Descriptions of Reiter's disease in Mexican medical texts since 1578.
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Arthritis, Reactive↗
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Ibn Sina (Avicenna). Historical note.
Ibn Sina (often known by his last name in Latin, Avicenna; 980-1037 A.D.) was the most famous physician and philosopher of his time. His Canon of Medicine, one of the most famous books in the history of medicine, surveyed the entire medical knowledge available from ancient and Muslim sources and provided his own contributions. In this article the authors present a unique picture of the neurosurgical technique of Ibn Sina and briefly summarize his life and work.
History, Medieval↗
Users' guides to the medical literature: XXI. Using electronic health information resources in evidence-based practice. Evidence-Based Medicine Working Group.
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Databases, Bibliographic↗
Use of information resources by veterinary practitioners.
Veterinary practitioners are often isolated from easy access to information in medical or hospital libraries, making necessary the use of a variety of information resources. A survey was conducted to assess the extent to which various information resources were used within the veterinary profession. Most responding veterinarians were small-animal practitioners who used the veterinary literature, colleagues, diagnostic laboratories, continuing education courses, association meetings, and pharmaceutical representatives as sources of information. Books and other practitioners were the preferred information source in critical-care situations, followed closely by diagnostic laboratories and journals. For keeping up-to-date with current advances in veterinary medicine, journals, books, other practitioners, and continuing education were used. University extension services, veterinary medical libraries, and computer applications to information use were not important resources ot most of the respondents. Many veterinarians indicated that they would use library services if they knew more about them. With the trend toward computerization in veterinary practice, it is possible for libraries to help reduce the information isolation of many veterinary practices.
Computers↗
Finding and applying evidence during clinical rounds: the "evidence cart".
CONTEXT: Physicians need easy access to evidence for clinical decisions while they care for patients but, to our knowledge, no investigators have assessed use of evidence during rounds with house staff. OBJECTIVE: To determine if it was feasible to find and apply evidence during clinical rounds, using an "evidence cart" that contains multiple sources of evidence and the means for projecting and printing them. DESIGN: Descriptive feasibility study of use of evidence during 1 month (April 1997) and anonymous questionnaire (May 1997). SETTING: General medicine inpatient service. PATIENTS: Medical students, house staff, fellows, and attending consultant. INTERVENTION: Evidence cart that included 2 secondary sources developed by the department (critically appraised topics [CATs] and Redbook), Best Evidence, JAMA Rational Clinical Examination series, the Cochrane Library, MEDLINE, a physical examination textbook, a radiology anatomy textbook, and a Simulscope, which allows several people to listen simultaneously to the same signs on physical examination. MAIN OUTCOME MEASURES: Number of times sources were used, type of sources searched and success of searches, time needed to search, and whether the search affected patient care. RESULTS: The evidence cart was used 98 times, but could not be taken on bedside rounds because of its bulk; hard copies of several sources were taken instead. When the evidence cart was used during team rounds and student rounds, some sources could be accessed quickly enough (10.2-25.4 seconds) to be practical on our service. Of 98 searches, 79 (81%) sought evidence that could affect diagnostic and/or treatment decisions. Seventy-one (90%) of 79 searches regarding patient management were successful, and when assessed from the perspective of the most junior team members responsible for each patient's evaluation and management, 37 (52%) of the 71 successful searches confirmed their current or tentative diagnostic or treatment plans, 18 (25%) led to a new diagnostic skill, an additional test, or a new management decision, and 16 (23%) corrected a previous clinical skill, diagnostic test, or treatment. When the cart was removed, the perceived need for evidence rose sharply, but a search for it was carried out only 12% of the time (5 searches performed out of the 41 times evidence was needed). CONCLUSIONS: Making evidence quickly available to clinicians on a busy medical inpatient service using an evidence cart increased the extent to which evidence was sought and incorporated into patient care decisions.
Evidence-Based Medicine↗
[An analysis of the information in the Medicom International Vade Mecum with respect to drugs with vitamin A].
OBJECTIVE: Determination of whether rational drug use is facilitated by the quality of the information provided by the Medicom International Vademecum on drugs containing vitamin A as active component. DESIGN: Descriptive study. SETTING: Primary, specialized and hospital health care within the national context. SUBJECTS: Total drugs containing vitamin A, included in the 1995 Medicom International Vademecum. MEASUREMENTS: Systematic analysis of the information contained in the technical note on drugs containing vitamin A included in the Medicom International Vademecum, with respect to several parameters. RESULTS: The Medicom International Vademecum lists a total of 37 drugs containing vitamin A (35 in combination). A total of 112 different indications are given; 74 are not accepted in the literature, and 29 are related to the active components present in combination with vitamin A. CONCLUSIONS: The analysis of the technical information provided by the Medicom International Vademecum on medications containing vitamin A reveals major deficiencies in the parameters investigated.
Contraindications↗
[Value of automated medical indexing of an image database and a digital radiological library].
We indexed the contents of a radiology server on the web to facilitate access to research documents and to link reference texts to images contained in radiology databases. Indexation also allows case reports to be transformed with no supplementary work into formats compatible with computer-assisted training. Indexation was performed automatically by ADM-Index, the aim being to identify the medical concepts expressed within each medical text. Two types of texts were indexed: medical imaging reference books (Edicerf) and case reports with illustrations and captions (Iconocerf). These documents are now available on a web server with HTML format for Edicerf and on an Oracle database for Iconocerf. When the user consults a chapter of a book or a case report, the indexed terms are displayed in the heading; all reference texts and case reports containing the indexed terms can then be called up instantaneously. The user can express his search in natural language. Indexation follows the same process allowing instantaneous recall of all reference texts and case reports where the same concept appears in the diagnosis or clinical context. By using the context of the case reports as the search index, all case reports involving a common medical concept can be found. The context is interpreted as a question. When the user responds to this question, ADM-Index compares this response with the answer furnished by the reference texts and case reports. Correct or erroneous responses can thus be identified, converting the system into a computer-assisted training tool.
Abstracting and Indexing↗
Dental writings in a medical self-help book of 1650.
Only one copy exists of the very first medical self-help book written in the Yiddish language. The author, a well respected. barber-surgeon in Prague, states that he wrote the book for those too poor to consult a physician. Physicians were not as knowledgable or experienced as the barber-surgeons who were the principal providers of medical care for the masses. The book follows the format of discussing illnesses from head to toe, and includes numerous prescriptions for toothache, loose teeth, foul mouth and sore tongue. We derive an interesting picture of what dental treatment was like in the mid-seventeenth century.
Barber Surgeons↗
On writing medical history.
Writing medical history papers can be professionally and personally rewarding, but a little overwhelming for novices. This paper offers step-by-step guidelines for the entire process, including developing appropriate topics, finding and using appropriate sources, and writing the paper. Specific reference sources are recommended.
Databases, Bibliographic↗
Use and perceived benefits of handheld computer-based clinical references.
OBJECTIVE: Clinicians are increasingly using handheld computers (HC) during patient care. We sought to assess the role of HC-based clinical reference software in medical practice by conducting a survey and assessing actual usage behavior. DESIGN: During a 2-week period in February 2005, 3600 users of a HC-based clinical reference application were asked by e-mail to complete a survey and permit analysis of their usage patterns. The software includes a pharmacopeia, an infectious disease reference, a medical diagnostic and therapeutic reference and transmits medical alerts and other notifications during HC synchronizations. Software usage data were captured during HC synchronization for the 4 weeks prior to survey completion. MEASUREMENTS: Survey responses and software usage data. RESULTS: The survey response rate was 42% (n = 1501). Physicians reported using the clinical reference software for a mean of 4 years and 39% reported using the software during more than half of patient encounters. Physicians who synchronized their HC during the data collection period (n = 1249; 83%) used the pharmacopeia for unique drug lookups a mean of 6.3 times per day (SD 12.4). The majority of users (61%) believed that in the prior 4 weeks, use of the clinical reference prevented adverse drug events or medication errors 3 or more times. Physicians also believed that alerts and other notifications improved patient care if they were public health warnings (e.g. about influenza), new immunization guidelines or drug alert warnings (e.g. rofecoxib withdrawal). CONCLUSION: Current adopters of HC-based medical references use these tools frequently, and found them to improve patient care and be valuable in learning of recent alerts and warnings.
Adult↗
Kidney disease in Byzantine medical texts.
The most significant contribution of the great Byzantine physicians to the evolution of medicine is their effort to summarize all the medical knowledge of the Greco-Roman world, which included earlier sources in antiquity, lost forever in our days. The transition from ancient to medieval medicine included the adoption of Christian spiritual values, which took place in the early Byzantine period (4th to 7th century). In the field of nephrology, under the influence of Hippocratic and Galenic doctrines, the most prominent medical personalities, Oribasius of Pergamum, Aetius of Amida, Alexander of Tralles and Paul of Aegina, performed the role of the researcher and healer, as well as that of the encyclopedist. Their works on kidney disease are presented in this paper.
Byzantium↗
From ICD9-CM to MeSH using the UMLS: a how-to guide.
One purpose of the Unified Medical Language System (UMLS) is to facilitate conversion of terms from one controlled medical vocabulary to another. We examined our ability to convert International Classification of Diseases, 9th Edition, Clinical Modifications (ICD9-CM) to Medical Subject Headings (MeSH) using the UMLS. We describe a method which mapped 30.4% of ICD9-CM to UMLS. Of these, 95.0% were linked to MeSH, of which translation was straightforward in 90.4%. We discuss the use of these translations for retrieval from MeSH-indexed databases, such as Medline.
Disease↗
The role of the Maternal and Child Health Handbook system in reducing perinatal mortality in Japan.
OBJECTIVE: The purpose of this paper is to demonstrate the direct and indirect roles of the Maternal and Child Health (MCH) Handbook in promoting overall improvement in maternal health and child care and to attempt to clarify the relationship between the use of the MCH Handbook and the reduced perinatal mortality in Japan. Another important objective is to propose possible future applications of the MCH Handbook, especially with respect to the networking function of providing client-care provider feedback, and the exchange of health data between the authorities and relevant medical societies. RESULTS: Japan has achieved a decline in neonatal mortality in the 30-year period from 1960 to 1990, from 17.0 to 2.6 per 1,000 live births. There is a correlation between the ratio of the number of Handbooks distributed and the actual number of births and the perinatal mortality. CONCLUSIONS: The wide use of the MCH Handbook system seems to have played an important role in bringing about this reduction and in maintaining the figure as one of the lowest in the world. The reduction of perinatal mortality through the use of the MCH Handbook in this country suggests a similar possibility for application in other nations. The Handbook could aid in the early recognition of high-risk pregnancy and thus reduce inappropriate use of medical resources. The system, with the establishment of a feedback system between the client and the authorities via the care provider, may improve health care in such areas as maternal mortality, toxemia of pregnancy, and diabetes mellitus.
Adult↗
The development and evaluation of a small ready-reference library collection for a rural practice: a case study.
A demonstration core collection of twenty-four ready-reference sources and five journals was selected cooperatively by a solo practitioner in rural Menifee County, Kentucky, and the University of Kentucky Medical Center Library Field Librarian to fit the ready-reference and current awareness information needs of a primary care solo rural practice in eastern Kentucky. The collection selections were systematically assessed by the physician to determine their utility in filling the practitioner's information needs with regard to his particular situation in terms of medical experience and level of training, available library and educational resources, and the type of health problems seen in his practice. This assessment showed that the Rural Demonstration Library Collection completely filled the information needs of the physician 66% of the time materials were consulted and filled his immediate information needs either completely or partially 82% of the time the collection was searched. This demonstration has shown that, under a specific set of circumstances, a librarian and a solo rural practitioner can effectively work together in identifying health sciences materials which fit the information needs of a solo rural practitioner. It suggests that cooperation between a librarian and a physician is important in meeting information needs.
Book Collecting↗
[The loose-leaf book of procedures. A regional model for diagnostic and referral routines--a basis for improved cooperation between primary and secondary services].
Initiated by the Telemark branch of the Norwegian Medical Association a loose-leaf book of procedures has been prepared for use in the region of Telemark Central Hospital. The professional advice given in the book is based on an agreement between the chief physicians of the various hospital units, their discussions in the unit, and a group of four general physicians. The advice is only intended as a guide. The editors' idea is to have the book distributed to all G.P.s and hospital units in Telemark. The book is meant to be updated once a year.
Community Health Services↗
[Impact of meta-analysis in clinical practice: the example of psychiatry].
BACKGROUND: To analyze the features of the studies on meta-analysis in psychiatry and assess the effect of these papers on the psychiatric reference textbooks. METHODS: Two researchers reviewed electronic databases Medline and Embase during the period 1977-98, using the key words: clinical trial, randomized observational trial, metaanalysis, systematic review. To confirm the validity of the searching strategy inter and intra-raters reliability was studied with satisfactory kappa figures. RESULTS: Psychiatry is the medical specialty in which more studies on meta-analysis have been carried out (N= 179, 11,79% out of the total), followed by cardiology and oncology. The increase in this kind of research during 1977-98 has been very high in all medical fields and, specifically, in psychiatry. There is no correlation between impact factor of a scientifical journal and number of meta-analysis published in it. Only 0.002% of the references of one of the most important textbook in psychiatry (Kaplan) are related to meta-analysis. There is no studies on meta-analysis developed by Spanish researchers. CONCLUSIONS: Studies on meta-analysis are not referred by psychiatric reference textbooks. As a consequence, their impact on clinical practice is scarce.
Meta-Analysis as Topic↗
Peer reviewing and curating the health care information infrastructure: experiences and recommendations.
As part of a digital health sciences library's continuous quality improvement process, a digital textbook of common medical problems was created which contained links to authoritative medical information on the Internet for patients and health care providers. The accomplishments of this project were the: 1) Identification of 50 common medical problems, 2) Development of a methodology for identifying authoritative medical information related to these problems, 3) Creation of a digital textbook containing links to this information with a problem-based interface, 4) Development of a methodology to allow local peer review of this information, and 5) Evaluation of the use of the information and the local peer review methodology.
Evaluation Studies as Topic↗
Personal digital assistant applications for the healthcare provider.
OBJECTIVE: To review some common medical applications available for personal digital assistants (PDAs), with brief discussion of the different PDA operating systems and memory requirements. Key search terms included handheld, PDA, personal digital assistants, and medical applications. DATA SOURCES: The literature was accessed through MEDLINE (1999-August 2002). Other information was obtained through secondary sources such as Web sites describing common PDAs. DATA SYNTHESIS: Medical applications available on PDAs are numerous and include general drug references, specialized drug references (e.g., pediatrics, geriatrics, cardiology, infectious disease), diagnostic guides, medical calculators, herbal medication references, nursing references, toxicology references, and patient tracking databases. Costs and memory requirements for these programs can vary; consequently, the healthcare provider must limit the medication applications that are placed on the handheld computer. CONCLUSIONS: This article attempts to systematically describe the common medical applications available for the handheld computer along with cost, memory and download requirements, and Web site information. This review found many excellent PDA drug information applications offering many features which will aid the healthcare provider. Very likely, after using these PDA applications, the healthcare provider will find them indispensable, as their multifunctional capabilities can save time, improve accuracy, and allow for general business procedures as well as being a quick reference tool. To avoid the benefits of this technology might be a step backward.
Computers, Handheld↗