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BACKGROUND: Bipolar affective disorder (BaD) has a great impact on health systems worldwide. Although bibliometric studies have been done on this subject, these studies did not do an analysis of the contents of papers, the cooperation between countries, or of the names currently used to describe the condition. Furthermore, the number of publications since the last bibliometric study has doubled. AIM: This study was to examine the recent developments in the field, explore main topics/subject areas of the top 10 authors in this research field, and to compare diagnosis-defined data between International Classification of Diseases, 10(th) edition (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). MATERIALS AND METHODS: Using distinct search terms, the Web of Science database developed by the Thompson Reuters Institute of Scientific Information was scanned for relevant items published between 1900 and 2008. Results were analyzed using scientometric methods and density-equalizing calculations. RESULTS: We found an important increase of publications on the subject over the last decade. Most published studies came from North America and Europe, while the countries cooperating with each other were comparable to other areas of medical research. Although there has been an increase in publications on BaD (m=3.3 publications per year in the last decade), the number of works using the term bipolar disorder (BD) was considerably higher (m=141.8 publications per year in the last decade). We found that the subject areas, genetics and pharmacology were focuses of research for the 10 most prolific authors, all of whom where psychiatrists. CONCLUSION: Research interest in BaD is rising. Reflecting the two main disease classification systems, DSM and ICD, both terms BD and BaD are used in research, with a preponderance of the former. The research of the most prolific authors engages genetic and pharmacological questions.
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The highly specialized occupation of professional dancers is a combination of sport and artistic expression. The exertion is only possible with a fully operative body. Although professional dancers may be compared with elite athletes and acute injuries frequently happen, dancers do not seem to be granted an appropriate therapy after accidents as compared with athletes. Although even minor injuries may potentially endanger the career of a professional dancer, physiotherapeutic or physical treatment methods are applied in every tenth case only. Alternative and holistic concepts such as Pilates or dance-specific re-integration that proved successful in professional dancers, are used in even fewer instances. The aim of this study is to develop a rehabilitation concept for professional dancers focusing on dance-medicine aspects. It has been taken into account that the best physical outcomes are reflected in an optimized, holistic, dance-specific therapy and rehabilitation. Intensifying and exploiting dance-specific methods of treatment can not only reduce costs in the end but can even contribute to reducing the duration of rehabilitation after injuries of dancers. Preconditions for realization of the rehabilitative model are a high qualification of all persons working in the rehabilitative field as well as a marked willingness to cooperate in the various dance fields. Both gender-specific and dance-style particularities are to be taken into account to ensure a successful rehabilitation.
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Baile/lesiones , Baile/psicología , Traumatismos Ocupacionales/psicología , Traumatismos Ocupacionales/rehabilitación , Modalidades de Fisioterapia , HumanosRESUMEN
An injury of cruciate ligament is one the most common knee injuries. This accident happens mostly without external impact and towards the end of training and competition sessions. Women, especially athletes playing team sports ball games such as soccer or disciplines such as tennis, are affected 2 to 8 times more often than men. Anatomic, biomechanical and endocrinological differences are currently discussed as potential risk factors. In terms of prevention, biomechanical impact is of greatest importance given its influenceability through various training opportunities. Training programs including endurance aspects, strengthening knee musculature, balance as well as plyometric trainings were most effective. Further studies should focus more on concomitants of course of injuries.
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Lesiones del Ligamento Cruzado Anterior , Ligamento Cruzado Anterior/fisiopatología , Traumatismos en Atletas/prevención & control , Traumatismos en Atletas/fisiopatología , Femenino , Humanos , Masculino , Factores SexualesRESUMEN
INTRODUCTION: Specific requirements in the Musical field such as the versatility of abilities in dancing, singing and acting, the aspiration for perfection as well as the high number of performances, lead to a high amount of occupational accidents not yet evaluated. Aim of this study is, therefore, to analyze and evaluate occupational accidents in Musical performers and to suggest preventive concepts. METHODS: The data of this evaluation comprise occupational accident reports of consultants, accident reports of various Berlin theatres as well as case records of all Berlin State Theatres (n = 89, m: 58, f: 31) of the Berlin State Accident Insurance covering a period 12-year period. RESULTS: A total of 60.3 % of the accidents happen during performances, 24.4 % during rehearsals, and 6.7 % during the training. Lower extremity injuries (m: 61.1 %, f: 58.2 %) are the most common for performers. The majority of injuries (m: 46.3 %, f: 50.0 %) happens during ordinary dance movements. Altogether 66.7 % of the injuries have a uniquely defined exogenous cause. The dance partner is with 17.9 % the most common exogenous cause, followed by props (15.4 %) and dance floor (11.6 %). 66.3 % of all accidents happen in the first three hours after starting work with an incidence in the evenings. There are gender specific differences. DISCUSSION: Parallels can be drawn (e. g. injured structures, type of injuries) to the professional dance and the dance theatre, however, there are also differences (e. g. age, injury location) Due to the results and the work specific requirements the Musical is to be considered as an autonomous field among the performing arts. Above all, the majority of injuries are - compared to other dance styles - caused by exogenous factors. Modifications may here reduce the incidence. At that, an early interaction in the planning progress of a production, an optimal selection of physical and psychic qualified performers as well as an improvement of training conditions are primary steps towards an injury prevention.
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Accidentes de Trabajo/estadística & datos numéricos , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/etiología , Baile/lesiones , Música , Adulto , Causalidad , Estudios Transversales , Femenino , Alemania , Humanos , Masculino , Estudios Retrospectivos , Factores de RiesgoRESUMEN
With the advances in gene therapy fears of an abuse in sports arise. The WADA's definition of the term strictly differentiates between gene doping and gene therapy. There are in vivo and ex vivo practices to manipulate the different phases of gene expression in the organism, with viral vectors being looked upon as the most efficient ones. IGF-1, PPARδ, MSTN and EPO play the most important roles in today's scientific research. Their potential was proven in various animal studies, showing a significant improvement of performances. Potential risks for human users include severe immune reactions, mutagenesis, and raised risk for cancer. Big efforts are being put into the development of ways of detection, however until now there are neither practicable methods of control nor any reported cases of manipulated humans. Still, a usage of gene doping that has already taken place cannot be ruled out and is highly likely.
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Doping en los Deportes/prevención & control , Doping en los Deportes/tendencias , Técnicas de Transferencia de Gen/tendencias , Mejoramiento Genético/ética , Mejoramiento Genético/métodos , Doping en los Deportes/métodos , Alemania , Humanos , Factores de RiesgoRESUMEN
INTRODUCTION: The dance theatre is an autonomous form of presentation within the performing arts. It is a combination of dance, drama, singing and speaking. As the actors are usually professional dancers the dance theatre is associated with the professional dance. Compared with other dance styles there is an enhanced usage of props, costumes or décor to intensify the production and the expressiveness. In contrast to the defined professional dance technique the range of movements is unlimited. There has not yet been done any research on the influence of props as well as décor in terms of exogenous factors potentially favouring injuries. Aim of this study is to characterize specific injury patterns, as well as their causes and to suggest basic approaches to prevent injuries in the dance theatre. METHODS: The data of this evaluation comprise occupational accident reports, accident reports of various Berlin theatres as well as case records of all Berlin State Theatres (n = 1106) of the Berlin State Accident Insurance over a 9-year period. 103 occupational accidents are accounted for the dance theatre. RESULTS: 44.6 % of the accidents happen during rehearsals, 42.4 % during performances, 76.7 % on stage and adjoining areas and 10.7 % in the ballet studio. Second most common movement resulting in an injury are jumps with 25.4 %. Altogether 69.7 % of the accidents have a uniquely defined exogenous cause with 30.5 % by props, 12.7 % by the floor and 17.2 % by the dance partner. 30.3 % of the accidents have multifactorial causes (e. g. the social situation, state of training and nutrition). 61 % of all accidents happen within three hours after starting work with an increase of occupational accidents between 11:00 - 12:00 hrs and 08:00- 09:00 hrs. The lower extremity is the most affected location (53.3 %), followed by the head/neck area (21.4 %) and the upper extremity (17.5 %). Contusions (26.2 %), distortions (17.5 %), muscular strains (19.4 %) and wounds (13.6 %) are the most frequent types of injuries. DISCUSSION: In combination with the partly undefined movement pattern the majority of the acute injuries is - compared to other dance styles - above all caused by susceptible exogenous factors. Corrections of the daily routine, the working conditions, state of training as well as of the state of nutrition of the dancers may be initial steps towards injury prevention. At that, early interactions and interventions in the planning process of a dance theatre production could help to minimize the amount of accidents caused by exogenous factors and contribute to a practicable injury prevention in the dance theatre.
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Accidentes de Trabajo/estadística & datos numéricos , Baile/lesiones , Baile/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Adulto , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Medición de Riesgo , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: Bronchial asthma is characterized by airway inflammation and reversible obstruction. Since the gold standard of therapy, a combination of anti-inflammatory corticosteroids and bronchodilatory ß(2) agonists, has recently been discussed to be related to an increased mortality, there is a need for novel therapeutic pathways. OBJECTIVE: A new experimental concept that encompasses the vasoactive intestinal peptide/pituitary adenylate cyclase activating peptide (PACAP) family of receptors by demonstrating the anti-inflammatory effects of the PACAP receptor 1 (PAC1R) in a murine model of allergic asthma is described. METHODS: PAC1R expression was investigated in lung tissue and isolated dendritic cells (DCs) via real-time PCR. Ovalbumin (OVA)-induced asthma models were used in PAC1R-deficient mice and BALB/c mice treated with PAC1R agonist maxadilan (MAX). Bronchoalveolar lavages have been performed and investigated at the cellular and cytokine levels. Fluorescence staining of a frozen lung section has been performed to detect eosinophil granulocytes in lung tissue. Plasma IgE levels have been quantified via the ELISA technique. Lung function was determined using head-out body plethysmography or whole-body plethysmography. RESULTS: Increased PAC1R mRNA expression in lung tissue was present under inflammatory conditions. PAC1R expression was detected on DCs. In OVA-induced asthma models, which were applied to PAC1R-deficient mice (PAC1R(-/-)) and to BALB/c mice treated with the specific PAC1R agonist MAX, PAC1R deficiency resulted in inflammatory effects, while agonistic stimulation resulted in anti-inflammatory effects. No effects on lung function were detected both in the gene-depletion and in the pharmacologic studies. In summary, here, we demonstrate that anti-inflammatory effects can be achieved via PAC1R. CONCLUSION: PAC1R agonists may represent a promising target for an anti-inflammatory therapy in airway diseases such as bronchial asthma.
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Asma/inmunología , Hipersensibilidad/inmunología , Neumonía/inmunología , Receptores del Polipéptido Activador de la Adenilato-Ciclasa Hipofisaria/inmunología , Animales , Antiinflamatorios/farmacología , Asma/metabolismo , Células Dendríticas/inmunología , Células Dendríticas/metabolismo , Modelos Animales de Enfermedad , Femenino , Expresión Génica , Perfilación de la Expresión Génica , Hipersensibilidad/metabolismo , Inmunoglobulina E/sangre , Ratones , Ratones Endogámicos BALB C , Ratones Transgénicos , Neumonía/metabolismo , Receptores del Polipéptido Activador de la Adenilato-Ciclasa Hipofisaria/biosíntesis , Receptores del Polipéptido Activador de la Adenilato-Ciclasa Hipofisaria/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
BACKGROUND: The connection between overweight and health risks has been known since the beginning of the 19th century. In order to define overweight, the "body mass index" (BMI) in kg/m (2) was introduced. METHODS: The present study evaluates the quantity and quality of the published literature available, and its changes over the years. Basic bibliographic methods and recent visualizing techniques were used in order to analyse and categorise research in the field of the BMI. The data were extracted from "ISI Web of Science" by Thomson Reuters beginning from 1900 to 2008 by defined search terms. RESULTS: There are 63,845 articles on the subject available. It shows, that the number of annual publications is increasing continuously, starting in 1972. The bibliometric methods and the application of density equalising maps reveal global research productivity and citation activity with emphasis on the USA. CONCLUSION: The present study supplies a first bibliometric approach to visualise research activity in the field of BMI. Furthermore, it provides data that can be used for the identification of research clusters and to locate regions where more research needs to be done. Despite the controversial discussion, the analysed data suggest that the BMI is still an important, simple, and inexpensive measure for the assessment of the nutritional status that comes to a worldwide use.
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Antropometría/métodos , Biometría/métodos , Índice de Masa Corporal , Examen Físico/métodos , HumanosRESUMEN
BACKGROUND: Allergen-induced bronchial asthma is a chronic airway disease that involves the interplay of various genes with environmental factors triggering different inflammatory pathways. OBJECTIVE: The aim of this study was to identify possible mediators of airway inflammation (AI) in a model of allergic AI via microarray comparisons and to analyse one of these mediators, Lipocalin2 (Lcn2), for its role in a murine model of allergic airway disease. METHODS: Gene microarrays were used to identify genes with at least a twofold increase in gene expression in the lungs of two separate mouse strains with high and low allergic susceptibility, respectively. Validation of mRNA data was obtained by Western blotting, followed by functional analysis of one of the identified genes, Lcn2, in mice with targeted disruption of specific gene expression. Epithelial cell cultures were undertaken to define induction requirements and possible mechanistic basis of the results observed in the Lcn2 knock-out mice. RESULTS: Lcn2 was up-regulated upon allergen sensitization and airway challenges in lung tissues of both mouse strains and retraced on the protein level in bronchoalveolar lavage fluids. Functional relevance was assessed in mice genetically deficient for Lcn2, which showed enhanced airway resistance and increased AI associated with decreased apoptosis of lung inflammatory cells, compared with wild-type controls. Similarly, application of Lcn2-blocking antibodies before airway challenges resulted in increased inflammation and reduced apoptosis. CONCLUSION: These data indicate a protective role for Lcn2 in allergic airway disease, suggesting a pro-apoptotic effect as the underlying mechanism.
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Proteínas de Fase Aguda/metabolismo , Células Epiteliales Alveolares/metabolismo , Asma/prevención & control , Hiperreactividad Bronquial/prevención & control , Lipocalinas/metabolismo , Proteínas Oncogénicas/metabolismo , Proteínas de Fase Aguda/deficiencia , Proteínas de Fase Aguda/genética , Células Epiteliales Alveolares/inmunología , Células Epiteliales Alveolares/patología , Animales , Apoptosis , Asma/genética , Asma/inmunología , Asma/metabolismo , Asma/patología , Western Blotting , Hiperreactividad Bronquial/genética , Hiperreactividad Bronquial/inmunología , Hiperreactividad Bronquial/metabolismo , Hiperreactividad Bronquial/patología , Líquido del Lavado Bronquioalveolar/química , Células Cultivadas , Citocinas/metabolismo , Modelos Animales de Enfermedad , Femenino , Perfilación de la Expresión Génica/métodos , Mediadores de Inflamación/metabolismo , Lipocalina 2 , Lipocalinas/genética , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Noqueados , Análisis de Secuencia por Matrices de Oligonucleótidos , Proteínas Oncogénicas/deficiencia , Proteínas Oncogénicas/genética , Ovalbúmina , ARN Mensajero/análisis , Factores de Tiempo , Regulación hacia ArribaRESUMEN
BACKGROUND: The oral leukoplakia and erythroplakia is one of the most common epithelial precursor lesions of the oral squamous cell carcinoma. Transformation rates are approximately 0.9-17% in 10 years for leukoplakia and in 14-50% for the erythroplakia. Despite the clinical relevance of these lesions, currently exists no detailed bibliometric analysis. METHODS: The present study combines classical bibliometric tools with novel scientometric and visualizing techniques in order to analyse and categorize research in the field of leukoplakia and erythroplakia. RESULTS: All studies related to leukoplakia and erythroplakia and listed in the ISI database since 1900 were identified by the use of defined search terms. The bibliometric analysis of the collected data shows a continuous increase in quantitative marker such as the number of publications and cooperation and qualitative markers, such as citations and H-index. The combination with density equalizing mapping revealed a distinct global structure of research and citing activity. Radar chart techniques were used to illustrate bi- and multilateral cooperations and institution research collaborations. DISCUSSION: The present study demonstrates the first scientometric approach that visualizes research activities in the area of leukoplakia and erythroplakia. It provides data that can be used for geografical context and research networks.
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Bibliometría , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Eritroplasia/diagnóstico , Eritroplasia/patología , Leucoplasia Bucal/diagnóstico , Leucoplasia Bucal/patología , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/patología , Publicaciones Periódicas como Asunto , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/patología , Humanos , Internacionalidad , Mucosa Bucal/patología , InvestigaciónRESUMEN
Pulmonary hypertension (PH) is a disease which is characterised by an increase in the mean pulmonary arterial pressure (mPAP) in the lung circulation of over 25 mmHg in rest and over 30 mmHg in movement. Due to the chronic overload of the right ventricle, the heart is always affected by a PH and often develops a so-called cor pulmonale chronicum which can lead to right-heart failure. There are five groups in the clinical WHO Venice classification which are arranged according to pathogenetical, clinical and therapeutical criteria. In addition, an adjusted NYHA classification helps to grade the significance of the disease stages. Principally, one classifies a mostly isolated form of the pulmonary arterial hypertension (PAH) and other secondary forms of the PH which develop on the grounds of existing problems such as left-heart diseases, hypoxic lung diseases, pulmonary embolism and infections. The pathophysiological reasons for a PH are just as various as the different manifestations. Yet there are generally four main alterations in the walls of the pulmonary vessels. This includes vasoconstriction, rarefaction of vessels, vascular remodelling and the occlusion of vascular lumen by a thrombus with subsequent structural remodelling of the vascular and mounted extracellular matrix. The diagnostic procedure should be algorithm-oriented and includes anamnesis, physical examination, electrocardiogram (ECG), thoracic x-ray and echocardiography. To confirm the diagnosis and for a better measuring of the prognosis, an examination with a right-heart flow-directed balloon-tipped catheter is favourable. Because of the change in the pathophysiological concepts of the PH from a vasoconstrictive to a vasoproliterative genesis, additional pharmacological targets are developed for therapeutic treatment. Today the former regime of therapy with high-dosed calcium-channel blockers such as vasodilatators only finds application after pharmacological testing at so-called responders. The current scheme of therapy is focused on the synergic effects of different drugs, such as prostacyclines, endothelial-receptor blockers and phosphodiesterase-5 inhibitors. After the failure of pharmacological treatments, the endarteriectomy remains as the last therapy option, although it is accompanied by poor survival rates.
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Presión Sanguínea , Hipertensión Pulmonar/diagnóstico , Hipertensión Pulmonar/fisiopatología , Hipertensión Pulmonar/terapia , Circulación Pulmonar , HumanosRESUMEN
BACKGROUND: Leishmaniasis is a chronic disease that is found in various countries of the world. The aim of the current study was to investigate the impact of leishmaniasis on the world's research output. The present study assessed benchmarking of research output for the period between 1957 and 2006. Using large database analyses, research in the field of leishmaniasis was evaluated. Furthermore, cooperation between different countries was identified. RESULTS: The number of publications increased with time. Most publications came from Western countries such as the US, UK or Germany. Interestingly, countries like Brazil and India had a high research output. We found a substantial amount of cooperation between countries. CONCLUSION: Although leishmaniasis is of limited geographic distribution it attracts a wide research interest. The central hub of research cooperation is the USA.
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The Methicillin-resistant Staphylococcus aureus (MRSA) is a Staphylococcus aureus (S. aureus) resistant against all kinds of beta-lactam antibiotics. Moreover, resistances against other antibiotics have gradually started to develop. In the last decades, MRSA started as a serious problem only in hospitals, but in recent years it also rose as an alarming community pathogen. In addition to the resistances against Penicillin which emerged in the 1940s. with the use of beta-lactamase proof antibiotics in the 1960s, the resistance of S. aureus against Methicillin started to develop. According to the kind of resistance, the genotype, the time of infection and the origin of the infection, MRSA infections are classified as hospital-associated (HA-MRSA) and community-associated (cMRSA). On the one hand, this differentiation results in distinct strategies of calculated therapy against each class of MRSA. On the other hand, it is important in order to identify relevant judicious aspects of transmission.
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Antibacterianos/uso terapéutico , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Estudios Transversales , Diagnóstico Diferencial , Farmacorresistencia Bacteriana Múltiple/genética , Europa (Continente) , Humanos , Leucocidinas/genética , Mala Praxis/legislación & jurisprudencia , Staphylococcus aureus Resistente a Meticilina/genética , Pruebas de Sensibilidad Microbiana , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/microbiología , Estados Unidos , Resistencia a la Vancomicina/genética , Virulencia/genéticaRESUMEN
The aim of the present study was to identify and validate the biological significance of new genes/proteins involved in the development of allergic airway disease in a murine asthma model. Gene microarrays were used to identify genes with at least a two-fold increase in gene expression in lungs of two separate mouse strains with high and low allergic susceptibility. Validation of mRNA data was obtained by western blotting and immunohistochemistry, followed by functional analysis of one of the identified genes in mice with targeted disruption of specific gene expression. Expression of two antioxidant enzymes, glutathione peroxidase-2 (GPX2) and glutathione S-transferase omega (GSTO) 1-1 was increased in both mouse strains after induction of allergic airway disease and localised in lung epithelial cells. Mice with targeted disruption of the Gpx-2 gene showed significantly enhanced airway inflammation compared to sensitised and challenged wild-type mice. Our data indicate that genes encoding the antioxidants GPX2 and GSTO 1-1 are common inflammatory genes expressed upon induction of allergic airway inflammation, and independently of allergic susceptibility. Furthermore, we provide evidence to illustrate the importance of a single antioxidant enzyme, GPX2, in protection from allergen-induced disease.
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Asma/enzimología , Asma/genética , Asma/inmunología , Proteínas Portadoras/genética , Glutatión Peroxidasa/genética , Glutatión Transferasa/genética , Alérgenos/inmunología , Animales , Western Blotting , Líquido del Lavado Bronquioalveolar/citología , Modelos Animales de Enfermedad , Femenino , Expresión Génica , Inmunoglobulina E/sangre , Inmunohistoquímica , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ovalbúmina/inmunología , Fenotipo , Pletismografía , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Estadísticas no Paramétricas , Regulación hacia ArribaRESUMEN
Background. Cannabis has been a topic of political and medical controversy in many countries over the past century. Although many publications on this topic are available, there is currently no comprehensive evaluation of global research activities in the field. Objective. This study was conducted in order to provide a quantitative and qualitative analysis of the worldwide research output on cannabis. Methods. In a quantitative approach, items concerning cannabis published between 1900 and 2008 were retrieved from the ISI Web of Science databases developed by the Thompson Institute of Scientific Information and analysed using scientometric methods. In a second step, research fields of growing interest were identified. Results. We found that publications on this topic increased during the late 1960s, as well as during the period 1990 - 2008. We noted that South Africa was one of the countries with a high research output; having published numerous articles on cannabis. A comparison of cannabis with other drugs (e.g. alcohol, tobacco, cocaine and heroin) showed that in relation to the proportion of respective drug users, cocaine and heroin are overly represented in terms of research output. When analysing the main subjects of the publications; psychiatry was prominent, especially with regard to research on psychosis. Conclusion. There is increasing interest in research on cannabis. The research only partially reflects the drug's importance with regard to number of users
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Benchmarking , Cannabis , Consumidores de Drogas , Psiquiatría , Trastornos Psicóticos , Publicaciones SeriadasRESUMEN
BACKGROUND: In recent years, data from questionnaires have demonstrated increasing criticism from junior physicians regarding their work conditions. Ideally, such subjective statements should be compared to accurate objective data regarding workload. However, such data is not available in the research literature. Therefore the aim of the current study is to deliver exact data about physicians' work in different gastroenterology departments to analyze and to optimize work routines. METHOD: An observational real-time study was conducted by shadowing 21 gastroenterologists individually during weekday shifts at three hospitals in urban German settings. A total of 585 hours of observations were recorded by using an ultra mobile computer. RESULTS: The observation results have shown that a gastroenterologist's working day lasted on an average 9 hours 16 min (SD = 1:11:18 h). The following amount of time was given to varying tasks within this time period: 30.21 % for meetings (SD = 8.54 %), 13.42 % for documentation duties (SD = 7.74 %), 15.53 % for indirect patient care (SD = 6.32 %), 7.98 % for hospital admissions and ward rounds (SD = 5.49 %). Doctor patient communication was restricted to 4.05 % of the working day (SD = 2.71 %). CONCLUSION: This is the first real time analysis on how hospital gastroenterologists spend their working hours. Some of the problems with work routine reported by the doctors themselves were partly confirmed. With regard to the study results a rearrangement of job tasks coupled with technological solutions may prove helpful in reducing the burden on gastroenterologists and thereby improving the quality of medical care.
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Gastroenterología/estadística & datos numéricos , Cuerpo Médico de Hospitales/estadística & datos numéricos , Estudios de Tiempo y Movimiento , Carga de Trabajo/estadística & datos numéricos , Sistemas de Computación , Alemania , Recursos HumanosRESUMEN
BACKGROUND: Cough is a prominent symptom of many allergic diseases and a major health burden but there is little information available on the current state of research in this area. OBJECTIVES: To analyze long-term developments in cough research and recent trends. METHODS: We searched the Thomson Reuters Web of Science databases for cough-related items published between 1900 and 2007 and analyzed the results using scientometric methods and density-equalizing calculations. RESULTS: We found 12 960 cough-related publications from 132 countries for the period studied. The most productive country was the United States of America (USA), followed by the United Kingdom (UK), France, Japan, Canada, and Germany. These 12 960 published items were cited 165 868 times. The average number of citations per item increased from 1976 to 1992, with peaks in 1977, 1979, 1981, 1984, 1989 and 1992. Each of these years was followed by a decrease in citation numbers. Bilateral and multilateral cooperation analysis using the radar chart technique showed a progressive increase in international co-authorship starting at the beginning of the 1990s, with a leading role by the USA and the UK. CONCLUSION: We detected a marked increased in cough-related research starting in the 1990s. While the majority of data originates from the US, other countries have taken a leading position in terms of research quality (number of citations per item).
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Tos/epidemiología , Bases de Datos Bibliográficas , Investigación Biomédica/tendencias , Canadá , Interpretación Estadística de Datos , Francia , Alemania , Humanos , Cooperación Internacional , Japón , Informática Médica , Publicaciones , Reino Unido , Estados UnidosRESUMEN
Tobacco smoking is the leading cause of preventable morbidity and mortality in the world. There are nearly 1, 3 billion users of nicotine and tobacco products worldwide while approximately 4, 9 millions of them die from smoking-related disease every year. Cigarette smoking is a highly addictive behavior. Pharmacotherapy can be useful to achieve long-term abstinence. Nicotine replacement products are widely employed and recommended by the World Health Organization. There is strong evidence for the efficacy of the atypical antidepressant Bupropion as therapy for smoking cessation. The partial nicotinic receptor agonist varenicline has recently been approved as treatment for nicotine addiction in Germany. Preliminary data from clinical trials have suggested that varenicline may be an effective therapy for tobacco dependence with minimal side effects. Clonidine and nortriptyline have demonstrated some efficacy but possible side effects may limit their use. Additionally both are not approved for smoking cessation in Germany. Other promising new therapeutic drugs include Rimonabant and nicotine vaccines. They will provide smokers additional options to assist in achieving smoking cessation. Treatment of psychological dependence in addition to physiological dependence, however, is a must for long-term abstinence. For this reason a successful smoking cessation intervention requires besides pharmacological treatments motivational counseling and behavioral interventions.
Asunto(s)
Agonistas alfa-Adrenérgicos/administración & dosificación , Antidepresivos/administración & dosificación , Benzazepinas/administración & dosificación , Bupropión/administración & dosificación , Antagonistas de Receptores de Cannabinoides , Clonidina/administración & dosificación , Nicotina/administración & dosificación , Agonistas Nicotínicos/administración & dosificación , Nortriptilina/administración & dosificación , Piperidinas/administración & dosificación , Pirazoles/administración & dosificación , Quinoxalinas/administración & dosificación , Cese del Hábito de Fumar/métodos , Tabaquismo/rehabilitación , Terapia Conductista , Ensayos Clínicos como Asunto , Terapia Combinada , Consejo , Humanos , Rimonabant , Vacunas/uso terapéutico , VareniclinaRESUMEN
BACKGROUND: The inverse correlation of mycobacterial infection with asthma prevalence and the inhibitory effects of vaccination with Bacille Calmette-Guérin (BCG) on airway hyperreactivity in asthma models suggest modulation of dendritic cell (DC) and T cell functions by mycobacterial compounds. METHODS: To delineate these immunological effects, the immunogenicity of BCG Copenhagen, BCG Chicago and BCG Pasteur was compared in a mouse model. Bone marrow-derived dendritic cells (BMDCs) from BALB/c mice were stimulated with ovalbumin (OVA) with or without BCG. BMDCs were phenotypically characterized by flow cytometry, and we used ELISA to measure the cytokine production of BMDCs as well as of co-cultivated allergen-specific T cells in response to OVA-pulsed. Immunomodulatory effects of BCG were studied in a model of allergic airway inflammation by adoptive transfer of allergen-pulsed BMDCs. RESULTS: Immunomodulation with BCG induced production of IL-10 and IL-12 by BMDCs. Co-cultured allergen-specific T cells produced less IL-5, IL-13 and IFN-gamma but more IL-10. Also the number of FoxP3(+) regulatory T cells was enhanced. Strongest effects were seen with BCG Chicago and BCG Pasteur. In vivo, administration of BCG modulated OVA-pulsed BMDCs then reduced eosinophilic airway inflammation but enhanced infiltration with granulocytes. Airway hyperreactivity and mucus production were reduced and more FoxP3(+) T cells were observed. CONCLUSION: BCG-induced suppression of Th2-type allergic airway inflammation was associated with enhancement of regulatory T cell function but also of Th1-associated neutrophilic airway inflammation. These findings raise concerns regarding the safety profile of BCG as a potential tool for prevention and therapy of allergic airway disease.