Publications In PubMed Research Articles

Prospective registration, bias risk and outcome-reporting bias in randomised clinical trials of traditional Chinese medicine: an empirical methodological study

BackgroundClinical trials on Traditional Chinese Medicine (TCM) should be registered in a publicly accessible international trial register and report on all outcomes. We systematically assessed and evaluated TCM trials in...

Executive Functions of Sedentary Elderly May Benefit from Walking: A Systematic Review and Meta-Analysis

The goal of the present meta-analysis was to address studies that examined the relationship between walking as one of the most prevalent types of leisure-time activity and executive function being a higher-order cognitive function essential for independent functioning. The following data sources were used: English-language publications in PubMed, EMBASE, PsycINFO, Cinahl, and Cochrane; the last search took place in January 2012. From these data sources, only randomized controlled trials including older people with (N= 3) and without (N=5) cognitive impairment were selected. Walking has been shown to improve set-shifting and inhibition in sedentary older persons without cognitive impairment (d= 0.36; 95% confidence interval: 0.16-0.55; z= 3.56; p<0.0001). In older persons with cognitive impairment, walking did not show improvements in executive functioning (d= 0.14; 95% confidence interval:-0.36-0.64; z= 0.35; p=0.56). This finding is clinically relevant because participation in a walking program may prevent or postpone a (further) decline in executive function in those who are sedentary.

Stretching for Sonographers

With increasing patient loads, many sonographers have found themselves scanning in pain; up to 90% of sonographers have experienced pain while scanning. In this literature review, the question is asked, Are there any methods, such as stretching exercises, that a sonographer could personally implement to reduce or alleviate musculoskeletal injury? The literature of interest was located using online databases including CINAHL, Medline, PubMed, and SAGE Publications. Themes included sonographer, injury, musculoskeletal, stretching, and exercise. The literature shows a clear pattern of work-related musculoskeletal injury for actively scanning sonographers, but it is clear that more research is needed in the area of musculoskeletal injury prevention and alleviation. Research reports and case studies were explored for benefits of stretching across a spectrum of disciplines; specifically absent are large-scale studies looking at the benefits of a stretching and exercise program, preferably one integrated into the daily work schedule.

Specific patterns of gyr A mutations determine the resistance difference to ciprofloxacin and levofloxacin in Klebsiella pneumoniae and Escherichia coli

BackgroundWide use of ciprofloxacin and levofloxacin has often led to increased resistance. The resistance rate to these two agents varies in different clinical isolates of Enterobacteriaceae. Mutations of GyrA within the quinolone resistance-determining regions have been found to be the main mechanism for quinolone resistance in Enterobacteriaceae. It has been shown that only some of the mutations in the gyrA gene identified from clinical sources were involved in fluoroquinolone resistance. Whether different patterns of gyrA mutation are related to antimicrobial resistance against ciprofloxacin and levofloxacin is unclear.MethodsThe minimum inhibitory concentration (MIC) of ciprofloxacin and levofloxacin were determined by the agar dilution method followed by PCR amplification and sequencing of the quinolone resistance determining region of gyrA to identify all the mutation types. The correlation between fluoroquinolone resistance and the individual mutation type was analyzed.ResultsResistance differences between ciprofloxacin and levofloxacin were found in 327 isolates of K. pneumoniae and E. coli in Harbin, China and in the isolates reported in PubMed publications. GyrA mutations were found in both susceptible and resistant isolates. For the isolates with QRDR mutations, the resistance rates to ciprofloxacin and levofloxacin were also statistically different. Among the 14 patterns of alterations, two single mutations (Ser83Tyr and Ser83Ile), and three double mutations (Ser83Leu+Asp87Asn, Ser83Leu+Asp87Tyr and Ser83Phe+Asp87Asn) were associated with both ciprofloxacin and levofloxacin resistance. Two single mutations (Ser83Phe and Ser83Leu) were related with ciprofloxacin resistance but not to levofloxacin. Resistance difference between ciprofloxacin and levofloxacin in isolates harboring mutation Ser83Leu+Asp87Asn were of statistical significance among all Enterobacteriaceae (P<0.001).ConclusionsResistance rate to ciprofloxacin and levofloxacin were statistically different among clinical isolates of Enterobacteriaceae harboring GyrA mutations. Ser83Leu+Asp87Asn may account for the antimicrobial resistance difference between ciprofloxacin and levofloxacin.

Continuous use of oral contraceptives: an overview of effects and side‐effects

To describe the effects and side-effects of the continuous use of oral contraceptives. A review of articles concerning oral contraceptives taken continuously or in cycles with hormones taken for more than 21 days per cycle. We searched publications in PubMed and Embase. Randomized controlled trials were selected if possible, otherwise case-control studies or cohort studies with controls were chosen. A level of evidence as described by the Centre for Evidence Based Medicine (Oxford University, Oxford, UK) was assigned to all selected studies. Clinical and paraclinical effects and side-effects of oral contraceptives administered continuously. The studies suggest that the endometrium is inactive during continuous use of oral contraceptives and the risk of endometrial hyperplasia is not increased. Numbers of bleeding days are halved with continuous use; however, spotting and irregular bleeding are more often seen in the beginning of use, decreasing with time. Hemostatic parameters and serum lipid and carbohydrate profiles in continuous and conventional users do not differ. Menstrual cycle-related symptoms are relieved better by continuous treatment. After surgery for endometriosis, the effect of continuously used oral contraceptives on the risk of recurrence of pain has been found to be less than that of gonadotropin-releasing hormone (GnRH) analogues, but better than the rate seen during conventional cyclic use. Oral contraceptives taken continuously or in long cycles seem to offer benefits with regard to menstrual symptoms and the recurrence of symptoms related to endometriosis. Long-term studies, comprising large groups of women, are lacking.

Is Laparoscopic Sleeve Gastrectomy an Acceptable Primary Bariatric Procedure in Obese Patients? Early and 5-Year Postoperative Results

In this paper, we analyze and discuss the possibility of Laparoscopic sleeve gastrectomy being accepted as a primary and definitive procedure for obese patients with comorbidities. This is based on our postoperative and 5 years of follow-up result and comparing them with the data reported in the international literature. For comparison of the results, a narrative revision of the literature was performed, using the Medline, Pubmed, and data base publications (Medline, Lilacs, and Cochrane Library), looking for the term "Sleeve gastrectomy," "Obesity," "Bariatric surgery," "Laparoscopic surgery" including "Review" articles and also other 42 selected papers. The current results demonstrate very low morbidity (<10%), nil mortality (<1%), mean % weight loss after 5 years of follow-up of 57%, very satisfactory results regarding comorbidities or improvement. However, gastroesophageal reflux manifestation after the operation (20% to 31%) and the possibility of regaining weight after 5 years (15% to 75%) appear as points for analysis.

Severe Hypertriglyceridemia in Pregnancy

Pregnancy-related hypertriglyceridemia is rare, but it can be life threatening in some patients with genetic susceptibility. Complications can include acute pancreatitis, hyperviscosity syndrome, and possibly preeclampsia. We present a case of successful management of recurrent gestational chylomicronemia due to compound heterozygous mutations in the LPL gene. To outline advances in clinical management of this condition, we searched English language publications in PubMed, EMBASE, and ISI Web of Science (search terms: pregnancy, pregnancy complications, pregnan*, hyperlipoproteinemia, hypertriglyceridemia, chylomicrons, chylomicronemia) and reference lists of relevant published articles from 2002 to 2011. We identified eight case reports. Interventions reported in those cases are reviewed including: 1) low-fat diet; 2) nutritional supplements; 3) oral prescription medications; 4) parenteral heparin; 5) insulin infusion in the context of hyperglycemia; and 6) therapeutic plasma exchange. Overall, our recommendations are to monitor for pregnancy-related hypertriglyceridemia in those with prepregnancy fasting triglyceride level greater than 4 mmol/liter and to institute therapy when triglyceride level increases to more than 10 mmol/liter. Therapy should include a multidisciplinary team to address dietary fat restriction, appropriate supplements, and possible medications when needed. Admission to hospital is recommended in severe cases. We conclude that complications are preventable with appropriate and timely intervention.

Progesterone and preterm birth prevention: translating clinical trials data into clinical practice

We sought to provide evidence-based guidelines for using progestogens for the prevention of preterm birth (PTB). Relevant documents, in particular randomized trials, were identified using PubMed (US National Library of Medicine, 1983 through February 2012) publications, written in English, which evaluate the effectiveness of progestogens for prevention of PTB. Progestogens evaluated were, in particular, vaginal progesterone and 17-alpha-hydroxy-progesterone caproate. Additionally, the Cochrane Library, organizational guidelines, and studies identified through review of the above were utilized to identify relevant articles. Data were evaluated according to population studied, with separate analyses for singleton vs multiple gestations, prior PTB, or short transvaginal ultrasound cervical length (CL), and combinations of these factors. Consistent with US Preventive Task Force suggestions, references were evaluated for quality based on the highest level of evidence, and recommendations were graded. Summary of randomized studies indicates that in women with singleton gestations, no prior PTB, and short CL ≤ 20 mm at ≤ 24 weeks, vaginal progesterone, either 90-mg gel or 200-mg suppository, is associated with reduction in PTB and perinatal morbidity and mortality, and can be offered in these cases. The issue of universal CL screening of singleton gestations without prior PTB for the prevention of PTB remains an object of debate. CL screening in singleton gestations without prior PTB cannot yet be universally mandated. Nonetheless, implementation of such a screening strategy can be viewed as reasonable, and can be considered by individual practitioners, following strict guidelines. In singleton gestations with prior PTB 20-36 6/7 weeks, 17-alpha-hydroxy-progesterone caproate 250 mg intramuscularly weekly, preferably starting at 16-20 weeks until 36 weeks, is recommended. In these women with prior PTB, if the transvaginal ultrasound CL shortens to < 25 mm at < 24 weeks, cervical cerclage may be offered. Progestogens have not been associated with prevention of PTB in women who have in the current pregnancy multiple gestations, preterm labor, or preterm premature rupture of membranes. There is insufficient evidence to recommend the use of progestogens in women with any of these risk factors, with or without a short CL.

Does the Presence of an Open-Label Antidepressant Treatment Period Influence Study Outcome in Clinical Trials Examining Augmentation/Combination Strategies in Treatment Partial Responders/Nonresponders With Major Depressive Disorder?

The authors sought to determine study design factors that may influence clinical trial outcome in augmentation/combination trials for antidepressant partial responders/nonresponders with major depressive disorder (MDD) and to examine whether the use of a prospective treatment phase (lead-in) to assess antidepressant nonresponse may result in a better chance to detect a drug-placebo separation in such trials. MEDLINE/PubMed publication databases were searched for randomized, double-blind, placebo-controlled trials of adjunctive pharmacologic strategies for antidepressant partial responders/nonresponders with MDD. The search term depression was successively cross-referenced with the terms augmentation, adjunct, and adjunctive to identify pertinent trials. (The search was limited to articles published between January 1980 and October 2010.) Thirty-five articles involving 40 adjunctive drug versus placebo comparisons were pooled (n = 4,676). Final inclusion of articles was determined by consensus between the authors. Data extracted included whether there was a lead-in phase and, if so, the drugs, the doses, and the total duration of the lead-in phase. Additional data extracted included the number of patients enrolled, patient characteristics, methods used to define treatment resistance, drug dosages, duration of the adjunctive trial, response and remission rates, and rates of discontinuation for any reason and for adverse events. The risk ratio of responding to the adjunctive drug versus placebo was not influenced by any of the study design factors analyzed (probability of receiving placebo, year of publication, severity of depression at baseline). Meta-regression analysis yielded no significant difference in the risk ratio of responding and remitting to the adjunctive drug versus placebo between studies that did versus did not include an antidepressant lead-in phase. However, pooled response/remission rates for adjunctive drug and placebo were statistically significantly lower in trials that did versus did not include a lead-in phase (response rates: for adjunctive drug, 42.6% vs 47.4%, respectively, P = .014; for adjunctive placebo, 29.7% vs 36.2%, respectively, P = .002; remission rates: for adjunctive drug, 31.0% vs 37.3%, respectively, P = .003; and adjunctive placebo, 18.1% vs 24.7%, respectively, P = .001). These results suggest that the choice to use historical data only to define treatment resistance prior to patient enrollment and randomization rather than requiring patients to first undergo a prospective lead-in phase can be a reasonable and evidence-supported approach to design effective clinical trials on augmentation/combination strategies for partial responders/nonresponders with MDD.

Endometriosis and Perinatal Outcome - A Systematic Review of the Literature

Objective: To assess any possible adverse effects of endometriosis on pregnancy outcome and complications, as well as in the postpartum period. Study Design: A systematic review of the literature. Data Sources: We searched all publications in Pubmed, Scopus and the Cochrane Library with the key words endometriosis, pregnancy outcome, preeclampsia, preterm birth, small-for gestational age babies (SGA) and postpartum. Eligibility Criteria for Selecting Studies: All studies reporting on endometriosis and perinatal outcome until December 2009. Results: According to the available bibliographic data, we found 38 reported cases of pregnancies, four being twin pregnancies, complicated by endometriosis (Table 1). Studies referring to specific pregnancy complications (preterm birth, small-for-gestational age babies, preeclampsia and postpartum complications) were limited to a total of 12 publications [61-63, 69, 75, 80, 82-86]. The few reported complications during pregnancy included hemoperitoneum and spontaneous bleeding [1, 9-21], perforations of the jejunum, appendix and sigmoid colon [22-24], urohemoperitoneum [25], deciduosis of the appendix [26], deciduosis of the omentum [27], infected endometrioma [28], hemoperitoneum and hemothorax [29], catamenial pneumothorax [30], endometriosis imitating a bladder tumor [31], decidualization mimicking ovarian malignancy [32], rupture of ovarian endometriotic cyst [23, 33], and rupture of the uterus affected by endometriosis [34] (Table 1). Data regarding the effect of endometriosis on preterm birth, small-for gestational age babies and preeclampsia, both in spontaneous pregnancies as well as in those conceived by Assisted Reproductive Techniques (ART) were conflicting. Conclusions: Symptoms of endometriosis often disappear during pregnancy. Yet, endometriosis must be included in the differential diagnosis of hemoperitoneum presenting during pregnancy or of heavy vaginal bleeding postpartum. Both maternal and fetal morbidity and mortality can be quite high and the woman’s childbearing ability might be irreversibly affected. The few available data on the association between endometriosis and preeclampsia are at present controversial. Together with the studies reporting an increased risk for preterm birth in women with endometriosis, physicians must be aware that close antenatal follow-up and early diagnosis is crucial. Postpartum manifestations of endometriosis, although extremely rare, can give rise to severe complications with a high possibility of irreversibly affecting the woman’s childbearing ability. Keywords: Endometriosis, postpartum, preeclampsia, pregnancy outcome, preterm birth, SGA (small for gestational age)

Doppler assessment of the fetus with intrauterine growth restriction

We sought to provide evidence-based guidelines for utilization of Doppler studies for fetuses with intrauterine growth restriction (IUGR). Relevant documents were identified using PubMed (US National Library of Medicine, 1983 through 2011) publications, written in English, which describe the peripartum outcomes of IUGR according to Doppler assessment of umbilical arterial, middle cerebral artery, and ductus venosus. Additionally, the Cochrane Library, organizational guidelines, and studies identified through review of the above were utilized to identify relevant articles. Consistent with US Preventive Task Force suggestions, references were evaluated for quality based on the highest level of evidence, and recommendations were graded. Summary of randomized and quasirandomized studies indicates that, among high-risk pregnancies with suspected IUGR, the use of umbilical arterial Doppler assessment significantly decreases the likelihood of labor induction, cesarean delivery, and perinatal deaths (1.2% vs 1.7%; relative risk, 0.71; 95% confidence interval, 0.52-0.98). Antepartum surveillance with Doppler of the umbilical artery should be started when the fetus is viable and IUGR is suspected. Although Doppler studies of the ductus venous, middle cerebral artery, and other vessels have some prognostic value for IUGR fetuses, currently there is a lack of randomized trials showing benefit. Thus, Doppler studies of vessels other than the umbilical artery, as part of assessment of fetal well-being in pregnancies complicated by IUGR, should be reserved for research protocols.

NASH (nicht alkoholische Steatohepatitis): Fettleber oder fatale Lebererkrankung?

Non-alcoholic steatohepatitis (NASH) was first described in 1980 and has emerged from an anecdotal disease to a widely distributed liver disease in the current decade. This review is based on publications in PubMed and our own experiences and deals with basic pathophysiological aspects, diagnostic, and therapeutic tools as well as with the modern management of this serious liver disease. For a long time the potenial for serious liver destruction and enhanced liver mortality by NASH has been observed. The recognition of the metabolic origin of NASH has contributed to diagnostic as well as therapeutic approaches. Since then patients with metabolic syndrome are often screened for liver disease. NASH might worsen other chronic liver diseases but should be judged as an independent illness rather than the exclusion of other potential liver diseases. Furthermore, non-alcoholic steatohepatitis has systemic consequences concerning insulin resistance, metabolic complications and cardiovascular diseases. Future research should concentrate on non-invasive screening strategies, identification of risk factors, evaluation of hepatocellular carcinogenesis and new therapeutic targets.

Literature mining of host–pathogen interactions: comparing feature-based supervised learning and language-based approaches

In an infectious disease, the pathogen's strategy to enter the host organism and breach its immune defenses often involves interactions between the host and pathogen proteins. Currently, the experimental data on host-pathogen interactions (HPIs) are scattered across multiple databases, which are often specialized to target a specific disease or host organism. An accurate and efficient method for the automated extraction of HPIs from biomedical literature is crucial for creating a unified repository of HPI data. Here, we introduce and compare two new approaches to automatically detect whether the title or abstract of a PubMed publication contains HPI data, and extract the information about organisms and proteins involved in the interaction. The first approach is a feature-based supervised learning method using support vector machines (SVMs). The SVM models are trained on the features derived from the individual sentences. These features include names of the host/pathogen organisms and corresponding proteins or genes, keywords describing HPI-specific information, more general protein-protein interaction information, experimental methods and other statistical information. The language-based method employed a link grammar parser combined with semantic patterns derived from the training examples. The approaches have been trained and tested on manually curated HPI data. When compared to a naïve approach based on the existing protein-protein interaction literature mining method, our approaches demonstrated higher accuracy and recall in the classification task. The most accurate, feature-based, approach achieved 66-73% accuracy, depending on the test protocol.

Deferasirox: pharmacokinetics and clinical experience

Introduction: Iron overload is an inevitable consequence of transfusion therapy for a variety of underlying anemias. Iron overload, without effective chelation, will lead to significant morbidity and mortality. Deferasirox (Exjade®) is an oral tridentate iron chelator used for reducing iron overload.Areas covered: In addition to the pharmacokinetic and pharmacodynamic profile of deferasirox, this review examines the efficacy and safety data from pivotal studies with deferasirox in iron-overloaded patients with various anemias, including thalassemia, sickle cell disease and myelodysplastic syndromes. A qualitative literature search for deferasirox was performed using PubMed and recent key congress publications (EHA and ASH); key search terms were deferasirox, pharmacokinetic, pharmacodynamic, efficacy and safety.Expert opinion: Based on the current available data, deferasirox treatment is effective with a clinically manageable safety profile although appropriate dosing according to the severity of iron burden and iron intake, together with the careful monitoring of laboratory parameters and adverse events, is recommended. However, despite advances made in the treatment of iron overload, some patients still do not respond adequately to iron chelators, and increased awareness, understanding and further research are still needed.

Determinants of late and/or inadequate use of prenatal healthcare in high-income countries: a systematic review

Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking. To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries. Search of publications in EMBASE, CINAHL and PubMed (1992-2010). Studies that attempted to study determinants of prenatal healthcare utilization in high-income countries were included. Two reviewers independently assessed the eligibility and methodological quality of the studies. Only high-quality studies were included. Data on inadequate use (i.e. late initiation, low-use, inadequate use or non-use) were categorized as individual, contextual and health behaviour-related determinants. Due to the heterogeneity of the studies, a quantitative meta-analysis was not possible. Ultimately eight high-quality studies were included. Low maternal age, low educational level, non-marital status, ethnic minority, planned pattern of prenatal care, hospital type, unplanned place of delivery, uninsured status, high parity, no previous premature birth and late recognition of pregnancy were identified as individual determinants of inadequate use. Contextual determinants included living in distressed neighbourhoods. Living in neighbourhoods with higher rates of unemployment, single parent families, medium-average family incomes, low-educated residents, and women reporting Canadian Aboriginal status were associated with inadequate use or entering care after 6 months. Regarding health behaviour, inadequate use was more likely among women who smoked during pregnancy. Evidence for determinants of prenatal care utilization is limited. More studies are needed to ensure adequate prenatal care for pregnant women at risk.

Bioinformatics Approach to BDNF and BDNF-Related Disorders

Context: Currently, the keyword ‘BDNF’ retrieves 7388 publications in Pubmed, which point to many directions. Objective: This paper aims to uncover patterns that are hidden under this huge mass of studies and then to review the most prominent sub-topics in ‘BDNF and mental health’. Method: Several semi-automatic tools employed, in order to present: 1. A visual representation of BDNFs main molecular pathways; 2. A table with all the components of this pathway that are known to be associated with human diseases; 3. A conceptual map of the whole literature; 4. A histogram of the mental disorders that are known to be associated with BDNF, as well as a review of the literature on each one of these topics. Results: The conceptual map suggests that the field is divided in two major sections: BDNF molecular pathways, receptors, other neurotrophins and neurotransmitters; and BDNF-related disorders. Among the latter, the mental disorders that are mostly related to BDNF are: depression, schizophrenia, Parkinson disease, Alzheimer disease, and bipolar disorder. Keywords: neurotransmitters, neurotrophins, neurotrophic factor, olfactory system, neurotrophic factor (BDNF), review, data mining, bioinformatics, genetic neuroscience, BDNF

The Effect of Mediterranean Diet on Metabolic Syndrome and its Components: A Meta-Analysis of 50 Studies and 534,906 Individuals

The aim of this study was to meta-analyze epidemiological studies and clinical trials that have assessed the effect of a Mediterranean diet on metabolic syndrome (MS) as well as its components. The Mediterranean diet has long been associated with low cardiovascular disease risk in adult population. The authors conducted a systematic review and random effects meta-analysis of epidemiological studies and randomized controlled trials, including English-language publications in PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials until April 30, 2010; 50 original research studies (35 clinical trials, 2 prospective and 13 cross-sectional), with 534,906 participants, were included in the analysis. The combined effect of prospective studies and clinical trials showed that adherence to the Mediterranean diet was associated with reduced risk of MS (log hazard ratio: -0.69, 95% confidence interval [CI]: -1.24 to -1.16). Additionally, results from clinical studies (mean difference, 95% CI) revealed the protective role of the Mediterranean diet on components of MS, like waist circumference (-0.42 cm, 95% CI: -0.82 to -0.02), high-density lipoprotein cholesterol (1.17 mg/dl, 95% CI: 0.38 to 1.96), triglycerides (-6.14 mg/dl, 95% CI: -10.35 to -1.93), systolic (-2.35 mm Hg, 95% CI: -3.51 to -1.18) and diastolic blood pressure (-1.58 mm Hg, 95% CI: -2.02 to -1.13), and glucose (-3.89 mg/dl, 95% CI:-5.84 to -1.95), whereas results from epidemiological studies also confirmed those of clinical trials. These results are of considerable public health importance, because this dietary pattern can be easily adopted by all population groups and various cultures and cost-effectively serve for primary and secondary prevention of the MS and its individual components.

A comparison of methods of pathogen inactivation of FFP

Current methods for pathogen inactivation of plasma involve four major processes using solvent-detergent (SD), methylene blue (MB), amotosalen and riboflavin as additives. Three of these methods involve the use of visible or ultraviolet light. A comparison of the four methods was made using publications in Medline, Pubmed, Embase and Biosis to obtain data on the logistics of use, the quality of the plasma proteins and the effectiveness of pathogen inactivation. Three of the methods, MB, amotosalen and riboflavin, are designed for use in a blood bank; the SD method is generally applied at a centralized manufacturing centre and involves large plasma pools. All methods result in a reduction in protein values with the per cent retention of FVIII activity in the range of 67-78% and fibrinogen of 65-84%. Protein S and alpha(2)-antiplasmin are lower following solvent-detergent treatment. Alterations in fibrinogen structure have been reported with methylene blue. Three of the methods are designed for small volume use in a blood bank. All four methods have some effect on the coagulant proteins; however, the final concentrations are within regulated limits. While there is variability in the effectiveness against pathogens, direct comparison is difficult because of the methodologies used. Nonetheless, all are effective in inactivating HIV and other lipid-enveloped pathogens. Clinical studies on the effectiveness of these products are surprisingly sparse, and no randomized clinical trials have yet been performed with amotosalen or riboflavin plasmas.

Trends in the investigation of social determinants of health: selected themes and methods

We analyze bibliometric trends of topics relevant to the epidemiologic research of social determinants of health. A search of the PubMed database, covering the period 1985-2007, was performed for the topics: socioeconomic factors, sex, race/ethnicity, discrimination/prejudice, social capital/support, lifecourse, income inequality, stress, behavioral research, contextual effects, residential segregation, multilevel modeling, regression based indices to measure inequalities, and structural equation modeling/causal diagrams/path analysis. The absolute, but not the relative, frequency of publications increased for all themes. Total publications in PubMed increased 2.3 times, while the subsets of epidemiology/public health and social epidemiologic themes/methods increased by factors of 5.3 and 5.2, respectively. Only multilevel and contextual analyses had a growth over and above that observed for epidemiology/public health. We conclude that there is clearly room for wider use of established techniques, and for new methods to emerge when they satisfy theoretical needs.

A bibliometric analysis of Australian general practice publications from 1980 to 2007 using PubMed

We analysed Australian general practice (GP) publications in PubMed from 1980 to 2007 to determine journals, authors, publication types, national health priority areas (NHPA) and compared the results with those from three specialties (public health, cardiology and medical informatics) and two countries (the UK and New Zealand). Australian GP publications were downloaded in MEDLINE format using PubMed queries and were written to a Microsoft Access database using a software application. Search Query Language and online PubMed queries were used for further analysis. There were 4777 publications from 1980 to 2007. Australian Family Physician (38.1%) and the Medical Journal of Australia (17.6%) contributed 55.7% of publications. Reviews (12.7%), letters (6.6%), clinical trials (6.5%) and systematic reviews (5%) were the main PubMed publication types. Thirty five percent of publications addressed National Health Priority Areas with material on mental health (13.7%), neoplasms (6.5%) and cardiovascular conditions (5.9%). The comparable numbers of publications for the three specialties were: public health - 80 911, cardiology - 15 130 and medical informatics - 3338; total country GP comparisons were: UK - 14 658 and New Zealand - 1111. Australian GP publications have shown an impressive growth from 1980 to 2007 with a 15-fold increase. This increase may be due in part to the actions of the Australian government over the past decade to financially support research in primary care, as well as the maturing of academic general practice. This analysis can assist governments, researchers, policy makers and others to target resources so that further developments can be encouraged, supported and monitored.