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This paper reviews the architecture of the Royal National Institute for the Insane in Stenjevec during its construction and the first years of its existence. Since the opening of the Institute in 1879 until the end of the World War I, there were numerous adaptations and extensions of the original capacities. The paper shows how these extensions reflected the existing paradigm of the institutional architecture in the second half of the 19th century. Architecture, under the influence of Pinel's "moral treatment" as a primary therapeutic approach to mental illnesses in the 19th century, was considered to be a remedy and its therapeutic importance in the context of psychiatry was not questioned. While early examples of the architecture of psychiatric hospitals copied prison construction and were adapted to control the mentally ill (e.g., the Viennese "Narrenturm"), later plans, such as linear and separate (pavilion), sought to simultaneously increase control effectiveness, act therapeutically and respond to some practical needs of the more crowded institutes. The Stenjevec Institute, designed by the Viennese architect Kuno Waidmann, was created exactly at the transition between the linear and the separate type. The institute, originally conceived as a linear type of institution, was later transformed into a separate or pavilion type institute. [ABSTRACT FROM AUTHOR]

The article asks about the function of clinical ethics. It does so by confronting the assumption that ethics is supposed to help in the solution of concrete problems, relying upon a defined set of principles and rules. The scientific character of such an approach to clinical ethics complements the very understanding of modern medicine as being increasingly scientific and technical; that is, as oriented toward the production of effects. The paper claims that, rather than sharing in the "suspension of meaning" pursued by medicine for the sake of scientific objectivity, the main task of clinical ethics consists of a retrieval, or "anamnesis," of the very questions medicine seems to suspend: the significance of illness and disease, of birth, suffering and death, and of the service to the ethos of generosity that sustains the healing professions. Also, the paper offers a cultural "etiology" of "the suspension of meaning" in ethics, and pleads for a moral reflection that begins with a free and open confrontation with clinical experience. Attending to the moral meaning of concrete situations, the paper argues that formal modes of logical argumentation are only derivative functions of the moral language and, thus, cannot exhaust the broad spectrum of ethical discourse in medicine. [ABSTRACT FROM AUTHOR]

As non-canonical texts, apocryphal prayers had been exposed to various influences, and thus became the most comprehensive written records of the interaction between medical knowledge on one hand, and folk and religious medicine on the other hand. This paper examines apocryphal prayers used to heal illnesses and acute conditions. By analyzing the selected examples of apocryphal prayers, such as against nežit (various inflammatory conditions thought to be caused by an evil spirit of this name), against toothache, against nosebleed, against snake bites, against bites by rabid dogs or wolves, the paper determines their characteristics. On one hand, the paper identifies medical knowledge appearing in the prayers and delineates ways in which the cause of an illness and the proper course of treatment are determined. On the other hand, apocryphal prayers are examined within a framework used for literary text analysis, which results in a consideration of their stylistic values. [ABSTRACT FROM AUTHOR]

During the 2nd World War, large numbers of allied military personnel in south-east Asia became prisoners-of-war (POWs) of the Japanese. During their internment of three and a half years, they suffered undernutrition, exposure to tropical diseases and frequently overwork. Perhaps the harshest POW experience was the construction of the railway between Thailand and Burma. This paper explores the medical conditions during Far East imprisonment, and in particular on the Thai-Burma Railway, as well as the long-term health effects in post-war decades. [ABSTRACT FROM AUTHOR]

In medicine, racial differences are frequently presented as part of the best explanation of differences in the risk of diseases. The problem of using racial classification in biomedical research has become important because of its ethical consequences in society. However, the biological relevance of the concept of race cannot be established by any ethical argument and the epistemological role of racial categorisation requires clarification. In this paper, different issues related to the concept of race are considered. This paper analyses the semantic problem concerning the definition of race, considers the ontological problem of race, drawing attention to the biological evidence for genetic differences among human groups, and presents a promising epistemological approach to the problem of race. The purpose of the paper is to examine whether, or when, racial categories belong in biological explanations. It shows that the concept of race cannot be justified in biology because it does not lead to successful predictions, and that genetic discontinuities are sufficient to explain differences in diseases but not needed in the explanation. The biomedical field should search for genetic patterns related to diseases, and should not assume racial discontinuities among human groups and use racial clusters as proxies for undetected genetic patterns. [ABSTRACT FROM AUTHOR]

An appreciation of the importance of interactions between microbes and multicellular organisms is currently driving research in biology and biomedicine. Many human diseases involve interactions between the host and the microbiota, so investigating the mechanisms involved is important for human health. Although microbial ecology measurements capture considerable diversity of the communities between individuals, this diversity is highly problematic for reproducible experimental animal models that seek to establish the mechanistic basis for interactions within the overall host-microbial superorganism. Conflicting experimental results may be explained away through unknown differences in the microbiota composition between vivaria or between the microenvironment of different isolated cages. In this position paper, we propose standardised criteria for stabilised and defined experimental animal microbiotas to generate reproducible models of human disease that are suitable for systematic experimentation and are reproducible across different institutions. [ABSTRACT FROM AUTHOR]

Background: Vitamin D receptor (VDR) gene polymorphisms are possibly involved in the development of type 1 diabetes mellitus (T1DM). However, the results to date have been inconclusive. We performed a meta-analysis to examine the association between 2 polymorphisms (FokI and BsmI) of the VDR gene and T1DM in the Asian population. Methods: Literature was retrieved from PubMed, Web of Science, CBM, Embase and Chinese databases. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random or fixed effect model. Results: In total, 20 papers (BsmI: 13 studies; FokI: 13 studies) were included. In contrast to the FokI polymorphism, the BsmI polymorphism was associated with an increased risk of T1DM in the Asian population (OR = 1.47, 95% CI = 1.13–1.91, P = 0.004 for B vs. b). Upon stratification by regional geography, an increased risk of T1DM in association with the BsmI polymorphism was observed in the East Asian population (OR = 1.97, 95% CI = 1.38–2.83, P<0.001 for B vs. b), whereas the FokI polymorphism was associated with an increased risk of T1DM in the West Asian population (OR = 1.45, 95% CI = 1.12–1.88, P = 0.004 for F vs. f). Conclusions: Our meta-analysis suggests that the BsmI polymorphism may be a risk factor for susceptibility to T1DM in the East Asian population, and the FokI polymorphism is associated with an increased risk of T1DM in the West Asian population. However, because the study size was limited, further studies are essential to confirm our results. [ABSTRACT FROM AUTHOR]

Data concerning the effects of phthalate exposure on preterm delivery and fetal growth are limited in humans. In this paper, we assessed the relationship between 15 phthalate levels in cord blood and preterm delivery and fetal growth parameters in 207 Chinese women going into labor. Exposure to phthalates except DCHP was associated with gestational age reduction and preterm delivery (p<0.05). There were associations between phthalates and fetal growth parameters, many of which disappeared when analyses were adjusted for gestational age, especially in male infants (Only DEEP was associated with birth weight; DEP, DNHP, BBP, DNP with abdominal circumference; DEP, DBP, DCHP, DEHP with femur length in female infants. And DPP, DBEP was associated with birth length in male infants. p<0.05). This study indicates that prenatal exposure to phthalates is associated with younger gestational age and preterm delivery. Also, phthalate exposure may adversely affect fetal growth parameters via gestational age reduction and preterm delivery with a significant gender effect. [ABSTRACT FROM AUTHOR]

Background: Infravesical obstruction leads to kidney and bladder dysfunction in a significant proportion of boys. The aim of this review is to determine the value of diagnostic tests for ascertainment of infravesical obstruction in boys. Methodology: We searched PubMed and EMBASE databases until January 1, 2013, to identify papers that described original diagnostic accuracy research for infravesical obstruction in boys. We extracted information on (1) patient characteristics and clinical presentation of PUV and (2) diagnostic pathway, (3) diagnostic accuracy measures and (4) assessed risk of bias. Principal Findings: We retrieved 15 studies describing various diagnostic pathways in 1,189 boys suspected for infravesical obstruction. The included studies reflect a broad clinical spectrum of patients, but all failed to present a standardised approach to confirm the presence and severity of obstruction. The risk of bias of included studies is rather high due to work-up bias and missing data. Conclusions: As a consequence of low quality of methods of the available studies we put little confidence in the reported estimates for the diagnostic accuracy of US, VCUG and new additional tests for ruling in or ruling out infravesical obstruction. To date, firm evidence to support common diagnostic pathways is lacking. Hence, we are unable to draw conclusions on diagnostic accuracy of tests for infravesical obstruction. In order to be able to standardise the diagnostic pathway for infravesical obstruction, adequate design and transparent reporting is mandatory. [ABSTRACT FROM AUTHOR]

Historical studies and reports on the human body are affected by history and culture, as viewed through what is deemed appropriate by the people of the time. When looking back, the historical memory of a culture also appears to affect the different perspectives that emerge from the common actions, speeches and ideas about social and cultural health processes of the time. In this paper we consider one specific representative issue of these processes: The social representations of health and illness as related to drug advertising of the late nineteenth century, from printed materials, focusing on the dynamics and key features of the advertising process. In this vein, we made efforts to identify the importance of analyzing of advertising documents and images to interpret historical press publications from Mexico in the nineteenth century. [ABSTRACT FROM AUTHOR]

The expression of HDAC2 is reported as reduced in chronic obstructive pulmonary disease (COPD). We assessed HDAC2 expression within the airways of smokers and subjects with COPD and effects of inhaled corticosteroids (ICS), using immuno-histology to contrast with previous molecular methodology. Endobronchial biopsies (ebb) from current smokers with COPD (COPD-CS; n = 15), ex-smokers with COPD (COPD-ES; n = 17), smokers with normal lung function (NS; n = 16) and normal controls (NC; n = 9) were immunostained for HDAC2. A double-blinded, randomized, placebo-controlled 6 months intervention study assessed effects of ICS on HDAC2 in 34 COPD subjects. There was no difference in epithelial HDAC2 staining in all groups. There was a significant reduction in total cell numbers in the lamina propria (LP) in COPD-CS and NS (p<0.05). LP cellularity correlated inversely with smoking history in COPD-CS (R = −0.8, p<0.003). HDAC2 expression increased markedly in NS (p<0.001); in contrast COPD-CS was associated with suppressed signal (p<0.03), while normal in COPD-ES. ICS did not affect HDAC2 cell staining. Our findings suggest that airway HDAC2 expression is increased in the LP by smoking itself, but is reduced in COPD. Ex-smokers have normalised HDAC2 cell expression, but ICS had no effect. The paper emphasise the pit-falls of relying on molecular data alone to define airway changes. Clinical Trial Registration Information: Name of registry: The Australian New Zealand Clinical Trials Registry (ANZCTR) Registry number: ACTRN12612001111864 [ABSTRACT FROM AUTHOR]

Background: Although maternal mortality has become a major focus on global public health agenda, maternal morbidity is a neglected area of research. The purpose of this paper is to present the burden of acute maternal illness during pregnancy. Methods: A cross sectional study was carried out in Anuradhapura district, Sri Lanka. Pregnant women residing in the Anuradhapura district with a gestational age more than 24 weeks through 36 weeks were recruited to the study using a two-stage cluster sampling technique. All pregnant women who consented participated in a detailed interview using a structured questionnaire. Self reported episodes of acute illness during pregnancy were the main outcome measures. Secondary outcomes were utilization of medical services and frequency of hospitalizations. Results: Nausea and vomiting during pregnancy (NVP) was experienced by 325 (69.7%) of the 466 pregnant women studied. Other common symptoms were backache (152, 32.6%), dizziness (112, 24.0%) and heartburn/regurgitation (107, 23.0%). Of the 421 pregnant women who reported ill health conditions 260 (61.8%) women sought medical treatment for these illnesses. Total number of episodes that needed treatment seeking were 373. Hospitalizations were reported by 83 (17.8%) pregnant women and the total number of hospitalizations was 109. The leading cause of hospitalization was NVP which accounted for 43.1% of total admissions and 49.1% of total days spent in hospitals. Conclusions: Minor maternal ill health conditions affecting day-to-day life have a major burden on pregnancy period. Evidence based management guidelines and health promotion strategies are needed to control and prevent these conditions, in order to provide comprehensive, good quality maternal health care. [ABSTRACT FROM AUTHOR]

Background: Until recently, mathematical models of person to person infectious diseases transmission had to make assumptions on transmissions enabled by personal contacts by estimating the so-called WAIFW-matrix. In order to better inform such estimates, a population based contact survey has been carried out in Belgium over the period March-May 2006. In contrast to other European surveys conducted simultaneously, each respondent recorded contacts over two days. Special attention was given to holiday periods, and respondents with large numbers of professional contacts. Methods: Participants kept a paper diary with information on their contacts over two different days. A contact was defined as a two-way conversation of at least three words in each others proximity. The contact information included the age of the contact, gender, location, duration, frequency, and whether or not touching was involved. For data analysis, we used association rules and classification trees. Weighted generalized estimating equations were used to analyze contact frequency while accounting for the correlation between contacts reported on the two different days. A contact surface, expressing the average number of contacts between persons of different ages was obtained by a bivariate smoothing approach and the relation to the so-called next-generation matrix was established. Results: People mostly mixed with people of similar age, or with their offspring, their parents and their grandparents. By imputing professional contacts, the average number of daily contacts increased from 11.84 to 15.70. The number of reported contacts depended heavily on the household size, class size for children and number of professional contacts for adults. Adults living with children had on average 2 daily contacts more than adults living without children. In the holiday period, the daily contact frequency for children and adolescents decreased with about 19% while a similar observation is made for adults in the weekend. These findings can be used to estimate the impact of school closure. Conclusion: We conducted a diary based contact survey in Belgium to gain insights in social interactions relevant to the spread of infectious diseases. The resulting contact patterns are useful to improve estimating crucial parameters for infectious disease transmission models. [ABSTRACT FROM AUTHOR]

In recent years, currently, we come to grip with „aflutter little child“ which, forth somatic disorders, present also hyperactivity, inattention, and social interaction deficits and communication disorders. At this age group, currently, we find symptoms which did not fit with classical clinical features of Autism (described by Leo Kanner) neither with ADHD (Attention Deficit Hyperactivity Disorder). For these reasons appear a lot of differential diagnostic problems between ADHD and ASD (Autism Spectrum Disorder, expression used by Baron-Cohen for Pervasive Developmental Disorder), disorders with an increase of incidence in the last years. All this generate a lot of questions for nosological enframe: ADHD, TSA, ADHD co-morbid with TSA, or a new disorder? In our paper we make a review of recent epidemiology and aetiology aspects because in the last years there is an important concern for the increase of prevalence and incidence of these two disorders. We wish to emphasize that early identification and intervention allows the elaboration of some targeted therapeutically strategies, psychotherapeutic and pharmacological, adapted to each child, with increased efficiency. [ABSTRACT FROM AUTHOR]

This paper summarises the common modalities that are available for researching ancient medicine and disease as well as explaining how some of these sources have survived to modern day. These are explained under the three broad headings of palceopathology, artefacts, and texts. The descriptions use a variety of examples from ancient societies including in the Bronze Age, Babylonia and Assyria, ancient Egypt, ancient Greece, and ancient Rome to help explain these modalities. In addition, a review of the advantages and disadvantages of using these tools is included to help current and future historians in stimulating future research in this fascinating area. [ABSTRACT FROM AUTHOR]

The application of a medical guideline to the treatment of a patient's disease can be seen as the execution of tasks, sequentially or in parallel, in the face of patient data. It has been shown that many of such guidelines can be represented as a ‘network of tasks,’ that is, as a sequence of steps that have a specific function or goal. In this paper, a novel methodology for verifying the quality of such guidelines is introduced. To investigate the quality of such guidelines, we propose to include medical background knowledge to task networks and to formalize criteria for good medical practice that a guideline should comply with. This framework was successfully applied to a guideline dealing with the management of diabetes mellitus type 2 by using KIV. [ABSTRACT FROM AUTHOR]

Always have been told that: there is not tiny enemies, this statement couldn't be more true when we are talking about the fight between the body and different pathogen agents, cellular mutations, and dangerous substances. Right now our knowledge allow us to handle the matter at nanoscale (1/1.000'000.000 m) sizes. The nanotechnology develop this knowledge and be able to improve things as new materials, small amount of material to build devices, better performance with maximal efficiency of devices, and others [1], [2]. Using nanotechnology to solve health problems is call nanomedicine [2], [3]. This paper review nanotechnologic develops apply to diseases with high mortality and treatments that doesn't solve the problem deeply they just handle the disease with partial solutions. Therefore, nanomedicine will have greater impact in the future, improving the health issues of humanity. [ABSTRACT FROM AUTHOR]

The need to restrain service users will vary according to the area of practice within which practitioners are employed. Many of the principles that relate to the issue of restraining service users are, however, applicable to all, or most, health and social care settings. While the emphasis should be on pre-emptive action, wherever possible, in order to prevent the need to restrain, there are some occasions on which the risks to the service user, or others, of inaction may outweigh those of taking action. Some of the key issues are discussed in this paper. [ABSTRACT FROM AUTHOR]

This paper examines the social construction of diagnosis and illness in several ways. First, I discuss the centrality of social construction in medical sociology. Next I discuss the major role of diagnosis in social construction, leading to the need for a sociology of diagnosis. I emphasize controversial and conflictual diagnoses, as a first step toward a more general sociology of diagnosis. Then I put forth a typology of social construction, involving four combinations based on whether a condition is generally accepted and whether a biomedical definition is applied. Next I detail a series of stages in the social construction of a condition. In that process, my primary concern is the initial social discovery, which is essentially a matter of diagnosis, with a secondary emphasis on illness experience. This is followed by stages of treatment and outcome, which recursively affect social construction. I conclude by noting the health policy implications of the social constructionist perspective. [ABSTRACT FROM AUTHOR]