Search PubMed⌕ Search

Biomedical subjects

D Kalra

Publications and source records attributed to D Kalra.

12 recordsLinked to original sources
PubMed1998

Cardiac remodeling as a consequence and cause of progressive heart failure.

Natural history studies in heart failure have shown that increases in left ventricular (LV) volume and LV mass are directly related to future deterioration in LV performance and a less favorable clinical course. Despite the recognized importance of remodeling in heart failure, very little is known about the basic mechanisms that lead to cardiac remodeling. In this review, we will summarize recent clinical and experimental studies that highlight the importance of the remodeling process during the progression of heart failure. The intent of this review is to provide an integrated view of the mechanisms that contribute to LV remodeling at the cellular level, the myocardial level, and the level of the chamber.

Heart Failure↗
PubMed1998

The role of cytokines in the failing human heart.

Despite repeated attempts to develop a unifying hypothesis that explains the clinical syndrome of heart failure, no single conceptual paradigm has withstood the test of time. In this regard, recent studies have shown that a class of biologically active molecules, generically referred to as cytokines, are overexposed in heart failure. This article will review recent clinical and experimental material that suggest proinflammatory (stress activated) cytokines such as tumor necrosis factor-alpha (TFN-alpha), interleukin-1 (IL-1), and interleukin-6 (IL-6) may play a role in the pathogenesis of congestive heart failure. The scope of this article includes an overview of the biology of cytokines in the heart, as well as review of the clinical studies that have documented elevated levels of cytokines and cytokine receptors in patients with heart failure.

Animals↗
PubMed1998

A CORBA-based integration of distributed electronic healthcare records using the synapses approach.

The ability to exchange in a meaningful, secure, and simple fashion relevant healthcare data about patients is seen as vital in the context of efficient and cost-effective shared or team-based care. The electronic healthcare record (EHCR) lies at the heart of this information exchange, and it follows that there is an urgent need to address the ability to share EHCR's or parts of records between carers and across distributed health information systems. This paper presents the Synapses approach to sharing based on a standardized shared record, the Federated Healthcare Record, which is implemented in an open and flexible manner using the Common Object Request Broker Architecture (CORBA). The architecture of the Federated Healthcare Record is based on the architecture proposed by the Technical Committee 251 of the European Committee for Standardization.

Medical Record Linkage↗
PubMed1995

A portable communicative architecture for electronic healthcare records: the Good European Healthcare Record project (Aim project A2014).

The European Union is supporting research into medical informatics via its Advanced Informatics in Medicine (AIM) program. One of the current AIM projects is the Good European Healthcare Record (GEHR) project. Its objective is to devise an architecture for electronic healthcare records that will enable them to be comprehensive, communicative, and portable to different systems. The work was funded from January 1992 to December 1994. The project team consisted of over 50 personnel representing clinicians, computer scientists, and computer programmers in eight European countries. The partner organizations are Health Data Management Partners (Belgium), Croix Rouge Francaise (France), France Telecom, Association des Medecins et Medicins Dentistes (Luxembourg), Instituto Clinica Geral Zona Norte (Portugal), Medical College of St Bartholomew's Hospital (UK), and SmithKline Beecham (UK). The work of the project has been carried out by three subgroups covering clinical, architecture, and systems aspects. One of the strengths of the project has been that most of the work has been done as collaborations between members of different groups. This has meant that there has been very close contact between clinicians and computer experts. The GEHR project is providing important input into the standardization process in Europe via, for example, PT011 of Working Group 1 of CEN TC/251 (the developing standards for the architecture of healthcare records).

Computer Communication Networks↗
PubMed1994

Electronic health records: the European scene.

Caring for patients' health problems relies increasingly on sharing information between clinical departments and disciplines and with managers. The medical record of the future will need to provide a flexible and shareable framework for recording and analysing the consultation process. The advanced informatics in medicine (AIM) programme seeks to encourage research and development in telemedicine in areas that are beyond the scope of any one country. It includes many European projects attempting to define the best storage and transmission formats for such diverse data types as laboratory results, biosignals, x ray images, and photographs, and in clinical specialties varying from intensive care to medicine for elderly people. One example, the good European health record project, is developing a model architecture for computerised health records across Europe that is capable of operating on a wide variety of computer hardwares and will also be able to communicate with many different information systems. The ultimate European health record will be comprehensive and medicolegally acceptable across clinical domains, hold all data types, and be automatically translated between languages.

Computer Communication Networks↗
PubMed1992

Medical records.

Explore the source record for details and available documents.

Abstracting and Indexing↗
PubMed1985

Horseshoe kidney in one of identical twin girls.

We report on a 5-month-old female twin who presented with urinary tract infection and was found to have a horseshoe kidney. Her identical twin had a normal renal anatomy. There have been only 2 other reports of a horseshoe kidney in monozygotic twins: in 1 instance both twins were affected, while in the other there was discordance.

Diseases in Twins↗
PubMedDate not supplied

Cytokines in heart failure: pathogenetic mechanisms and potential treatment.

Recent studies have shown that patients with heart failure overexpress a class of biologically active molecules, generically referred to as pro-inflammatory cytokines. This article will review recent clinical and experimental material that suggests that pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1), and interleukin-6 (IL-6) may play a role in the pathogenesis of congestive heart failure. In addition, we will review recent studies that suggest that antagonizing cytokines may represent a novel target for heart failure therapy.

Animals↗
PubMedDate not supplied

Information technology for doctors.

Recent advances in information technology will offer clinicians valuable new tools to support the medical management of patients. The most important of these developments is the electronic health-care record itself, which will enable the quick and complete documentation of all clinical consultations, investigation and interventions, using voice or a pen to enter data onto intuitive graphical screen-interfaces. The next generation of systems will offer computerised decision support for a wide range of clinical management problems.

Decision Support Techniques↗