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[Electronic forum of Revista de neurología: 'Internet, Medicine and Neuroglia'].

INTRODUCTION: In recent years Internet has drastically transformed the world of telecommunications. Questions about whether Internet and the global communication accessibility may be considered as a fundamental aspect in the medicine of today and tomorrow have been brought up. OBJECTIVE: Discuss current and future applications of Internet to the field of Medicine and Neurology. METHODS: Bibliographical review based on Medline and standard Web search engines. Forum sessions performed through Internet by means of Web-Chat. Forum coordination entirely performed by electronic mail. RESULTS: There are several opinions regarding the influence of Internet on Medicine and Neurology. Currently, the communication and collaboration between teams is improving. It allows scientific publications on-line, improves continuous remote training and facilitates information to patients. New applications like telemedicine need more development. CONCLUSIONS: Currently, Internet represents an efficient tool for collaboration, training and distribution of information in the field of Medicine and Neurology.

Humans↗

Towards a component driven infrastructure for integrated healthcare systems.

A high level summarised description of the distributed clinical information system implemented in the hospital of the free university of Brussels (AZ-VUB) is described. It evolves towards a component based clinical distributed system that consists of a set of co-operating middelware software components running on a number of computers connected by a network that will foster the integration of applications, data servers and other resources in the medical field. This system is implemented in the University Hospital of Brussels (AZ-VUB) a full-service 800-bed university hospital that provides care for 23,000 inpatients, supports over 300,000 outpatient visits and receives 32,000 emergency patients a year.

Belgium↗

Automated production of an on-line laboratory reference manual from a laboratory information system.

Laboratories provide information beyond test results, including information related to patient preparation, specimen collection and handling, test methodology, test availability, and interpretation of results. Most laboratories publish reference manuals to distribute this information to clients, while relying on the laboratory information system to provide this information to laboratory staff. Maintaining duplicate sources of information is expensive and error-prone, and printed materials become rapidly outdated. We developed a process to automate the production of a web-based reference manual directly from the laboratory information system, using a combination of MUMPS programs and HTML templates. We now focus our resources to assure that the laboratory information system database is accurate and complete, and then with minimal additional effort or expense produce an up-to-date on-line reference manual. We are therefore able to provide better sources of information in a sustainable manner.

Clinical Laboratory Information Systems↗

Information content of Caenorhabditis elegans splice site sequences varies with intron length.

A database of sequences of 139 introns from the nematode Caenorhabditis elegans was analyzed using the information measure of Schneider et al. (1986) J. Mol. Biol. 128: 415-431. Statistically significant information is encoded by at least the first 30 nt and last 20 nt of C. elegans introns. Both the quantity and the distribution of information in the 5' splice site sequences differs between the typical short (length less than 75 nt) and rarer long (length greater than 75 nt) introns, with the 5 sites of long introns containing approximately one bit more information. 3' splice site sequences of long and short C. elegans introns differ significantly in the region between -20 and -10 nt.

Animals↗

Population encoding of spatial frequency, orientation, and color in macaque V1.

1. We recorded local field potentials in the parafoveal representation in the primary visual cortex of anesthetized and paralyzed macaque monkeys with a multicontact electrode that provided for sampling of neural activity at 16 sites along a vertical penetration. Differential recordings at adjacent contacts were transformed into an estimate of current source density (CSD), to provide a measure of local neural activity. 2. We used m-sequence stimuli to map the region of visual space that provided input to the recording site. The local field potential recorded in macaque V1 has a population receptive field (PRF) size of approximately 2 deg2. 3. We assessed spatial tuning by the responses to two-dimensional Gaussian noise, spatially filtered to retain power only within one octave. Responses to achromatic band-limited noise stimuli revealed a prominent band-pass spatial tuning in the upper layers, but a more low-pass spatial tuning in lower layers. 4. We assessed orientation tuning by the responses to band-limited noise whose spectrum was further restricted to lie within 45 degrees wedges. The local field potential showed evidence of orientation tuning at most sites. Orientation tuning in upper and lower layers was manifest by systematic variations not only in response size but also in response dynamics. 5. We assessed chromatic tuning by the responses to isotropic band-limited noise modulated in a variety of directions in tristimulus space. Some lower-layer locations showed a nulling of response under near-isoluminant conditions. However, response dynamics in upper and lower layers depended not only on luminance contrast, but also on chromatic inputs. 6. Responses to near-isoluminant stimuli and to low-contrast luminance modulation were shifted to lower spatial frequencies. 7. We determined the extent to which various temporal frequencies in the response conveyed information concerning spatial frequency, orientation, and color under the steady-state conditions used in these studies. In each case, information is distributed in the response dynamics across a broad temporal frequency range, beginning at 4 Hz (the lowest frequency used). For spatial frequency the information rate remains significant up to at least 25 Hz. For orientation tuning and chromatic tuning, the information rate is lower overall and remains significant up to 13 Hz. In contrast, for texture discrimination, information is shifted to lower temporal frequencies.

Animals↗

Establishment of a drug information service on a public-access computer bulletin board.

OBJECTIVE: Computerized bulletin board services (BBSs) have existed for several decades; in recent years there has been increased use and acceptance. We have established a drug information service called The Pharmacy on a local public-access BBS, the Cleveland FreeNet. The goal of this service is to provide drug information to the lay public as well as healthcare professionals. DESCRIPTION: The Pharmacy is divided into 4 areas: (1) About the Pharmacy, which provides instructions for use; (2) Drug Information, which contains postings on selected drug information topics that are prepared by the BBS staff; (3) Pharmacy Questions, the most popular feature, where FreeNet users are invited to post questions, the answers to which are provided by clinical, staff, and consultant pharmacists, as well as baccalaureate and graduate pharmacy students; and (4) Investigational Studies, where patient recruitment for investigational studies is done. RESULTS: A total of 259 questions have been posted in the first 3 years of operation. An average of 5.2, 7.78, and 8.7 questions/month have been posted in 1992, 1993, and 1994, respectively. Four drug information monographs have been prepared and posted, and approximately 5 investigational studies have been advertised. CONCLUSIONS: A computerized BBS is a new means of distributing drug information to the public and healthcare professionals. In addition to meeting a need for a public service of drug information in the community, it permits increased visibility for pharmacists and a unique learning experience for students.

Community Networks↗

Padlocked societies.

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Ambulatory Care Facilities↗

Don't be scared.

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Behavior↗

The use of a geographical information system (GIS) to evaluate the distribution of tuberculosis in a high-incidence community.

OBJECTIVE: To determine the geographical distribution of tuberculosis in the two Western Cape suburbs with the highest reported incidence of tuberculosis. DESIGN: Descriptive illustrative study. SETTING: Two adjacent Western Cape suburbs covering 2.42 km2 with a population of 34,294 and a reported tuberculosis incidence of > 1,000/100,000. SUBJECTS: All patients notified as having tuberculosis over a 10-year period (1985-1994). INTERVENTIONS: None OUTCOME MEASURE: The geographical distribution of the cases was determined using a geographical information system (GIS) and the National Population Census (1991). RESULTS: One thousand eight hundred and thirty-five of the 5,345 dwelling units (34.3%) housed at least 1 case of tuberculosis during the past decade and in 483 houses 3 or more cases occurred. These cases were distributed unevenly through the community, with the tuberculosis incidence per enumerator subdistrict (ESD) varying from 78 to 3,150/100,000 population. CONCLUSION: In a small area with a high incidence of tuberculosis, the cases are spread unevenly through the community and there are certain houses where tuberculosis occurs repeatedly. This information should be used to direct health services to concentrate on certain high-risk areas.

Adolescent↗

PHEXdb, a locus-specific database for mutations causing X-linked hypophosphatemia.

X-linked hypophosphatemia (XLH) is a dominant disorder of phosphate (Pi) homeostasis characterized by growth retardation, rachitic and osteomalacic bone disease, hypophosphatemia, and renal defects in Pi reabsorption and vitamin D metabolism. The gene responsible for XLH was identified by positional cloning and designated PHEX (formerly PEX) to depict a Phosphate regulating gene with homology to Endopeptidases on the X chromosome. To date, 131 mutations in the PHEX gene have been reported. We undertook to centralize information on mutations in the PHEX gene by establishing a database search tool, PHEXdb (http://data.mch.mcgill.ca/phexdb). This site is dedicated to the collection and distribution of information on PHEX mutations, and is accessible to the scientific community. PHEXdb provides a submission form to allow the addition of newly identified mutations in the PHEX gene. Users can search the database by mutation, phenotype, and authors who have published or submitted mutations. The PHEXdb home page includes links to information pages, which refer to recent publications on PHEX, XLH, and murine Hyp and Gy homologues, and to other web pages relevant to XLH. This resource will facilitate the identification of PHEX structure-function relationships and phenotype-genotype correlations.

DNA Mutational Analysis↗

Phospho.ELM: a database of experimentally verified phosphorylation sites in eukaryotic proteins.

BACKGROUND: Post-translational phosphorylation is one of the most common protein modifications. Phosphoserine, threonine and tyrosine residues play critical roles in the regulation of many cellular processes. The fast growing number of research reports on protein phosphorylation points to a general need for an accurate database dedicated to phosphorylation to provide easily retrievable information on phosphoproteins. DESCRIPTION: Phospho.ELM http://phospho.elm.eu.org is a new resource containing experimentally verified phosphorylation sites manually curated from the literature and is developed as part of the ELM (Eukaryotic Linear Motif) resource. Phospho.ELM constitutes the largest searchable collection of phosphorylation sites available to the research community. The Phospho.ELM entries store information about substrate proteins with the exact positions of residues known to be phosphorylated by cellular kinases. Additional annotation includes literature references, subcellular compartment, tissue distribution, and information about the signaling pathways involved as well as links to the molecular interaction database MINT. Phospho.ELM version 2.0 contains 1703 phosphorylation site instances for 556 phosphorylated proteins. CONCLUSION: Phospho.ELM will be a valuable tool both for molecular biologists working on protein phosphorylation sites and for bioinformaticians developing computational predictions on the specificity of phosphorylation reactions.

Animals↗

Mechanistic information from analysis of molecular weight distributions of starch.

A methodology is developed for interpreting the molecular weight distributions of debranched amylopectin, based on techniques developed for quantitatively and qualitatively finding mechanistic information from the molecular weight distributions of synthetic polymers. If the only events occurring are random chain growth and stoppage (i.e., the rates are independent of degree of polymerization over the range in question), then the number of chains of degree of polymerization N, P(N), is linear in ln P(N) with a negative slope, where the slope gives the ratio of the stoppage and growth rates. This starting point suggests that mechanistic inferences can be made from a plot of lnP against N. Application to capillary electrophoresis data for the P(N) of debranched starch from across the major taxa, from bacteria (Escherichia coli), green algae (Chlamydomonas reinhardtii), mammals (Bos), and flowering plants (Oryza sativa, rice; Zea mays, maize; Triticum aestivum, wheat; Hordeum vulgare, barley; and Solanum tuberosum, potato), gives insights into the biosynthetic pathways, showing the differences and similarities of the alpha-1,4-glucans produced by the various species. Four characteristic regions for storage starch from the higher plants are revealed: (1) an initial increasing region corresponding to the formation of new branches, (2) a linear ln P region with negative slope, indicating random growth and stoppage, (3) a region corresponding to the formation of the crystalline lamellae and subsequent elongation of chains, and (4) a second linear ln P with negative slope region. Each region can be assigned to specific enzymatic processes in starch synthesis, including determining the ranges of degrees of polymerization which are subject to random and nonrandom processes.

Animals↗

Geographical and temporal distribution of human giardiasis in Ontario, Canada.

BACKGROUND: Giardia is the most frequently identified intestinal parasite in North America. Although information on geographical distribution of giardiasis is critical in identifying communities at high risk, little has been done in this area. Therefore, the objective of this study was to investigate the geographical and temporal distribution of human giardiasis in Ontario in order to identify possible high risk areas and seasons. Two spatial scales of analyses and two disease measures were used with a view to identifying the best of each in assessing geographical patterns of giardiasis in Ontario. Global Moran's I and Moran Local Indicators of Spatial Associations were used to test for evidence of global and local spatial clustering, respectively. RESULTS: There were seasonal patterns with summer peaks and a significant (P < 0.001) decreasing temporal trend. Significant (P < 0.05) global spatial clustering of high rates was observed at the Census Sub-division spatial scale but not at the Census Division scale. The Census Sub-division scale was a better scale of analyses but required spatial empirical Bayesian smoothing of the rates. A number of areas with significant local clustering of giardiasis rates were identified. CONCLUSIONS: The study identified spatial and temporal patterns in giardiasis distribution. This information is important in guiding decisions on disease control strategies. The study also showed that there is benefit in performing spatial analyses at more than one spatial scale to assess geographical patterns in disease distribution and that smoothing of disease rates for mapping in small areas enhances visualization of spatial patterns.

Journal Article↗

Methodist's migration path to the future.

As a result of work through the Care Data consortium in cooperation with Iowa Methodist and University of Chicago Hospitals, Methodist has implemented: an open systems integration strategy, a clinical repository, and clinician-centric access and distribution of information. The Care Data consortium gave rise to a new breed of automation that meets the needs of both ends of the clinical automation spectrum: migrating an integrated, single-vendor solution to an open systems integrated repository to users of a distributed, best-of-breed approach.

Computer Communication Networks↗

[Computerized decision support in drug prescribing II: A national database to provide up-to-date and unbiased information].

Prescribers today encounter increasing demands for up-to-date knowledge of medical advances and drug therapies, and for a straightforward dialogue with patients. Cost-effective drug treatment calls for fast and intuitive access to information about drugs, treatment strategies and patient data. There are several computer-based drug-prescribing systems in Sweden. Information independent of the drug industry is wanting, as are uniform national standards for medical content and functionality. Decision-support systems must facilitate decisions about therapy, drug distribution and intake, as well as quality work, i.e. support the entire process which defines an effective drug therapy. A very important feature is access to a patient's drug list showing all current drugs. This joint initiative by county councils aims at drawing up a national Swedish specification of requirements for a suitable decision-support system and at creating a national entity responsible for distributing unbiased information from a unique database to a range of computerized medical records systems.

Catalogs, Drug as Topic↗