INTRODUCTION: Collecting information about drugs in clinical practice is essential for ongoing riskbenefit analysis of the drug use. Medical literature is an important source of new information on drug safety, in particular for the signal assessment. A signal is an information about a new potentially causal association, or a new aspect of a known association (e.g. change in frequency or severity of the reaction) between a drug and an adverse event (AE). AIM OF THE STUDY: To verify the effectiveness of the identification of adverse drug reaction (ADR) reports published in the local medical literature using MEDLINE and Embase, versus manual full text review of journals. MATERIAL AND METHODS: The study was performed for 20 randomly selected drugs and 84 Polish medical journals and covers a review of 1,576 individual journal issues with 20,146 articles. Retrospective analysis of literature reports collected during manual full text review was performed and compared to the outcome of database search. RESULTS: ADRs for analyzed drugs were identified only in 17 out of 84 journals, as a result of which 66 reports were analyzed. The majority of reports (55%) were found in local non-indexed journals. Three reports originated from journals indexed in MEDLINE and 9 reports from journals indexed in Embase were not found in these databases because databases do not fully cover conference abstracts and journal supplements. Moreover, while using databases for ADR report search there is a risk of missing up to 30% of ADR reports. The average gap between article publication date and database entry was 119 days. CONCLUSIONS: We verified that the effectiveness of the identification of ADR reports published in the local medical literature is more accurate based on manual full text review than by searching in bibliographic databases.
- Klíčová slova
- drug safety evaluation, medical literature monitoring, risk-benefit analysis, signal management,
- MeSH
- lidé MeSH
- MEDLINE MeSH
- nežádoucí účinky léčiv * MeSH
- periodika jako téma * MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Polsko MeSH
The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) conducted a review of existing systematic reviews and meta-analyses to explain the relationship between different dietary patterns and patient-important cardiometabolic outcomes. To update the clinical practice guidelines for nutrition therapy in the prevention and management of diabetes, we summarize the evidence from these evidence syntheses for the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Portfolio, Nordic, liquid meal replacement, and vegetarian dietary patterns. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. We summarized the evidence for disease incidence outcomes and risk factor outcomes using risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. The Mediterranean diet showed a cardiovascular disease (CVD) incidence (RR: 0.62; 95%CI, 0.50, 0.78), and non-significant CVD mortality (RR: 0.67; 95%CI, 0.45, 1.00) benefit. The DASH dietary pattern improved cardiometabolic risk factors (P < 0.05) and was associated with the decreased incidence of CVD (RR, 0.80; 95%CI, 0.76, 0.85). Vegetarian dietary patterns were associated with improved cardiometabolic risk factors (P < 0.05) and the reduced incidence (0.72; 95%CI: 0.61, 0.85) and mortality (RR, 0.78; 95%CI, 0.69, 0.88) of coronary heart disease. The Portfolio dietary pattern improved cardiometabolic risk factors and reduced estimated 10-year coronary heart disease (CHD) risk by 13% (-1.34% (95%CI, -2.19 to -0.49)). The Nordic dietary pattern was correlated with decreased CVD (0.93 (95%CI, 0.88, 0.99)) and stroke incidence (0.87 (95%CI, 0.77, 0.97)) and, along with liquid meal replacements, improved cardiometabolic risk factors (P < 0.05). The evidence was assessed as low to moderate certainty for most dietary patterns and outcome pairs. Current evidence suggests that the Mediterranean, DASH, Portfolio, Nordic, liquid meal replacement and vegetarian dietary patterns have cardiometabolic advantages in populations inclusive of diabetes.
- Klíčová slova
- DASH, Mediterranean, Nordic, cardiometabolic outcomes, cardiovascular disease, diabetes, dietary patterns, liquid meal replacements, portfolio, vegetarian,
- MeSH
- DASH dieta MeSH
- diabetes mellitus dietoterapie MeSH
- dieta vegetariánská MeSH
- dieta * MeSH
- kardiovaskulární nemoci epidemiologie mortalita prevence a kontrola MeSH
- komplikace diabetu epidemiologie prevence a kontrola MeSH
- lidé MeSH
- MEDLINE MeSH
- metaanalýza jako téma MeSH
- metabolické nemoci epidemiologie prevence a kontrola MeSH
- nutriční terapie metody MeSH
- rizikové faktory MeSH
- strava středomořská MeSH
- systematický přehled jako téma MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Skandinávie a severské státy MeSH
OBJECTIVE: The aim of the present systematic review and meta-analysis was to evaluate the safety and efficacy of intensive blood pressure (BP) reduction in patients with acute-onset intracerebral hemorrhage (ICH) using data from randomized controlled trials. METHODS: We conducted a systematic review and meta-analysis according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines of all available randomized controlled trials that randomized patients with acute ICH to either intensive or guideline BP-reduction protocols. RESULTS: We identified 4 eligible studies, including a total of 3,315 patients (mean age 63.4 ± 1.4 years, 64% men). Death rates were similar between patients randomized to intensive BP-lowering treatment and those receiving guideline BP-lowering treatment (odds ratio = 1.01, 95% confidence interval: 0.83-1.23; p = 0.914). Intensive BP-lowering treatment tended to be associated with lower 3-month death or dependency (modified Rankin Scale grades 3-6) compared with guideline treatment (odds ratio = 0.87, 95% confidence interval: 0.76-1.01; p = 0.062). No evidence of heterogeneity between estimates (I(2) = 0%; p = 0.723), or publication bias in the funnel plots (p = 0.993, Egger statistical test), was detected. Intensive BP reduction was also associated with a greater attenuation of absolute hematoma growth at 24 hours (standardized mean difference ± SE: -0.110 ± 0.053; p = 0.038). CONCLUSIONS: Our findings indicate that intensive BP management in patients with acute ICH is safe. Fewer intensively treated patients had unfavorable 3-month functional outcome although this finding did not reach significance. Moreover, intensive BP reduction appears to be associated with a greater attenuation of absolute hematoma growth at 24 hours.
- MeSH
- antihypertenziva terapeutické užití MeSH
- cerebrální krvácení komplikace farmakoterapie MeSH
- hypertenzní intrakraniální krvácení farmakoterapie etiologie MeSH
- krevní tlak účinky léků fyziologie MeSH
- lidé MeSH
- MEDLINE statistika a číselné údaje MeSH
- randomizované kontrolované studie jako téma statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- systematický přehled MeSH
- Názvy látek
- antihypertenziva MeSH
OBJECTIVE: To point out the latest trends in the surgical training that need to be implemented in Slovak and Czech Republic, not only in gynecology and obstetrics but also in all surgical specialties. SUBJECT: Review article. SETTING: Department of Obstetrics and Gynecology, Faculty Hospital Nitra and Constantine the Philosopher University Nitra. METHODS: Analysis of the database Medline 1979-2010 with the searching words education, competency, surgeon. CONCLUSION: The development of high-technologies, mainly minimally invasive surgery, working-hours shortage and public medical awareness are the factors that have major influence on the education of surgeons. Subspecialization, shortage of learning curve and higher safety of surgical procedures are the key elements of the surgical training.
- MeSH
- chirurgové výchova MeSH
- gynekologické chirurgické výkony výchova trendy MeSH
- gynekologie výchova MeSH
- klinické kompetence MeSH
- křivka učení MeSH
- lidé MeSH
- MEDLINE MeSH
- miniinvazivní chirurgické výkony MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
The rapid growth of medical knowledge creates a demand for new ways of providing information. Health professionals are dealing with a variety of cases, and as they have no time to visit the library, they need filtered information instantly. Medical knowledge databases and data sets are increasingly available in electronic form, particularly on the World Wide Web. The premise of this medium is that it offers a "world of knowledge at your fingertips". The reality, however, is somewhat different, as information systems are not well integrated into clinical practice, they prove difficult to find specific information in, and contain content of varying quality. The continued evaluation of the medium in the future, should be beneficial as evidence-based resources available, and these resources are integrated into electronic medical record systems. The DIMDI and OVID CD-ROM databases are presented as vehicles of research in Bio-Medical Sciences.
- MeSH
- CD-ROM MeSH
- databáze bibliografické * MeSH
- internet MeSH
- knihovníci MeSH
- lidé MeSH
- medicína založená na důkazech * MeSH
- MEDLINE MeSH
- podpora zdraví MeSH
- systémová integrace MeSH
- ukládání a vyhledávání informací MeSH
- veřejné zdravotnictví - informatika * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Německo MeSH
Bilirubin, a major intravascular product of heme catabolism, is a potent antioxidant compound. Numerous studies have been published showing the relationship between serum bilirubin levels and atherosclerosis. In the present investigation all the epidemiological studies available on the effect of serum bilirubin levels and atherosclerotic disease were analyzed. Studies on the epidemiology of atherosclerotic diseases in relation to serum bilirubin levels were searched in the MEDLINE database. Selected studies were subdivided according to serum bilirubin levels and severity of atherosclerotic disease. Because of the limited number of females involved in the studies, only males were included into meta-analysis. Associations for ordered categorical variables (bilirubin and natural history of graded atherosclerosis) were assessed to find correlation and linear trend between analyzed variables. A stratified analysis was conducted to compare risks of clinical outcomes. Eleven relevant studies were used for analysis. A close negative relationship was found between serum bilirubin levels and severity of atherosclerosis (Spearman rank coefficient r = -0.31,P < 0.0001). The linear trend was confirmed in analysis of proportions with x(2) values for both disease conditions to be very significant (P < 0.0001). Unambiguous inverse relationship between serum bilirubin levels and atherosclerosis was demonstrated in this preliminary meta-analytic study. These results indicate the importance of hem oxygenase-related products in the prevention of oxidative stress-mediated diseases.
- MeSH
- arterioskleróza metabolismus MeSH
- bilirubin krev MeSH
- epidemiologické studie MeSH
- lidé MeSH
- MEDLINE MeSH
- regresní analýza MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- Názvy látek
- bilirubin MeSH
In the medical community, bibliographic databases are widely accepted as a most important source of information both for theoretical and clinical disciplines. To improve access to medical bibliographic databases at Charles University, a database server (ERL by Silver Platter) was set up at the 2nd Faculty of Medicine in Prague. The server, accessible by Internet 24 hours/7 days, hosts now 14 years' MEDLINE and 10 years' EMBASE Paediatrics. Two different strategies are available for connecting to the server: a specialized client program that communicates over the Internet (suitable for professional searching) and a web-based access that requires no specialized software (except the WWW browser) on the client side. The server is now offered to academic community to host further databases, possibly subscribed by consortia whose individual members would not subscribe them by themselves.
- MeSH
- databáze bibliografické * MeSH
- internet * MeSH
- MEDLINE MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Authors' experience gained during a one year usage of the Internet is presented. By now we have found many useful information resources related to the field of pathology. The MEDLINE database is available free of charge at several web sites as well as teaching diagnostic seminars, electronic color atlases, medical publishers homepages, etc. There is also a possibility to enter various topic-related groups in the framework of Internet discussion groups. The limiting factors for reaching medical information from the Internet is hardware and software equipment, the cost of Internet connection, and the data transmission capacity of phone lines.
