavior of all participants was collected from the general practitioner (GP) record using a computerized search engine and an additional manual check of the electronically selected files. RESULTS: The incidence and prevalence rate of the men at risk was 19.6% and 14.0%, respectively, and these rates increased with age. For sensitivity and the positive predictive value, the case-definition of clinical BPH as an International Prostate Symptom Score greater than 7 had the best predictive value for GP visits for LUTS within 2 years after baseline. CONCLUSIONS: Because only marginal improvement (greater specificity but lower sensitivity) in the prediction of GP visits for LUTS was possible by adding information on prostate volume and flow, for the prediction of future GP visits for LUTS suggestive of BPH, we suggest that the International Prostate Symptom Score questionnaire be used and that estimation of the prostate volume and flow is not required.

Aged↗

PubMed2005

Academic research on solid waste in Sweden 1994-2003.

A small desk survey was conducted in the spring of 2004 to get an overview on the development of waste research. The survey targeted the last 10 years of waste research at Swedish academic institutions trying to identify the total amount of research and trends over time with regard to issues, volume and distribution over academic disciplines. In the survey, only the theses written at major Swedish universities were considered. All post-graduate theses from major Swedish universities were reviewed. Data were obtained from the homepages and search engines of the various libraries as of May 13 2004. Altogether 90 theses were identified from nine universities, i.e., an average of 1 thesis per University per year. The results of the survey indicate that: (1) the academic waste research is very small in comparison to the R&D performed by the industry; there seems to be a lack of interaction between industry and academia; (2) waste research is slowly getting into established academic environments and gains in quantity and diversion over time; (3) in addition to being driven by environmental protection legislation, there also seems to be emerging more industry interest from a production perspective.

Academic Dissertations as Topic↗

PubMed2005

An evaluation of the quality of epilepsy education on the Canadian World Wide Web.

BACKGROUND: Despite the substantial amount of epilepsy-related information available on the Internet, little is known about its quality. Epilepsy-related information in English on the Canadian Internet was reviewed. METHODS: Popular search engines (google.ca, yahoo.ca, ca.altavista.com, simpatico.msn.ca) were interrogated. Web sites aimed primarily at patient and family education, geared toward human epilepsy, and epilepsy in general as opposed to one specific type or aspect of epilepsy, were included. Web sites were then subdivided in to proprietary (directly sponsored by the industry) and nonproprietary, and evaluated according to compliance with the principles of the Health on the Net (HON) Foundation Code of Conduct. Web sites without comprehensive contents were excluded. Comparison between total scores was done using the rank test. Categorized descriptors were assessed with t tests. RESULTS: Five proprietary and fourteen nonproprietary websites were identified. None of them were compliant with all eight principles of the HON code. The average number of principles with which these sites were in compliance was 3.3 (range: 1-6.5, P = 0.4, proprietary vs nonproprietary). CONCLUSIONS: The Internet has the potential to be a very powerful educational tool for patients with epilepsy. However, most of the easily accessed epilepsy web sites do not comply with accepted standards for health web sites.

Canada↗

PubMed2004

Administering an effective health intervention for smoking cessation online: the international users of Stop-Tabac.

BACKGROUND: The Internet has opened up new possibilities in public health, yet to date, there are few examples of online health interventions that go beyond information provision. This paper describes the users and return rates of an effective intervention for smoking cessation that has gone online. METHODS: Open enrollment of smokers via links and search engines with voluntary follow-up for an Internet-based expert system in French and English. RESULTS: Between June 1998 and March 2001, 18,361 people from 112 countries used the program. When compared to the distribution of smokers in the general population in seven main countries, smokers in the action stage (11%) were overrepresented among online program users. Among the 3591 returnees in the study period (20%), we observed a median time to return of 132.5 days. One of the strongest predictors of return was stage of change with smokers in the action stage being most likely to return (28%) and those in the precontemplation stage least likely (14%). CONCLUSIONS: The reach of an online public health intervention can be impressive in geographical and numerical terms. Although the quality of behavioral data collected was high, the utility of this medium for science should be refined.

Adult↗

PubMed2000

Statins: effective antiatherosclerotic therapy.

BACKGROUND: Statins are the most effective agents currently available for lowering plasma levels of low-density lipoprotein cholesterol (LDL-C) and are the mainstay of therapy for hyperlipidemia. The statins are highly liver-selective, inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, a key enzyme in the synthesis of cholesterol. Several large, controlled clinical trials have confirmed significant reductions in rates of coronary heart disease morbidity and death with long-term statin therapy in patients with mild to severe hypercholesterolemia. METHODS AND RESULTS: This review article is based on a literature search of more than 60 relevant articles from peer-reviewed journals. Search engines included Medline and Embase. In surveying clinical and angiographic evidence, we found that statins appear to reduce the incidence of coronary events by slowing the progression of atherosclerosis and preventing atheromatous lesion formation. We found that the 6 statins currently marketed-atorvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, and simvastatin-differ in their inhibitory action on the HMG-CoA reductase enzyme. CONCLUSIONS: The use of more potent statins such as atorvastatin and simvastatin affords greater lowering of LDL-C and triglyceride levels, allowing more patients to achieve target goals. The question of how low LDL-C levels should be lowered will be answered by ongoing clinical trials.

Anticholesteremic Agents↗

PubMed1997

Use of the Internet for obstetricians and gynecologists.

The Internet is such a large unstructured body of information that it must be used to be understood. This article limits itself to the World Wide Web for information retrieval. Equipment and access methods are discussed but not in depth. Search engines and their use are discussed in greater detail and examples are given. Repetitive personal use is emphasized as the best possible method of learning. Liberal use of bookmarks is emphasized to build one's own map of this immense knowledge structure.

Computer Communication Networks↗

PubMed2003

American ophthalmology graduate medical education and the web: current state of internet resource utilization.

PURPOSE: To evaluate the presence and accessibility of ophthalmology graduate medical education (GME) programs on the internet and the degree to which web-based resources are currently being utilized by American Ophthalmology training programs. DESIGN: Prospective sampling of internet postings of ophthalmology GME programs. METHODS: Ophthalmology residency programs listed in the American Medical Association Fellowship and Residency Electronic Interactive Database (FREIDA) online website (http://www.ama-assn.org/ama/pub/category/2997. html) were evaluated. Departmental websites were accessed either directly from the FREIDA website or from one of eight search engines or four metacrawlers utilized in the study. Each site was evaluated for the presence, extent, and type of postings in the following categories: residency, medical student resources, faculty, patient care, video utilization, and links. RESULTS: Departments with websites numbered 102 (83%). Specific posting rates were residency 84%; medical student resource 12%; faculty 72%; patient care 69%; video 2%; links 70%. CONCLUSIONS: Most departments have websites, but only a small number have postings in all categories.

Education, Medical, Graduate↗

PubMed2004

[Diagnosis of thyroid nodule. Application of evidence-based medicine].

OBJECTIVE: The frequency of thyroid nodules requires an appropriate and consistent undertaking of such pathology by the entire medical profession. Over the past few years, the ANAES (National Agency of Health Accreditation and Evaluation - 1995 - 1997) had formulated medical recommendations. Our work aimed at updating such recommendations considering recent literature developments and their level of evidence. MATERIAL AND METHODS: We have selected high-level of evidence's articles published since 1997 dealing with the diagnostic undertaking of thyroid nodule. Such analysis was conducted using the search engine "Medline" and the level of evidence of the selected articles was evaluated by taking into account the professional recommendations of the "literature analysis and gradation of recommendations' guide" of ANAES. RESULT: At present, two diagnostic tests are necessary in the diagnostic evaluation of a thyroid nodule (ultrasonography and fine-needle aspiration). CONCLUSION: The medical recommendation will hence result in the synthesis of these two different diagnostic tests, nevertheless fine-needle aspiration being essential and having priority in evaluating the risk of cancer.

Diagnosis, Differential↗

PubMed2003

A sphingosine-dependent protein kinase that specifically phosphorylates 14-3-3 (SDK1) is identified as the kinase domain of PKCdelta: a preliminary note.

A specific protein kinase that phosphorylates Ser60, Ser59, or Ser58 of 14-3-3beta, eta, or zeta, respectively, only in the presence of sphingosine (Sph) or N,N-dimethyl-Sph (DMS), was termed "sphingosine-dependent protein kinase-1" (SDK1) [J. Biol. Chem. 273(34) (1998) 21834]. We have now identified SDK1 as a protein having the same amino acid sequence as in the C-terminal-half kinase domain of PKCdelta, with approximately 40 kDa molecular mass, based on large-scale purification of a protein from rat liver, and partial sequence using three different combinations of LC-MS or LC-MS/MS with respective search engine. PKCdelta did not display any SDK1 activity and PKCdelta activity was inhibited by Sph and DMS. However, strong SDK1 activity, only in the presence of Sph or DMS, became detectable when PKCdelta was incubated with caspase-3, which releases the approximately 40 kDa kinase domain.

14-3-3 Proteins↗

PubMed2004

Internal limiting membrane: ultrastructural relationships, with clinical implications for macular hole healing.

BACKGROUND: Recent data on macular hole formation have changed our understanding of the mechanisms involved. However, the mechanisms of macular hole closure, despite the introduction of internal limiting membrane (ILM) removal, are not fully understood. We reviewed the charts of patients who underwent surgery for macular hole with and without intentional removal of ILM and reviewed the basic science literature on the components and relationships of the ILM-glial cell interface to help interpret our surgical data. METHODS: We reviewed the records of 205 eyes with a clinical diagnosis of macular hole at a university centre in Montreal between 1998 and 2002. Of these, 117 eyes of 108 patients were included. Vitrectomy with intentional ILM removal was done under indocyanine green (ICG) staining. Macular hole stage and rates of hole closure, failure and reopening were recorded, comparing the eyes with intentional ILM peeling versus no ILM peeling. Anatomic success was defined as a flat/closed configuration. A basic science literature review was done through the PubMed search engine with the key words "internal limiting membrane," "internal limiting lamina," "macular hole," "retinal glial cells" and "retinal Müller cells." RESULTS: Eighty-four eyes had ICG-guided ILM removal (26 stage 2 macular holes, 45 stage 3 holes and 13 stage 4 holes), and 33 eyes had no ILM removal (10 stage 2 holes and 23 stage 3 holes). Of the 117 eyes 110 (94.0%) were successfully closed. Four (3.6%) of the closed holes reopened (none had ILM peeling), and 7 (6.0%) of the 117 eyes had primary failure. Ten of the 11 eyes that had primary failure or hole reopening were reoperated, and 8 were successfully closed after the second procedure. One patient refused reoperation. Including second procedures, the final anatomic closure rate was 97.4% (114/117). INTERPRETATION: Intentional ILM peeling is not mandatory for all macular holes to close but does play a role in preventing reopening. Removal of ILM increases the rate of flat/closed hole configuration on reoperation without the need for biologic adjuvants. Review of the basic science evidence helped clarify the possible role of ILM removal.

Coloring Agents↗

PubMed2004

Behavioral interventions in asthma: biofeedback techniques.

OBJECTIVES: Biofeedback techniques have long been recommended as an adjunctive treatment for bronchial asthma. Techniques that target lung function directly, or indirectly by altering facial muscle tension, heart rate, heart rate variability (HRV) or inspiratory volume together with accessory muscle tension, have been proposed. We review evidence for the effectiveness of these biofeedback interventions and discuss the psychophysiological rationale behind individual techniques. METHOD: Controlled studies of biofeedback in asthma were retrieved using relevant search engines and reference lists of published articles. Effect sizes comparing intervention with control groups were calculated where appropriate. RESULTS: Most of the studies suffer from methodological inadequacies or poor reporting of methods and results. Interventions targeting respiratory resistance directly have yielded only small and inconsistent changes in lung function and are difficult to implement without producing dynamic hyperinflation. Biofeedback-assisted facial muscle relaxation as an indirect intervention has yielded mixed results across studies, with only half of the studies showing significant albeit very small and clinically irrelevant improvements in lung function. The underlying physiological assumptions of the technique are questionable in the light of current knowledge of respiratory physiology. For other indirect techniques, only preliminary evidence of small effects is available. CONCLUSION: Currently, there is little good evidence that biofeedback techniques can contribute substantially to the treatment of asthma.

Asthma↗