Formulating questions and locating primary studies for inclusion in systematic reviews

Much time and effort are spent on designing primary research studies. Similar care must be given to planning systematic reviews. The review should be based on an important, well-focused question that is relevant to patient care. By formulating the question properly, the criteria that primary studies must meet to be included in the review become clear. These criteria, which comprise the types of persons involved, exposure, control group, outcomes, and study designs of interest, can then be refined so that they are clinically relevant, sensible, and workable. Inclusion criteria that are too narrow will limit the amount of data in the review, thereby increasing the risk for chance results and making the review less useful for the reader. Reviews should include studies whose designs offer the least biased answer to the question being asked. To maximize available data and reduce the risk for bias, as many relevant studies as possible need to be identified, regardless of publication status or language. Multiple overlapping search strategies should therefore be used and must be carefully planned. Strategies include searching the many electronic databases available (after careful consideration of which terms to enter), manually searching journals and conference proceedings, searching bibliographies of articles, searching existing registers of studies, and contacting companies or researchers. The time taken to formulate the question adequately and develop appropriate searches will increase the chance of producing a high-quality, meaningful review.     

Biochemical alterations of the tunica albuginea in impotence

PURPOSE: The objectives of this study were to quantify the immunohistochemical stainings of collagen types I, III and IV, and investigate the value of glycohistochemical staining with 3 lectin types specific to a particular glycan structure, Arachis hypogaea, Triticum vulgare and concanavalin A, as a method of defining possible changes in the collagen structure of the tunica albuginea in potent and impotent patients. MATERIALS AND METHODS: The study involved 4 normal men, 4 with pure venous leakage and 4 with pure arterial disease. Collagen types I, III and IV, and lectins Arachis hypogaea, Triticum vulgare and concanavalin A were studied using a cell image processor. The labeling index relates to the percentage of staining and mean optical density relates to the staining intensity. RESULTS: Mean labeling index values for the 3 types of collagen and lectins were similar (p > 0.05). Mean optical density value relating to collagen type I was significantly higher in the arteriogenic group than in the other groups (p < 0.05), while mean optical density value of collagen type IV was significantly higher in the venogenic group than in the 2 other groups (p < 0.05). Mean optical density values relating to the 3 lectin types were similar in the 3 clinical groups (p > 0.05). CONCLUSIONS: An alteration in the distribution and structure of the various collagen types and lectins in the tunica albuginea of impotent patients has been shown that may interfere with normal function and lead to impotence.     

Determination of dissociation constants of loop diuretics in acetonitrile-water mixtures

The dissociation pK values of the representative loop diuretics furosemide, bumetanide and ethacrynic acid in 10, 30, 40, 50 and 70% (w/w) acetonitrile-water mixtures at 298.15 K were determined, according to the rules and procedures endorsed by IUPAC. The variation in pK values over the whole composition range studied can be explained by tacking into account the preferential solvation of ionizable substances in acetonitrile-water mixtures. With a view to determining the pK values of the loop diuretics studied in any of the binary solvent acetonitrile-water mixtures, correlations of pK values and different bulk properties of the solvent were examined, and the linear solvation energy relationships method, LSER, has been applied. The pK values were then correlated with the pi*, alpha and beta solvatochromic parameters of acetonitrile-water mixtures. The resulting equations allowed us to calculate pK values for the loop diuretics in any acetonitrile-water mixture up to 70% (w/w) acetonitrile.     

Synthesis and characterization of molybdenum disulphide formed from ammonium tetrathiomolybdate

An investigation has been carried out into the possibility of in situ formation of MoS2 within porous anodic films on aluminium, to improve subsequent tribological behaviour, by re-anodizing in thiomolybdate electrolyte. Acidification of thiomolybdate was employed to simulate the conditions for formation of the sulphide at the anodic film/electrolyte interface, followed by appropriate vacuum heat treatments to study possible temperature effects on the sulphide due to either friction or Joule heating during anodizing. The products of both acidification and heat treatment, characterized by X-ray powder diffraction and scanning electron microscopy, were compared with those formed by direct thermal decomposition of ammonium tetrathiomolybdate crystals. The precipitate formed by acidification was mainly amorphous molybdenum trisulphide (MoS3), which on heat treatment at 450 and 850°C yielded 3R-MoS2. 3R-MoS2 also formed by the thermal decomposition of thiomolybdate crystals. Thermogravimetric and differential thermal analyses showed that the decomposition of MoS3 to MoS2 occurred in the range 220–370°C and revealed the sequence of reaction steps. The findings suggest that mainly amorphous MoS3 is formed as a consequence of changes in the pH of the film/electrolyte interface during re-anodizing but the product is relatively easily transformed to crystalline MoS2 on moderate heating which may occur during wear processes.     

Real and virtual borders in the Poggendorff illusion

The strength of the Poggendorff illusion has been determined by a nulling method for the classical as well as other configurations of the central inducing region. Compared to a uniform field, an inducing rectangle with very low contrast produces a marked illusion, which saturates at a Michelson contrast of about 0.1. With virtual borders of the Kanizsa type there is a weak illusion and this effect is attenuated when the 'pacman' sectors are occluded. Texture borders without luminance contrast induce a stronger illusion. These results are discussed in relation to earlier data for contrast dependence of Vernier acuity and for the orientation discrimination and tilt illusion with real and virtual borders.     

Induced abortion in a Swiss canton from 1990 to 1993: implications for epidemiological surveillance

BACKGROUND: To describe abortion utilization in the Canton of Vaud (Switzerland) and to identify desirable changes in the data collection system to improve the epidemiologic monitoring METHODS: Retrospective survey of the 5600 abortion requests to the Canton Health Authority for resident women between 1990 and 1993. RESULTS: Nine women out of 1000 residents requested an abortion, but the abortion rate was higher among women of foreign origin compared to Swiss women (17/1000 vs. 6/1000, p < 0.0001). The proportion of terminated recognized conceptions was 127/1000, and the ratio of IVG to livebirths was 0.18. The abortion rate was lower during adolescence (6/1000) or after 40 years of age (1.8/1000), whereas the proportion of terminated conceptions was highest at these ages (527/1000 and 312/1000). Abortion utilization in Canton of Vaud is among the lowest. CONCLUSIONS: Although these indicators do reflect a satisfactory accessibility and use of family planning services, improvements could be made. A better knowledge of the causes (motives, contraceptive method, reproductive history) and of the consequences of abortion (psycho-social implications, medical complications) would allow to design more focused prevention strategies and to fit health services to current needs. Updating the 1942 Swiss legislation is also desirable.     

Bladder pseudotumor in childhood

The application of frozen and radiation sterilized allogenic bone grafts for reconstructions in orthopaedic operations is described. Analysis of results of treatment of 1125 patients was performed. It was found that use of preserved bone allows to reduce the extend and duration of surgery. Nearly total substitution of grafts may be seen in 3 to 8 months after surgery.