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Advantages of computer-based record filing when compared with conventional methods are outlined, and a detailed description given of the use of a microcomputer for establishing a filing system in a department of radiology.
The authors, from perusal of 340 files where accidents in obstetrics were reported, have classified the medico-legal risks in pregnancy, wether the accidents gave rise or did not give rise to claims for responsibility. These accidents occurred between 1950 and 1978 and they happened during and after delivery. The classification shows up the most dangerous situations for the specialist and points out the factors that increase this risk so that systematically a preventive attitude can be taken to avoid claims, whether they are made under criminal or civil procedures. Particularly detailed have been statistical risks which are increasing continuously in association with instrumental deliveries and with the large indicence of Caesarean operation. After they have listed all the clinical forms of medico-legal risk picked out by counsel so that they can be avoided or their effects reduced, the authors have attempted to define the responsibility that the gynaecologist-obstetrician takes at present in the midst of his team that is always increasing in number. Among these are paediatricians, anaesthetists and resuscitators, midwives, nurses who give anaesthetics and all the para-medical team who have specialised responsibility which depends more or less on the needs of the gynaecologist-obstetrician. The medico-legal risks which are linked with a deficiency in premises, numbers of personnel and quality and quantity of equipment have been singled out with a relatively small balance of the characteristics of those who carried out the procedures recorded in a large series of files which are already old and which for the most part have been docketed so that they could be used without revealing any professional secrets nor legal secrets.
The clinical research in the oncological field makes it necessary to have in the shortest possible time information as to the statistical elements of the various neoplasias according to the adopted treatment schemes. In this report we are going to describe the realization of a computerized file with the patient's data of our radio-chemo-therapy department. From the clinical report of each patient, according to the physician's judgement, the more important medical and anagraphical data have been taken out to be then memorized in the computer. The analysis of the data introduced allows to obtain an inventory of patients in alphabetical order, according to the type of neoplasia and to the type of the treatment. The system is quite easy to be used and the interaction with the user is dialogue oriented. In this way both the inserting and the research stage of the filing data as well as the printing of the lists can be effected even by people not particularly trained in the computer use.
The wall thickening was assessed by regional count increase from end-diastole (ED) to end-systole (ES) in gated 99mTc-MIBI SPECT. The wall thickening index was calculated as (ES count--ED count)/ED count x 100 (% thickening). Gated SPECT was performed three hours after injection of 600 MBq of 99mTc-MIBI in 20 normal subjects to create normal files (ED, ES perfusion maps and % thickening map). In normal ED and ES perfusion maps, distribution in anterior and lateral regions were higher than other regions, indicating heterogeneous perfusion. In addition, the % thickening in apex was higher than anterior and lateral and septal regions, suggesting heterogeneous % thickening in normal subjects. Furthermore, the % thickening was different between male and female. We conclude that quantitative analysis of regional thickening can be performed by gated 99mTc-MIBI SPECT with normal files.
The emerging widespread adoption of the Digital Imaging Communications in Medicine (DICOM) standard will increase the demand for radiologic image transfer between radiologic image acquisition, archive, display and printing devices. Unfortunately, there are and will continue to be many devices that do not and will not support this standard, especially older radiologic equipment and devices from nonradiologic vendors. Determining the image file format characteristics of images from such equipment is often difficult, and done on an ad hoc basis. We have developed a software tool that assists users in determining the image file format parameters of unknown radiologic images.
The rapid technological development of biomedical instruments, and of hardware and software systems is giving new opportunities in the management of medical activities. We have developed a multimedial filing system for an Endoscopy Unit which, thanks to its versatility, is also suitable for other medical branches. The system is built on a database, and includes clinical records of patients together with endoscopic pictures and vocal comments for each case. It was developed by using "Microsoft Windows 3.1" programming and is directly connected to the videoendoscopes. The system operates in a "Novell Netware" network. Future fields of interests are reported with regard to: a) image processing procedures that can be applied; b) other types of images that can be stored such as radiological, echographic images, etc.; c) transmission of information and a global multimedial filing system serving the entire hospital; and d) a written report, including the endoscopic images of the disease.
Visual interpretation of 123I-BMIPP (BMIPP) myocardial images has difficulties in detecting mild reduction in tracer uptake. We studied the significance of the objective assessment of myocardial BMIPP maldistributions at rest by using a Bull's-eye map and its normal data file for detecting ischemic heart disease. Twenty nine patients, 15 with prior myocardial infarction and 14 with effort angina were studied. The initial 15-min BMIPP image was evaluated by visual analysis and by generating the extent Bull's-eye map which exhibits regions with reduced % uptake under mean-2SD of 10 normal controls. The sensitivity for determining coronary lesions in non-infarcted myocardial regions with the extent map was superior to that with visual analysis (67% vs. 33%). In the regions supplied by the stenotic coronary artery, those which showed visually negative but positive in the map and which showed positive in both had higher incidence of wall motion abnormalities and severe coronary stenosis than those with normal findings in both. These results suggest that the objective assessment based on the normal data file in a Bull's-eye polar map is clinically important for improving the limitation of the visual interpretation in 123I-BMIPP imaging.
UNLABELLED: The Internet and particularly the World-Wide-Web is becoming a useful tool for the nuclear medicine community. METHODS: The Computer and Instrumentation Council of the Society of Nuclear Medicine convened an Internet Focus group to discuss collaboration using the Internet. The prototype application considered was development of case-based teaching files using the World-Wide-Web. Teaching file cases (clinical history, images, description of findings and discussion) on World-Wide-Web servers at different institutions are integrated using the Internet. The user can navigate from case to case using point-and-click hypertext linking. RESULTS: The initial experience with collaboration has been encouraging. An etiquette to help foster collaboration has been proposed. Development of quality control mechanisms and introduction of peer review were identified as issues needing further work. CONCLUSION: The World-Wide-Web offers great potential for new forms of collaboration. There is, however, a need to learn how to make best use of this new resource.
Supplemental Security Income (SSI) statistics have been published in the Social Security Bulletin since the program began in 1974. For the most part, these statistics have been snapshots of current caseloads. Now, a new SSI longitudinal file permits a retrospective look at past program data. It also permits us to redefine key program indicators and to produce new distributions for these data. In this article, we take a look back in time at SSI applications, caseloads, and awards, and describe how these data were obtained from the SSI administrative computer files.
Because of the difficulties involved in endodontic preparation of curved canals, many techniques have been suggested using mechanical means to improve final results. Ultrasonics have been used in dentistry for many years as adjuncts for cleaning instruments and as aids in scaling during periodontal treatment. Recent reports on their use in canal preparation have indicated that cleaner canals were obtained. This has led to attempts at using this instrument in curved canals. In this study, preparation with ultrasonics alone in canals of extracted human teeth with curvatures of 30 degrees or greater led to severe straightening, zipping, and strip perforations. The use of ultrasonics more coronally, with hand filing at the apex, avoids these problems. This article presents a step-by-step technique for a combination of hand filing with ultrasonics preparation.
A discussion of the advantages of filing family folders by geographic location is presented in addition to several methods for determination of socioeconomic status. Advantages of current filing techniques at the University of Rochester-Highland Hospital Family Medicine Program are detailed. Examples are given of the use of such information to estimate health-care utilization as determined by factors of distance from practice, socioeconomic status, natural barriers, and family size.
Careful preoperative and postoperative photographs are an essential part of facial plastic surgery for medical and legal documentation, publication, patient education, and lectures. Computers play an increasing role in many aspects of the medical practice. A method of filing photographs and procedures and a related data base system allows rapid access by multiple factors, including name, procedure, age, surgeon, assistants, anesthetic, complications, dates of all photographs, multiple procedure subheadings, and so on. Additional variables can be added as a date base for analysis of operation results and postoperative recall of patients. This system is based on a personal computer (IBM-PC Computer) and readily available software. The system allow simple entry and retrieval of photographs on any of the multiple variables. We found it to be a superb adjunct to photography in facial plastic and reconstructive surgery.
A computer file system was used in our pediatric allergy clinic to assess the value of chest roentgenograms and hemoglobin determinations used in the examination of patients and to correlate exposure to pets and forced hot air with the severity of asthma. Among 889 children with asthma, 20.7% had abnormal chest roentgenographic findings, excluding hyperinflation and peribronchial thickening, and 0.7% had abnormal hemoglobin values. Environmental exposure to pets or forced hot air was not associated with increased severity of asthma, as assessed by five measures of outcome: number of medications administered, requirement for corticosteroids, frequency of clinic visits, frequency of emergency room visits, and frequency of hospitalizations.
FILELB is a comprehensive library of subroutines for the storage, retrieval, location, inspection and entry of sequences of experimental and analytical data. The general purpose, highly organised data file structure implemented by FILELB is the core of our interactive computer package for the analysis of physiological systems.
The PNSCROLL program has been specifically developed for interactively scrolling through binary data files under mouse control, in order to analyse single channel current records and printout, or plot, records and histograms of currents. PNSCROLL requires the use of a Microsoft Mouse and runs on an IBM or IBM-compatible microcomputer operating under MS DOS, ideally with 256K EGA or VGA graphics card and colour display. It will print on Epson dot matrix printers and plot records and histograms on HP plotters and LaserJet laser printers.
A new system was developed for filing all the endoscopic images generated in our hospital. The system is composed of an on-line network for analog images supplied from the endoscopy stations and stored on 300 mm optical disks, on the one hand, and an off-line PACS for digital images recorded on a 130 mm magneto-optical disk (MOD) at each endoscopy station, on the other. For close examination of the images digital images are displayed from the MOD on a high-resolution computer graphic monitor, and for quick review of a large number of images, analog images are retrieved from the 300-mm optical disks. This system has been in clinical use at our university hospital for the past year and has proven useful for education of endoscopy, for the quality control of the endoscopy practice, and for the management of the patients.
The development of an organized filing system for referencing articles pertinent to emergency medicine is presented. This simple and flexible system allows for modification for the individual needs of the emergency physician.
Guidelines for improving the effectiveness and efficiency of conducting a search of scientific literature are presented. Initial leads can be gained by contacting a local expert or consulting a textbook. An impression of advances being made in a particular field can be gained efficiently by scanning weekly issues of Current Contents, containing the tables of contents of most scientific journals. Recent review articles on most topics can usually be found listed in the Index Medicus. With at least one significant reference dealing with a specific topic of interest, the Science Citation Index may be used to identify articles published during a particular indexing period which cited the article as a reference. Practical guidelines are also presented for establishing a simple but comprehensive personal system for filing and retrieving on demand reprints, pamphlets, and notes.