Bioscience trends
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Although qualitative studies have increased since the 1990s, some reports note that relatively few influential journals published them up until 2000. This study critically reviewed the characteristics of qualitative studies published in top tier medical journals since 2000. We assessed full texts of qualitative studies published between 2000 and 2004 in the Annals of Internal Medicine, BMJ, JAMA, Lancet, and New England Journal of Medicine. ⋯ Qualitative data analysis software was used by 33 studies (41%). Among influential journals of general medicine, only BMJ consistently published an average of 15 qualitative study reports between 2000 and 2004. These findings lend insight into what qualities and characteristics make a qualitative study worthy of consideration to be published in an influential journal, primarily BMJ.
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Pediatric telephone triage programs have been initiated to reduce overcrowding of pediatric medical facilities, yet it is unclear what impact these programs have on reducing after hours room visits. This study used a decision analysis model and data from reference literature to investigate the effectiveness of this program and determine the factors that influence the results. The decision analysis model focused on a hypothetical group of children who were not undergoing ongoing treatment but developed symptoms or sustained injuries thought to require a nighttime visit to a medical facility. ⋯ The sensitivity analysis showed that increasing telephone triage use from 10% to 20% would reduce after hours visits by approximately 8%. We conclude that the benefits of this program to the region as a whole would outweigh the harmful effects. However, the effectiveness of telephone triage programs will be limited unless its usage is expanded.
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Randomized Controlled Trial
Effects of premedication of midazolam or clonidine on perioperative anxiety and pain in children.
The aim of the present study was to compare clinical effects of oral midazolam and clonidine premedication in children. In a prospective randomized double blind trial, 45 children between 2-8 years old received either oral midazolam 0.5 mg/kg (group M) or clonidine at 2 microg/kg (group C 2) or 4 microg/kg (group C4). The level of sedation, quality of parental separation, mask acceptance and thermodynamics were recorded. ⋯ However, the rate of postoperative analgesia decreased significantly in group C 2 and C 4 compared to group M. The incidence of shivering was significantly increased in group M compared to group C 2 and C 4. Oral clonidine premedication can therefore provide better preoperative sedation and postoperative analgesia with few adverse effects.
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Case Reports
Malignant mesothelioma associated with chronic empyema with elevation of serum CYFRA19: A case report.
Malignant neoplasms are reported to occur with long-standing tuberculous pleuritis or chronic empyema. During the clinical course of chronic empyema, subjective symptoms such as chest pain and deterioration of dyspnea and abnormal clinical signs such as increased abnormal chest shadows have frequently been found. Though difficult, differentiating the occurrence of malignant tumors from worsening chronic inflammation is crucial. We report here a case of malignant mesothelioma associated with chronic empyema with elevation of serum CYFRA19.
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The purpose of the present study was to compare which parts of the body fat mass tended to increase during the third trimester and at 1 month postpartum between lactating and nonlactating Japanese women. This prospective study examined 49 healthy pregnant women in the third trimester, and at 1 month postpartum. Demographic data, including lactation status, were obtained from a self-administered questionnaire. ⋯ There were no significant differences between the lactating and nonlactating women regarding their demographic data, energy intakes and body fat mass changes during the third trimester of pregnancy. The trunk fat mass change showed a significant difference (p = 0.008) between the third trimester and 1 month postpartum, after adjustment by age and parity using repeated measurement ANCOVA, in the lactating and nonlactating women. In conclusion, the total body fat mass and body fat mass in the trunk at 1 month postpartum was significantly greater in lactating women than in nonlactating women.