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At least 793 records · Page 44Linked to original sources

Accessing wound-care information on the Internet: the implications for patients.

The Internet and the World Wide Web have revolutionised communication and provide a unique forum for the exchange of information. It has been proposed that the Internet has given the public more access to medical information resources and improved patient education. This study assessed the impact of the Internet on the availability of information on wound care management. The search phrases 'wound care', 'wound healing' and 'wounds' were analysed using a powerful Metacrawler search engine (www.go2net.com). Web site access was classified according to the target audience (wound-care specialists, other health professionals, patients) and the author (societies, institutions or commercial companies). The largest proportion of web sites were commercially based (32%). Of the total number, 23% specifically targeted patients, mostly by advertising. Only 20% were aimed at wound specialists. Extensive surfing was required to obtain wound-care information, and objective information sites were under-represented. Regulated, easily accessible, objective information sites on wound-healing topics are needed for improved patient education and to balance the existing commercial bias.

Advertising↗

Web-based framework for improving geriatric education.

Despite the growth in the elderly population, physicians with special geriatric training and certification number only 9,000 out of 650,000 doctors in the United States. The flexibility and increasing availability of the Internet makes it an ideal avenue for addressing the educational needs of health care providers to improve the health and care of older adults. We performed an Internet search using popular search engines. This yielded between 321 and 358,000 websites about geriatrics and 164 to 175,000 about geriatric education. This paper reviews popular health and medical Web sites to determine geriatric educational content and proposes a structure for an "ideal" geriatric Web site that would provide resources and enhance training for allied health professionals, physicians in training and community doctors in practice. We also propose a framework addressing the design and content for developing a geriatric specific website. We use this framework to propose a prototype resource on falls and gait instability.

Aged↗

Endometriosis: internet resources.

Endometriosis is a puzzling disease characterized by pelvic pain, infertility, allergies, fatigue, and bowel problems. It is a non-lethal medical condition that disables only women and frustrates physicians who are frequently limited in their treatment success. Recently endometriosis has been linked with endocrine, environmental, genetic, and immune factors. The public health impact of endometriosis is significant in terms of suffering, lost income, infertility, stress on families, and medical costs. Resources for endometriosis on the Internet include search engines, medical sources, advocacy sources, U.S. government sources, personal Web sites, public library databases, and social science sources.

Consumer Organizations↗

Accidental Epipen injection into a digit - the value of a Google search.

Despite the lack of awareness by the clinicians consulted of the most suitable treatment for accidentally injected epinephrine, this patient was successfully treated due mainly to the ability of clinicians on-site to access the Internet in the A&E department. A broad search engine such as Google can be an invaluable tool in finding important clinical information rapidly.

Adrenergic alpha-Agonists↗

[Psychotherapy and gender: do men and women require different treatments? ].

Research has demonstrated that men and women differ considerably on a wide variety of variables. However, the effect of gender on the psychotherapy experience is little understood. This article provides a brief review of the current research literature on gender effects in psychotherapy and reports findings of gender differences in outcome for two different treatment modalities. Literature was collected using Medline and PsycLit search engines. Results from a randomized trial on supportive and interpretive short-term individual psychotherapy were used to investigate interaction effects between patient gender and form of treatment in 88 female and 56 male patients. Gender of the patient, therapist, or their interaction has minimal impact on treatment outcome. However, when gender is compared with the form of therapy, the success of the therapy differs between men and women. The findings suggest that for research on gender effects in psychotherapy to be productive, investigators need to consider how gender interacts with other conceptually meaningful variables.

Female↗

Known and hidden sources of caffeine in drug, food, and natural products.

OBJECTIVE: To review the pharmacology, pharmacokinetics, adverse effects, and drug interactions associated with caffeine and to raise awareness of the caffeine content of many prescription, nonprescription, and herbal drugs, beverages, and foods. DATA SOURCES: Articles in English retrieved through a MEDLINE search (1966-August 2000) using the terms caffeine, human, and systemic. Additional product information was obtained from manufacturers' Web sites, through direct communications with manufacturers or distributors, and via Internet searches using the AltaVista search engine and the term caffeine. Only the first 10 Web sites selling caffeine products identified were visited. STUDY SELECTION: All articles and correspondence items from data sources were evaluated, and all information deemed relevant was included. Priority was given to information provided by manufacturers. CONCLUSION: With the increase in consumers' use of over-the-counter products for health maintenance and self-care, it is imperative for pharmacists to be knowledgeable about the caffeine content of all drug and herbal products. It is important to be familiar with patients' self-treatment habits in order to identify potential caffeine-drug interactions or caffeine-laboratory interactions resulting in false laboratory values. These interactions increase health care costs by creating adverse effects and causing misdiagnoses.

Caffeine↗

Evaluation of HIV drug interaction web sites.

BACKGROUND: Clinicians frequently consult HIV drug interaction Web sites of unknown quality. OBJECTIVE: To systematically review and identify HIV drug interaction Web sites of high quality and usefulness for healthcare professionals. METHODS: Relevant Web sites were identified through a structured search on commonly used search engines. An assessment tool containing 4 domains (content, reliability, access restrictions, ease of navigation) was developed. English and French Web sites were selected for review if they included HIV drug interaction information directed to healthcare professionals. Web sites were excluded if antiretroviral interaction data were not available or were out of date. Commercial online databases and sites that required payment were not included. Seventeen HIV pharmacists from across Canada participated in the review. The Web sites were ranked with total mean scores. Mean scores for each domain were then analyzed. Interrater agreement and ANOVA using the rater as a covariate were determined. RESULTS: Nine Web sites met the criteria for review. Web sites from Toronto General Hospital (Canada), HIVinSite (beta version) (US), and the University of Liverpool (UK) ranked highest for total mean scores and for content. Other Web sites were found to be reliable, accessible, and easy to navigate; however, they did not consistently include unpublished data or data on herbal preparations, recreational drugs, or multiple interactions. CONCLUSIONS: Three HIV interaction Web sites of high quality were identified that can be valuable tools for HIV and non-HIV health-care professionals. Regular reviews are necessary in order to keep pace with the growing body of HIV interaction data and the constant evolution of Web sites.

Anti-Retroviral Agents↗

Ask the pharmacist: an analysis of online drug information services.

BACKGROUND: The Internet plays a large role in the provision of drug information. Given the growing number of patients seeking consultation on the Internet and the difficulty in regulating online pharmacy providers, an analysis of drug information provided by Internet pharmacies is warranted. OBJECTIVE: To assess the response rates and quality of responses to drug information questions submitted to "ask the pharmacist"services on Internet pharmacy sites and determine whether differences exist between National Association of Boards of Pharmacy-approved and nonapproved sites and among free-standing, chain, and independent pharmacy sites in the quality of information provided. METHODS: A content analysis was conducted on responses to 5 drug information questions electronically mailed to each of 64 Internet pharmacies identified through a meta-engine search. Three judges rated the quality of response components using a scoring system developed by an expert panel, with inter-rater reliabilities subsequently calculated. Both t-test and ANOVA procedures tested for differences in response quality. RESULTS: Responses were received for 51% of all questions submitted to the sites. Few differences in quality were found between approved/unapproved sites and among types of pharmacies. The percentage of correct responses provided for each of 22 response components ranged from 7% to 96%. CONCLUSIONS: While few differences were found among sites based on their approval status or type, low response rates and incomplete counseling information among many of the responses are cause for concern.

Drug Information Services↗

Optimizing antiepileptic drug therapy in the elderly.

OBJECTIVE: To review and evaluate the medical literature concerning antiepileptic drug (AED) therapy in elderly patients. DATA SOURCES: A MEDLINE search (1982-December 2004) was conducted. Bibliographies of the articles identified were also reviewed, and an Internet search engine was used to identify additional pertinent references. STUDY SELECTION AND DATA EXTRACTION: Clinical studies and reviews were evaluated, and relevant information was included. DATA SYNTHESIS: The elderly have the highest incidence of seizures among all age groups. Complex partial seizures are the most common, followed by primary generalized tonic-clonic seizures. An accurate diagnosis may prove difficult because of a low suspicion of epilepsy in the elderly and other diseases that may mimic seizures. Most AEDs are approved for treatment of elderly patients who have partial and tonic-clonic seizures. However, a number of age-related variables should be addressed when selecting an appropriate AED. Age-dependent differences in pharmacokinetics and pharmacodynamics of AEDs must be taken into account. Drug-drug interactions must be considered since elderly people often take multiple medications. The ultimate factor that often determines AED selection is tolerability. CONCLUSIONS: Numerous factors must be considered in treating elderly patients for seizures, but maximizing the ability of patients to tolerate drug therapy is often the basis for AED selection. Special consideration should be made along several lines, including elderly patients' cognitive functioning and their tendency to respond to lower AED concentrations.

Anticonvulsants↗

The NCBI. Publicly available tools and resources on the Web.

As computing technology advances and new sources of valuable biological information are collected the numbers of database and the tools that are used to analyze the data they contain will change. From the time this article was originally written to the time (about 6 months) this summary was put together another 4 releases of Genbank have been made available, two new BLAST search engines, PHI-BLAST and organism-specific BLAST, a database of Human Genetic Variation (dbSNP), and a new version of Cn-3D. The NCBI will, for the forseeable future, provide the research community with a wealth of information and computing tools. made a number of other tools available for molecular biologists.

Animals↗

N-glycosylation analysis using the StrOligo algorithm.

N-glycosylation of proteins is the predominant glycosylation in mammals and confers specific conformations, localization, and functions to proteins. High-throughput proteomics techniques have focused on the identification of proteins through amino acid sequence determination, with little attention paid to their post-translational modification, in particular, glycosylation. High-throughput mass spectrometric data often contain information about glycosylation, but this is systematically discarded by proteomic search engines. We have developed an algorithm, StrOligo (for STRucture of OLIGOsaccharides), capable of automated analysis of oligosaccharide composition and possible structures by mass spectrometry. The algorithm analyzes tandem mass spectrometry (MS/MS) data in an automated three-step process and provides possible structures and a discrimination score. In the first step, the algorithm constructs a relationship tree of the monosaccharide moiety losses observed in the MS/MS spectrum. In the second step, the algorithm uses the tree to propose possible compositions and structures from combinations of adduct and fragment ions as well as a discrimination score, which reflects the fit with the experimental results. Finally, an interface is available to visualize the proposed structures and their scores. As well, the MS/MS spectrum is displayed with relevant peaks labeled for the proposed structure with the highest discrimination score, using a modified nomenclature.

Algorithms↗

Proteomic data exchange and storage: the need for common standards and public repositories.

The ever increasing volumes of proteomic data now being produced by laboratories across the world have resulted in major issues in data storage and accessibility. The further demands of multilaboratory initiatives has highlighted issues when collaborators cannot import data generated within the same project but generated by different hardware types and processed by laboratory-specific work flows and analyses packages. There is an increasing need for common data standards that will allow the interchange of data between different instrumentation, search engines, and between laboratory databases. This could then lead to the establishment of data repositories from where benchmark datasets could be accessed and reanalyzed. The Human Proteome Organization is currently supporting efforts to establish such standards. The work of the Proteomics Standards Initiative has lead to the development of the mzData XML interchange standard and is now broadening its scope to produce a spectral analysis output format, mzIdent. Accompanying controlled vocabularies allow the accurate, while systematic, representation of metadata throughout both schema.

Benchmarking↗

Online continuing dental education.

BACKGROUND: An increasing number of continuing dental education, or CDE, courses are available on the Internet. The authors conducted this study to determine general characteristics of online CDE course offerings. METHODS: The authors found online CDE courses through Internet search engines and dental indexes. They recorded each course's Web page address, title, topic, length, credit hours and cost. Then they classified course providers, categorized topics, compared course length with credit hours and calculated cost per credit hour. RESULTS: The authors located 157 online CDE courses offered by 32 providers. The courses covered a wide range of topics, and most were five screens long or shorter. Credit hours per screen ranged from 0.05 to two, and cost per credit hour ranged from no charge to $25. CONCLUSIONS: Online CDE courses are hard to locate, making this material accessible only to people who are well-versed in retrieving information on the Internet. The brevity of most courses may make them appropriate for incremental study at the dental practitioner's convenience. Guidelines to correlate credit hours with course length should be developed. PRACTICE IMPLICATIONS: Online CDE courses may become an important tool to help practitioners keep current. Several issues, however, need to be addressed before online CDE can reach its full potential.

Computer-Assisted Instruction↗

Where are you, my beloved? On absence, loss, and the enigma of telepathic dreams.

The subject of dream telepathy (especially patients' telepathic dreams) and related phenomena in the psychoanalytic context has been a controversial, disturbing 'foreign body' ever since it was introduced into psychoanalysis by Freud in 1921. Telepathy- suffering (or intense feeling) at a distance (Greek: pathos + tele)-is the transfer or communication of thoughts, impressions and information over distance between two people without the normal operation of the recognized sense organs. The author offers a comprehensive historical review of the psychoanalytic literature on this controversial issue, beginning with Freud's years-long struggles over the possibility of thoughttransference and dream telepathy. She then describes her own analytic encounter over the years with five patients' telepathic dreams-dreams involving precise details of the time, place, sensory impressions, and experiential states that the analyst was in at that time, which the patients could not have known through ordinary sensory perception and communication. The author's ensuing explanation combines contributory factors involving patient, archaic communication and analyst. Each of these patients, in early childhood, had a mother who was emotionally absent-within-absence, due to the absence of a significant figure in her own life. This primary traumatic loss was imprinted in their nascent selves and inchoate relating to others, with a fixation on a nonverbal, archaic mode of communication. The patient's telepathic dream is formed as a search engine when the analyst is suddenly emotionally absent, in order to find the analyst and thus halt the process of abandonment and prevent collapse into the despair of the early traumatization. Hence, the telepathic dream embodies an enigmatic 'impossible' extreme of patient-analyst deep-level interconnectedness and unconscious communication in the analytic process. This paper is part of the author's endeavour to grasp the true experiential scope and therapeutic significance of this dimension of fundamental patient-analyst interconnectedness.

Adult↗

Cystic fibrosis on the Internet: a survey of site adherence to AMA guidelines.

OBJECTIVES: The Internet permits unprecedented and mostly unrestricted access to medical knowledge; however, concerns exist regarding viewer privacy, accountability of authorship, accuracy of information, and patient safety. To address these issues, the American Medical Association (AMA) has developed guidelines concerning web site content and visitor rights. Cystic fibrosis (CF) is the most common genetically inherited lethal disease in North America. Many Internet sites that provide information on CF have been developed, although adherence to validated guidelines for online health information is not required. The purpose of this study was to assess systematically web sites with content pertaining to CF for adherence to the published AMA guidelines. METHODS: The search term "cystic fibrosis" was entered into a commonly used search engine (Google), and the first 100 eligible sites were reviewed. Each site was examined for adherence to the AMA Guidelines for Medical and Health Information Sites on the Internet using a series of adapted questions. There were 15 questions divided into the following main categories: 1) site structure and viewer privacy, 2) author accountability, 3) scientific citation, and 4) patient safety. The number of positives for each question was tabulated. RESULTS: With respect to site structure, fewer than half (45%) of the reviewed sites indicated a date of last revision. Only 11 (11%) carried an explicit privacy policy. A responsible author or group was listed in only 43 (43%) of 100 sites. Presented data regarding CF was supported by references, sources, or expert review in only 38 (38%) of 100 sites. A medical disclaimer noting that information provided does not substitute for evaluation by a health care team was evident in only 37 (37%) sites. CONCLUSIONS: The majority of easily accessible CF informational web sites do not adhere to guidelines published by the AMA. Patients and families who use the Internet as a CF information resource should examine the web sites carefully and be familiar with the guidelines established by the AMA. Personal information is not protected, and few sites provide explicit privacy guarantees. Finally, CF care teams should inquire about Internet use by patients and families and be prepared to discuss findings from the Internet to heighten patient safety and awareness.

American Medical Association↗

[The use of bibliographic databases by Spanish-speaking Latin American biomedical researchers: a cross-sectional study].

OBJECTIVE: To describe how Spanish-speaking biomedical professionals in Latin America access and utilize bibliographic databases. METHODS: Based on a MEDLINE search, 2 515 articles published between August 2002 and August 2003 were identified that dealt with and/or had authors from 16 countries: Argentina, Bolivia, Chile, Colombia, Costa Rica, Cuba, Ecuador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Uruguay, and Venezuela. The search was limited to references to basic science, clinical science, or social medicine. A survey was sent by e-mail to researchers who lived in 15 of the 16 countries (the exception being Nicaragua). The survey asked about the researcher's area of work (basic science, clinical science, or public health), the level of skill in using databases, the frequency and type of access to the databases most utilized, the impact from not having access to the full text of articles when preparing a manuscript, and how the respondent usually obtained the full-text version of articles. RESULTS: A total of 586 e-mail messages with the survey were sent out, and 185 responses were received (32%). The databases most utilized to obtain biomedical information were MEDLINE (34.1%), general search engines (Google, Yahoo!, and AltaVista) (15.9%), on-line journals (9.8%), BIREME-LILACS (6.0%), BioMedNet (5.4%), the databases of the Centers for Disease Control and Prevention of the United States of America (5.2%), and the Cochrane Library (4.9%). Of the respondents, 64% said they had average or advanced abilities in using MEDLINE. However, 71% of the respondents did not use or were not aware of the MEDLINE Medical Subject Headings (MeSH), a controlled vocabulary established by the National Library of Medicine of the United States of America for indexing articles. The frequency of accessing the databases was similar in all the countries studied, without significant differences in terms of the type of access (authorized access to commercial databases, unauthorized access to those databases, or access to databases available for free) or the level of abilities. Of the respondents, 87% said they had not included important references in the articles that they had published because they had not had access to the full text of those items, and 56% said they had cited articles that they had not read in full. In addition, 7.6% of the respondents admitted to unauthorized use of limited-access databases, such as through borrowed passwords or copied disks. More than two-thirds of the respondents said they obtained the full text of articles through photocopies or directly from the authors. CONCLUSIONS: In order to encourage scientific output by Latin American researchers, more of them need to be trained in the use of the most frequently used databases, especially MEDLINE. Those researchers also need to have expanded access to the biomedical literature.

Biomedical Research↗

Prevention of preeclampsia with low-dose aspirin -- a systematic review and meta-analysis of the main randomized controlled trials.

The purpose of this paper is to evaluate the effectiveness of low-dose aspirin in the prevention of preeclampsia in low-risk and high-risk women. We identified randomized clinical trials of the use of low-dose aspirin to prevent preeclampsia through the PUBMED search engine, and through the Cochran Library database. Twenty-two studies met our inclusion criteria, and were divided according to the studied population into 2 groups: trials with women at low risk for preeclampsia and trials with women at high risk. Effects were measured through the incidence of preeclampsia in women taking either placebo or aspirin, in studies where the relative risks and the 95% confidence intervals were calculated for both groups. A total of 33,598 women were studied, comprising 5 trials with 16,700 women at low-risk and 17 trials including 16,898 women at high risk. The incidence of preeclampsia was 3.75% (626/17,700), in the low-risk group, 9.01% (1,524/16,898) in the high-risk group, and 6.40% (2,150/33,598) overall. Low-dose aspirin had no statistically significantly effect on the incidence of preeclampsia in the low-risk group (RR = 0.95, 95% CI = 0.81-1.11), but had a small beneficial effect in the high-risk group (RR = 0.87, 95% CI = 0.79-0.96). Therefore, low-dose aspirin is mildly beneficial in terms of reducing the incidence of preeclampsia in women at high risk of developing preeclampsia.

Aspirin↗

The fate of patients not returning for follow-up five years after total knee arthroplasty.

BACKGROUND: Patients who do not return for follow-up after total knee arthroplasty are often assumed to have had a worse outcome. We postulated that the Internet may be useful for locating patients who do not return for follow-up. The purpose of this study was to compare outcomes between patients who attended prescribed postoperative appointments and those who did not. METHODS: We retrospectively reviewed the outcomes for 161 patients (200 knees) at a minimum of five years after a total knee replacement. All patients who had had no contact of any type with their surgeon in any manner beyond six months following the date of the surgery were classified as not having returned for follow-up. When patients could not be located with use of all available information in their chart, a standardized Internet search algorithm was employed with use of readily available and free search engines. RESULTS: Thirty patients with thirty-five treated knees met the definition of not returning for follow-up. Thirteen patients could not be located with use of the contact information given at their last visit. All were located with use of the Internet. None of the patients had had knee surgery elsewhere. The reasons for not adhering to the prescribed postoperative regimen were identified. The group had improved Knee Society pain and function scores compared with the preoperative values, and the patients were not significantly different from those who did return for follow-up. CONCLUSIONS: The patients who did not attend follow-up appointments in this series had not had any additional surgery and did not have any significant differences in measured outcome variables when compared with patients who had complied with a follow-up protocol. The Internet proved to be a valuable tool for locating patients who had not returned for follow-up postoperatively.

Adult↗