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[Not Available].

Hildegard of Bingen (1098-1179), the famous priestess of South-Germany, wrote an outstanding work including theological books, a composers work, a large correspondence and a medical book named "the book about the subtilities in the different natures of the creatures": "Liber subtilitatum diversarum naturarum creaturarum". This work has later been splitted in two or three books, the "Physica", the "Causae et curae" and the "Berliner Fragmente", perhaps a part of the "Causae et curae". Until today not all handwritings are critically edited. 25 plants can be found in gynecological or obstetrical indication in her writings. Regarded under modern aspects most of them could be used in minor gynecological problems. Some are almost unknown today, others are regarded as too dangerous. Finally the medical work of Hildegard of Bingen can be estimated as a threshhold of experience, but it should not be transferred into the modern medicine without a detailed analysis.

Germany↗

[Medical aspect of the winter march of the Fifth Regiment of the Eighth Military Division in the winter of 1902 - particularly concerning the cause of Major Yamaguchi's death].

Two hundred and ten military soldiers of the Fifth Regiment of the Eighth Division of the Japan Imperial Army joined a marching practice in the end of January, 1902, but 193 soldiers out of 210 died due to severe frost-bite during stormy weather and only seventeen, including Major Yamaguchi, were rescued to survive and brought to the Veteran's Administration Hospital at Aomori. This accident was most tragic and world-shaking for the Japanese people as well as for the Japanese Imperial Army. In December of 1991, an admission record of the Veteran's Administration Hospital at Aomori was found in the residence of Dr. Murakami of Aomori City. Judging from its handwriting, this record was written by a military physician Ki-ichi Murakami, Dr. Murakami's uncle. The record describes the details of seventeen patients, most of whom were severely injured and frost-bitten during the winter march. The content of this newly discovered record is similar to the report written by the military physicians of the Fifth Regiment which appeared in the Japan Imperial Military Medical Journal, but a more detailed description about Major Yamaguchi's vital signs, and symptoms of his frost-bite were found in the former. In the journal, Major Yamaguchi was reported to have died because of sudden cardiac arrest but Jiro Nitta described in his novel "Death March on Mount Hakkoda" that he committed suicide using his gun. However, this record strongly tells us that both of his hands, as well as both lower extremities, were severely frost-bitten and swollen and that he could not pull the trigger of his gun with his fingers. Since Jiro Nitta's novel has been published, it is widely accepted that Major Yamaguchi committed suicide with his gun. But we do not have any definite proof to substantiate his suicide. The present detailed survey on the medical references strongly suggests that he could not have pulled his gun's trigger by himself.

Frostbite↗

Content based information retrieval in forensic image databases.

This paper gives an overview of the various available image databases and ways of searching these databases on image contents. The developments in research groups of searching in image databases is evaluated and compared with the forensic databases that exist. Forensic image databases of fingerprints, faces, shoeprints, handwriting, cartridge cases, drugs tablets, and tool marks are described. The developments in these fields appear to be valuable for forensic databases, especially that of the framework in MPEG-7, where the searching in image databases is standardized. In the future, the combination of the databases (also DNA-databases) and possibilities to combine these can result in stronger forensic evidence.

Computer Graphics↗

Gaining MD buy-in: physician order entry.

Computerized physician order entry (CPOE) eliminates illegible handwriting, reduces medical errors, and improves patient care. The administration, medical staff, nursing, and health information systems departments of a community teaching hospital cooperated to achieve organization-wide use of its CPOE system.

Attitude of Health Personnel↗

Evaluation of clumsiness in children.

Parents and physicians often dismiss seemingly minor motor difficulties in children. Approximately 6 percent of school-aged children have coordination problems serious enough to interfere with academic performance and social integration. These problems often arise during the early school years and manifest in difficulties with such simple motor tasks as running, buttoning, or using scissors. Increasing evidence shows that rather than improving over time, these motor difficulties remain stable throughout adolescence and adulthood. While these children are initially singled out for motor difficulties, their problems are rarely limited to poor motor coordination. Many of them have a range of associated deficits, such as attention-deficit/hyperactivity disorder, learning disabilities, poor handwriting and drawing skills, and emotional immaturity. Associated problems magnify with time, and as teenagers, these children have higher rates of educational, social, and emotional problems. Diagnosis is determined by taking a careful history that includes a review of fine motor, visual, adaptive, and gross motor milestones, and performing a physical examination. Formal standardized testing may be indicated. Referral to occupational therapy that is appropriately individualized to the needs of each child appears to be effective. To aid in management, the family physician must be aware of this condition, as well as the associated coexisting deficits.

Attention Deficit Disorder with Hyperactivity↗

[The meaning of the sixth edition of "Organon der Heilkunst"].

Like any artist, the paractitioner of the healing art should exactly know his tools, i.e. his medicines and the directions for their application. In addition, he should be able to rely on their genuineness. Regarding the tool "Organon", considerable uncertainty has been expressed by some physicians about the authenticity of Hahnemann's instructions for preparing and applying Q-potencies, as described in the sixth edition of the Organon of Medicine published by Richard Haehl in 1921. Since 1992, however, the first text-critical edition of the sixth edition of the Organonis available. Unlike Haehl's edition this one is exclusively based on Hahnemann's original manuscript and precisely transcribing all its handwriting, vouches for its authenticity. Hence there is no reason left to ignore Hahnemanns instructions concerning Q-potencies. This paper presents the history of the reception of Q-potencies as well as their prerequisites and evolution up to Hahnemann's final modifications of his earlier directions. As it turns out, these late instructions of Hahnemann do not mean complete change of all his previous opinions. Rather they are the logical completion of a course followed by him for ten years already. Q-potencies were Hahnemann's solution of the following therapeutic dilemma: on the one side physicians are inclined to repeat the dose of a high potency as often as possible in order to accelerate the process of healing; on the other side they should refrain from repeating the dose to avoid violent aggravations of the state of the patient.

Books↗

Clinical features, assessment and treatment of essential tremor.

Essential tremor is the most common of the movement disorders, being 20 times more common than Parkinson's Disease. It is characterised by postural and kinetic tremor which maximally affects the hands. It can be assessed by physiological techniques, subjective clinical methods, objective clinical methods and handicap/disability scales. Accelerometry, spirography and handwriting assessment, volumetry and handicap/disability questionnaires are commonly used methods. Primidone and propranolol are the first-line drugs. Several second-line drugs have been identified. Surgical techniques include lesioning or stimulation of the ventral lateral thalamus. Alcohol and botulinum toxin A are found to reduce tremor amplitude as well.

Essential Tremor↗

Tomorrow's transcription tools: what new technology means for healthcare.

The year is 2006, and there are just a few hundred medical transcriptionists (MTs) still transcribing reports, serving only those older physicians who haven't changed with the times--and the times have definitely changed. Physicians have finally recognized the power of electronic health records (EHRs) as well as the fact that this power is realized only if they input clinical data directly into the EHR. The vast majority of physicians are using empirically refined templates, pick lists, and other methods of structured, codified input through the evolved progeny of today's Palm PCs, Pocket PCs, and Tablet PCs. Input methods include touch-screen, speech recognition, handwriting recognition, and perhaps other technology not yet invented. There are no longer any delays or expenses resulting from transcription. Plus healthcare organizations enjoy numerous benefits derived from analyzing codified clinical data. But this is only one vision. Another vision of 2006 incorporates an unavoidable reality: many physicians strongly resist directly inputting clinical data. They believe it slows them down, which outweighs the potentials overall healthcare benefits. Additionally, these physicians believe that structured input of patient information limits the freedom of expression afforded by free text. And frankly, these physicians don't put much stock in the value of clinical practive analysis. So transcription continues. In fact, it expands dramatically. Due to regulatory controls and other pressures, more providers dictate more clinical notes than ever. The need for MTs explodes. In 2006, there are half a million MTs required to convert voice dictations into text, more than double today's number.

Computers, Handheld↗

[Mirror writing secondary to left parietal-occipital infarction].

INTRODUCTION: Mirror writing is a rare disorder in which the patient's handwriting is done backwards and a mirror is needed to be able to read it. Although mirror writing presents both spontaneously and pathologically, it is mainly due to cerebrovascular lesions in the dominant hemisphere. CASE REPORT: A right-handed 62-year-old female who, following a left parietal-occipital infarction, evidenced by computerized tomography scanning, developed mirror writing with the left hand associated with mnemonic, gnosic and praxic disorders. The symptoms continued for a year after the episode. CONCLUSIONS: Mirror writing and other associated disorders are a consequence of a dysfunction of the left parietal-occipital lobe and the optic thalamus on the same side.

Cerebral Infarction↗

Prevention of prescription errors by computerized, on-line, individual patient related surveillance of drug order entry.

Computerized prescription of drugs is expected to reduce the number of many preventable drug ordering errors. In the present study we evaluated the usefullness of a computerized drug order entry (CDOE) system in reducing prescription errors. A department of internal medicine using a comprehensive CDOE, which included also patient-related drug-laboratory, drug-disease and drug-allergy on-line surveillance was compared to a similar department in which drug orders were handwritten. CDOE reduced prescription errors to 25-35%. The causes of errors remained similar, and most errors, on both departments, were associated with abnormal renal function and electrolyte balance. Residual errors remaining on the CDOE-using department were due to handwriting on the typed order, failure to feed patients' diseases, and system failures. The use of CDOE was associated with a significant reduction in mean hospital stay and in the number of changes performed in the prescription. The findings of this study both quantity the impact of comprehensive CDOE on prescription errors and delineate the causes for remaining errors.

Drug Prescriptions↗

[Cytostatic prescription errors: an analysis of causes, and proposals regarding their prevention].

OBJECTIVE: To collect and analyze prescription errors for parenterally-administered cytostatic drugs, to identify causes from results obtained, and to suggest feasible solutions to prevent them. METHOD: In our hospital, parenterally-administered cytotoxic drugs are prepared in the Pharmacy Department, where 100% of prescriptions are validated with the help of a software program. Prescription errors detected at validation over a 2-year period of time were recorded in a specific form to facilitate analysis. RESULTS: In all, 292 possible errors were detected and 183 were confirmed; most resulted from dosing errors, followed by incorrect treatment duration. Other errors detected included: dose or drug omitted, wrong administration route, wrong patient, and wrong medication. The following measures were suggested: improvement of the data processing system at the Pharmacy Department, implementation of an electronic prescription system, continuous updating of cytostatic therapy protocols, and inclusion of cytostatic prescription recommendations within Pharmacotherapeutic Guidelines. CONCLUSION: Most common errors included doses above or below the correct ones, with the primary cause being poor handwriting in manual prescriptions. Active recording of prescription errors is essential if an analysis of real causes in our setting is to be undertaken, as well as to making proposals and implementing definite solutions.

Antineoplastic Agents↗

[A brief textual research on the editions of Fu Ren Liang Fang (A complete book of effective prescriptions for women) before the Qing Dynasty].

Fu Ren Liang Fang (A Complete Book of Effective Prescriptions for Women), the first complete gynecologic and obstetric work in China, was written by Cheng Zi-ming in the first year of Jiaxi Reign of the Southern Song Dynasty (A.D.1237). It has many different editions in its long circulation of more than 760 years. According to The National Associated Catalog of TCM Books, it is estimated that there are as many as over 30 different editions. After choosing the edition of Qingyou Hall of the Yuan Dynasty as the original edition for comparisons with other editions, it is claimed that the edition of this Qingyou Hall was well preserved, with excellent and clear handwriting, reflecting the style and features of Chen's original work.

Books↗

A comparison of the effectiveness of sensory integrative therapy and perceptual-motor training in treating children with learning disabilities.

This study compared the effect of sensory integration therapy (SI), perceptual-motor training (PM) and no treatment (NT) on the performance of 103 children with learning disabilities and sensory integrative dysfunction, aged 58 to 107 months, who were randomly assigned to one of the two treatment groups or to no treatment. After receiving a total of 72 1-hour sessions of therapy for 3 hours per week, PM-treated subjects showed significant gains over the other two groups, primarily in gross motor performance. SI-treated subjects showed an advantage in motor planning. There were no accompanying group differences in visual perception, handwriting readiness, copying ability, cognitive, academic, language and attentional skills or in self-concept. These findings demonstrate motor gains resulting from motor treatments without carry-over to functional skills and abilities more directly associated with school performance.

Attention↗

[Introducing computer units into the reception office as part of the Vrapce Psychiatric Hospital Information System].

Computerized medical record has become a necessity today, because of both the amount of present-day medical data and the need of better handling and processing them. In more than 120 years of the Vrapce Psychiatric Hospital existence, the most important changes in the working concept of the reception office took place when computer technology was introduced into the routine use. The reception office of the Hospital is the vital place where administrative activities intersect with medical care for a patient presenting to the Hospital. The importance of this segment of the Hospital is emphasized by the fact that the reception office is in function and at patients' disposition round-the-clock, for 365 days a year, with great frequency of patients. The shift from the established way of registering medical data on patient admission in handwriting or, later, typescript, to computer recording was a challenging and demanding task (from the aspects of hardware, software, network, education) for the development team as well as for the physicians because it has changed the concept (logic of the working process) of previous way of collecting the data from the patient (history, status, diagnostic procedures, therapy, etc.). The success in the development and implementation of this project and the confirmation of its usefulness during the four-year practice at Vrapce Psychiatric Hospital are best illustrated by the fact that other psychiatric hospitals in Croatia have already introduced or are introducing it in their daily practice.

Croatia↗

The information seeking of on-duty critical care nurses: evidence from participant observation and in-context interviews.

OBJECTIVES: An observational study describes on-duty nurses' informative behaviors from the perspective of library and information science, rather than patient care,. It reveals their information sources, the kinds of information they seek, and their barriers to information acquisition. METHODS: Participant observation and in-context interviews were used to record in detail fifty hours of the information behavior of a purposive sample of on-duty critical care nurses on twenty-bed critical care unit in a community hospital. The investigator used rigorous ethnographic methods-including open, in vivo, and axial coding--to analyze the resulting rich textual data. RESULTS: The nurses' information behavior centered on the patient, seeking information from people, the patient record, and other systems. The nurses mostly used patient-specific information, but they also used some social and logistic information. They occasionally sought knowledge-based information. Barriers to information acquisition included illegible handwriting, difficult navigation of online systems, equipment failure, unavailable people, social protocols, and mistakes caused by people multitasking while working with multiple complex systems. Although the participating nurses understood and respected evidence-based practice, many believed that taking time to read published information on duty was not only difficult, but perhaps also ethically wrong. They said that a personal information service available to them at all hours of the day or night would be very useful. CONCLUSIONS: On-duty critical care nursing is a patient-centric information activity. A major implication of this study for librarians is that immediate professional reference service--including quality and quantity filtering-may be more useful to on-duty nurses than do-it-yourself searching and traditional document delivery are.

Communication↗

Compliance with good practice in prescription writing at outpatient clinics in Saudi Arabia.

A sample of prescription orders received from outpatient departments by a hospital pharmacy in Asir, Saudi Arabia, were analysed over 1 year for the essential elements of prescriptions. The prescriber's name, address and signature were on 83.3%, 9.6% and 81.9% of prescriptions respecti-vely. The patient's name, age and sex were on 94.6%, 77.3% and 51.3%. No prescription contained the patient's address and weight. Generic drug names were used in only 15.1% and strength of medication and dose units were included in 26.6% and 55.6% of prescriptions. Most prescriptions (94.0%) had no quantity indicated and had only partial instructions for patient use (90.7%); the diagnosis was included in about two-thirds. The prescriber's handwriting was illegible in 64.3% of prescriptions. Measures to improve the situation are suggested.

Ambulatory Care↗

Clinical communication and patient safety.

JCAHO says communication problems were the leading root cause of sentinel events in 2005. The reasons are manifold: a harried environment, a hierarchical staffing system and illegible handwriting, to name a few. This gatefold examines the scope of the problem, including data and risk factors, and offers some strategies for improvement.

Abbreviations as Topic↗

[The founding of the 'Vereeniging Nederlandsch Tijdschrift voor Geneeskunde' [Society of the Dutch Journal of Medicine] on 28 September 1856].

On Sunday the 28th of September 1856, 150 years ago this year, a meeting was held in Amsterdam at which the 'Nederlandsch Tijdschrift voor Geneeskunde' [Dutch Journal of Medicine] was founded. There are strikingly few sources of information on this happening. The 150th volume of the Journal is appearing this year. In view of the coming anniversary, some old documents that had been laid aside at the time of the move from the Jan Luykenstraat to the Johannes Vermeerstraat in 1992 were re-examined. In a bundle of bound meeting reports from the early years, hidden in a folder inserted into the front cover, we found a printed 'Provisional rules and regulations'; the founding date of 28 September is given in these bylaws. These 'Provisional rules and regulations' also contain some handwritten remarks in the handwriting of J. Zeeman, the Chief Editor during the period 1867-1883. For example, he crossed out the provision that the Journal would be published 'at the expense of the editors' and changed this to 'by a society of editors'. This document provides insight into the introduction of the Society of Editors that still publishes the Journal to this day.

History, 19th Century↗