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Medical Databases (medical + databases)
Selected AbstractsA systematic review on the clinical diagnosis of gastrointestinal stromal tumorsJOURNAL OF SURGICAL ONCOLOGY, Issue 5 2008Marco Scarpa MD Abstract Background The aim of this work was to assess the prevalence of symptoms of gastrointestinal stromal tumors (GISTs) and the diagnostic yield of clinical procedures for its diagnosis. Methods Medical databases were consulted between 1998 and 2006 for potentially relevant publications. All studies dealing with the clinical presentation of GIST and related diagnostic procedures were included. Two researchers worked independently on the study selection, quality assessment, data extraction, and analysis phases of the study. Results Forty-six observational studies were included with a total of 4,534 patients. Gastrointestinal bleeding was the most common clinical presentation. Twenty studies provided adequate information on the diagnostic yield of various procedures. The pooled diagnostic yield of endoscopy,+,mucosal biopsy and of intestinal contrast radiography was 33.8% (0,100%) and 35.1% (11,100%), respectively, while that of EUS and that of EUS-FNA was 68.7% (40,100%) and 84.0% (73.8,100%), respectively. Abdominal CT scan and MRI had similar pooled diagnostic yields: 73.6% (34.8,100%), and 91.7% (75,100%), respectively. Conclusion Endoscopy,+,mucosal biopsy should be reserved to patients with gastrointestinal bleeding. EUS-FNA provides direct visualization of the neoplasm and adequate samples for molecular diagnosis. EUS, abdominal CT and MRI may be considered valid alternatives whenever EUS-FNA is unavailable or a cytological diagnosis is unnecessary. J. Surg. Oncol. 2008;98:384,392. © 2008 Wiley-Liss, Inc. [source] Annotated chromosome maps for renal disease,HUMAN MUTATION, Issue 3 2009Amy Jayne McKnight Abstract A combination of linkage analyses and association studies are currently employed to promote the identification of genetic factors contributing to inherited renal disease. We have standardized and merged complex genetic data from disparate sources, creating unique chromosomal maps to enhance genetic epidemiological investigations. This database and novel renal maps effectively summarize genomic regions of suggested linkage, association, or chromosomal abnormalities implicated in renal disease. Chromosomal regions associated with potential intermediate clinical phenotypes have been integrated, adding support for particular genomic intervals. More than 500 reports from medical databases, published scientific literature, and the World Wide Web were interrogated for relevant renal-related information. Chromosomal regions highlighted for prioritized investigation of renal complications include 3q13,26, 6q22,27, 10p11,15, 16p11,13, and 18q22. Combined genetic and physical maps are effective tools to organize genetic data for complex diseases. These renal chromosome maps provide insights into renal phenotype-genotype relationships and act as a template for future genetic investigations into complex renal diseases. New data from individual researchers and/or future publications can be readily incorporated to this resource via a user-friendly web-form accessed from the website: www.qub.ac.uk/neph-res/CORGI/index.php. Hum Mutat 0, 1,8, 2008. © 2008 Wiley-Liss, Inc. [source] The effects of physical exercise on depressive symptoms among the aged: a systematic reviewINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2006Noora Sjösten Abstract Objective To determine the effects of physical exercise on depression or depressive symptoms among the aged. Method A literature search covering various medical databases was conducted to identify randomised controlled trials (RCT's) about the effects of exercise treatments on depression or depressive symptoms among the aged. The studies were classified according to the baseline depression status of participants and assessed in relation to allocation concealment, blinding at outcome assessment, follow-up and whether intention to treat analysis was used. Studies meeting the inclusion criteria were accepted. Results Exercise was effective in treating depression among those suffering from minor or major depression and in reducing depressive symptoms among those with a high amount of depressive symptoms at baseline. However, both the allocation concealment and the blinding method were adequately described in only four studies. Furthermore, intention-to-treat analysis was conducted in half of the studies and some follow-up information after the intervention has been published for five studies. Conclusions Physical exercise may be efficient in reducing clinical depression and depressive symptoms in the short-term among the aged suffering from depression or a high amount of depressive symptoms. More well controlled studies are needed. Copyright © 2006 John Wiley & Sons, Ltd. [source] Development of Two Search Strategies for Literature in MEDLINE,PubMed: Nursing Diagnoses in the Context of Evidence-Based NursingINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2005Almuth Berg Dipl.-PGW PURPOSE.,To develop and validate search filters for MEDLINE via PubMed according to two categories of the NLINKS-EBN matrix. METHODS.,The search results of the search filters were compared to a gold standard. FINDINGS.,The usage of nursing classification terms for the literature search in evidence-based nursing (EBN) is still limited because taxonomies are neither widely used in nursing literature nor applied for indexing by MEDLINE. The proposed filters achieved a sensitivity of 96% and a specificity of 94% for "secondary data" and a sensitivity of 87% and a specificity of 73% for "diagnostic tests." CONCLUSIONS.,The usage of database-specific search filters are a reliable and valid method to search for nursing classification terms in medical databases. [source] Aetiology of molar,incisor hypomineralization: a critical reviewINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2009FELICITY CROMBIE Objective., The objective of this study was to assess the strength of evidence for the aetiology of molar,incisor hypomineralization (MIH), often as approximated by demarcated defects. Method., A systematic search of online medical databases was conducted with assessment of titles, abstracts, and finally full articles for selection purposes. The level and quality of evidence were then assessed for each article according to Australian national guidelines. Results., Of 1123 articles identified by the database search, 53 were selected for review. These covered a variety of potential aetiological factors, some of which were grouped together for convenience. The level of evidence provided by the majority of papers was low and most did not specifically investigate MIH. There was moderate evidence that polychlorinated biphenyl/dioxin exposure is involved in the aetiology of MIH; weak evidence for the role of nutrition, birth and neonatal factors, and acute or chronic childhood illness/treatment; and very weak evidence to implicate fluoride or breastfeeding. Conclusion., There is currently insufficient evidence in the literature to establish aetiological factor/s relevant for MIH. Improvements in study design, as well as standardization of diagnostic and examination protocols, would improve the level and strength of evidence. [source] Early versus late enteral nutritional support in adults with burn injury: a systematic reviewJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 2 2007J. Wasiak Abstract Background Burn injury increases the body's metabolic demands, and therefore nutritional requirements. Provision of an adequate supply of nutrients is believed to lower the incidence of metabolic abnormalities, thus reducing septic morbidity, and improving survival rates. Enteral nutrition support is the best feeding method in a patient who is unable to achieve an adequate oral intake, but optimal timing of its introduction after burn injury (i.e. early versus late) needs to be established. The purpose of this review is to examine evidence for the effectiveness and safety of early versus late enteral nutrition support in adults with burn injury. Methods An examination of randomized and controlled clinical trials using various medical databases such as The Cochrane Library (Issue 3, 2006), MEDLINE (from 1950), CINHAL (from 1982) and EMBASE (from 1980). Results The trial evidence about the benefit of early enteral nutritional support on standardized clinical outcomes such as length of hospital stay and mortality remained inconclusive. Similarly, the question of whether early enteral feeding influenced or decreased metabolic rate, reduced septic and other complications remained uncertain. Conclusions Promising results suggest early enteral nutrition support may blunt the hypermetabolic response to thermal injury, but it is insufficient to provide clear guidelines for practice. Further research incorporating larger sample sizes and rigorous methodology that utilizes valid and reliable outcome measures is essential. [source] Antipsychotic drugs and short-term mortality after peptic ulcer perforation: a population-based cohort studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2008C. CHRISTIANSEN Summary Background, Peptic ulcer perforation is a serious surgical emergency with a substantial short-term mortality, but the influence of antipsychotic drug use on the prognosis remains unknown. Aim, To examine the association between antipsychotic drug use and 30-day mortality following peptic ulcer perforation. Methods, This cohort study comprised 2033 patients with a first-time hospitalization with peptic ulcer perforation, in Northern Denmark, between 1991 and 2004. Data on preadmission use of antipsychotics and other medications, psychiatric disease, other comorbidities and mortality were obtained through population-based medical databases. We used Cox regression analyses to compute adjusted mortality rate ratios (MRRs). Results, One hundred and sixteen (5.7%) patients with peptic ulcer perforation were current users of antipsychotic drugs at the time of hospital admission and 205 (10.1%) were former users. The overall 30-day mortality was 27%. Among current users of antipsychotics 30-day mortality was 39%. The adjusted 30-day MRR for current users of antipsychotic drugs compared with non-users was 1.7 (95% CI: 1.2,2.3). Former use was not a predictor of mortality. The increase in mortality was equal in users of conventional and atypical antipsychotics. Conclusion, Use of antipsychotic drugs is associated with substantially increased mortality following peptic ulcer perforation. [source] Influence of anesthesia on immune responses and its effect on vaccination in children: review of evidencePEDIATRIC ANESTHESIA, Issue 5 2007J.N. SIEBERT MD Summary Anesthesia and surgery exert immunomodulatory effects and some authors argue that they may exert additive or synergistic influences on vaccine efficacy and safety. Alternatively, inflammatory responses and fever elicited by vaccines may interfere with the postoperative course. There is a lack of consensus approach among anesthesiologists to the theoretical risk of anesthesia and vaccination. Few studies have assessed the influence of anesthesia and surgery on pediatric vaccine responses. We have undertaken an extensive review of articles published in English between 1970 and 2006 meeting the criteria: measurement of immune parameters following general anesthesia in children. By searching the major medical databases (OVID Medline, PubMed, ISI Web of Science) and references cited in the articles themselves, among 277 articles obtained none examined directly the influence of anesthesia/surgery on vaccine responses. Only 16 original reports assessed the influence of several anesthetic agents on various markers of immunity including lymphocyte numbers and functions. These results are reinterpreted here in view of our current understanding of the immune mechanisms underlying vaccine efficacy and adverse events. We conclude that the immunomodulatory influence of anesthesia during elective surgery is both minor and transient (around 48 h) and that the current evidence does not provide any contraindication to the immunization of healthy children scheduled for elective surgery. However, respecting a minimal delay of 2 days (inactivated vaccines) or 14,21 days (live attenuated viral vaccines) between immunization and anesthesia may be useful to avoid the risk of misinterpretation of vaccine-driven adverse events as postoperative complications. [source] Total knee replacement in the morbidly obese: a literature reviewANZ JOURNAL OF SURGERY, Issue 9 2010Anthony J. Samson Abstract Background:, The ,obesity epidemic' is expected to result in an increased incidence of knee osteoarthritis and hence total knee replacements (TKRs). Reviews have demonstrated the conflicting results of TKR for all obese (body mass index (BMI) >30). The aim of this literature review was to specifically evaluate outcomes of TKR in patients with morbid obesity (MO; BMI >40). Methods:, A systematic review of medical databases (PubMed, Medline, Cochrane Library, ScienceDirect) by use of keywords from January 1990 to September 2009 was undertaken. Results:, Clinical and functional Knee Society Scores (KSS) improve after TKR for patients with MO. The post-operative functional KSS was, in general, less than in controls. Radiographic analysis was inconclusive because of small study populations and short duration of follow-up. All studies reporting complications noted a greater prevalence in MO patients (10,30%). Of concern was the significantly higher prevalence of deep prosthetic infection (3,9-times that of controls). The morbidly obese also had a significantly higher incidence of wound complications. TKR did not result in weight loss for MO patients, and therefore has no benefit on weight-related medical conditions. Bariatric surgery in MO under 65 years of age has been shown to be a cost-effective and clinically effective method of weight reduction. This surgery also results in significant improvement in weight-related medical conditions, the KSS and knee pain. Conclusions:, Given the increase in complications for MO patients after TKR, these patients should be advised to lose weight before surgery and, if suitable, would probably benefit from bariatric surgery. [source] The outcomes of pregnancies following a prenatal diagnosis of fetal exomphalos in Western AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Nick CALVERT Aims: To review the perinatal outcomes for prenatally diagnosed exomphalos from a single geographical region. Methods: Retrospective review of cases of prenatally identified exomphalos in the state of Western Australia in the ten-year period 1998,2007 using the medical databases of the sole tertiary obstetric and paediatric hospitals. Results: Ninety-four cases of prenatally identified exomphalos comprise this consecutive case series. Culture-proven karyotypic abnormalities occurred in 40 (42.6%) fetuses. No karyotypically abnormal fetus survived the neonatal period, with 33 of 40 (82.5%) pregnancies interrupted, five of 40 (12.5%) resulting in fetal demise and two (5%) neonatal deaths. For the 49 (52.1%) fetuses with a normal karyotype, 26 (53.1%) had associated abnormalities with termination occurring in 22 (84.6%). Prenatally isolated exomphalos was present in 23 cases (24.5%), with live birth in 15 cases (30.6% of euploid fetuses). Fourteen (93.3%) of the liveborn prenatally isolated exomphalos cases survived with no postoperative deaths, although four (28.5%) had significant abnormalities detected postdelivery and most have experienced childhood morbidity. Conclusions: In the the majority of cases of prenatally detected exomphalos the pregnancy was interrupted secondary to chromosomal or structural abnormalities. In only 10.6% of prenatally recognised fetuses with exomphalos was the disorder truly isolated with neonatal survival occurring. [source] | ||||||||||