Biomedical subjects
M A Belmonte
Publications and source records attributed to M A Belmonte.
Validation of the medical expert system RENOIR.
RENOIR is an expert system developed to assist the diagnosis of 37 diseases of connective tissue and inflammatory arthropathies. Precise diagnosis of rheumatic diseases implies great uncertainty and there is no gold standard with which to compare the expert system output. To overcome this problem a set of clinical cases was submitted to RENOIR and its diagnoses were compared with those of clinicians. Medical records of 81 patients with rheumatic diseases were interpreted by RENOIR and by 12 clinicians at three different expertise levels in rheumatology. Distances between the likelihoods of the 37 considered diseases provided by clinicians and RENOIR were computed as a disagreement measure. Mahalanobis distance was used to correct the collinearity between the possibilities of each pair of diseases. Using the resulting matrices of distances between experts, cluster analyses were carried out to classify RENOIR among human experts. Greater differences between RENOIR and clinicians than among clinicians themselves were not found.
Avascular necrosis of bone in human immunodeficiency virus infection and antiphospholipid antibodies.
We describe 3 cases of human immunodeficiency virus (HIV) infected patients with antiphospholipid antibodies (aPL) in serum who developed avascular necrosis (AVN), an association that to our knowledge, has rarely been described. Given that the 3 patients had stopped their intravenous drug addiction 2 years before the clinical picture appeared, and none had any known risk factors for developing AVN, there may be an association, perhaps fortuitous, between HIV infection, the presence of aPL and the development of AVN.
[Diabetologic education at a general hospital in Cataluna: methodology and short-term indicators of effectiveness].
In order to carry out an initial evaluation of an intrahospital diabetes education programme after its first year, the methods used are described and some previously established short term effectiveness indicators are analyzed: 1) knowledge of the theory, 2) insulinization, 3) blood glucose self testing at home, 4) metabolic control, 5) readmission in hospital, and 6) detection of chronic complications. An analysis of the previous situation was carried out resulting in a mean hospital stay of 10.8 days/patient/year during 1985, being the mean hospital stay for the general population of 8.1 days. 222 diabetic patients (63 type I and 159 type II) were included in the programme during the first year, and their cultural background, diabetes education, place of origin and participation were evaluated. 358 written tests were examined. The scores obtained after the educational sessions (75.6 +/- 17.5) were significantly higher than the initial scores (47.4 +/- 23.1; p less than 0.001). Prior the programme, 93 patients (41.9%) were on insulin. At the time of the evaluation 156 (70.2%) were on insulin treatment, of which 86 (38.7%) were on rapid insulin. Furthermore, 141 patients (66.1%) were carrying out periodic (over 10 tests/week) blood glucose determinations at home. In a 96 patient follow up group (36 type I and 60 type II) a significant improvement in baseline glucose levels (8.6 +/- 2.7 vs 12.6 +/- 4.2 mmol/l; p less than 0.001) as well as glycosylated hemoglobin levels (9.3 + 1.2% vs 11.0 + 2.0%; p greater than 0.001) was confirmed; this improvement was maintained throughout the time period considered.(ABSTRACT TRUNCATED AT 250 WORDS)
[Serum C4 concentration, diabetes mellitus and diabetic microangiopathy].
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Severe ventricular arrhythmia after methylprednisolone pulse therapy in rheumatoid arthritis.
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