[New role and position of the nurse in the changing medical system].
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Delivery of Health Care↗
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Results for “Medication Systems”
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.
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Drug diversion control systems, medical practice, and patient care.
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Drug Prescriptions↗
International Medical Systems Exposcop Plus mobil C-arm system.
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Equipment Design↗
Photothermal sclerosis of leg veins. ESC Medical Systems, LTD Photoderm VL Cooperative Study Group.
BACKGROUND: The flashlamp-pumped pulse dye laser at 585 nm has previously been reported to be somewhat effective in treating leg telangiectasia with diameters less than 0.2 mm. A pulsed photothermal devise (intense pulsed light source [IPLS]) has been developed to treat leg veins ranging in size from 0.1 to 3 mm in diameter. Vessel necrosis occurs from an intense pulsed light that penetrates through the skin and is absorbed by the blood vessels based on the principle of selective photothermolysis. OBJECTIVE: To determine the effectiveness of this novel device on treating leg veins. METHODS: One hundred fifty-nine patients with 369 lesions were treated with the IPLS in a multicenter trial. RESULTS: Clearance of 75-100% was achieved in 79% of treated lesions. Better than 50% clearance was achieved in 94% of completed cases. A very low rate of adverse effects occurred. CONCLUSION: The IPLS is a safe and effective modality to treat leg veins ranging in size from 0.1 to 3 mm in diameter.
Adolescent↗
Computer-based medical system for the computation of blood pressure excess in the diagnosis of hypertension.
A computer-based system for assessing hypertension was designed by combining hardware for automatic, long-term blood pressure (BP) measurement with a set of software modules for computing time-specified tolerance intervals and evaluating measures of BP excess. BP is so variable that the identification and proper definition of hypertension are highly ambiguous when based on single measurements. One first step in dealing with such variability is to replace the constant limits for BP frequently used in the assessment of hypertension by a time-specified reference interval. Once such a threshold is available, a hyperbaric index can be computed by numerical integration as the total area (within one cycle) of any given patient's BP above the threshold. In order to examine the extent of normal physiologic excess, a series of 266 systolic and diastolic BP and heart rate (HR) measurements were automatically monitored every 30 minutes for at least 48 hours from clinically healthy subjects, aged 19 to 25 years. Original data were used to obtain 90% tolerance intervals for each gender separately. The hyperbaric index was then computed for each individual BP profile. The distribution of the maximum hyperbaric index (maximum of the values computed for systolic, mean arterial, and diastolic BP levels shows a highest value of 14.839 mmHg x hr for the men and of 10.229 mmHg x hr for the women. These values represent a testable threshold for assessing hypertension based on the proposed approach. The tolerance intervals obtained from the reference population were also used to compute hyperbaric indices for a series of 175 BP measurements sampled from clinically healthy people, as well as a series of 60 measurements sampled from patients with mild hypertension. Sensitivity and specificity in the diagnosis of hypertension based on the hyperbaric index were both 100%, as opposed to values obtained from computing the BP load, the average of the BP series, or the circadian amplitude, all of which provided a much poorer diagnostic test. The software system developed for automatically establishing time-qualified tolerance limits from a reference population and assessing the extent and timing of BP elevation for a test subject may help to establish a prognosis and diagnosis, with a correspondingly better assessment of health status, to initiate treatment if needed, to time treatment when it is most desirable and least harmful in terms of undesired effects, and to gauge the patient's response to treatment.
Adult↗
First contacts between Indian and European medical systems: Goa in the sixteenth century.
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Cross-Cultural Comparison↗
[The effect of wood dust on the respiratory system. Medical examination of furniture factory workers].
The medical-environmental questionnaire, physical examination and pre-shift and post-shift spirometry have been performed in 48 furniture factory workers. The workers showed the work-related symptoms: cough, shortness of breath, chest pain, headache, general malaise, skin symptoms, eye symptoms, rhinitis. No relationship was found between the spirometry values and the frequency of the symptoms. The exposed workers showed a significant post-shift reduction of the FVC, FEV1, FEV1%VC and PEF (p < 0.001). The higher drops of the spirometric parameters occurred in younger workers. The presented data show that processing of wood may be associated with the work-related respiratory symptoms and diseases in exposed workers.
Adult↗
Students evaluate MEDFILE, a preprinted medical literature filing system.
Medical professionals are highly dependent on personal libraries and reprint files as their sources for current information. A large population of practising doctors have poorly organized medical literature data bases in their professional environment. To expedite the development of a personal library data base by medical students, we created MEDFILE, a preprinted, cross-indexed file folder system for organizing the medical literature. This paper reports the results of two surveys performed in connection with the distribution of the MEDFILE system. One hundred per cent of the students who used MEDFILE found the system to be beneficial. Ninety-seven per cent felt their ability to find their personal literature improved by using MEDFILE, and 65% felt MEDFILE improved their clinical preparation. Of all surveyed recipients of the system, 96.8% felt MEDFILE would be useful in their future studies.
Attitude of Health Personnel↗
Evaluation of the Unified Medical Language System as a medical knowledge source.
OBJECTIVE: The authors evaluated the use of the Unified Medical Language System (UMLS) as a medical knowledge source for the representation of medical procedures in the MAOUSSC system. DESIGN: MAOUSSC, a multiaxial coding system, was used for the representation of 1500 procedures from 15 clinical specialties, using UMLS concepts (augmented by full sources for three new vocabularies being added to the UMLS) and relationships whenever possible. Evaluation criteria for the UMLS included (1) completeness of representation of concepts and of inter-concept relationships, (2) consistency in the categorization of both concepts and inter-concept relationships, and (3) usability, including adaptability of the UMLS to a foreign language (French), its suitability to a geographic region with different medical practices than the USA, and issues relative to the annual update changes in the test vocabularies. RESULTS: During the MAOUSSC trial, the number of missing concepts or relationships identified in the augmented UMLS sources was deemed to be inconsequential relative to overall project goals. "Missing" UMLS inter-concept relationships were identified, although they were small in number. Some inconsistencies in the UMLS were noted, especially in the area of hierarchic relationships. CONCLUSION: After UMLS was used for five years as a knowledge source for representing 1500 complex medical procedures in MAOUSSC, its value is considered significant. Future editions of the UMLS are expected to improve representation of inter-concept relationships and global consistency.
Language↗
Systemic collapse: Medical care in the aftermath of Hurricane Katrina.
This article describes and analyzes key aspects of the medical response to Hurricane Katrina in New Orleans. It is based on interviews with individuals involved in the response and on analysis of published reports and news articles. Findings include: (1) federal, state, and local disaster plans did not include provisions for keeping hospitals functioning during a large-scale emergency; (2) the National Disaster Medical System (NDMS) was ill-prepared for providing medical care to patients who needed it; (3) there was no coordinated system for recruiting, deploying, and managing volunteers; and (4) many Gulf Coast residents were separated from their medical records. The article makes recommendations for improvement.
Delivery of Health Care↗
Design of medical device alarm systems.
Medical device alarms are intended to enhance safety by augmenting the operator's ability to monitor an array of system and patient variables. To this end, alarm design must consider both technical and human requirements. Technical factors include selection of variables, limit-setting techniques, alarm reliability, and alarm output system. Human factors include the types of controls, displays, and instructional materials that assist the users in effective use of the machine. The designer and the user of medical devices must recognize that alarms can at times present problems unless the operator takes care to maintain correct use and to avoid false reliance on the alarm's ability to indicate all unacceptable conditions in the clinical setting.
Biomedical Engineering↗
Medical Practice Support System. A medical practitioner's multimedia workstation.
The United States Navy has developed a computer based Medical Practice Support System (MEPSS) intended for use by medical practitioners working in isolated situations. The system, now being tested in operational settings, emphasizes inexpensive, easily obtained off-the-shelf hardware and specially developed, readily implemented software to provide users with: 1) medical record keeping, 2) an electronic medical library, 3) interactive video instruction programs suitable for continuing medical education, 4) computer based medical diagnosis and treatment assistance, and 5) electronic communications with other facilities. This demonstration emphasizes a user based developmental approach, integration of diverse systems under a single user interface, and portable hardware. The resulting system makes medical information needed by practitioners instantly available at the time of a patient encounter, whenever and wherever that encounter may occur. Making clinically valuable information immediately available, MEPSS demonstrates how practitioners can use computers to help their own efforts to improve patient care quality and efficiency.
Decision Making, Computer-Assisted↗
[Status of the clinical laboratory in the mandatory postgraduate medical training system: from the medical technologists' view (2)].
When the new system of mandatory postgraduate medical training was introduced, we developed a new training program in our clinical laboratory. We will describe this training program in the microbiology laboratory and our experience. We have had 45 min practice of basic microbiology tests, including Gram staining and microscopic examination, for first-grade postgraduate doctors since 2004, and during this practice we emphasize the importance of quality in the clinical specimens collected for cultures and at the same time, explain how to read microbiological test results. Although we had prepared a kit for the Gram-staining procedure to be used any time they want, it was very disappointing that no doctors used this kit to diagnose an infectious disease. In 2005, four 2nd grade doctors selected the training course in our clinical laboratory for 2 months and 3 of them have finished. In the microbiological laboratory we were in charge of the program for 1 or 2 weeks, which includes the isolation and identification of bacterial pathogens from clinical samples and their susceptibility tests, and the isolation, identification and nucleic acid amplification test for Mycobacterium tuberculosis. All of these trainees acquired the basic knowledge and skills required for microbiological diagnosis. This activity gave us a great opportunity to understand what they do not know and what they want to know. We now have some useful suggestions to develop a good education system for medical microbiology for postgraduate doctors.
Education, Medical, Graduate↗
Modelling and eliciting organisational and information system requirements for medical information systems.
In this paper an outline of a modelling technique will be presented that allows for the encapsulation and analysis of the social and technical aspects of an organisational information system. This notation is used to construct and analyse both the static and dynamic models of organisations and organisational behaviour. The construction and analysis is achieved through the use of concepts such as role and responsibility. The conceptual modelling framework is then applied to a case study. This case study is based upon an accident and emergency department of an inner city hospital situated within the centre of Dublin, Ireland.
Emergency Service, Hospital↗
Using a bar-coded medication administration system to prevent medication errors in a community hospital network.
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Adult↗
Bar coding at the bedside. New England hospital implements an automated point-of-care medication administration system to reduce medication errors and their associated complications.
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Automation↗
Pilot study on the effects of a computer-based medical image system.
Current medical imaging systems are developed for the purpose of data management. Evaluations of these systems are usually done by assessing users' subjective appreciation rather than objectively gauging performance influence. The present report discusses the evaluation of a medical image presentation system prototype utilizing a cognitive approach. Experimental results showed hypothesized performance improvement attributed to advanced presentation techniques. However, this improvement was almost inadvertently masked by users' previous strategies and interactions with new technology. Overall these data demonstrate the potential benefit of implementing such a system in actual practice as well as provide an example of applying the cognitive approach in evaluating the usability of medical systems.
Cognition↗
HL7 ontology and mobile agents for interoperability in heterogeneous medical information systems.
Modern medical information management is a knowledge intensive activity requiring a high degree of interoperability across various health management entities. Ontology-based multi-agent systems provide a framework for interactions in a distributed medical systems environment without the limitations of a more traditional client server approach. In this paper, we describe electronic Medical Agent System (eMAGS) a multi-agent system with an ontology based on an accepted public health message standard, Health Level Seven (HL7), to facilitate the flow of patient information across a whole healthcare organisation.
Computer Communication Networks↗