There has been a great advance in the pharmacognosy field, which has increased the use of medicinal plants by health professionals and practitioners of folk medicine. This systematic review explored the history and the present day application of phytotherapeutic medicines. We searched the databases Cochrane Library, Embase, Lilacs, PubMed, Scielo and a specialized bibliography. We concluded that there are many therapeutic potentialities in the use of phytotherapeutic medicines and medicinal plants. We also concluded that despite the increasing number of publications in the field each year, there is still a lack of reviews and meta-analyses that could promote a better integration of the knowledge produced. In addition, research about pharmacological interactions and multidisciplinary studies may promote a quicker and safer process from the workbench up to the clinical trials.Keywords: medicine history, herbal medicine, primitive medicine, phytotherapy. RESUMO: Fitoterapia: introdução a sua história, uso e aplicação. Diante do avanço que vem ocorrendo na área da farmacognosia, decorrente do aumento do uso de plantas medicinais na medicina popular e por profissionais da saúde, este trabalho apresenta uma revisão sistemática sobre a história dos fitoterápicos e sobre sua aplicação na atualidade. Foram realizadas buscas nas bases de dados Cochrane Library, Embase, Lilacs, PubMed, Scielo e em bibliografia especializada. Concluiu-se que, apesar da quantidade de estudos publicados crescer a cada ano, há ainda escassez de revisões e meta-análises que promovam melhor integração do conhecimento produzido. Pesquisas contemplando interações farmacológicas e trabalhos multidisciplinares podem acelerar os estudos em bases mais seguras, desde a bancada até os ensaios clínicos.Palavras-chave: história da medicina, ervas medicinais, medicina primitiva, fitoterapia.

Objective: To describe the natural history of vitamin D deficiency in an at‐risk population of African migrants living in Sydney. Design, setting and participants: Opportunistic study of 25‐hydroxyvitamin D [25(OH)D] concentrations over time in a community‐based cohort of North African refugee families living in south‐western Sydney. As part of a health‐screening program, serum concentrations of 25(OH)D, parathyroid hormone (PTH), calcium, phosphate (PO4) and alkaline phosphatase (ALP) were measured in September 2006 (end of winter, T1). Results for 25(OH)D were made available, and treatment was recommended as appropriate. In February–March 2007 (end of summer, T2), in the setting of a separate study of high‐dose vitamin D (stoss) therapy, the same cohort was contacted, and measurements were repeated. Main outcome measures: Changes in 25(OH)D, PTH, ALP and PO4 concentrations between T1 and T2 in those who had not received vitamin D supplementation in the intervening period. Results: We collected data from 149 participants at T1; by T2, 58 participants (39%) had been excluded or lost to follow‐up. Data from 91 participants (46% female), all of whom had Type VI (very dark) skin pigmentation, were included in the analysis. All 91 were 25(OH)D deficient at T1. Between T1 and T2, mean 25(OH)D serum concentration increased from 19 nmol/L (SD, 5.6 nmol/L) to 36 nmol/L (SD, 12.4 nmol/L) (P< 0.001). Of the 91 participants, 79 (87%) remained vitamin D deficient at T2. Serum PTH and ALP activity decreased between T1 and T2 (P< 0.05). Conclusion: Despite a significant increase in 25(OH)D serum concentration over the study period, most participants (87%) remained 25(OH)D deficient at the end of summer. Our results support the current consensus that recommends annual screening for vitamin D deficiency and routine vitamin D supplementation in at‐risk populations, such as dark‐skinned or veiled groups.

Post-exposure immunisation remains an effective tool for preventing secondary cases of measles.

Objective: To compare the reliability and validity of two classification systems used to evaluate the quality of mammograms: PGMI ('perfect', 'good', 'moderate' and 'inadequate') and EAR ('excellent', 'acceptable' and 'repeat'). Setting: New South Wales (Australia) population-based mammography screening programme (BreastScreen NSW). Methods: Thirty sets of mammograms were rated by 21 radiographers and an expert panel. PGMI and EAR criteria were used to assign ratings to the medio-lateral oblique (MLO) and cranio-caudal (CC) views for each set of films. Inter-observer reliability and criterion validity (compared with expert panel ratings) were assessed using mean weighted observed agreement and kappa statistics. Results: Reliability: Kappa values for both classification systems were low (0.01-0.17). PGMI produced significantly higher values than EAR. Agreement between raters was higher using PGMI than EAR for the MLO view (77% versus 74%, Po0.05), but was similar for the CC view. Dichotomized ratings ('acceptable' or 'needs repeating') did not improve reliability estimates. Validity: Kappa values between raters and the reference standard were low for both classification systems (0.05-0.15). Agreement between raters and the reference standard was higher using PGMI than EAR for the MLO view (74% versus 63%), but was similar for the CC view. Dichotomized ratings of the MLO view showed slightly higher observer agreement. Conclusions: Both PGMI and EAR have poor reliability and validity in evaluating mammogram quality. EAR is not a suitable alternative to PGMI, which must be improved if it is to be useful. The objective of population mammography screening is the early detection of breast cancer and consequent reduction in breast cancer mortality.1-3 Consistent production of high-quality mammograms that allow optimal visualization of breast tissue is critical to the success of screening programmes. Constant case-by-case assessment of mammogram quality, with immediate corrective measures and repeat imaging where required, is a feature of a highquality screening programme. 4 Evaluation of image quality is also essential in mammography training programmes in order to facilitate the development of standards of excellence, both during training and in subsequent practice. 5Mammogram quality is affected by the positioning of the breast, which determines the amount of breast tissue included on the film, and by imaging technique, which produces, records and displays the differing breast tissue components. 6 The criteria for assessing mammogram quality have previously been identified. 4,7,8 Criteria used to assess breast positioning relate to adequate visualization of the pectoral muscle and inframammary fold, profiling of the nipple, and spreading of the glandular tissue. 4,7 Criteria used to assess the imaging technique relate to mammographic equipment, film and its processing, and include optical density, contrast, image sharpness, breast compression, processing and film artefacts. 4,6 Inadequate film density has been f...

Objectives: To compare proportions of kindergarten children in Auburn presenting School Immunisation Certificates (SIC) or other school‐entry immunisation documentation over time, and to examine the immunisation status of these children. Methods: Immunisation records of kindergarten children enrolled in all primary schools in the Auburn local government area were reviewed in 1994 and 1998. Results: Eight hundred and thirty‐three and 737 school entry records of children enrolled in kindergarten were reviewed in 1998 and 1994 respectively. There was no change in the overall proportion of children with immunisation documentation and SICs. Sixty‐nine per cent (571/833) of children had SICs in 1998, compared with 72% (531/737) in 1994. Thirteen per cent of children had other immunisation documentation in 1998, compared with 11 % in 1994. The proportion of invalid certificates fell from 39.2% in 1994 to 12.6% in 1998 (p<0.001). The 1998 survey indicated that 80.2% of children provided a certificate indicating they were completely immunised compared with 56.7% in 1994 (p<0.001). Implications: Although SICs play an important role in promoting the importance of immunisation among parents and in the school community, there continues to be a substantial number of children whose immunisation status is unknown. In the event of an outbreak, an effective public health response may need to incorporate the use of additional objective measures, such as the Australian Childhood Immunisation Register or personal health records.