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Biomedical subjects

B Allen

Publications and source records attributed to B Allen.

At least 55 records · Page 3Linked to original sources
PubMed1996

MAGIC: an experimental system for generating multimedia briefings about post-bypass patient status.

We describe MAGIC, an experimental system for generating multimedia briefings about the clinical status of post-bypass patients entering a cardiac ICU. MAGIC is a distributed system whose components use knowledge-based techniques for planning and generating briefings in text, speech, and graphics. These briefings are coordinated together by reasoning with dynamically generated temporal and spatial constraints. Formative evaluation using system mock-ups with ICU nurses and residents have been used to determine the general format and content of these briefings. We present an overview of MAGIC's architecture and show what it can currently generate.

Computer Systems↗
PubMed1995

Prescriber guidelines improve initiation of anticoagulation.

OBJECTIVES: To improve the initiation of anticoagulation in patients with thrombotic disorders. DESIGN AND SETTING: We carried out a preliminary audit in 1991, developed and implemented strategies to address identified problems, and followed up with another audit in 1993. Medical records of inpatients at The Royal Melbourne Hospital whose anticoagulation therapy was initiated with heparin (intravenous) in therapeutic doses and subsequently converted to warfarin were prospectively assessed over 19-day periods. INTERVENTION: Pocket-sized laminated prescriber guidelines for initiating anticoagulation were disseminated after publishing the results of the first audit, together with a single prominent display of two posters in series advocating the use of the guidelines. RESULTS: The audits identified 25 eligible patients in 1991 and 27 in 1993. The mean duration of intravenous heparin therapy was reduced from 150 hours in 1991 to 97 hours in 1993 (P < 0.002). The mean delay before initiating warfarin therapy after starting heparin therapy was reduced from 69 hours in 1991 to 21 hours in 1993 (P < 0.002). The mean percentage of time the activated partial thromboplastin time was within the therapeutic range increased from 30% in 1991 to 44% in 1993 (P < 0.05) and was above the therapeutic range increased from 13% in 1991 to 24% in 1993 (P < 0.01). Although the number of adverse events was too small to draw definitive conclusions, no difference in adverse haemorrhagic effects was noted between the 1991 and 1993 groups. CONCLUSION: There was an improvement in the initiation of anticoagulation and we hypothesise that this was most likely due to a broad acceptance of the guidelines into clinical practice.

Attitude of Health Personnel↗
PubMed1995

Effect of high-lipid high-nitrogen intravenous nutrition on total body nitrogen, visceral protein synthesis and nitrogen balance.

The impact of high-lipid intravenous nutrition (IVN) on selected indices of nitrogen retention following major surgical resection was studied. Twenty-two patients, randomly allocated to two equal well matched groups, received either high-lipid IVN (75 per cent non-protein calories supplied as lipid) or isocaloric isonitrogenous glucose IVN (100 per cent non-protein calories supplied as glucose). Total body nitrogen (assessed by in vivo neutron activation analysis), nitrogen balance and levels of circulating proteins were measured. Mean(s.d.) total body nitrogen and fat-free mass decreased (P = 0.04) in patients receiving high-lipid IVN, -109(36) gN and -1.7(0.4) kg respectively, but not in those given glucose-only IVN, 8(43) gN and 0.1(1.0) kg. This small loss of body protein does not appear to be clinically significant because postoperative hospital stay, complication rates and the acute-phase protein response (immunological and visceral) were similar in the two groups.

Body Composition↗
PubMed1994

Total body nitrogen as a predictor of clinical status in anorexia nervosa.

It has been demonstrated that clinical outcome is positively correlated with depletion of total body nitrogen (TBN) and therefore of body protein in certain serious medical conditions such as cystic fibrosis or patients receiving dialysis for chronic renal failure. Patients with anorexia nervosa are not suffering from medical illness per se yet the illness can be chronic and severely debilitating requiring numerous hospitalizations for refeeding and/or management of medical complications. The prediction of chronicity remains an important and difficult issue that this study seeks to address by examining the correlation between several clinical indices in 18 patients suffering from anorexia nervosa with parameters of body composition, namely TBN and percentage body fat. TBN was measured using the technique of in vivo neutron-activation analysis (IVNAA) and expressed as nitrogen index. Percentage body fat was estimated using skinfold measurements. The highest correlation was between nitrogen index and number of hospitalizations (r = -.80). The data support a relationship between depletion of body nitrogen/protein and chronicity in anorexia nervosa.

Adolescent↗
PubMed1994

Invertebrate host-parasite relationships: convergent evolution of a tropomyosin epitope between Schistosoma sp., Fasciola hepatica, and certain pulmonate snails.

Monoclonal antibodies (mAb) directed against Schistosoma mansoni tropomyosin isoform, SMTM (Xu et al. Experimental Parasitology 69, 373-392, 1989), were used to test for cross-reactivity with Biomphalaria glabrata antigens. One mAb (1F10) recognized antigens of 39, 41, and 80 kDa in a snail head/foot antigen preparation but not a hepatopancreas antigen preparation. Another mAb (1C1) cross-reacted with a 39-kDa antigen in the head/foot extract but not in the hepatopancreas extract. Epitope mapping revealed the 1F10 epitope to be between amino acids 135 and 188 of both Bg39 (Dissous et al. Molecular and Biochemical Parasitology 43, 245-256, 1990) and BgTMII (Weston and Kemp, Experimental Parasitology 76, 358-370, 1993), while the 1C1 epitope was located between amino acids 189 and 213 of BgTMII. Various invertebrate species, including members from Trematoda, Pulmonata, Annelida, and Arthropoda, were tested for cross-reactivity with the monoclonal antibodies. While the 1F10 mAb displayed broad invertebrate cross-reactivity, the 1C1 mAb cross-reactivity was restricted to schistosomes, F. hepatica, and the pulmonate snails B. glabrata and Physa sp.

Amino Acid Sequence↗
PubMed1994

Encoding a post-operative coronary artery bypass surgery care plan in the Arden Syntax.

The Arden Syntax for medical logic modules (Arden) was used to test the feasibility of encoding large, complex care plans. The critical portions of an existing paper-based care plan for the management of patients following coronary artery bypass graft (CABG) surgery were encoded in Arden and an X-windows user-interface was developed. The Arden Syntax proved adequate for encoding all of the necessary functions of the care plan. The limitations of the current Arden Syntax and possible additions to Arden are discussed.

Artificial Intelligence↗
PubMed1994

IAIMS and sharing.

The Integrated Academic Information Management System (IAIMS) concept is about sharing resources and information, and about improving the decision-making ability of health care professionals by integrating information. At Columbia-Presbyterian Medical Center, the IAIMS project has established an information architecture based on common, shared computing and networking resources. The institutional computing culture has been changed with increased sharing of information and, consequently, improved quality of information. Several classes of information in the areas of clinical, scholarly, administrative, basic research, and core resources have been identified for better understanding of information responsibility. Technical problems such as heterogeneity on workstation platforms and lack of universal syntactic and semantic standards for health care information exchange still impede inter-institutional sharing of information.

Artificial Intelligence↗