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M S Klein

Publications and source records attributed to M S Klein.

At least 19 recordsLinked to original sources

End-user searching: impetus for an expanding information management and technology role for the hospital librarian.

Using the results of the 1993 Medical Library Association (MLA) Hospital Libraries Section survey of hospital-based end-user search services, this article describes how end-user search services can become an impetus for an expanded information management and technology role for the hospital librarian. An end-user services implementation plan is presented that focuses on software, hardware, finances, policies, staff allocations and responsibilities, educational program design, and program evaluation. Possibilities for extending end-user search services into information technology and informatics, specialized end-user search systems, and Internet access are described. Future opportunities are identified for expanding the hospital librarian's role in the face of changing health care management, advances in information technology, and increasing end-user expectations.

Computer Communication Networks↗

Effect of online literature searching on length of stay and patient care costs.

PURPOSE: To examine the associations between (1) the economic indicators of hospital costs, charges, and length of stay (LOS) for inpatient cases and (2) the use of MEDLINE searches for such cases. METHOD: An outcome-based, objective, prospective study with an economic evaluation was conducted from September 1989 to September 1990 at three metropolitan Detroit teaching hospitals representing both allopathic and osteopathic care. The study consisted of (1) 192 test cases, derived from a consecutive sample of inpatients of all ages for whom MEDLINE searches were requested at the participating medical libraries, and (2) 10,409 control cases, which were of the same diagnosis-related groups (DRGs) as the test cases but did not involve identified MEDLINE searches. Statistical analysis included the use of multivariate analyses of variance and correlation coefficients. Comparisons of cases were made on case-by-case and DRG bases regarding total patient costs, charges, and lengths of stay for cases with or without MEDLINE searches. RESULTS: The test cases were found to have a higher severity of illness. Among test cases, statistically significant relationships existed between (1) hospital expenses and LOS and (2) hospital expenses and the timing of the search during hospitalization when controlling for LOS. When cases were matched for DRG and LOS, the cases with early searches (i.e., conducted during the first half of hospitalization) had significantly lower expenses. CONCLUSION: Of the test-case patients (for whom MEDLINE searches were conducted during hospitalization), those whose searches were conducted earlier had statistically significantly lower costs, charges, and lengths of stay than those whose searches were conducted later.

Adolescent↗

Increasing access to clinical information on hospital wards.

Medical library information resources can make a positive contribution to the clinical information needs of health care professionals. To increase availability of knowledge-based information and transfer information to its point of use, a CD-ROM resource library was networked and interfaced with the existing hospital information system at Children's Hospital of Michigan in Detroit, Michigan. Clinicians in 21 patient care areas now have access to the patient record, full-text pediatric journal information and the Micromedex CCIS database at one location.

CD-ROM↗

Behavioral thermoregulation in mice inoculated with influenza virus.

Mice housed at 30 degrees C and inoculated with a mouse-adapted influenza virus show a fall in body temperature (Tb) and a decrease in food intake to almost 0 grams per day. This study tested whether the fall in Tb could be accounted for by the decreased food intake and whether the fall in Tb was due to a decrease of thermoregulatory set point or to an inability to maintain Tb at set point level. The fall in Tb of influenza-infected mice was greater than that of food-deprived mice. When food deprived, mice given access to a thermal gradient increased their preference for warmer areas in the gradient and, as a result, Tb did not fall as much as Tb of starved mice not given access to a thermal gradient. When infected with influenza virus, mice given a thermal gradient decreased Tb less and at a slower rate than mice not given a gradient. However, this fall in Tb of influenza-infected mice was greater than that of food-deprived mice given a thermal gradient. Mice given a thermal gradient increased their preference for the warmer temperatures after inoculation; this returned to preinoculation preference for cooler temperatures during the later days of infection despite a continuous fall in Tb. Influenza-infected mice given a thermal gradient survived significantly fewer days than infected mice not given a thermal gradient. We conclude that the influenza-induced fall of Tb in mice cannot be explained solely by the decrease in food intake, and is partially due to a decrease in thermoregulatory set point.

Animals↗

Inguinal hernia.

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Hernia, Inguinal↗

Adapting IAIMS to a hospital library level.

The Children's Hospital of Michigan Medical Library has adapted several of the Integrated Academic Information Management Systems (IAIMS) concepts and implemented them at a hospital library level. These have included features of network development, electronic interfacing and interlinking, and implementing an integrated information system in the library. The library has incorporated several information systems into library operations, including a variety of in-house, local, and national automated systems and telecommunication networks. Hospital libraries can incorporate IAIMS features and promote an institutional framework of interconnecting communication systems and electronic linkages.

Computer Communication Networks↗

Assessment of myocardial perfusion in humans by contrast echocardiography. I. Evaluation of regional coronary reserve by peak contrast intensity.

Myocardial contrast echocardiography was performed during coronary angiography with 2 ml of sonicated meglumine diatrizoate sodium 76% (meglumine) in 40 patients (ranging in age from 25 to 79 years) before and 10 to 15 s after intracoronary injection of papaverine, 8 mg into the right coronary artery (n = 43) and 10 mg into the left (n = 46). The same protocol was repeated in 17 patients 5 to 10 min after completion of coronary angioplasty. In 13 patients with normal coronary angiograms, peak contrast intensity corrected for background myocardial intensity was measured in 36 regions and was found to increase after papaverine from 36 +/- 16 to 55 +/- 22 U (p less than 0.001). In contrast, in the 27 patients with angiographic evidence of coronary artery disease, peak intensity in 64 regions remained unchanged after papaverine (35 +/- 22 versus 36 +/- 23 U). An increase in peak intensity greater than or equal to 10 U was 80% sensitive and 92% specific for coronary artery disease. After successful coronary angioplasty, peak intensity in the involved regions improved significantly (p less than 0.001) during baseline contrast injections (from 32 +/- 16 to 50 +/- 25 U) as well as in the postpapaverine contrast injections (from 30 +/- 12 to 60 +/- 26 U). In conclusion, measurement of peak contrast intensity after intracoronary injections of sonicated meglumine provides a relative index of myocardial perfusion that allows assessment of regional coronary reserve in patients with coronary artery disease. This may be of particular value in evaluating the immediate effects of coronary angioplasty on myocardial perfusion.

Adult↗

External assessment of myocardial metabolism with C-11 palmitate in vivo.

The externally detected rate of clearance of C-11 palmitate ([11C]palmitic acid) from isolated hearts varies directly with CO2 production from neutral lipids and with physiological indexes of myocardial oxygen consumption. The present study was performed to determine whether myocardial metabolism could be quantified noninvasively in vivo in a fashion analogous to that in the isolated heart. Opened chest, male rabbits were injected with C-11 palmitate (100-200 muCi) and coincidence counts were detected externally with two NaI(TI) crystals so placed that their colinear field of view encompassed the heart. The monoexponential rate of clearance of tracer--obtained from the portion of the residue-detection curve reflecting metabolism of fatty acid incorporated into neutral lipids--correlated directly with induced changes in tension-time index after injections into the left atrium (r = 0.96, n = 12), right atrium (r = 0.86, n = 14), and ear vein (r = 0.93, n = 14). Clearance of labeled palmitate from the vascular pool within the field of detection (determined with both C-14 palmitate and red blood cells labeled with C15O-hemoglobin) was rapid and did not significantly affect measurements of palmitate clearance from the heart itself.

Animals↗