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Query: UMLS:C0036474 (scurvy)
 685 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Scurvy is a thousand-year-old stereotypical disease characterized by apathy, weakness, easy bruising with tiny or large skin hemorrhages, friable bleeding gums, and swollen legs. Untreated patients may die. In the last five centuries sailors and some ships' doctors used oranges and lemons to cure and prevent scurvy, yet university-trained European physicians with no experience of either the disease or its cure by citrus fruits persisted in reviews of the extensive but conflicting literature. In the 20(th) century scurvy was shown to be due to a deficiency of the essential food factor ascorbic acid. This vitamin C was synthesized, and in adequate quantities it completely prevents and completely cures the disease, which is now rare. The protagonist of this medical history was James Lind. His report of a prospective controlled therapeutic trial in 1747 preceded by a half-century the British Navy's prevention and cure of scurvy by citrus fruits. After lime-juice was unwittingly substituted for lemon juice in about 1860, the disease returned, especially among sailors on polar explorations. In recent decades revisionist historians have challenged normative accounts, including that of scurvy, and the historicity of Lind's trial. It is therefore timely to reassess systematically the strengths and weaknesses of the canonical saga.
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PMID:Sailors' scurvy before and after James Lind--a reassessment. 1951 73

Health research serves to answer questions concerning health and to accumulate facts (evidence) required to guide healthcare policy and practice. However, research designs vary and different types of healthcare questions are best answered by different study designs. For example, qualitative studies are best suited for answering questions about experiences and meaning; cross-sectional studies for questions concerning prevalence; cohort studies for questions regarding incidence and prognosis; and randomised controlled trials for questions on prevention and treatment. In each case, one study would rarely yield sufficient evidence on which to reliably base a healthcare decision. An unbiased and transparent summary of all existing studies on a given question (i.e. a systematic review) tells a better story than any one of the included studies taken separately. A systematic review enables producers and users of research to gauge what a new study has contributed to knowledge by setting the study's findings in the context of all previous studies investigating the same question. It is therefore inappropriate to initiate a new study without first conducting a systematic review to find out what can be learnt from existing studies. There is nothing new in taking account of earlier studies in either the design or interpretation of new studies. For example, in the 18th century James Lind conducted a clinical trial followed by a systematic review of contemporary treatments for scurvy; which showed fruits to be an effective treatment for the disease. However, surveys of the peer-reviewed literature continue to provide empirical evidence that systematic reviews are seldom used in the design and interpretation of the findings of new studies. Such indifference to systematic reviews as a research function is unethical, unscientific, and uneconomical. Without systematic reviews, limited resources are very likely to be squandered on ill-conceived research and policies. In order to contribute in enhancing the value of research in Africa, the Pan African Medical Journal will start a new regular column that will highlight priority systematic reviews relevant to the continent.
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PMID:Systematic reviews in context: highlighting systematic reviews relevant to Africa in the Pan African Medical Journal. 2779 77