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PubMed1980

Atherosclerosis and mortality statistics.

WHO mortality statistics are subject to severe criticism all over the world due to the ICD code, the monocausal evaluation and th inhomogenity of data which are only partially verified by post mortem findings. Despite this fact WHO statistics are the only possibility to compare morality in different areas. In order to prove their reliability we have collected data of patients who have died in 9 Vienna hospitals. Our material consists of more than 15000 out of 25000 death cases in the year 1976. The autopsy rate was about 70%. To handle this amount of datas a computer system was used. In comparison with the official Austrian statistics our total atherosclerosis rate was higher due to the multicausal evaluation and the much higher percentage of CHD. Atherosclerosis of the brain was found in a lower percentage than officially mentioned when autopsy was performed. An example for single case studies is the myocardial infarction in a defined age group to support the importance of statistics based on a high rate of autopsies and the use of electronic data processing.

Aged↗
PubMed1981

[Emergency tests in the central laboratory of a hospital (author's transl)].

In 1975 an emergency laboratory, which is quite independent of the routine laboratory, was established within the central laboratory. The emergency laboratory carries out urgent chemical and hematological analyses and coagulation tests around the clock. As accelerated and late tests as well as not urgent tests on Saturdays and Sundays are done in the routine laboratory it was possible to restrict the demands on the emergency laboratory largely to tests of clinical emergency cases. One medical technician is permanently present in the emergency laboratory, one clinical chemist is on call. The emergency laboratory is subject to a severe quality control to ensure precise and correct results which correspond with the results of the routine laboratory. In 1980 56,392 emergency tests were carried out. These are 5.7% of all tests done in the central laboratory. On the average it takes 21.6 minutes for analytical work from the arrival of the sample until transmitting the result. The costs of the emergency tests amount to 3 to 4 times the costs of the mechanized routine tests. In some foreign hospitals the integration of "actualized" routine tests into the emergency laboratory has led to a share of 25% of the total amount of tests and to the full mechanisation with an own EDV system. These tests should not be carried out in the emergency laboratory. They should be carried out in the "actualized"routine laboratory with the help of a new generation of analyzers and a new concept for electronic data processing.

Austria↗
PubMed1981

Epidemiology of occupational noise-induced hearing loss in Poland throughout 1971--1979.

In Poland a uniform system for registering occupational diseases is mandatory. Special individual statistical cards of diagnosed cases are delivered from all over the country to the Institute of Occupational Medicine in Lodź, where the incidence of diseases is analysed using electronic data processing system; such procedure is aimed, among others, at specification of prophylactic needs. Due to this, epidemiological studies could be carried out of the prevalence of occupational noise -- induced hearing loss in the total national economy throughout 1971--1979. Of the 35 mln Polish population, approx. 5 mln. 240 thous. persons are employed in industry, in this about 600 000 workers exposed to noise levels posing a risk of the hearing impairment of (Leq greater than or equal to 90 dB-A). It was found that occupational noise -- induced hearing loss was most frequent among all occupational diseases and its incidence rate exceeded 16 new cases annually per 100 000 employees. The highest incidence rate concerned transport means industry, coal mining and textile industry. The data analysis, by age and exposure duration, showed that the disease mostly affects those aged 40 -- 49 and 50 -- 59, as well as those exposed to excessive noise levels for over 20 years. In addition, the distribution of occupational noise -- induced hearing loss in specific areas throughout the country, considering the degree of industrialization, was analysed. The highest incidence rate was found in the Southern and Western areas of Poland. The above information seems to be essential for setting up more efficient hearing conservation program in industry.

Adult↗
PubMed1981

Some research opportunities in hospital pharmacy.

Research opportunities in hospital pharmacy, especially in administrative and managerial areas, are discussed. Six areas of hospital pharmacy practice that have potential for research are discussed: personnel, inventory, services, evaluation, management, and research/education. Specific topics mentioned are employee satisfaction, technicians and their impact on hospital pharmacy, purchasing, use of electronic data processing in inventory control, extent of decentralization of pharmaceutical services, pharmacy and therapeutics committees, reimbursement for consultations and pharmacokinetics services, quality assurance, evaluation of pharmacy management, and the cost-benefit ratio of research and education activities.

Costs and Cost Analysis↗
PubMed1995

Magnetoencephalography and magnetic source imaging. Capabilities and limitations.

The advent of large-array superconducting biomagnetometer systems, including sophisticated operating and data processing electronics, has enabled practical patient studies evaluating the potential contribution of magnetoencephalography to clinical medicine. The superimposition of sources localized magnetically onto anatomic images, referred to as magnetic source imaging, has allowed physicians to conduct this evaluation in the content of their customary medical practice. This article summarizes the basic technology of magnetoencephalography and magnetic source imaging and includes brief descriptions of the various applications that are being studied with these new sensor systems, some of which are discussed in subsequent articles.

Brain↗
PubMed1975

[Radioimmunologic diagnosis and pathobiochemistry of the renin-angiotension-aldosterone system. Report of the workshop conference of the German Society for clinical chemistry on January 31 and February 1, 1975 in Bonn (author's transl)].

Studies on the individual components of the renin-angiotensin-aldosterone system are of crucial importance for the investigation of hypertension. The purpose of the workship conference was to give occasion for discussion amongst German speaking research groups on the determination of the individual components of this system, and for the consideration of new results and their pathophysiological significance, as well as possibilities for the evaluation of radioimmunological data with the aid of electronic data processing. The following report is a summary of the contributions to the discussion by those taking part in the workshop conference.

Aging↗
PubMed1995

[Medical informatics in research, teaching and patient management].

The field of medical informatics in its current understanding is defined and criteria distinguishing this field from similar areas are provided. Special consideration is given to its position at a School of Medicine - in particular to the University of Vienna Medical School with the Vienna General Hospital as its teaching hospital. Demands for medical informatics and electronic data processing (EDP) in this extended field of activity come from four different sources: (1) research in medical informatics, (2) teaching of medical informatics as well as EDP training, (3) EDP service for research and teaching, and (4) EDP hospital operations to assist patient care. (Purely administrative EDP demands are not considered here.) It is shown that the different demands can be fulfilled by the usually available institutions involved in medical informatics and EDP at a School of Medicine. At many places these institutions are as follows: (1) a department or division of medical informatics with a possibly attached computer center dedicated to provide assistance in the area of research and teaching, (2) the computer center of the respective university the School of Medicine belongs to, (3) the computer center of the hospital-owned institution responsible for all EDP activities connected to patient care, and (4) external software companies and EDP training centers. To succeed in the development of an exhaustive, school-wide system of medical informatics and EDP that considers the different demands in research, teaching, and EDP hospital operations equally, close and well-suited coordination between the institutions involved is necessary.

Artificial Intelligence↗
PubMed1994

[Registration of activities at Norwegian anesthesia departments].

Documentation and quality control of anaesthesiologic activity based on electronic data processing is less than optimal in Norwegian departments of anaesthesia. Major efforts have been made to register and store information in large data bases. It has been difficult, however, to put the collected data to practical use. The Norwegian Association of Anaesthesiologists has developed and distributed a data program, NAFREG, which is designed to take care of a minimum set of basic data to serve our needs. In order to obtain data of relevance to quality, a special code list has been developed to facilitate registration of problems related to anaesthesiologic activity. NAFREG has been in use for more than three years, and has been distributed to more than 30 hospitals in Norway. The article evaluates the registration system as practised in six hospitals participating in an evaluation project.

Anesthesia Department, Hospital↗
PubMed1993

The reporting of dental care. A comparison of time and activity related follow-up methods.

In 1989, a time study method was developed and tested by the Public Dental Service, Göteborg Sweden (PD). The purpose was to estimate the distribution of time used for different activities in the PD clinics supplying general dental care. Using the results from the test of the time study (TIA) the aim of the present study was to compare, evaluate and discuss the corresponding reported results from the administrative Electronic Data Processing (EDP) systems used for reporting dental care, and to analyze the parameters included as tools for reporting dental care procedures. This study has shown that values for diagnostic and preventive procedures were too high as reported, in relation to intervention procedures, whereas agreement was good with regard to the values in the intervention categories for dental procedures. The reported values from the EDP systems which are based on the codes in the Swedish dental insurance tariff, represent dental care in the intervention categories. However, one must take account of the verified divergences in reporting values concerning all three main areas of dental procedures. Correct time reporting for the main sectors of dental procedures--diagnostic, prevention and intervention sectors--will improve the validity of EDP systems for cost report.

Adolescent↗
PubMed1977

[Information and statistics in pathological anatomy].

The theme is centred on the topics: informatics without computer-stitistics without numbers. Informatics without computers: the development of electronic data processing in medicine and especially in pathology has demonstrated that we are still far from clear text processing or automated diagnosis. An essential reason is seen in the fact that the present nomenclature allows no clear distinction between the terms of entity of disease and diagnosis. An exact differentiation between these terms is prerequisite for a further development of data processing. Statistics without nombers: In a larger interdisciplinary study we examined how the known risk factors to arteriosclerosis and myocardial infarction can be correlated upon the morphometrical explored patho-anatomical changes of the coronary vessel system. The method used was the factor analysis. In about 30% of the observed cases (total number: 419) the morphologic aspect alone and under simultaneous consideration of the risk factors did not sufficiently explain the patho-anatomically detected myocardial infarctions. As a possible explanation of this phenomenon the simultaneous and concordant attack of the intramural coronary vessels is being discussed.

Arteriosclerosis↗
PubMed1995

[Principles and limits of auditory equipment].

A very wide choice of hearing aids are available to the hearing aid acousticians. Thanks to the progress in electronics they have greatly improved over the last few years. The principles of the hearing aid remain the same but the results are getting better and better. Thus, the hearing aid acousticians can make the hearing aid meet the needs of the individual, cut down the drawbacks and make the hearing aids ever more effective.

Acoustics↗
PubMed1996

The Danish Conscription Registry: a resource for epidemiological research.

According to the Danish constitution all Danish male citizens must appear before a Conscript Board for assessment prior to military or civil service. Conscript Board examinations have followed the same standardized procedures over many decades, and the Danish Conscript Registry represents a valuable resource for epidemiological research in Denmark. During the last two decades investigations based on information in the registry have produced significant contributions to many areas of medical science. Within the last decade new procedures and electronic data processing and storage have resulted in restricted possibilities concerning current and future utilization of the Danish Conscript Registry for epidemiological purposes. To improve this it is recommended to maintain all codes describing present illnesses and conditions together with the civic registration numbers in the computerized archive of all subjects assessed by the Conscript Board.

Adolescent↗
PubMed1977

[Isotopic study of cardiac hemodynamics after multiple valve prothesis (author's transl)].

The radiocardiography of the minimal transit times (MTTs) produces cardiologically useful hemodynamic data also in such instances where invasive techniques with the cardiac catheter are technically difficult, as is the case in patients with multiple valve prothesis. The present study reports on MTT measurements in 9 patients with tricuspidal prothesis, 8 of which had additional mitralvalve prothesis and 2 additional aortic valve prothesis. The measurements were made with Tc-99m Pertechnetate, and an Anger camera with electronic data processing was used as detector system. The results indicate that following implantation of valve prothesis the hemodynamic state remained essentially disturbed. The pathologically altered transit times are an expression of disturbed volume ratios. The transit times in the atria remained prolonged by an average factor of 4-5. The ejection of the left ventricle stayed diminished more pronounced than on the right. The values of one patient who was examined before and after implantation of the prothesis in mitral and tricuspidal position, also showed a worsening of the data especially in the atria. Because the cardiac function study with radioisotopes is non invasive, simple, and fast, and leads to only a minor radiation burden, the method may be repeated and without hazard used for control follow-ups.

Adult↗
PubMed1977

[ADP system for automatic production of physician's letters as well as statistics analyses in the area of obstetrics and perinatology].

Report about an electronic data processing system for obstetrics and perinatology. The developed data document design and data flowchart are shown. The continuously accumulated data allowed everytime a detailed interpretation record. For all clinical treated patients the computer printed out a final obstetrical report (physician report). By means of this simple system there is an improvement of the information and the typewriting work of medical staff has been reduced. Cost and work-expenditure for this system are limited in relation to our earlier hand made procedure.

Computers↗
PubMed1997

[Routine PCR screening for HBV, HCV and HIV-I genome in a large blood donation services--experiences and initial results].

We adapted the PCR method to screen up to 3,000 blood donations per day for HBV, HCV, and HIV-1 contamination. Concerning logistics: The first step is the generation of 3 identical microtiter plates (PT) by using the self-validated automatic sample processor with disposable tips. Using the first PT, we pooled up to 600 aliquots taken from blood donations which are serological negative and free for clinical usage according to actual federal regulations. In the case of a positive PCR pool result the viremic donation is identified by 2 additional PCR pool testing steps with smaller pool sizes using the second and third PT. All described steps are supported by electronic data processing. The PCR-method: After virus concentration by ultracentrifugation and--in case of HCV and HIV-1--additional reverse transcription PCR-amplifications were performed. PCR in two genomic regions are done for each virus. Laser-induced fluorescence detection after polyacrylamide gel electrophoresis and computer analysis were used to check the amplification products. Using this approach, a virus-containing donation can be detected in up to 599 negative samples with following sensitivity: HBV and HIV-1, 1,000-1,500 genome equivalents/ml; HCV, 2,000-2,500 genome equivalents/ml, thus sensitivity being in the range of commercial available PCR kits when testing nonpooled samples. The sensitivity was validated by using national and international available standards with known virus genome concentrations. All processing steps are checked using different controls such as, e.g., negative, positive, premix controls, reporter virus, inhibition controls. Routinely employing this validated methodology, we investigated 327,013 donations until the end of June 1996. During this survey, we found at least 16 virus-containing donations which are negative in corresponding serological tests and would have been transfused (4 HBV-, 13 HCV-, 0 HIV-1-containing donations), including one later seroconversion for HBV and one for HCV. Using our adapted PCR-methodology, it seems possible to shorten the diagnostic window periods with acceptable costs for large transfusion centers (15 DM per donation for all 3 viruses including all steps and investments). Therefore, PCR seems to become a new method of choice to prevent transfusion transmitted infections.

Blood Banks↗
PubMed1976

[Progression of rheumatoid arthritis].

In order to recognize courses with high and low progression in rheumatoid arthritis deviating from former approach the values of a locomotor function test were used which do not belong to the dispersion region for the adequate classes of duration of a disease. With the help of a material of an electronic data processing study of 1,000 cases with ascertained diagnosis correlations between high progression and, among others, following criteria could be ascertained: male sex, old age, early beginning of the disease, manual trades, unfavourable functional values and very much changed laboratory values including high titres of the rheumatoid factor. In this method there was no relation to the duration of the disease, as it was existing with other methods of the determination of progression which were comparatively included into the investigation.

Adult↗