International Journal of Risk & Safety in Medicine - Volume 14, issue 3-4
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The International Journal of Risk and Safety in Medicine is concerned with rendering the practice of medicine as safe as it can be; that involves promoting the highest possible quality of care, but also examining how those risks which are inevitable can be contained and managed.
This is not exclusively a drugs journal. Recently it was decided to include in the subtitle of the journal three items to better indicate the scope of the journal, i.e. patient safety, pharmacovigilance and liability and the Editorial Board was adjusted accordingly. For each of these sections an Associate Editor was invited. We especially want to emphasize patient safety. Our journal wants to publish high quality interdisciplinary papers related to patient safety, not the ones for domain specialists. For quite some time we have also been devoting some pages in every issue to what we simply call WHO news. This affinity with WHO underlines both the International character of the journal and the subject matter we want to cover. Basic research, reports of clinical experience and overviews will all be considered for publication, but since major reviews of the literature are often written at the invitation of the Editorial Board it is generally advisable to consult with the Editor in advance. Submission of news items will be appreciated, as will be the contribution of letters on topics which have been dealt with in the journal.
Abstract: Non‐insulin dependent diabetes mellitus appears to be increasing in prevalence in most developing and developed countries. The Maltese population has been identified as having a high prevalence for NIDDM, this high rate apparently becoming of concern during the twentieth century. Objective: The study attempts to analyse the cause‐specific mortality trends from diabetes mellitus in the Maltese population during the period 1873–1999. Results: A definite gradual increase in cause‐specific mortality rates has been identified throughout the late nineteenth and twentieth century, this rise being offset by the social upheaval of the Second World War. A fall in cause‐specific mortality…rates appears to have occurred in the last two decades of the period. Conclusions: The rising cause‐mortality rates probably reflect a trend in an increasing prevalence rate for NIDDM caused by significant changes in the dietary regimen of the population during the period. A fugal diet predisposed the Maltese population to a Thrifty Genotype that was offset by an increasing abundance of fat and refined carbohydrate diet. In the presence of an abundant diet, individuals with a Thrifty Genotype predispose to obesity, insulin resistance and NIDDM disorders.
Abstract: Gestational Impaired Glucose Tolerance (G‐IGT) is generally assumed to be of no significance to the developing fetus. The present study, comparing the fetal characteristics of 28 infants born to G‐IGT mothers with those of 237 infants born to mothers with normal glucose tolerance, confirms that G‐IGT has no effects on the anthropomorphic characteristics of the newborn infant. However, the mild carbohydrate disorder is shown to affect adversely the intrauterine millieu interieur causing a mild derangement to the fetal pancreatic beta cells.
Keywords: Diabetes and pregnancy, glucose intolerance, perinatal outcome
Abstract: From the humanistic perspective of the social sciences, the most complex task in evidence‐based medicine lies in the communication of specialized medical knowledge to non‐professionals. Information is never simply the neutral transmission of facts, even when dealing with scientific knowledge and research. It is always interpreted and evaluated from a particular perspective in a specific context. That information can be neutral is thus a myth. In all medical consultations the process of communication is not just a matter of transmitting information from one who knows to one who does not. Knowledge created and disseminated in a scientific context is thus…recontextualised, first in a clinical situation and then as an interpreted version in people's real lives. Furthermore there are difficulties when practice must be based on current research, in a situation in which no prior clinical experience exists and in which results are interpreted and used regardless of the degree of certainty provided by current evidence.
Abstract: The Swedish Medical Birth Registry was used for the monitoring of maternal drug usage in early pregnancy and the occurrence of congenital malformations in infants. An association between maternal use of the anti‐allergic drug loratadine and infant hypospadias was noticed. Continued monitoring suggested that this was probably not a chance phenomenon, but a biological mechanism which could explain the association is unknown. Comparisons with the outcome after exposure for other anti‐allergic drugs suggested a drug specificity.