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PubMed1994

Diffusion of digital radiology modalities in the Nordic countries and Japan.

The Nordic countries have 23 million inhabitants. About 14 million radiology examinations are performed annually at hospitals and in primary health care. This represents about 600 examinations per 1000 inhabitants per year. Japan, on the other hand, has 125 million inhabitants and annually performs about 200 million radiology examinations at hospitals and in primary health care. This represents about 1600 examinations per 1000 inhabitants per year. The above figures do not include dental X-ray examinations. Between 15% and 20% of all radiology examinations in the Nordic countries and about 5% in Japan are performed with digital modalities such as computerized tomography, digital subtraction angiography, computed radiography, and magnetic resonance imaging. Computerized tomography is the most diffused digital X-ray modality in the Nordic countries with 95,000 inhabitants per scanner while Japan only has 17,000 inhabitants per scanner. For magnetic resonance imaging the difference is almost of the same order. Japan has the same diffusion of magnetic resonance imaging units per 100,000 inhabitants as the Nordic countries have of computerized tomography scanners. The large difference between Japan and the Nordic countries regarding diffusion of digital radiology modalities is explained mainly by differences in the nature and organization of radiology services.

Diagnostic Imaging↗

PubMedDate not supplied

Information technologies, health, and "globalization": anyone excluded?

Modern information technologies and worldwide communication through the Internet promise both universal access to information and the globalization of the medico-social network s modes of communication between doctors, laboratories, patients, and other players. The authors, specialists in public health and members of an association that aims to create opportunities for access to training in public health in developing countries, warn that the use of the term "globalization" ignores the reality of the "digital divide," that is, the fact that social inequalities may preclude the realization of this promise on a truly global scale.

CD-ROM↗

PubMed1997

Can dentists recognize manipulated digital radiographs?

OBJECTIVES: To determine the ability of dentists to recognize digitally manipulated radiographs. METHODS: A poster was presented at the Annual Meeting of the German Society for Periodontology displaying the intra-oral radiographs of 12 different patients. Half of the radiographs were subjected to digital manipulation to add or remove specific features. Dentists were asked to identify these radiographs by means of a questionnaire. RESULTS: Thirty-nine dentists submitted usable questionnaires. Statistical evaluation revealed a distribution of hits similar to the random distribution. None of the dentists detected all the six manipulated radiographs; three dentists had five correct, but there were five with only one. An authentic radiograph scored highest as a manipulation. CONCLUSIONS: Image manipulations which alter the diagnostic content of a radiograph are unlikely to be detected by dentists. Digital radiography requires additional measures for data protection.

Clinical Competence↗

PubMed2005

Friends in the 'hood: Should peer-based health promotion programs target nonschool friendship networks?

PURPOSE: To examine the characteristics of inner city African-American adolescents nonschool-based and school-based friendship networks and to explore the influence of these networks on health risk behavior. METHODS: We assessed close friendships networks in a probability sample of inner city African-American youth living in a single neighborhood and describe the networks and health risk behavior of network members. The initial probability sample was obtained via telephone (Random Digit Dialing [RDD] sampling) and followed up with in-person interviews with telephone respondents (seeds). Subsequently, seeds' friends were recruited and completed an in-person interview. RESULTS: A majority of friendship networks included some nonschool friends (57%) and 24% of networks were composed exclusively of nonschool friends. As expected, youth were more likely to spend time with school-based friends on weekdays. On weekends, youth were equally likely to spend time with both school and nonschool networks. Youth in the same friendship group tended to engage in similar behaviors. Health risk behaviors were high regardless of whether networks were nonschool based, mixed, or school based. CONCLUSIONS: The high proportion of nonschool friendships suggests that out-of-school networks may be an important influence in this population. Youth spend time with their friends, regardless of network type, on weekends, and weekends are a high-risk period for health-damaging behaviors. Levels of experience with health risk behaviors suggest that both school and nonschool environments require intervention. Future social influence prevention efforts that are broad-based are likely to have maximal impact.

Adolescent↗

PubMed2003

Prevalence of claw disorders in Dutch dairy cows exposed to several floor systems.

Claw health was examined in an observational study on Dutch dairy farms with either a slatted floor (SL), slatted floor with manure scraper (SL-SCR), solid concrete floor (SCF), a straw yard (SY), or a zero-grazing feeding system (ZG). Hooves of cows' hind legs were examined for the presence and severity of claw disorders during hoof trimming events at the end of the pasture (P-study) and housing period (H-study). The number of cows in each study was 3078 (49 herds) and 3190 (47 herds), respectively. Due to a different hoof trimming strategy, data collected during both observation periods in SY herds (638 cows; 16 herds) were combined. Cows in straw yards (SY) had by far the lowest numbers of claw disorders. Over 80% of cows exposed to concrete flooring had at least one claw disorder at the time of observation, whereas on SY surfaces, this percentage was between 55 and 60. Cows on SL-SCR were less frequently affected by interdigital dermatitis/heel erosion (IDHE) and digital dermatitis (DD) than cows on SL (reference floor system). Little difference in claw health was found between SF and SL. The ZG cows were at higher risk (OR > 2) for most claw disorders in the P-study, whereas in the H-study, ZG cows showed less IDHE, sole hemorrhage, and sole ulcer. All herds on concrete flooring (SL, SL-SCR, SCF, ZG) were infected by DD, resulting in an average cow level prevalence of 30%. This indicates that the level of DD infection has increased considerably over the last 10 yr in The Netherlands.

Animals↗

PubMed2004

Computer telephony in healthcare.

The telephone provides an easy-to-use, reliable and cheap computer interface. We review computer telephony applications for patient care, clinical research and medical education. We describe uses at our academic health sciences centre and discuss strengths and weaknesses of this technology. Until more sophisticated interfaces, for example personal digital assistants with wireless Internet access, are commonplace, we believe computer telephony can play a useful role in electronic healthcare.

Canada↗

PubMed1999

A literature review on communication between picture archiving and communication systems and radiology information systems and/or hospital information systems.

The purpose of this literature review is to present the concepts surrounding the issue of communication between imaging systems and information systems in radiology and the literature about them. Picture archiving and communication systems (PACS) were developed to combine viewing of modality images, archiving, and distribution of images. When PACS is integrated/interfaced with radiology information systems (RIS) or hospital information systems (HIS), it can merge patient demographics, medical records, and images. To address several issues surrounding communication between PACS and HIS/RIS and to make interface development easier and faster, various organizations have developed standards for the formatting and transfer of clinical data. Additional work continues to better handle these issues. Communication protocol Health Level 7 (HL7) is a standard application protocol used for electronic text data exchange in health care by most HIS/RIS. The imaging communication protocol for PACS is the Digital Imaging and Communications in Medicine (DICOM) standard specification protocol that describes the means of formatting and exchanging images and associated information.

Computer Communication Networks↗

PubMed2006

A mobile clinical e-portfolio for nursing and medical students, using wireless personal digital assistants (PDAs).

This paper outlines the development and evaluation of a wireless personal digital assistant (PDA) based clinical learning tool designed to promote professional reflection for health professionals. The "Clinical e-portfolio" was developed at the University of British Columbia School of Nursing to enable students immediately to access clinical expertise and resources remotely, and record their clinical experiences in a variety of media (text, audio and images). The PDA e-portfolio tool was developed to demonstrate the potential use of mobile networked technologies to support and improve clinical learning; promote reflective learning in practice; engage students in the process of knowledge translation; help contextualize and embed clinical knowledge whilst in the workplace; and to help prevent the isolation of students whilst engaged in supervised clinical practice. The mobile e-portfolio was developed to synchronise wirelessly with a user's personal Web based portfolio from any remote location where a cellular telephone signal or wireless (Wi-Fi) connection could be obtained. An evaluation of the tool was undertaken with nurse practitioner and medical students, revealing positive attitudes to the use of PDA based tools and portfolios, but limits to the use of the PDA portfolio due to the inherent interface restrictions of the PDA.

Attitude of Health Personnel↗

PubMed2002

Informed consent for clinical photography.

The question of (informed) consent to medical photography has long been a vexed one. This paper briefly considers key landmarks in the debate, and examines in detail the evolution of the Addenbrooke's NHS Trust policy Photography and Video Recordings of Patients: Confidentiality and Consent, Copyright and Storage. The impact of the 1998 Data Protection Act, the Department of Health's Model Policy on Consent, and the implications of wider access to digital photography are discussed together with their integration into the Addenbrooke's policy.

Computer Security↗

PubMed2006

Virtual reality applications to agoraphobia: a protocol.

Recently, educators and instructional designers have focused on the development and implementation of virtual learning environments that effectively combine theoretical and applied knowledge to teach university students. One of the trusts of the Psychology Virtual Teaching Laboratory in collaboration with the IXTLI observatory is to develop dissemination programs to promote the insertion of virtual reality (VR) technologies applied to rehabilitation in their clinical practice. This paper describes the development of (1) agoraphobia VR learning objects to be use as a teaching support tools in class and (2) a multimedia teaching program that incorporate digital video and VR scenarios address to students in the field of mental health. Promotion among professors and students about the use of this technology will allow us to initiate research in our country as well as to validate contextualized applications for our culture, therefore contributing with new advances in this field.

Agoraphobia↗

PubMed1994

Protein intake and risk of renal cell cancer.

BACKGROUND: Renal cell cancer, although still relatively uncommon, has been increasing in incidence in the United States and other countries around the world. PURPOSE: Since previous studies have suggested an association with high intake of meat, we sought to further examine the role of diet in renal cell cancer risk. METHODS: Patients with histologically confirmed renal cell cancer that had been diagnosed between July 1, 1988, and December 31, 1990, were identified through the Minnesota Cancer Surveillance System, a statewide cancer registry. The patients eligible for inclusion in this study were white residents of Minnesota between 20 and 79 years of age. Control subjects were selected from the general population of Minnesota residents; subjects under age 65 were selected by use of a random-digit-dialing method and those 65 years or older were sampled from the Health Care Financing Administration files. Population-based control subjects were frequency-matched to cases by sex and 5-year age groups. A total of 690 patients and 707 control subjects were interviewed. Patients and control subjects were similar in distribution by sex, age, and educational level. Usual adult dietary intakes were assessed by questionnaire, and odds ratios were calculated by logistic regression analyses. RESULTS: Significantly increased risks of renal cell cancer were observed with increasing consumption of several food groups, including red meat (P for trend = .05), high-protein foods (P = .01), and staple (grains, breads, and potatoes) foods (P = .009). When examined by macronutrient status, risks increased monotonically with the amount of protein intake, from 1.2 (95% confidence interval [CI] = 0.7-1.9) to 1.4 (95% CI = 0.8-2.5) and 1.9 (95% CI = 1.0-3.6) (P for trend = .03) in the second, third, and fourth quartiles of intake, respectively, after adjustment for age, sex, caloric intake, body mass index, and cigarette smoking. No significant or consistent associations were detected with the intake of other dietary nutrients or beverages. CONCLUSION: Although an independent effect of dietary protein has not been previously associated with renal cell cancer, high protein consumption has been related to development of other chronic renal conditions that may predispose an individual to this cancer. IMPLICATION: These findings should prompt further study of dietary protein and its potential contribution to the origins of renal cell cancer.

Adult↗

PubMed1980

The treatment of herpetic whitlow--a new surgical concept.

Characteristics of cutaneous lesions caused by herpes simplex virus (HSV-1) are: Acquired by skin-to-skin contact; humans are the only natural host. Often on the hands of health care personnel. Painful swelling, erythema, vesicles, and ulcerations. Possible involvement of cutaneous digital areas of paronychium, eponychium, and subungual matrix. Similar to a bacterial (septic) or fungal felon. Self-limiting--14- to 21-day course. An aseptic felon, which provides a contraindication to surgical incision and drainage of the deep pulp space. Severe pain: the major complaint from all patients. Relieved of pain by decompression of the involved nail bed, either by segmentally excising or perforating the overlying nail or both to unroof the vesicles.

Adult↗

PubMed2005

Computerized diagnosis from tongue appearance using quantitative feature classification.

This study investigates relationships between diseases and the appearance of the human tongue in terms of quantitative features. The experimental samples are digital tongue images captured from three groups of candidates: one group in normal health, one suffering with appendicitis, and a third suffering with pancreatitis. For the purposes of diagnostic classification, we first extract chromatic and textural measurements from original tongue images. A feature selection procedure then identifies the measures most relevant to the classifications, based on which of the three tongue image categories are clearly separated. This study validates the use of tongue inspection by means of quantitative feature classification in medical diagnosis.

Appendicitis↗

PubMed2003

Quality of life and psychometric functionality in patients with differentiated thyroid carcinoma.

We studied the psychological performance and the quality of life in patients with differentiated thyroid carcinoma, either during treatment with chronic suppressive doses of levothyroxine, or during the withdrawal of levothyroxine needed to perform whole-body scanning with radioactive iodine, with those of appropriate healthy controls. Eighteen women with differentiated thyroid carcinoma and 18 euthyroid age-matched healthy women were recruited. Patients were studied the day before levothyroxine withdrawal (when in chronic mild or subclinical hyperthyroidism), 4-7 days later (when most patients had normal serum free thyroxine and free triiodothyronine levels), and the day before scanning (when in profound hypothyroidism). Controls were studied at one time point. When compared with controls, patients presented with impairment of several indexes during chronic suppressive levothyroxine therapy (total score, emotional, sleep, energy and social of the Nottingham Health Profile; mental health, general health and social function of the SF-36, and total score on Wais Digit Span; P<0.05 for all comparisons). Also, quality of life indexes (19 of 21 scores), cognitive tests (6 of 12 scores), and affective and physical symptoms visual mental scales (18 of 19) worsened during profound hypothyroidism (P<0.05 for all comparisons). Quality of life and cognitive performance were almost comparable with those of euthyroid controls when most patients had normal free thyroxine and triiodothyronine levels. In conclusion, quality of life and psychometric functionality in patients with differentiated thyroid carcinoma is not only affected by withdrawal of levothyroxine but also by long-term treatment with supraphysiological doses of levothyroxine.

Adult↗

PubMed2004

Adolescents and firearms: a California statewide survey.

OBJECTIVES: We assessed the prevalence and correlates of adolescents' reports regarding firearms in their homes, of their own, of close friends, and of same-aged peers. METHODS: Random-digit-dialed interviews were conducted with 5801 adolescents as part of the California Health Interview Survey. RESULTS: One fifth (19.6%) of California adolescents reported having a firearm in their homes; few (3.0%) reported having their own gun. Characteristics associated with having one's own gun and with perceptions regarding others' guns generally were consistent with characteristics associated with having a firearm in the home. The 2 exceptions were related to socioeconomic status and to ethnicity. CONCLUSIONS: The source from which adolescents obtain guns, especially adolescents from less wealthy households, merits further investigation. Further research is needed to ascertain the accuracy of Black and Latino adolescents' perceptions regarding handguns among their peers.

Adolescent↗

PubMed1999

Application of risk analysis and geographic information system technologies to the prevention of diarrheal diseases in Nigeria.

Among the poor in developing countries, up to 20% of an infant's life experience may include diarrhea. This problem is spatially related to the lack of potable water at different sites. This project used risk analysis (RA) methods and geographic information system (GIS) technologies to evaluate the health impact of water source. Maps of Imo State, Nigeria were converted into digital form using ARC/INFO GIS software, and the resulting coverages included geology, hydrology, towns, and villages. A total of 11,537 diarrheal cases were reported. Thirty-nine water sources were evaluated. A computer modeling approach called probabilistic layer analysis (PLA) spatially displayed the water source at layers of geology, hydrology, population, environmental pollution, and electricity according to a color-coded five-point ranking. The water sources were categorized into A, B, and C based on the cumulative scores < 10 for A, 10-19 for B, and > 19 for C. T-test showed revealed significant differences in diarrheal disease incidence between categories A, B, and C with mean +/- SEM values of 1.612 +/- 0.325, 6.257 +/- 0.408, and 15.608 +/- 2.151, respectively. The differences were significant between categories A and B (P = 0.0000022), A and C (P = 0.0000188), and B and C (P = 0.0011348). The PLA enabled estimation of the probability of the risk of diarrheal diseases occurring at each layer and solutions to eliminate these risks.

Adolescent↗

PubMed2003

[Non-insulin-dependent diabetes: an expanding disease. Diabetic ophthalmopathy: diabetic retinopathy facts].

Diabetic retinopathy (DR) is the 5th cause of blindness in the population of less than 50 years old in industrialized countries. Sample survey showed a lack of detection of DR and a discrepancy between the medical practices and the guidelines during the follow-up. Moreover the number of ophthalmologists is decreasing and the number of diabetics increasing. Faced with this public health problem, an organization for detecting the DR is in progress: non mydriatic digital camera are used by non medical technicians connected with reading centres. Diabetic macular edema (DME) is the most common cause of visual impairment. Recently, optical coherence tomography (OCT), a new imaging tool has showed the role of vitreous tractions in some DME. OCT provides clear diagnostic elements for vitrectomy indications. Very recently, vitrectomy proved to be favorable in DME with vitreous tractions.

Diabetes Mellitus, Type 2↗

PubMedDate not supplied

Anatomic sites of foot lesions resulting in amputation among diabetics and non-diabetics.

OBJECTIVE: To identify and quantify the anatomic sites of foot lesions resulting in amputation among patients suffering from peripheral arterial disease with and without diabetes mellitus. DESIGN: A retrospective study. SETTING: Department of Orthopaedic Rehabilitation. PATIENTS: A total of 212 recent lower limb amputees with diabetes mellitus (158) or peripheral arterial disease only (54) admitted for prosthetic rehabilitation. RESULTS: In 62.2% of all amputees the site of lesion that led to amputation was located in the digits. A lesion under the metatarsal heads was reported in 8.0%, along the mid-foot and heel in 8.5%, on the dorsum of the foot in 3.3%, around the ankle joint and lower leg in 5.7%. Finally, 12.3% reported multiple lesions or were unable to recall the exact anatomic location. CONCLUSIONS: Most foot lesions resulting in amputation are located around the digits. These high-risk sites, therefore, need the patient's and the health care team's special attention. The patient should be trained in self foot examination and meticulous daily care, whereas the role of the health care team is in foot evaluation and provision of protective foot wear.

Adult↗