Maintenance therapy and schizophrenia.
Explore the source record for details and available documents.
Acute Disease↗
SEARCH · Search PubMed
Results for “Therapy, Computer-Assisted”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Cardiorespiratory monitoring in postoperative patients: I. Prediction of outcome and severity of illness.
An index for prediction of outcome for use as a measure of the severity of illness was developed by a nonparametric multivariate analysis of cardiorespiratory data from 113 critically ill postoperative general surgical patients. This severity (predictive) index was based on a computerized algorithm that compares a given observed value with the frequency distributions of survivors and nonsurvivors. The difference in the mean values of this index for survivors and nonsurvivors was statistically significant (p less than 0.001) during each stage of shock. Sensitivity of the index in prediction of survival ranged from 70-93% depending upon stage, the specificity of the index ranged from 76-92%, and the predictive accuracy ranged from 87-96%. The severity index is used as a process measure to track the course of critically ill patients and to evaluate the efficacy of alternative therapies.
Cardiovascular System↗
Cardiorespiratory monitoring in postoperative patients: II. Quantitative therapeutic indices as guides to therapy.
Immediate (proximate) and late (optimal) therapeutic goals for critically ill postoperative general surgical patients were based on the frequency distributions of cardiorespiratory data of the survivors immediately after resuscitation and in the late stage of shock, respectively. An algorithm was developed which expresses in quantitative terms the distance from observed values for each variable to both of these therapeutic goals. Further, composite indices were also made of related cardiorespiratory variables that reflect the important aspects of acute circulatory failure and its therapy; i.e., volume, flow, tissue perfusion, oxygen transport, and bodily response to stress. The therapeutic indices of nonsurvivors were found to have greater mean deficits that survivors (p less than 0.05) during all but the middle stage of shock. The therapeutic indices greatly aid in the organization and display of monitored cardiorespiratory variables by expressing the circulatory defects in easily understood indices that can be related to therapeutic interventions. Moreover, the interactions of the various aspects of cardiorespiratory function before and after therapy may be easily observed.
Cardiovascular System↗
Robust optimisation for photon radiotherapy: A scoping review of models, paradigms, and reporting.
BACKGROUND AND PURPOSE: Robust optimisation offers an alternative to conventional margin-based photon radiotherapy planning by explicitly modelling uncertainty, but practice is variable and not standardised. MATERIALS AND METHODS: A scoping review was conducted to map robust optimisation for photon external beam radiotherapy. Electronic searches of Scopus, PubMed and Google Scholar (2000-2025, English language) identified planning studies that incorporated modelled uncertainties into the optimisation process and reported at least one robustness-related outcome. Data were charted on clinical context, uncertainty models, optimisation paradigms, robustness metrics and evidence for clinical implementation. RESULTS: Seventy-one studies were included. Most investigated prostate, breast or lung cancer and used intensity-modulated radiotherapy or volumetric-modulated arc therapy in commercial or research treatment planning systems. Scenario-based worst-case (minimax) optimisation was the dominant paradigm in clinically oriented work, while chance-constrained, conditional value at-risk, distributionally robust and adaptive formulations were confined to small methodological series. Uncertainty modelling focused mainly on rigid set-up error; fewer studies incorporated respiratory motion, inter-fraction anatomical change, dose-calculation uncertainty or biological variation. Robustness was evaluated with diverse scenario-based dose-volume metrics, probabilistic coverage measures, composite robustness indices and, less often, biological endpoints. Direct clinical implementation reports were scarce. CONCLUSION: Robust photon planning is technically feasible and generally maintains or improves target coverage and organ sparing compared with margin-based planning. However, heterogeneity in uncertainty models, optimisation configuration and robustness reporting limits comparison and synthesis. Pragmatic minimum standards are proposed to support future consensus and wider clinical adoption.
Humans↗
Evaluating the performance of a computer-based consultant.
The performance of a computer-based clinical consultation system is evaluated. The program, called MYCIN, is designed to function as an aid for infectious disease diagnosis and therapy selection, with an initial emphasis on bacteremias. The evaluation methodology is discussed, as well as the difficulties encountered in attempting to evaluate clinical judgments. Specialists in infectious diseases judged MYCIN's final therapy recommedation, and intermediate conclusions about the significance of the infection and identity of infecting organisms. The evaluation techniques described may be useful in assessing the performance of other clinical decision aids. Results of the evaluation show that the program's therapy recommedations meet Stanford experts' standards of acceptable practice 90.9% of the time (table 2), with some variation noted both among individual experts and between Stanford experts and others (tables 1, 2).
Animals↗
Application of pattern recognition methodology to the design of an electronic aid for coordination therapy.
Automated aids for developing coordination skills in the handicapped are not common, with the result that therapy of such a nature tends to be highly teacher intensive. This paper describes an electronic aid, based on pattern recognition techniques, for the teaching of writing and drawing skills which, while retaining the flexibility to allow tailoring of its operation to the needs of individual patients and applicability to a variety of tasks, is sufficiently cheap and convenient in implementation to be an effective tool of general acceptability.
Adult↗
Fundamentals of pacemakers ECG interpretation - part 2.
BACKGROUND: Modern pacemakers incorporate arrhythmia-response algorithms, ventricular pacing minimization protocols, and safety mechanisms that generate ECG patterns indistinguishable from pathological AV block, sensing malfunction, or device-mediated tachycardia. Failure to recognize these algorithm-driven signatures leads to unnecessary interventions, misdiagnosis, and inappropriate device reprogramming. This manuscript is the second in a two-part series on pacemaker ECG interpretation. METHODS: We conducted a narrative review of peer-reviewed literature and device-specific documentation on algorithm-driven ECG behavior, synthesizing evidence across arrhythmia recognition, upper rate physiology, ventricular pacing minimization, mode switching, safety mechanisms, and hysteresis algorithms. RESULTS: Pacemaker-mediated tachycardia produces regular paced wide-complex tachycardia locked at the upper tracking rate, initiated by any event with retrograde VA conduction. Ventricular tachycardia is identified by QRS morphology diverging from the known paced pattern, absent pacing spikes, and AV dissociation. Upper rate Wenckebach behavior mimics Mobitz type I AV block; 2:1 upper rate response mimics second-degree AV block. Ventricular pacing minimization algorithms produce isolated nonconducted P waves and prolonged AV intervals that simulate pathological conduction disease. Mode switching causes abrupt rate drops misidentified as output failure. Ventricular safety pacing generates a conspicuously short, fixed AV interval. Three discrete pacing artifacts reflect AV-sequential cardiac resynchronization therapy (CRT), ventricular safety pacing in CRT, or His-bundle pacing with backup RV output. Rate and AV hysteresis produce pauses and wandering AV intervals mimicking oversensing or Wenckebach periodicity. CONCLUSIONS: Recognizing algorithm-driven ECG patterns requires knowledge of device timing intervals and refractory periods, which lets clinicians distinguish programmed behavior from true malfunction or cardiac arrhythmia.
Humans↗
Reduction of intimal thickening in canine coronary bypass vein grafts with dipyridamole and aspirin.
The potential benefit of platelet inhibitor drugs on coronary arterial bypass vein grafts was assessed in dogs with magnification-corrected angiographic luminal measurements and quantitative histologic evaluation of the vein grafts. There were 11 control animals and 11 animals treated with dipyridamole, 55 mg/day, plus aspirin, 325 mg/day. Eighteen animals with patent grafts were studied when electively killed 2, 4 or 6 months after grafting. At 14 days, there was greater angiographic narrowing in the most distal 1 cm of vein grafts in control than in treated dogs (P less than 0.01). This same angiographic narrowing persisted in control dogs until they were killed (P less than 0.03). Computer-assisted measurements of the entire area of intimal thickening were done on vein graft cross sections taken 1 cm from the distal anastomosis. The circumference of the vein grafts at the intimal-media junction was measured from the same section and the potential maximal luminal area calculated. The calculated luminal narrowing due to intimal thickening was greater in control than in treated dogs (P less than 0.03). These data correlate well with the demonstrated angiographic narrowing. The findings indicate that the degree of early intimal thickening that persists 2 to 6 months postoperatively in canine coronary bypass vein grafts may be reduced by the platelet inhibitor combination of dipyridamole plus aspirin.
Animals↗
Scene segmentation techniques for the analysis of routine bone marrow smears from acute lymphoblastic leukemia patients.
Automated analysis of lymphoblast cell morphology is being evaluated as a basis for predicting the response to therapy of patients with acute lymphoblastic leukemia. A new technique of scene segmentation particularly applicable to the "cluttered" images of cells in routine bone marrow smears is described. Morphologic characteristics of lymphoblasts found in bone marrow smears made at time of diagnosis were measured by an automated, interactive image-processing system using the new scene segmentation technique. These characteristics, on a patient by patient basis, are being compared to remission length and survival data to develop and test new prognostic methods.
Autoanalysis↗
[Prognostic value of cytological signs in breast cancer].
From a variety of cytological patterns of breast cancer the signs are singled out, which may be of a prognostic value for determining the degree of tumor malignancy prior to instituting any kind of therapy. The data on 59 patients, radically treated for breast cancer, stage IIIb, are reported: 17 patients died during a year period, 42 - survived for 5 years and longer. There were singled out 11 cytological signs among which are those available in the WHO classification for typing breast cancer malignancy. The most informational signs were as follows: the character of cell location, the content of "naked" nuclei and nuclear hyperchromia. It was found that for low malignancy cancer a combination of the following signs is typical: a predominance of cell aggregations, the content of "naked" nuclei not exceeding 20%, and the absence of nuclear hyperchromia. To determine the rate of breast cancer malignancy in a cytological investigation, it is recommended to take into account, in addition to the recommended by the WHO classification signs (hyperchromia, the number of mitoses, heterogenity of nuclei in size, form and character of staining), also such a sign as the content of "naked" nuclei.
Breast↗
Meta-Analysis of the Efficacy of Ultrasound-Guided Mammotome Minimally Invasive Surgery and Traditional Open Surgery in the Therapy of Benign Breast Tumors.
ObjectiveTo systematically analyze the efficacy of ultrasound-guided mammotome minimally invasive surgery and traditional open surgery in the therapy of benign breast tumors.MethodsA computerized search retrieved original literature on the therapeutic effects of ultrasound-guided mammotome minimally invasive surgery and traditional open surgery for benign breast tumors from authoritative databases, including CNKI, Wanfang, VIP, Web of Science, PubMed, ScienceDirect, Cochrane Library, and Embase. The search covered from database inception to January 2024, using a strategy of subject terms combined with free terms. The retrieved literature was screened, data were extracted, and quality was evaluated. Meta-analysis was performed using RevMan 5.4 software.ResultsA total of 8 literatures were included in the study, and a total of 1909 patients with benign breast tumors were found from 2018 to 2023. The results of meta-analysis showed that the operation time [MD = -12.79, 95%CI (-14.04, -11.55), P < 0.00001], intraoperative blood loss [MD = -11.55, 95%CI (-14.74, -8.36), P < 0.00001], healing time [MD = -2.73, 95%CI (-4.03, -1.43), P < 0.00001] and complication rate [MD = 0.17, 95%CI (0.12, 0.26), P < 0.00001] was apparently different from traditional open surgery (P < 0.05).ConclusionUltrasound-guided mammotome minimally invasive surgery can effectively shorten the operation time of patients with benign breast tumors, reduce intraoperative blood loss, promote healing, and reduce the risk of complications. The effect is better than that of traditional open surgery.
Humans↗
Radiotherapy treatment planning using the ACTA-scanner.
Computerized tomography is useful in radiotherapy treatment planning in the following ways: (1) Its image provides the most accurate possible contour of the patient and demonstrates the internal structures in their proper relation to each other. (2) The tumor and its extension are accurately demonstrated. (3) Corrections for tissue heterogeneities can be accomplished in one of two ways, either by arbitrary assignment of densities to tissues or by direct scanning with a therapy source. This latter procedure is under investigation. (4) The computer can be programmed to demonstrate summations of dose delivered from multiple fields.
Dose-Response Relationship, Radiation↗
Computer-aided tumour classification and treatment selection in breast cancer.
In order to provide a common basis for treatment decisions and the future evaluation of breast cancer therapy, the breast cancer protocol used in our clinic was formulated for the computer. A system for the simulation of clinical reasoning was used which allows the physician to express the medical logic as a series of inferences to be confirmed or rejected on the basis of Boolean combinations of medical criteria. The system enables the physician to rearrange these criteria into a questionnaire for complete and accurate recording of patient data. These data are then fed into the computer to produce a patient status report and treatment recommendations. The data from 26 patients in various stages of breast cancer have been processed by the computer and the computer's conclusions compared to the assessment made by a junior physician in our department. In three cases the staging was not identical, in 15 cases the treatment decisions were not identical and in all cases investigations were left out by the physician. The system has been of considerable value in standardising patient examination and treatment and in training inexperienced physicians.
Breast Neoplasms↗
Computer use in diagnosis, prognosis, and therapy.
Computers are used to influence diagnostic and therapeutic decisions. The computer's information-handling capabilities allow it to serve as a reliable extension of the physician's memory and expander of the physician's information and synthesized knowledge resources. Computers have been used to facilitate decisions through organization of patient data, improved classification of patients, decision analysis in clinical settings, and simulation of expert clinical reasoning. Computer programs are more successful in narrow, constrained, single arenas of medicine with much underlying pathophysiologic understanding and where decisions are based largely on hard laboratory data. New models of synthetic reasoning that simulate expert clinical behavior show promise of supporting complicated decisions concerning problems of multiple diseases. All systems are confronted by problems of consensus and authority of the underlying information used.
Computers↗
[A computer-controlled monitoring and therapy system for shock compensation in severe burns (author's transl)].
A computer-controlled control loop for the automatic diagnosis of shock and infusion therapy is reported. External information (off-line) and vital parameters measured with serial devices (on-line) are used by the computer for the automatic control of infusion pumps. By this method the critical shock phase could be prevented in five seriously burned patients. The construction of the system also permits its use in other shock conditions.
Blood Pressure↗
[The effectiveness of treatment for breast cancer patients].
The study of late results of treatment in 1166 patients with breast cancer permitted to find the percentage of a 5-year survival to be equal to 55.58, 37.93% of patients survived for 10 years, 28.25% -- for 15 years. In the first stage a 5-year survival was 87.20%, while in the second and third -- 57.7% and 31.56% of patients survived for 5 years, accordingly. The modern methods of radiotherapy (radiosurgical method, interstitial gamma therapy with Au-198 granules, distance grammatherapy on the machine LUCH) enhanced the efficacy of therapeutic measures in patients with widespread breast cancer. A complex diagnosis -- cytology, non-contrast mammography and mathematical analysis by means of a computer contributes to recognition of early forms of breast cancer.
Adenocarcinoma↗
Enlarged acid-base and blood gas calculations by electronical data computing in the blood gas laboratory.
A rapid anaysis of parameters of the acid-base equilibrium and blood gases during open heart surgery and emergency therapy is absolutely necessary. Computing of the several parameters of the acid-base status by slide rules or nomograms is time consuming and can be shortened by computer applications. The central blood gas laboratory consists of a blood gas analyzer for PO2, PCO2 and pH, an electronic desktop calculator, a four color X-Y-plotter and two data lines to the cardiac surgery unit and to the intensive care unit. The time needed for computing and feedback of the parameters could be decreased to one quarter. In addition to numerical data printout, a graphical representation of the several parameters is possible on a X-Y-plotter and includes the Rahn-Fenn-O2-CO2-Diagram with venous admixture, ventilation perfusion ratio, alveolar dead space ventilation and the standard and actual oxygen dissociation curve as well as the pH/HCO3- Acid-Base nomogram. Furthermore, a computer diagnosis of the actual disturbances can be plotted.
Acid-Base Equilibrium↗
[Electronic data processing in the clinical nuclear medicine].
Computer techniques as introduced into clinical nuclear-medicine 12 years ago, were first exclusively used for scintigraphic purposes. Through the development of a comprehensive pilot system for nuclear medical data processing on the basis of two Siemens Process control computers it could be demonstrated, that besides of scintigraphy there are also other important fields for computer application, e.g. in function diagnostics and therapy planning.
Bayes Theorem↗