RHC 2010;1(1)3-5

Editorial

Silvia Maina 1, Mario Di Napoli 2

1 Editor, SEEd Medical Publishers

2 UOC Neurologia. Ospedale Generale Provinciale San Camillo de’ Lellis, Rieti

The speed of advancement is breathtaking in the world of modern science and technology. This aspect is also more evident in medicine. The increasingly rapid progression of medical discovery on the one hand, and the abundance and complexity of scientific information on the other, make difficult, if not impossible, to stay up to date in every medical discipline. Nevertheless, in this era of world wide web-accessible information, the ethologist Kornad Lorenz’s words, in his book on the natural history of human knowledge (1977), sound as appropriate to the present status of scientific information and knowledge: “The specialist comes to know more and more about less and less, until finally he knows everything about a mere nothing. There is a serious danger that the specialist, forced to compete with his colleagues in acquiring more and more specialized knowledge, will become more and more ignorant about other branches of knowledge, until he is utterly incapable of forming any judgment on the role and importance of his own sphere within the context of human knowledge as a whole.”

In some way, Lorenz’s words can be applied to current medicine. Obviously, focus expertise has some clear advantages. Specialised physicians with more training, knowledge and technical skills may be more efficient at clinical problem solving, with better outcomes for the patients. However, excessive and narrow subspecialisation may yield fragmented care. Furthermore, the traditional separation between medical fields has caused very little incentive to see what other specialists are doing outside. At the same time speciality journals give a little space to other specialities because they guard the frontiers of their own speciality so that the so-called grey areas are not encroached by others with the attempt to establish hegemony or monopoly.

We firmly believe that there is a clear need for the scientific community, to bridge the gap between medical disciplines. This is the main goal of Reviews in Health Care published quarterly by SEEd Medical Publishers.

To keep the specialities together is another purpose of this journal: to establish a harmonious balance between specialities so that the researchers in the different fields are aware of the need of the clinicians, and clinicians in turn are kept abreast of the frontiers of research. Our generation has seen the disintegration of medical disciplines and we did not like it. While in a romantic way medicine should have looked like a proud mother of so many outstanding superspecialities, today she appears as a weak, osteoporotic, depressed, and anaemic old lady! Yes, we are all in favour of strengthening of subspecialities, but we should consider that a healthy body and completely, a sick body, works as one unit and not as the sum of different organs and systems. Through publication, decisions and policies that maintain high standards and that establish this journal’s multidisciplinary taste, the editor should be able to encourage the readers to develop the same taste.

This new general medical journal will provide comprehensive coverage of a broad range of medical fields, to ensure an update on advances across the whole spectrum of healthcare disciplines. Its coverage includes all aspects of clinical practice: new drugs and prospects of treatment, emerging diseases, economic analyses, new technologies, surgical procedures, laboratory methodologies and techniques, epidemiologic studies, testing and clinical use of devices, diagnostic technologies and their performances in clinical practice. Technology today can fix things without touching them and touch things without seeing them. To evaluate newer technology and see whether it is truly beneficial or yet another attempt at clever repackaging of an old and obsolete idea. Opening our mind to what is good, yet closing our doors to what is not, is surely one of the most difficult jobs for everyone in our clinical practice.

The aim is to create a link between medical disciplines, sharing innovations, experiences, expertise, point-of-views. The readers audience of Reviews in Health Care is ample. This journal is ideal for academic physicians working in a specific fields, as well as clinicians interested in brief updates in different medical fields, and general practitioners who are interested in the translation of basic findings into their own clinical practice.

The journal will publish reviews on all areas of medicine. Primarily systematic reviews – better suitable for focused topics – whose rigorous approach allows to systematically search, identify, and summarise the available evidence, with particular attention to methodological quality. Then, narrative reviews – better suitable for comprehensive topics – which give the opportunity to speak with self-knowledge, reflective practice and acknowledgment. The international Editorial Board, constituted by experts in their own field, will work with the main goal to help the readers who have carefully built a foundation of scientific knowledge and strive to keep that knowledge base current by reading professional, scientific literature. The process and value of editorial peer review will be enlightening and reassuring to the individual practitioners clinicians and researchers about the scientific quality of the articles published in the journal. This is the formal engagement of the Editorial Board with all the readers of Reviews in Health Care.

Now, some practical aspect about the journal. Each issue can be read totally, to find out what is new or what is discussed in the different fields. It can be split into articles, reading only that mostly capture the attention. Everyone can read either an issue with the aim of learning something in a medical discipline one hardly knows, either can read to analyse thoroughly a topic that is essential for the everyday clinical practice, or can read for the pleasure to read a good well-written and interesting article to enlarge own medical culture and natural curiosity. Each review can be studied in detail, to find clear and comprehensive information about a drug, a device, a disease. There is also a thought for all busy physicians: a quick look can be sufficient, to find the answer to a focused or relevant clinical question: searching the final box The review in brief at the end of any article. This further effort by the Authors and Editors will help the less attentive but probably more busy readers to obtain the right response to their doubts.

In addition, Reviews in Health Care will also have its public arena. This arena will be on the journal’s website where commentary from Readers, Authors and Collaborators will be published regularly to stimulate the discussion among experts in various fields.

Finally, at the end of this chat with the readers we hope that they will appreciate our efforts, and will join us in reading papers, discussing topics, suggesting important subjects, or sending their own contributions to growing together in this intellectual stimulating adventure that is the born of a new journal.

Featured in this Issue

Efficacy and safety of new oral anticoagulants in prophylaxis and treatment of venous thromboembolism (VET)

  • Medical area. Orthopaedics, internal medicine, geriatrics, cardiology, general medicine, physical medicine and rehabilitation.
  • Why is a review on this topic needed? Recently published articles and ongoing trials suggest that the new oral anticoagulant agents could soon be used in several types of patients and medical conditions (atrial fibrillation, and prophylaxis and acute treatment of VET in surgical and non-surgical conditions). Since the enormous amount of patients included, it is essential to describe the efficacy and safety data available up to today.
  • Key message. The new anticoagulant drugs are as safe and efficacious in prophylaxis and treatment of VET as the standard medications.

Prevalence of influenza vaccination among physicians and related enhancing and preventing factors in Italy

  • Medical area. Public health and prevention.
  • Why is a review on this topic needed? To assess the attitude in Italy towards influenza vaccination in healthcare workers, and the reasons behind it.
  • Key message. Current vaccination coverage in healthcare workers is insufficient and the reasons bought are worrying, showing a serious lack of information.

The role of combined multichannel intraluminal impedance and pH-monitoring in newborn with gastroesophageal reflux disease (GERD)

  • Medical area. Neonatology.
  • Why is a review on this topic needed? Multichannel Intraluminal Impedance associated with esophageal pH-monitoring (MII/pH) has been recently introduced to study GERD, useful both in research and in clinical practice. This technique is proving very useful in paediatrics, especially to study the effects of gastrointestinal reflux in infants. This review analyses the main available data about the use of MII/pH in neonatal GERD.
  • Key message. Multichannel MII/pH allows the identification of refluxes independently from their pH. This technique is especially useful in neonates, in which non acid-refluxes result prevalent. It can be used in combination with other techniques to evaluate the presence of an association the evaluation of the temporal relation between refluxes and symptoms and in the analysis of the benefits obtained by pharmacological and non-pharmacological therapy.

Use of herbal medicines in children following Evidence Based Medicine (EBM) criteria. Effectiveness, and tolerability of echinacea, cranberry and chamomile

  • Medical area. Complementary and Alternative Medicine (CAM).
  • Why is a review on this topic needed? Several statistic and epidemiological surveys highlight that the use of complementary and alternative medicine is very widespread among the population of most of the western countries. This use is often associated with self-prescription, without any kind of medical control.
  • Key message. Independently from the prescriptive trends and the consent on the efficacy of CAM, it is essential that clinicians are aware of the scientific criteria and requirements of phytotherapic remedies. Furthermore they need to have a deep knowledge of their clinical applications, pharmacology, dosage, possible contraindications and precautions. This is even more important in paediatric age.

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