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Biomedical subjects

R B Friedman

Publications and source records attributed to R B Friedman.

At least 73 records · Page 4Linked to original sources
PubMed1978

Automated monitoring of drug-test interactions.

A computer-based file of the effects of drugs on clinical laboratory tests was used in a university hospital to generate reports of all potential interactions between the drugs administered to a patient and the laboratory tests ordered on his body fluids. More than 13,000 patient days were monitored in four different nursing units. The physician users of the system indicated that automatic reporting of possible drug-test interactions had both educational and clinical value. A critical review of patient charts suggested that automatic reporting of drug-test interactions caused physicians to alter therapy in about 0.1% of instances in which a report was generated. The users themselves indicated that they altered treatment as a result of the reports in a substantially greater number of cases.

Attitude of Health Personnel↗
PubMed1978

Gathering diagnostic statistics.

There is currently a dearth of numerical data on symptom occurrence for medical diseases. These data would be useful in many computer applications to medicine, particularly for computer-assisted diagnosis, computer-based clinical simulations, and computer-assisted instructions. These data might be obtained from (1) published review articles, (2) combined data bases already developed for previous automated diagnosis programs, (3) retrospective chart reviews, (4) computerized medical information systems, or (5) data supplied by expert committees. Each of these techniques has drawbacks, especially in providing data for multiple time cuts throughout the disease course, and in accounting for prior therapies, the interactions of symptoms, or the locality, sex, race, or environment of the patient. However, even a preliminary effort documenting the judgment of expert committee members would be a substantial contribution and would facilitate further progress in important areas of medical computing.

Computer-Assisted Instruction↗
PubMed1978

Experience with the simulated patient-physician encounter.

The development of computer-based simulations of the patient-physician encounter has made it possible to give students the opportunity to manage a case without jeopardizing a real patient's life. At the University of Wisconsin Medical School simulated patients have been an integral part of the third-year teaching program for the past five years. They have been used to permit the students to gain clinical experience, as part of a series of structured teaching conferences, and in a medical testing program. Student and faculty response to the program generally has been favorable.

Clinical Competence↗
PubMed1978

An automated verbal medical history system.

Computer-based automated medical history acquisition systems have not been as widely utilized as originally anticipated. The high cost, limited accessibility and alien nature of the computer terminal equipment have all been cited as important factors in the limited acceptance. A system has been developed that makes it possible to use a standard household telephone as the computer input and output terminal in obtaining medical history data. Patient acceptance is excellent, and medical information gathered using this technique is as accurate as that obtained by self-administered questionnaires or personal interviews. This system maintains the advantages of the terminal-based automated history program while eliminating many of its deficiencies.

Computers↗
PubMed1978

Improved thin-layer chromatographic method in the diagnosis of mannosidosis.

An improved thin-layer chromatographic method is described for the facile separation of neutral oligosaccharides excreted in the urine of patients with mannosidosis. The urine sample is treated with mixed-bed ion-exchange resin to remove charged species. The eluate is then chromatographed on silica gel thin-layer plates with n-propanol water as the developer. Eleven unique orcinol-positive components can thus be resolved. The advantages of this method over previously described techniques are the ease and rapidity of assay, better resolution of components, and clarity of resolution. It should be applicable to other disease states in which distinctive neutral carbohydrate products are produced.

Carbohydrate Metabolism, Inborn Errors↗
PubMed1977

A simulated patient-physician encounter using a talking computer.

Computer-based clinical simulations provide a means for evaluating the information-gathering and patient-management competencies of physicians. The need for expensive computer terminals has restricted physician use of these simulations. This computer-based program permits physicians to complete computer-based encounters using a standard touch-tone telephone.

Clinical Competence↗
PubMed1977

Mannosidosis. New clinical presentation, enzyme studied, and carbohydrate analysis.

Mannosidosis is a rare inborn error of metabolism characterized by deficiency of the lysosomal enzyme alpha-mannosidase and widespread storage of complex carbohydrate, which is enriched in mannose. Two affected unrelated males, aged 6 and 26 years, are reported. Both had a nonprogressive encephalopathy with moderately severe mental retardation. The older patient showed several unique features, including massive gingival hyperplasia associated with histiocytes containing large amounts of a material with the staining characteristics of glycoprotein. The best determinant of mannose storage proved to be the ratio of mannose to other carbohydrates in urinary polysaccharides. The enzyme deficiency in this disease is most convincingly demonstrated at pH values below 4.0. The ability of zinc to activate the mutant enzyme in vitro offers a possible mode of therapy for this disease. Retarded individuals with a Hurler-like appearance and gum hyperplasia of unknown cause should be screened for alpha-mannosidase deficiency.

Adult↗