Hieronymus Bosch (1450-1516): paleopathology of the medieval disabled and its relation to the Bone and Joint Decade 2000-2010.
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BACKGROUND: At the start of the Bone and Joint Decade 2000-2010, a paleopathologic study of the physically disabled may yield information and insight on the prevalence of crippling disorders and attitudes towards the afflicted in the past compared to today. OBJECTIVE: To analyze "The procession of the Cripples," a representative drawing of 31 disabled individuals by Hieronymus Bosch in 1500. METHODS: Three specialists--a rheumatologist, an orthopedic surgeon and a neurologist--analyzed each case by problem-solving means and clinical reasoning in order to formulate a consensus on the most likely diagnosis. RESULTS: This iconographic study of cripples in the sixteenth century reveals that the most common crippling disorder was not a neural form of leprosy, but rather that other disorders were also prevalent, such as congenital malformation, dry gangrene due to ergotism, post-traumatic amputations, infectious diseases (Pott's, syphilis), and even simulators. The drawings show characteristic coping patterns and different kinds of crutches and aids. CONCLUSION: A correct clinical diagnosis can be reached through the collaboration of a rheumatologist, an orthopedist and a neurologist. The Bone and Joint Decade Project, calling for attention and education with respect to musculoskeletal disorders, should reduce the impact and burden of crippling diseases worldwide through early clinical diagnosis and appropriate treatment. (+info)
Evaluation of the Dartmouth COOP charts in a large-scale community survey in the United Kingdom.
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BACKGROUND: The aim of this study was to gain population norms for the COOP Charts in a large community sample, and to explore the construct validity, and whether the inclusion of the illustrations influences response rates. METHODS: A postal survey was carried out using a questionnaire booklet, containing the COOP Charts and a number of other items concerned with lifestyles and illness, sent to 6007 randomly selected subjects over the age of 18 years. Respondents were randomized to receiving the questionnaire booklet with a copy of the COOP Charts including illustrations, or the same booklet but including the COOP items without illustrations. The sample was drawn from the Family Health Services Authority (FHSA) computerized register for Oxfordshire. Outcome measures were scores for the eight dimensions of the COOP Charts. RESULTS: The survey achieved an adjusted response rate of 56.72 per cent. There was no difference in response rate or scores on the eight dimensions of the COOP Charts when broken down by those who received the illustrated Charts or simply the items from the measure without illustrations. Normative data for the COOP Charts are reported, broken down by age, sex, social class and whether respondent reported chronic illness or not. CONCLUSION: The illustrations included in the original charts do not appear to influence response rates, or responses given to the questions. The evidence suggests that items of the COOP Charts provide a short and comprehensive survey of health status. The normative data provided in this paper may further facilitate their validation and use. (+info)
The first American textbook of surgery.
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The first systematic textbook of surgery written in the United States, The Elements of Surgery, was completed in 1813 by John Syng Dorsey, a University of Pennsylvania surgeon. The work thoroughly covered all major clinical areas of surgery of that time in a two-volume, 797-page text. Subsequent editions were published in 1818, 1823, and 1831. It became the standard surgical textbook in this country during that era and was the first American medical text exported abroad for use at the more established European centers of medical education. The reasons for writing the text included a desire to put into print the teachings of Philip Syng Physick (first Chair of the Department of Surgery at the University of Pennsylvania, and Dorsey's uncle), the new American nationalism, and socioeconomic pressures forced on the American publishing industry by the War of 1812 and preceding trade embargoes. In addition to extensive exposure to Physick, Dorsey was also uniquely qualified to write and illustrate this text, as he exhibited an unusually succinct style and was a remarkable medical artist. The book was the forerunner to William Gibson's The Institutes and Practice of Surgery and all American surgical textbooks to follow. (+info)
The quantity and quality of scientific graphs in pharmaceutical advertisements.
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We characterized the quantity and quality of graphs in all pharmaceutical advertisements, in the 10 U.S. medical journals. Four hundred eighty-four unique advertisements (of 3,185 total advertisements) contained 836 glossy and 455 small-print pages. Forty-nine percent of glossy page area was nonscientific figures/images, 0.4% tables, and 1.6% scientific graphs (74 graphs in 64 advertisements). All 74 graphs were univariate displays, 4% were distributions, and 4% contained confidence intervals for summary measures. Extraneous decoration (66%) and redundancy (46%) were common. Fifty-eight percent of graphs presented an outcome relevant to the drug's indication. Numeric distortion, specifically prohibited by FDA regulations, occurred in 36% of graphs. (+info)
A BASIC CAMERA UNIT FOR MEDICAL PHOTOGRAPHY.
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A camera unit suitable for most medical photographic purposes is described. The unit comprises a single-lens reflex camera, an electronic flash unit and supplementary lenses. Simple instructions for use of th's basic unit are presented. The unit is entirely suitable for taking fine-quality photographs of most medical subjects by persons who have had little photographic training. (+info)
Perceptions of science. The anatomical mission to Burma.
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Until the 1830s, most Americans were unfamiliar with the images of anatomy. Then a small vanguard of reformers and missionaries began to preach, at home and around the world, that an identification with the images and concepts of anatomy was a crucial part of the civilizing process. In his essay, Sappol charts the changes in the perception of self that resulted from this anatomical evangelism. Today, as anatomical images abound in the arts and the media, we still believe that anatomical images show us our inner reality. (+info)
A customizable MR brain imaging atlas of structure and function for decision support.
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We present a MR brain atlas for structure and function (diffusion weighted images). The atlas is customizable for contrast and orientation to match the current patient images. In addition, the atlas also provides normative values of MR parameters (T1, T2 and ADC values). The atlas is designed on informatics principles to provide context sensitive decision support at the time of primary image interpretation. Additional support for diagnostic interpretation is provided by a list of expert created most relevant 'Image Finding Descriptors' that will serve as cues to the user. The architecture of the atlas module is integrated into the image workflow of a radiology department to provide support at the time of primary diagnosis. (+info)
Gunther von Hagens and Body Worlds Part 1: the anatomist as prosektor and proplastiker.
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Recent calls to reintegrate the sciences and humanities are challenged by the contemporary work of anatomist Gunther von Hagens and his Body Worlds exhibits of plastinated cadavers. The anatomical quest to understand our physical interior has long been in tension both with aesthetic ideals and religious sensitivities regarding the metaphysical significance of the human body. Part I of this two-part Historical Note examines tensions epitomized by Goethe's figures of the prosektor and proplastiker. The former, driven by scientific curiosity, is willing to destroy, even desecrate, the human form to obtain knowledge. The latter demurs at such mutilation of our physical body, wondrous even in death--seeking instead to rejoin what the prosektor has pulled apart, to restore human dignity. In the confrontation between prosektor and proplastiker, roles disturbingly fused in the person of von Hagens himself, questions arise regarding the authenticity of models as well as the appropriate recipients of such mediated yet intimate anatomical knowledge. Part II will focus on religious perspectives on the human body, variously interpreted as God's handiwork, habitation for the soul, and vehicle of resurrection. Consideration also is given to the role of anatomist as priest, prophet, and Promethean creator, roles self-consciously embraced by von Hagens. (+info)