Biomedical subjects

J Fackler

Publications and source records attributed to J Fackler.

4 recordsLinked to original sources

PubMed1996

A real time patient monitoring system on the World Wide Web.

World Wide Web (Web) technology has become increasingly popular and successful, because it uses standard communication protocols and Hyper Text Markup Language(HTML), and is supported on multiple platforms. Innovations such as server push, secure socket layer and Java make it possible to use the Web as the basis for creating monitoring systems of dynamic processes. This paper presents a project, whose goal is to develop a Web based Intelligent on-line Monitoring system for Intensive Care Units (IMI). IMI has been tested and evaluated in an intensive care unit since October 1995, and the results are promising. After presenting the motivations of using Web technology, we present the system structure and the functionality of IMI as well as the testing and evaluation results. Security issues are also addressed.

Computer Communication Networks↗

PubMed1994

Monitor-driven data visualization: SmartDisplay.

Exhaustive display of all available clinical data, particular in data-rich environments like the intensive care unit, can easily overwhelm the ability of clinicians to comprehend the clinical status and evolution of their patients and may reduce their ability to detect pathological trends in a reliable and timely manner. SmartDisplay is a system we have designed that restricts the data sets displayed to time-lines of those parameters that are relevant to the patient context and to the particular care provider. The relevance criteria are provided by monitoring programs which may range in complexity from simple threshold alarms to full-fledged diagnostic engines. SmartDisplay can specify which parameters to display and the time intervals during which they should be displayed.

Data Display↗

PubMed1993

Endogenous nitrogen oxides and bronchodilator S-nitrosothiols in human airways.

Recent discoveries suggesting essential bioactivities of nitric oxide (NO.) in the lung are difficult to reconcile with the established pulmonary cytotoxicity of this common air pollutant. These conflicting observations suggest that metabolic intermediaries may exist in the lung to modulate the bioactivity and toxicity of NO.. We report that S-nitrosothiols (RS-NO), predominantly the adduct with glutathione, are present at nano- to micromolar concentrations in the airways of normal subjects and that their levels vary in different human pathophysiologic states. These endogenous RS-NO are long-lived, potent relaxants of human airways under physiological O2 concentrations. Moreover, RS-NO form in high concentrations upon administration of NO. gas. Nitrite (10-20 microM) is found in airway lining fluid in concentrations linearly proportional to leukocyte counts, suggestive of local NO. metabolism. NO. itself was not detected either free in solution or in complexes with transition metals. These observations may provide insight into the means by which NO. is packaged in biological systems to preserve its bioactivity and limit its potential O2-dependent toxicity and suggest an important role for NO. in regulation of airway luminal homeostasis.

Adolescent↗

PubMedDate not supplied

Building national electronic medical record systems via the World Wide Web.

Electronic medical record systems (EMRSs) currently do not lend themselves easily to cross-institutional clinical care and research. Unique system designs coupled with a lack of standards have led to this difficulty. The authors have designed a preliminary EMRS architecture (W3-EMRS) that exploits the multiplatform, multiprotocol, client-server technology of the World Wide Web. The architecture abstracts the clinical information model and the visual presentation away from the underlying EMRS. As a result, computation upon data elements of the EMRS and their presentation are no longer tied to the underlying EMRS structures. The architecture is intended to enable implementation of programs that provide uniform access to multiple, heterogeneous legacy EMRSs. The authors have implemented an initial prototype of W3-EMRS that accesses the database of the Boston Children's Hospital Clinician's Workstation.

Boston↗