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[Experience in introducing monitoring computer systems in anesthesiology and intensive care units].

The paper describes the author's experience in practically using a monitoring computer system at the Anesthesiology, Resuscitation and Intensive Care Unit, Republican Clinical Hospital No.1, in Izhevsky Udmurtia. The system enables physicians, primarily anesthesiologists-reanimatologists to automate their work. It also allows the problem of routine accounting and report documentation to be solved.

Anesthesiology

Whole words and decoding for short-term learning: comparisons on a "talking-computer" system.

Low-and average-ability readers in first and second grade studied a list of 36 words using a "talking-computer" system. The system highlighted and simultaneously pronounced orthographic units in the words when the children touched the words with a light pen. During two training sessions, the computer presented four groups of 9 words each, one group as whole words, one in syllabic units, one in subsyllabic units, and one as single grapheme-phoneme units. All children learned the least words with single grapheme-phoneme units, having had the greatest difficulty blending the units into words during training. The other presentation units did not differ significantly from each other for most students on post-testing. However, the low first-grade readers learned fewer words segmented and presented by subsyllables than by syllable or word units, but only for multisyllabic words. Monosyllabic words were blended and learned as easily with onset-rime segmentation as with whole word units, for all children.

Achievement

Application of a gas chromatography mass spectrometry computer system for clinical diagnosis.

Currently, one of the major clinical problems is diagnosis of inherited metabolic disorders in neonates which are caused by a defect of specific enzymes. In order to diagnose such diseases at an earlier stage, we have developed a new mass screening method, consisting of a gas chromatography mass spectrometry computer system with a newly developed 'Diagnosis Computer Program'. In this program, the chromatographic pattern of the urine of a patient with an inherited metabolic disorder is compared with that of a normal person. Internal standards are applied to simplify the comparison. The total ion current chromatogram is drawn with the relative retention times plotted on the horizontal axis and the relative intensities on the vertical axis. Diseases are diagnosed by characteristics and quantity of abnormal compounds in the urine. Reference to the stored mass spectra of abnormal compounds by a library search enables the diagnosis to be more precise. Using this program, twenty-six inherited metabolic disorders are routinely diagnosed. The diagnosis of tyrosinosis is used here as an example.

Alkaptonuria

Analysis of a Bacillus subtilis genome fragment using a co-operative computer system prototype.

Analysis of the huge volume of data generated by large scale sequencing projects requires the construction of new, sophisticated computer systems. These systems should be able to manage the biological data as well as the results of their analysis. They should also help the user to choose the most appropriate methods, and to string them together in order to solve a global analysis task. In this paper we present the prototype of a software system providing an environment for the analysis of large-scale sequence data. As a first step toward this end, this environment has been put to the test within the Bacillus subtilis genome sequencing project. This system integrates both the descriptive knowledge of the entities involved (genes, regulatory signals and the like) and the methodological knowledge comprising an extensible set of analytical methods. A knowledge representation based on two existing object-oriented models is used to implement this integrated system. In addition, the present prototype provides a suitable user interface both for displaying simultaneously the results generated by several methods and for interacting with the objects. We present in this paper the analysis of a B. subtilis genome fragment, present in data libraries but not annotated. Annotation of the genes present in the fragment allowed us to combine the results of several methods used for predicting coding sequences, and to characterize it as comprising a cryptic phage, the skin element. Comparison between the annotation of the skin element and a standard region of the chromosome indicated that local features of the nucleotide sequence could discriminate between phage and non-phage DNA sequence.

Bacillus subtilis

An on-line computer system for hospital bacteriology: description of its development and comments after five years' use.

The development over several years of a computer system for hospital bacteriology reporting is described. The system was developed from a manual method to a punch-card batch processing system and finally to a real-time on-line system. The value of the system to the clinical departments and laboratory is discussed. Apart from minor defects the system has been of immense advantage to all who make use of its facilities.

Bacteriology

Interactive computer system for monitoring multiphasic health screening.

In an on-going population screening investigation at the Department of Preventive Medicine in Malmö, an interactive computer system has been developed for monitoring: (i) the electron and invitation of the health screening population; (ii) on-line registration and representation of demographic informations, test results and questionnaires; (iii) generation of the patient files and other listings; (iv) systems for diagnostic and statistical processing and representation. Ten thousand health screening investigations have now been monitored by the system, which is described in this report.

Computers

Expert system computer program for troubleshooting the gel-clot Limulus amebocyte lysate (LAL) assay.

This article describes a knowledge-based or expert system computer program that can assist in troubleshooting the gel-clot Limulus Amebocyte Lysate (LAL) method for the assay of endotoxin in parenteral products and in-process materials. The program may also be used to train new personnel and/or to assist in the development of an LAL method for a new product or material. The program includes LAL assay information for 31 parenteral products and materials. The program uses rules-of-thumb and intuition to diagnose 155 possible LAL assay problems and logically reduce them to 37 recommended problem solving processes. The program also provides references to support its recommendation.

Endotoxins

Assessment of renal transplantation using a gamma camera computer system.

Five hundred eleven isotope studies were performed following renal transplantation in 130 patients, using a standard technique and a gamma camera computer system in a nuclear medicine department situated half a mile away from the renal transplant unit. A comprehensive picture of renal function is obtained from perfusion studies, renography, effective renal plasma flow, I-131-Hippuran uptake, and excretion measurements.

Acute Kidney Injury

A community hospital laboratory computer system: an eight-year longitudinal study of economic impact.

An analysis of the intralaboratory economic effects of installation of a dedicated laboratory computer system in a 450-bed acute care general hospital laboratory is presented using data accumulated during an eight-year period. Data collection and analytic conventions used included: (1) an inflation factor derived from the CPI to adjust costs; (2) semilogarithmic plotting; (3) patient procedure counts tallied as the raw count for patient specimens according to the CAP Workload Recording Method; and (4) total workload (including patient standard and control items) recorded according to the CAP WRM. The authors conclude that computerization has produced: (1) a decrease in inflation adjusted labor costs per unit of work; (2) a decrease in inflation adjusted direct cost per unit of work; (3) A decline in the ratio of clerical to technical labor force; and (4) An increase in overall productivity of approximately 7%.

Computers

EMG-LAB computer system for routine electromyography.

The new computer aided program for fully automatic single MUAPs and IP analysis is described. This software programs called EMG-LAB represents the integrated system of IBM PC/AT computer with any kind of EMG machine. The individual MUAPs are automatically extracted, identified and measured on line, thanks to the sophisticated program based on statistical averaging. All the measured parameters like duration, amplitudes, areas, turns and phases are presented in computer display in a form of histograms. The summary of complete examination are presented in six parameters in form of histograms together with statistical values representing their distribution and variability. Those histograms represent the MUAPs waveforms remodeled during different disease processes. During maximum voluntary effort the interference pattern analysis is made on the new developed method. It allows to determine the parameters of different MU size, their quantity and intensity of recruitment. The most specific feature of this analysis concerns the information of the background activity, where the indirect data of single MUAPs and their parameters typical for given pathology could also be evaluated from interference pattern.

Action Potentials

Capability of hospital computer systems in performing drug-use evaluations and adverse drug event monitoring.

A survey to determine the extent of computerization in key areas of hospitals, the information being collected in the databases, and the capabilities of the computer systems for performing adverse drug event monitoring and drug-use evaluations was conducted. The questionnaire was distributed to clinical pharmacists in the 500 hospitals composing the Drug Surveillance Network. In the majority of the 166 responding hospitals (> 85%), the pharmacy department, clinical chemistry and hematology laboratories, patient admissions, and microbiology laboratory were computerized for data acquisition and management. The medical records and purchasing departments were computerized in a smaller proportion of hospitals (75% and 74%, respectively). In the majority of hospitals with a computerized pharmacy department (> 78%), there was ready access to computer databases in other departments, but simultaneous querying of multiple databases was possible in only 30%. Patients could be identified according to diagnosis in 82% of the hospitals and according to medication received in 83%. More than 85% of responding hospitals had implemented spontaneous reporting systems for the identification of adverse drug events. Computers are widely used in hospitals participating in the Drug Surveillance Network, but a substantial effort is necessary to make these resources more useful and to standardize processes so that data may be pooled across institutions to deal with important public health concerns.

Adverse Drug Reaction Reporting Systems

A computer system for haematology: experience in the use of the Trent-Phoenix system employing two central processing units and seven analysers--three remote.

We describe a modified Phoenix data processing system which has been introduced over a three year period into the Leicestershire Haematology and Blood Transfusion Services. The system is unique, employing two central processing units, which serve six Coulter S Plus IVD Counters and a Coulter S880, three of the analysers being located in satellite haematology laboratories. Details are provided of the system design and experience with the data processing activities within haematology. The blood transfusion laboratories utilize the same computer and this will be the subject of a later report.

Computer Systems

Transferability of a computer system for medical history taking and decision support in dyspepsia. A comparison of indicants for peptic ulcer disease.

The transferability of a British data base for differential diagnosis of dyspepsia using data obtained by computer interrogation was tested in 467 Swedish patients. The diagnostic value for peptic ulcer disease of symptoms such as frequent night pain relieved by food or antacids, smoking, family history of ulcer, food relief pain, male sex, and episodic pain was shown to be reproducible. However, for a number of symptoms their value for the diagnosis of peptic ulcer disease could not be reproduced in Swedish patients. The combined value of indicants was tested using a computer based algorithm for calculating diagnostic probabilities. The performance of this algorithm was poor when British data were applied to Swedish patients but reclassification of the Swedish patients on their own data base showed promising results. Crean and colleagues in Glasgow have developed a computer system for automated interrogation of patients with dyspepsia. The system utilises a large number of questions to obtain information regarding a maximum of 160 diagnostic indicants. The symptoms elicited from a patient can be compared with those of a large number of previously examined patients and the probabilities of ten different diagnoses can be calculated. The calculation of diagnostic probabilities is based on scores reflecting the diagnostic value of different symptoms in different diseases. After careful translation of questions the system has been transferred for use in Sweden. The present report is based on data from patients seen during the first two years with the system at a Swedish hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent