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PubMed2003

[Whiplash injury of the neck from concepts to facts].

OBJECTIVES: To focus on a topic of traumatology and rehabilitation becoming recently a much debated public health problem. METHOD: A references search from Medline database with whiplash as keyword was carried out. Were selected articles with abstracts in french or english and focusing on accidentology, biomechanics, demonstrated lesions, epidemiology and treatments. RESULTS: From 1664 references found, 232 were reviewed. The usual mechanism of crash is a rear-end collision inducing in the occupants of the bumped vehicle a sudden lower cervical spine extension with upper flexion followed by a global flexion. In nearly 50% of the cases, the stress occurring in the collision is comparable to that observed in bumper cars. The velocity changes are seldom up to 15 km/h. A headrest at the level of the center of gravity of the head restrict significantly the extension of the neck. Every structure of the cervical spine could be damaged and mainly the facet joints but the lesions were only demonstrated in severes traumatisms. The discrepancies in incidence among the different countries could be related to their medicolegal system. Although subjectives, the early symptoms are rather similar among patients suggesting true anatomical or functional disorders but the chronicity seems to be mainly related to social and psychological factors. The association of: no posterior midline cervical tenderness, no intoxication, normal alertness, no focal neurological deficit and no painful distracting injuries has a good predictive value of the lack of osteo-articular lesion on X-rays. Except the grade IV of the Quebec task Force (0, no symptom; 1, pain and stiffness; 2, neck complaint and physical signs; 3, neck complaint and neurological signs; 4, fracture or dislocation) the use of a collar should be avoided and the cervical spine should be mobilized. CONCLUSION: In most whiplash injuries, the mildness should be early stated, mobilization encouraged, and procedures of compensation shortened.

Accidents, Traffic↗
PubMed1994

[Characteristics of blood pressure regulating endocrinological factors in elderly essential hypertensives].

Plasma renin activity (PRA) was lower in elderly normotensive subjects and essential hypertensives (EHT), and a significant negative correlation was found between PRA and age in both groups. In EHT, the proportion of the low renin group to total EHT increased with aging. There was a significantly positive correlation between plasma norepinephrine (PNE) and age in NT, but not in EHT. The mean value of PNE in young subjects was significantly higher in EHT than in NT, but not in the middle-aged and elderly groups, suggesting the important role of PNE in young EHT. Power spectral analysis revealed a significant reduction of both sympathetic and parasympathetic activity with aging in NT and EHT, indicating much caution may be required if sympathetic nerve activity is evaluated only by PNE levels in elderly EHT. The expanded plasma volume was another characteristic in elderly EHT, and suppressed activity of renal kallikrein-kinin, prostaglandin and dopamine may be involved with its mechanisms. Regarding insulin sensitivity in elderly EHT, it was shown that 1) the reduction of insulin sensitivity plays some role in age related acceleration of hypertension and glucose intolerance, 2) selective insulin resistance with respect to glucose metabolism already exists at lower ages in EHT, and 3) both Na retention and pressor system activation via insulin action might be a cause of blood pressure elevation in EHT.

Adult↗
PubMed1997

[Glucose tolerance and insulin resistance in the elderly].

Glucose tolerance is reported to be impaired in the elderly, and this is said to be mainly due to a decrease in insulin sensitivity (insulin resistance). Insulin resistance is known to be associated with atherosclerosis and coronary artery disease. To clarify whether or not age-dependent changes in glucose tolerance and insulin sensitivity are risk factors for coronary artery disease, as they are in the case of the insulin resistance syndrome, we studied age-dependent changes in glucose tolerance, insulin sensitivity, blood pressure, and serum lipids in a large number of subjects who underwent annual health check-ups, and then studied the relationships between coronary artery disease and aging, insulin sensitivity, and other risk factors in subjects who underwent coronary angiography. Aging was associated with an increased prevalence of noninsulin-dependent diabetes mellitus and impaired glucose tolerance; even in subjects with normal glucose tolerance, plasma glucose levels during an oral glucose tolerance test were significantly higher in the elderly. Insulin sensitivity, as assessed by the ratio of the sum of the plasma glucose divided by the sum of the serum insulin during the test (sigma PG/sigma IRI), was significantly lower in subjects over 60 years old than in younger subjects. Age-dependent impairment of insulin sensitivity and glucose tolerance was associated with increased blood pressure and serum cholesterol levels, but not with changes in boy mass index or serum triglyceride levels. As an independent variable, aging, but not insulin sensitivity, was related to the severity of coronary artery disease. These data suggest that aging is associated with glucose intolerance, insulin resistance, and an increased risk of coronary artery disease, but that the effect of aging on coronary artery disease cannot be explained by insulin resistance alone. Other factors, such as glucose intolerance and increased blood pressure, in addition to insulin resistance, appear to be responsible of the increased risk for coronary artery disease in the elderly.

Aged↗
PubMed2001

[Reality in carrying out clinical studies in a non-university hospital].

Carrying out clinical research at non-university hospitals is complicated by a lack of appropriate material and staffing resources, but is necessary considering the far greater number of patients attending (approximately 80%). A poll of surgical department heads (n = 27) revealed that, nevertheless, scientific research, was carried out by a majority of them. Retrospective studies and case studies are being carried out in the majority at single centers, whereas for multicenter studies participation in prospective randomized studies predominates. Preferred subjects are surgical strategies and techniques. Publications are primarily in German, most of them being original articles. It is striking that there is a relatively high percentage of abstracts amongst the publications in English. Improved know-how and coordination centers simplify, while lack of time, increasingly similar performance figures, and wildly growing documentation complicate studies.

Germany↗
PubMed2006

[Cross-cultural adaptation of health-related quality of life questionnaire: English version of Qualiveen abstract].

INTRODUCTION: The Qualiveen questionnaire is a urinary disorder-specific health-related quality of life (HRQL) instrument. Developed in French, the instrument's translation into English was the first step of a process leading to an HRQL questionnaire that can be used in a different culture. However, the cultural adaptation of an HRQL questionnaire is achieved only when the psychometric properties of the translated questionnaire are documented. AIM: To develop an equivalent English version of the Qualiveen questionnaire and to assess its discriminative measurement properties. METHODS: Fifty-five Canadian out-patients with multiple sclerosis (MS) completed a set of questionnaires, including the Qualiveen; the MS Quality Of Life-54 (MSQOL-54), an MS-specific HRQL questionnaire; urinary function assessment; and the expanded disability status scale (EDSS) twice at an interval of 2 to 4 weeks. RESULTS: The English Qualiveen proved to be test-retest reliable (intraclass correlation coefficient=0.94). Consistent with a priori predictions, we found a strong association between overall Qualiveen score and degree of incontinence (0.63), a moderate association with type of urinary symptoms (0.49), a weak association with manner of voiding (0.28) and weak or absent associations with MSQOL-54, EDSS bladder/bowel and global EDSS domains. Predictions proved to be generally accurate (weighted kappa=0.65). CONCLUSION: The test-retest reliability and cross-sectional construct validity of the English version of Qualiveen are excellent and similar to the original French version. Further studies should explore Qualiveen's longitudinal validity and responsiveness.

Cross-Sectional Studies↗
PubMed2001

[The Revista Médica de Chile in a science library in the Internet].

Medical journals published in non-English languages face a handicap: their worldwide readership and citation are reduced in comparison to journals published in English. This handicap is worse for small journals edited in developing countries, regardless of whether they publish original research articles including abstracts in English. To facilitate the international diffusion of selected Chilean scientific journals, the "Comisión Nacional de Investigación Científica y Tecnológica" enforced the program "SciELO Chile" with a web site in Internet (www.scielo.cl) including the full text of articles published in recent issues. Revista Médica de Chile is the first Chilean medical journal that appears in this web site, sponsored by the National Library of Medicine, Washington D.C. We expect that this web site will give a favorable input to authors of articles published in our journal.

Bibliometrics↗
PubMed1998

Obituary

Sheila Willmott, (1921-1998)CAB International and the Editor, Assistant Editor and Editorial Board of the Journal of Helminthology wish to express their deepest sympathy to the family and friends of Sheila Willmott who died on 8 May 1998 after a very short illness. Sheila served as Editor of the Journal of Helminthology from 1980 to 1986.Dr Lotfi Khalil, formerly Deputy Director of the International Institute of Parasitology at St Albans, worked closely with Sheila and has written the following tribute.John W. Lewis, EditorSheila Willmott was a leading contributor to the dissemination of parasitic information before the development of computerization and information technology. She was born on 8 June, 1921, in London, and was educated at Tollington High School for Girls, Chelsea Polytechnic and University College, London. She did her PhD at the London School of Hygiene and Tropical Medicine under the supervision of Professor John Buckley, the subject of her thesis being the study of amphistome digeneans. Her studies were interrupted as a result of the Second World War when she was 'drafted' as a Rodent Instructor at the Ministry of Agriculture, Fisheries and Food. After completing her PhD, she was appointed Assistant Lecturer in Zoology at the University College of South Wales and Monmouthshire, Cardiff. In 1951, Professor R.T. Leiper, the Director of the Bureau of Agricultural Parasitology (Helminthology) recruited her as a Scientific Information Officer. She was appointed Assistant Director of the Bureau in 1954, and Director in 1961, where she stayed until her retirement in 1980.During her period as Director of the Bureau, which was sited in the White House in the centre of St Albans, she maintained and improved the high quality of Helminthological Abstracts and, in 1976, accepted the extra burden of starting and producing Protozoological Abstracts. In 1979, she initiated and edited a primary journal, Systematic Parasitology, devoted to papers on the taxonomy and systematics of parasites, published by Junk. The activities of the Bureau were greatly expanded and she initiated the taxonomic laboratories to provide a worldwide service for the identification of animal helminths and plant-parasitic nematodes and to undertake taxonomic research. A vast helminth reference collection was started, and the Bureau became a recognized centre for the deposition of type specimens. The library of the Bureau accumulated an enormous number of reference books, journals and reprints, and provided a photocopying service supplying, at short notice, copies of papers and publications. A number of books and other publications, including the CIH Keys to the Nematode Parasites of Vertebrates, were produced and edited by her and others. She also persuaded the Natural Environment Research Council to finance the Fisheries Helminthology Unit which she established at the Bureau in 1960, where it remained until it was transferred to Plymouth as part of the Institute for Marine Environmental Research. The Bureau's name and status were changed to the Commonwealth Institute of Helminthology, Commonwealth Institute of Parasitology and, finally, the International Institute of Parasitology.As Director, she travelled extensively and visited Commonwealth and other countries, where she gave a number of seminars on information services and the work of the Institute and the Commonwealth Agricultural Bureaux (CAB) as a whole. She encouraged contact with Eastern Europe and visited Poland, Czechoslovakia, Hungary, Bulgaria and the USSR. She initiated the system of exchange publications with these countries, and this resulted in the exposure of the literature from these countries to other research workers when abstracts of these papers appeared in Helminthological Abstracts in English. Her links with Eastern Europe resulted in her editing three volumes of taxonomic monographs produced in English by Czech and Russian scientists. (ABSTRACT TRUNCATED)

Journal Article↗
PubMed2002

[Latin American social medicine: contributions and challenges].

This piece presents and analyzes a number of issues related to social medicine: the context of the emergence of social medicine; the differences between social medicine and public health; the theories, methods, and debates in social medicine; the main subjects or problems considered in social medicine; and the difficulties of disseminating the concepts of social medicine among English-speaking persons and among medical and public health professionals in general. Latin American social medicine has challenged other views by contributing to an understanding of the determinants of the health-disease-health care process and by using theories, methods, and techniques that are little known in the field of public health. Introducing Latin American social medicine, especially among English speakers, will be difficult due to the conceptual complexity of this field for persons who are accustomed to the theoretical framework of public health and medicine and also due to skepticism concerning research coming from the Third World. A multidisciplinary team is facing this challenge through two primary initiatives: 1) the creation of an Internet portal and database where there are structured abstracts in English, Portuguese, and Spanish of books, book chapters, and articles on social medicine and 2) the electronic publication of two journals on Latin American social medicine.

Databases, Factual↗
PubMed1999

[The impact factor as an assessment criterion of scientific achievements--the right to equal chances].

BACKGROUND: Regularly the Institute of Scientific Information publishes the impact factor (IF) that plays an increasing role when the scientific quality of scientific performances of journals, single publications, scientists, and research groups have to be evaluated in order to support them. QUESTIONS: How valid is the IF assigned to journals, single publications, scientists, and research groups? Have all these the same chance to be evaluated? How can fairness of evaluation be increased? Can its validity be improved? RESULTS: The value of IF equals the average number of citations per article published in the preceding 2 calendar years in a journal. The criteria for selection of citing journals and of those with an "official" IF are not fully explicated. Although the citations have no equal units of measurement, empirical findings confirm their pragmatic applicability. IF of journals and even the citation rates of its articles are skewedly distributed to right hand. Additionally, the citation rates of the articles within a journal vary. Therefore, the IF of journals rarely equal the actual citation rates of their articles. Usually, IF overestimates the citation rate and quality of the articles. Its tendency not to recognize low and high quality even increases when IF is administered to individual scientists and small research groups, whereas it decreases in large research groups. Under the premise that the extent of scientific quality corresponds to the amount of information a paper adds to the state of science, language, actuality etc. are confounders because English, reviewing, biomedical, and actual articles have preferred citation rates. CONCLUSIONS: Evaluation of scientific performances by IF is to be restricted to journals and large research groups. Fairness demands comparisons to homogeneous journals with respect to confounders such as language. Principally, no journal should be excluded to obtain an IF if it fulfills the minimum criteria of an internationally communicating science. For this purpose they have to provide a title, key words, and an abstract in English, a peer review system etc. Often journals are the centre of science cultures that are able to generate research of highest levels. The users can contribute to increase the IF of "their" journal and to care for the valid application of this indicator.

Bibliometrics↗
PubMed2005

[National consensus for management of community acquired pneumonia in adults].

Community acquired pneumonia (CAP) is an acute respiratory infection that affects pulmonary parenchyma, and is caused by community acquired microorganisms. In Chile, pneumonia represents the main cause of death due to infectious diseases and is the third specific cause of mortality in adults. In 1999, an experts committee in representation of "Sociedad Chilena de Enfermedades Respiratorias", presented the first National Guidelines for the Treatment of Adult Community Acquired Pneumonia, mainly based in foreign experience and documents, and adapted it to our National Health System Organization. During the last decade, impressive epidemiological and technological changes have occurred, making the update of guidelines for treatment of NAC by several international scientific societies, necessary. These changes include: new respiratory pathogens that are being identified in CAP and affect adult patients (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila); the increasing senescent adult population that carries multiple co-morbidities; the emergence of antimicrobial resistance among respiratory pathogens associated to massive antibiotic prescription; the development by the pharmaceutical industry of new drugs that are effective for pneumonia treatment (macrolides, ketolides and respiratory fluorquinolones); and the development of new diagnostic techniques for detection of antigens, antibodies, and bacterial DNA by molecular biology, useful in respiratory infections. Based on these antecedents, an Advisory Committee of "Sociedad Chilena de Enfermedades Respiratorias" and "Sociedad Chilena de Infectología" has reviewed the national and international evidence about CAP management in adults in order to update clinical recommendations for our country.

Acute Disease↗
PubMed1998

Vaginal weights for assessment and training of the pelvic floor.

Urinary incontinence is a common problem for women. A trial of conservative treatment is frequently suggested before considering other treatment options. One method involves the use of vaginal weights for retraining the pelvic floor muscle. This review examines articles and abstracts on vaginal weights published in English or with abstracts in English between 1985 and 1997. It concludes that, despite some practical and theoretic concerns, there is adequate clinical evidence to support the use of weights in selected populations. Weights may be an effective training aid for women with mild to moderate stress incontinence, particularly in the absence of severe pelvic organ prolapse. They also may be useful for pelvic floor strengthening during the immediate postpartum period, as a behavioral program for continence maintenance, and for self-management programs. Suggestions for further research to refine treatment parameters and client selection are also presented.

Exercise Therapy↗
PubMed1997

[New therapeutic methods against rheumatoid arthritisp6. Antibodies against TNFalpha significant for the progress].

This review, which is the second part of an abstract from a book-length work in English, describes the great advances made in the treatment of rheumatoid arthritis. After the failure of anti-CD4 therapy, the macrophage has gained prominence as the prime mover in rheumatoid synovitis. The proinflammatory, macrophage-derived cytokine tumor necrosis factor alpha has in particular been implicated as an important therapeutic target. The clinical trials carried out with antibodies against this cytokine, as well as various approaches towards cytokine-modulating gene therapy in rheumatoid arthritis, are described.

Antibodies↗