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Biomedical subjects

O Guerci

Publications and source records attributed to O Guerci.

50 records · Page 3Linked to original sources

[Applications of a simple system of aid to medical decision-making with various patients in internal medicine: SELF].

Many medical decision helping systems are very complex and require expensive computers, which restricts their diffusion and limits their use to specialized people. The idea was to find a simplified system that any practitioner--even unaccustomed to microcomputing--would be able to use. Moreover, this system had to work on widely available and inexpensive microcomputers. SELF (system in fuzzy set) is this kind of system. It has been devised as a complete interactive system of medical decision help. It is entirely parameterized, allows any kind of application and works according to such rules as "if there is premise, then there is conclusion", tempered by a coefficient. The bases of knowledge are represented on a correspondence chart where columns materialize the premises (clinical signs, laboratory results, etc.) and horizontal lines all the diagnoses and therapeutic conclusions. The system includes proceedings that create, modify and update basic knowledge. It uses the fuzzy set rules to draw conclusions. SELF was first applied to the prescription of contraceptive methods, but it has now been tested in other specialties, such as gynaecology, pneumology, haematology and so forth. In every case, the reliability of the results obtained depends on the bases chosen by the creator himself. Owing to the general character of the system, one may regard it as being open to any user who would like to create his own applications.

Decision Making, Computer-Assisted↗

[1 alpha 25-dihydroxyvitamin D3 (calcitriol) and malignant hemopathies. Decreased serum levels in acute leukemia: preliminary results].

We used the Amersham radioimmunological method to measure plasma 1 alpha 25-dihydroxyvitamin D3 (calcitriol) levels in patients presenting with one of the following diseases: (i) non-acute myelodysplastic syndrome (39 cases); (ii) acute myeloid leukaemia in blastic phase (43 cases) or in complete remission (15 cases) and (iii) acute lymphoid leukaemia in blastic phase (11 cases). All patients had normal metabolic functions. Compared with our standard laboratory values (15-35 pg/ml), the results of these assays were related to the type of pathology or, in patients with acute myeloid leukaemia, to the stage of the disease (p less than 0.001). Moreover, the mean plasma calcitriol values differed according to the type of pathology (p less than 0.003). Patients with acute myeloid leukaemia in blastic phase had a low level of calcitriol as compared with controls (p less than 0.05) and with patients with acute myeloid leukaemia in complete remission (p less than 0.001) whose calcitriol levels were never low. In contrast, there was no significant difference between controls and patients with myelodysplastic syndrome or acute lymphoid leukaemia in blastic phase. This study demonstrates the usefulness of plasma calcitriol assays in malignant blood diseases where low values in certain types of leukaemia would incite to include calcitriol in therapeutic regimens.

Acute Disease↗

[Realization of an assisted system for medical decision and follow-up in hematologic diseases treated with sequential chemotherapy].

The follow-up of patients treated with sequential chemotherapy in internal medicine departments with special interest in haematology imposes a heavy burden on the entire treating staff. The chances of errors, notably in medical prescriptions and care, are not negligible, and these errors result in iatrogenic complications, readmissions and prolonged stays in hospitals. Designing a medical decision and therapeutic follow-up aid system should be time-saving for the staff and ensure good quality and safe prescriptions as well as reliable therapeutic evaluations and better hospital management. The system described here is developed on 4D Macintosh computer which handles a relational data-base. It includes the data-base, i.e. a knowledge-based system devised by the expert clinician containing "declarative" data and deduced rules which represent the expert's reasoning and determine the action to be taken, and the interface between them. The system easily accepts many parameters, thereby enabling medical knowledge and therapeutic attitudes to be updated.

Decision Making, Computer-Assisted↗