Graffiti - visual memory of Croatian history. (65/5154)

Throughout the Middle Ages a unique Croatian Glagolitic script co-existed with Latin and western Cyrillic scripts, thus creating an open, large, and tolerant cultural environment. Many works common to European cultural heritage were translated into Croatian (Church Slavonic) language and preserved in the Glagolitic script. Among the oldest preserved Glagolitic monuments carved in stone are the so-called tables from Baska on the island Krk and Valun (11th-12th century) containing not only many names and church dedications but also valuable historical data. For centuries this script also provided a vehicle of transferring and preserving medical knowledge.  (+info)

Healthier mothers and babies. (66/5154)

At the beginning of the 20th century, for every 1000 live births, six to nine women in the United States died of pregnancy-related complications, and approximately 100 infants died before age 1 year. From 1915 through 1997, the infant mortality rate declined >90% to 7.2 per 1000 live births, and from 1900 through 1997, the maternal mortality rate declined almost 99% to <0.1 reported death per 1000 live births (7.7 deaths per 100,000 live births in 1997). Environmental interventions, improvements in nutrition, advances in clinical medicine, improvements in access to health care, improvements in surveillance and monitoring of disease, increases in education levels, and improvements in standards of living contributed to this remarkable decline. Despite these improvements in maternal and infant mortality rates, significant disparities by race and ethnicity persist. This report summarizes trends in reducing infant and maternal mortality in the United States, factors contributing to these trends, challenges in reducing infant and maternal mortality, and provides suggestions for public health action for the 21st century.  (+info)

The early introduction of percutaneous renal biopsy in Italy. (67/5154)

BACKGROUND: Percutaneous renal biopsy, based on the use of an aspiration needle and the patient in the sitting position, was first described by Iversen and Brun in 1951. In 1954, Kark and Muehrcke described the use of the cutting Vim-Silverman needle on patients in the prone position, with a substantial improvement in the rate of success. The 1961 CIBA Foundation Symposium on renal biopsy marked the coming of age of this technique. During the 1950s in Italy, several individuals played a part in promoting and developing percutaneous renal biopsy. Because this pioneer work has received insufficient attention, we describe the contributions of Italians to the early introduction of this technique. METHODS: The Italian and international literature about percutaneous renal biopsy of the period 1951 through 1965 was reviewed. In addition, structured interviews with surviving members of the Italian researchers who first used renal biopsy were conducted. RESULTS: The first renal biopsies in Italy were performed in 1951 in Pisa by the group of Ernico Fiaschi (1913-1989). In their hands, renal biopsy became a tool to investigate the pathogenesis of renal diseases in particular, while simultaneously using the early application of immunofluorescence and electron microscopy. In 1954, Pietro Leonardi (1914-1991) and Arturo Ruol (born 1924) introduced renal biopsy in Padova; they used this technique extensively and published one of the first monographs on the subject. In 1957, Vittorio Bonomini (born 1928) introduced renal biopsy in Bologna, and in subsequent years used this technique to focus on the study of pyelonephritis. CONCLUSIONS: Our historical research shows that Italian groups were among the first to use and develop percutaneous renal biopsy both as a clinical tool and an investigative tool. This article gives international credit to their work.  (+info)

Tobacco use--United States, 1900-1999. (68/5154)

Smoking--once a socially accepted behavior--is the leading preventable cause of death and disability in the United States. During the first decades of the 20th century, lung cancer was rare; however, as cigarette smoking became increasingly popular, first among men and later among women, the incidence of lung cancer became epidemic (Figure 1). In 1930, the lung cancer death rate for men was 4.9 per 100,000; in 1990, the rate had increased to 75.6 per 100,000 (1). Other diseases and conditions now known to be caused by tobacco use include heart disease, atherosclerotic peripheral vascular disease, laryngeal cancer, oral cancer, esophageal cancer, chronic obstructive pulmonary disease, intrauterine growth retardation, and low birthweight. During the latter part of the 20th century, the adverse health effects from exposure to environmental tobacco smoke also were documented. These include lung cancer, asthma, respiratory infections, and decreased pulmonary function (2).  (+info)

The decline and fall of Esperanto: lessons for standards committees. (69/5154)

In 1887, Polish physician Ludovic Zamenhof introduced Esperanto, a simple, easy-to-learn planned language. His goal was to erase communication barriers between ethnic groups by providing them with a politically neutral, culturally free standard language. His ideas received both praise and condemnation from the leaders of his time. Interest in Esperanto peaked in the 1970s but has since faded somewhat. Despite the logical concept and intellectual appeal of a standard language, Esperanto has not evolved into a dominant worldwide language. Instead, English, with all its idiosyncrasies, is closest to an international lingua franca. Like Zamenhof, standards committees in medical informatics have recognized communication chaos and have tried to establish working models, with mixed results. In some cases, previously shunned proprietary systems have become the standard. A proposed standard, no matter how simple, logical, and well designed, may have difficulty displacing an imperfect but functional "real life" system.  (+info)

IAIMS: an interview with Dick West. Integrated Advanced Information Management Systems. Interview by Joan S Ash and Frances E Johnson. (70/5154)

Richard T. West, IAIMS (Integrated Advanced Information Management Systems) Program Officer at the National Library of Medicine for 13 years, reflects on the origin, development, effectiveness, and future of IAIMS efforts. He dwells on the changes that have taken place as the concept of IAIMS has evolved from a technology-based to an organization-based level of integration. The role of IAIMS in patient care, education, and research is discussed, along with the role of the librarian in the implementation of IAIMS programs. He sees a need for training for librarians, informaticians, and others in preparation for these efforts and for the development of academic reward systems that encourage them. He expresses a desire for those working in information technology in hospitals to gain a clearer understanding of IAIMS, because the concept fits hospitals as well as academic health science centers. He exhorts informaticians to bring to reality the futuristic fantasies of a new information world.  (+info)

50th anniversary historical article. Myocardial infarction and coronary care units. (71/5154)

The results of treatment of 250 patients with established acute myocardial infarction in a coronary care unit in a university hospital are described. The criteria for diagnosis have been carefully defined. In 62 percent of patients admitted with a tentative diagnosis of acute infarction, the initial impression was confirmed. Fifteen percent of patients admitted to the unit were classified as having possible infarction; in this group, the mortality rate was 3 percent. A classification of functional severity based on clinical evidence of heart failure or shock is presented. Morbidity and mortality in acute myocardial infarction are related to the functional severity of the illness. Although arrhythmia is common, the overriding importance of five life-threatening arrhythmias is emphasized. Mortality of patients in the coronary care unit was not improved in comparison to those treated under regular care until strong central direction of therapeutic programs, immediate treatment of arrhythmia in cardiac arrest, and delegation of some medical authority to trained nurses was accomplished. The change in concept of the purposes and practices of special coronary care from resuscitation to prevention of arrhythmia is emphasized. The mortality in myocardial infarction complicated by shock remains high. In the absence of shock, aggressive medical treatment in the coronary care unit reduced mortality from 26 to 7 percent. The implications of these data in the management of patients admitted to a hospital with a diagnosis of acute myocardial infarction are discussed.  (+info)

50th anniversary historical article. Acute coronary syndromes: the degree and morphology of coronary stenoses. (72/5154)

In 110 patients with either stable or unstable angina, the morphology of coronary artery lesions was qualitatively assessed at angiography. Each obstruction reducing the luminal diameter of the vessel by 50% or greater was categorized into one of the following morphologic groups: concentric (symmetric narrowing); type I eccentric (asymmetric narrowing with smooth borders and a broad neck); type II eccentric (asymmetric with a narrow neck or irregular borders, or both); and multiple irregular coronary narrowings in series. For the entire group, type II eccentric lesions were significantly more frequent in the 63 patients with unstable angina (p less than 0.001), whereas concentric and type I eccentric lesions were seen more frequently in the 47 patients with stable angina (p less than 0.05). Type II eccentric lesions were also present in 29 of 41 arteries in patients with unstable angina compared with 4 of 25 arteries in those with stable angina (p less than 0.0001) in whom an "angina-producing" artery could be identified. Therefore, type II eccentric lesions are frequent in patients with unstable angina and probably represent ruptured atherosclerotic plaques or partially occlusive thrombi, or both. A temporary decrease in coronary perfusion secondary to these plaques with or without superimposed transient platelet thrombi or altered vasomotor tone may be responsible for chest pain in some of these patients with unstable angina.  (+info)