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PubMed1997

Attitudes of radiology residents toward personal computing: results of survey.

RATIONALE AND OBJECTIVES: The authors' purpose was to evaluate radiology residents' assessment of their own computer skills for potential development of computer training in a residency curriculum. METHODS: The authors conducted a survey to evaluate the attitudes of radiology residents concerning personal computing. Surveys were completed by 136 radiology residents from six academic institutions. RESULTS: Sixty percent of residents surveyed considered themselves to be computer literate and 93% would like further computer training. Fifty-six percent had a computer at home and 9% had a laptop. Almost all residents had access to a computer at work. Word processing and medical literature searches were the most common computer tasks performed by residents. Image processing was the least common task performed. Although all hospitals surveyed were connected to the Internet, only 26% of residents used the Internet and 14% used Internet teaching files. Most residents expressed a preference for self-paced, on-line evening training sessions. CONCLUSION: Most radiology residents believed they possessed adequate computer skills. This proportion has markedly increased over that found in previous surveys. Radiology residents desire and could likely benefit from computer training included as part of the residency curriculum.

Attitude of Health Personnel↗
PubMed2004

An autonomous molecular computer for logical control of gene expression.

Early biomolecular computer research focused on laboratory-scale, human-operated computers for complex computational problems. Recently, simple molecular-scale autonomous programmable computers were demonstrated allowing both input and output information to be in molecular form. Such computers, using biological molecules as input data and biologically active molecules as outputs, could produce a system for 'logical' control of biological processes. Here we describe an autonomous biomolecular computer that, at least in vitro, logically analyses the levels of messenger RNA species, and in response produces a molecule capable of affecting levels of gene expression. The computer operates at a concentration of close to a trillion computers per microlitre and consists of three programmable modules: a computation module, that is, a stochastic molecular automaton; an input module, by which specific mRNA levels or point mutations regulate software molecule concentrations, and hence automaton transition probabilities; and an output module, capable of controlled release of a short single-stranded DNA molecule. This approach might be applied in vivo to biochemical sensing, genetic engineering and even medical diagnosis and treatment. As a proof of principle we programmed the computer to identify and analyse mRNA of disease-related genes associated with models of small-cell lung cancer and prostate cancer, and to produce a single-stranded DNA molecule modelled after an anticancer drug.

Antineoplastic Agents↗
PubMed2000

Assessment of coronary calcification by electron-beam computed tomography in symptomatic patients with normal, abnormal or equivocal exercise stress test.

AIMS: Exercise stress testing is often used as the initial non-invasive diagnostic test in symptomatic patients with suspected obstructive coronary artery disease. Positive standard ECG criteria are quite specific for obstructive coronary artery disease, but there may be a substantial number of false negative tests, including patients with severe coronary artery disease. Also, exercise stress tests frequently yield equivocal results. Instead of detecting the functional consequences, electron-beam computed tomography visualized atherosclerotic plaque disease directly, but its relationship to functional testing has not been clearly delineated. It was the aim of the current study to examine electron-beam computed tomography for the identification of obstructive coronary artery disease in patients with a normal, abnormal, or equivocal exercise stress test. METHODS AND RESULTS: Symptomatic patients referred for coronary angiography were prospectively included in a consecutive manner if they had no prior diagnosis of coronary artery disease and an unremarkable resting ECG. All patients underwent both exercise stress test and electron-beam computed tomography on the day before coronary angiography. Standard protocols and ECG criteria to diagnose inducible ischaemia were used for the exercise stress test. The electron-beam computed tomography-derived total calcium score was computed according to standard Agatston criteria. Of the 323 patients (mean age, 55+/-11 years; 77% male), 179 (55%) had obstructive coronary artery disease, defined angiographically as luminal diameter narrowing >/=50%. A normal exercise stress test was documented in 105 patients (32.5%), an abnormal exercise stress test ('diagnostic for ischaemia') in 113 (35%), and an equivocal exercise stress test ('inadequate exercise or non-diagnostic ECG-changes') in 105 (32.5%). Multivariate analysis indicated that exercise stress test and electron-beam computed tomography yielded independent information for predicting obstructive coronary artery disease. Sensitivity, specificity and overall accuracy of the exercise stress test were 71%, 75% and 73%, respectively, if equivocal tests were not included, and 50%, 84% and 65% if they were included. Irrespective of the cutpoint regarded as 'positive', the overall accuracy of the electron-beam computed tomography-derived calcium score remained approximately 80% in patients with a normal, abnormal or equivocal exercise stress test. In patients with an equivocal and - to a lesser degree - with a normal exercise stress test, electron-beam computed tomography was able to significantly improve classification regarding obstructive coronary artery disease. Electron-beam computed tomography added no incremental predictive value in patients with an abnormal exercise stress test. CONCLUSION: In patients who are judged to have an intermediate post-test probability of disease after exercise stress test, electron-beam computed tomography scanning may be a meaningful strategy for further stratification regarding the likelihood of obstructive coronary artery disease.

Calcinosis↗
PubMed1980

Computer communication and the elderly.

Elderly's involvement with a society's information resources has been thought to indicate their social status. Moreover, as the societal status of information resources themselves is greater, the status of elderly may be even greater. Computer-based communication systems are leading the transformation of post-industrial societies from previously industrial to primarily informational. As elderly become effective computer users, they may enhance their social status and personal well-being. The present research examines effects of elderly's participation with computer-mediated communication on attitudes toward computers and themselves. A quasi-experimental design involving residents of a retirement community is used with a sample of 30 pre- and 13 post-treatment subjects. The treatment consists of using recreational computer games and computer messaging. Self-administered questionnaires and observer ratings are the primary data collection instruments. Results show that computer use may increase favorability towards computers and self-esteem. Also, the greater the degree of interactiveness of specific computer use activities, the greater user preference. Facilitator and inhibitors of elderly's interaction with computers are suggested.

Aged↗
PubMedDate not supplied

Computer-assisted learning: cyberPatient--a step in the future of surgical education.

Computer-assisted learning is a hot topic and is evolving parallel with the rapidly growing computer technology. Today, modern computers with sophisticated software are able to create a new dimension in the application of many important pedagogical principles and philosophies. Modern computers with excellent multimedia applications are capable of simulating a realistic situation that enriches the educational environment, improves the learning process, and brings new challenges to the process of "learning by doing." The use of computers in medical industry and in medical education lags far behind other applications in the industrial world. Although a great many computer-assisted learning programs have been developed in the last decade and patient simulation has been attempted, there are no computer programs in the market that are capable of simulating the realism of the patient-doctor relationship. cyberActive Technology Ltd. has been able to complete this mission. The computer software cyberPatient developed by cyberActive Technology Ltd. is able to realize this long-term dream of medical students and educators. The discrepancy between theoretical and practical medical knowledge in the classical medical education was greater than in any other aspect of science. In classical medical education, diseases were taught beginning with etiology and pathogenesis to signs and symptoms. In practice, the patient comes to the doctor with complaints, and the doctor has to think backward to find out about the etiology and pathogenesis. This discrepancy created enormous difficulties for interns and young doctors with respect to the application of theoretical medicine to medical practice. This was one of the reasons why medical schools turned to a new problem-based learning curriculum. The new curriculum, however, has brought new challenges and problems of its own. Some of the problems include patient availability, increased demands for teachers, and, in turn, significant increases in the costs of medical education. Intensive use of computers may be a solution for problem-based learning. The aim of this article is to give an overview of computer-based learning and its place in the future of medical education.

Computer-Assisted Instruction↗
PubMed2004

Demonstration of a universal surface DNA computer.

A fundamental concept in computer science is that of the universal Turing machine, which is an abstract definition of a general purpose computer. A general purpose (universal) computer is defined as one which can compute anything that is computable. It has been shown that any computer which is able to simulate Boolean logic circuits of any complexity is such a general purpose computer. The field of DNA computing was founded in 1994 by Adleman's solution of a 7-bit instance of the Hamiltonian path problem. This work, as well as most of the subsequent experimental and theoretical investigations in the area, focused primarily upon the solution of NP-complete problems, which are a subset of the larger universal class of problems. In the present work a surface DNA computer capable of simulating Boolean logic circuits is demonstrated. This was done by constructing NOR and OR gates and combining them into a simple logic circuit. The NOR gate is one of the universal gates in Boolean logic, meaning that any other logic gate can be built from it alone. The circuit was solved using DNA-based operations, demonstrating the universal nature of this surface DNA computing model.

Computers, Molecular↗
PubMed2005

The validity of searching routinely collected general practice computer data to identify patients with chronic kidney disease (CKD): a manual review of 500 medical records.

BACKGROUND: We conducted a search of 12 practices' routinely collected computer data in three localities across the UK and found that 4.9% of the registered population had an estimated glomerular filtration rate (GFR) of <60 ml/min/1.73 m(2) (equivalent to stages 3-5 CKD). Only 3.6% of these were known to have renal disease. Although UK general practice is computerized, important clinical data might be recorded in letters or free-text computer entries and might therefore be invisible to the standard computer search tools. We therefore manually searched through all the records of patients with stages 3-5 CKD in one practice, to test the validity of the computer generated diagnosis and to see if other relevant information was missed by the computer search. METHODS: We identified 492 people with stages 3-5 CKD using computer searching and then manually searched their computer records and written notes for any missed data. The dataset included cardiovascular morbidities and risk factors including diabetes; drugs which may impair renal function; known renal disease; and terminal diagnoses and dementia. RESULTS: The manual searches only added four renal diagnoses to the 36 already identified. Although heart failure and stroke appear to be over-estimated by computer searches, other cardiovascular diagnoses were reliably recorded. Cardiovascular risk factors and drug recording is a strength of general practice computer data. It is complete and contemporary, though most patients had scope to have their cardiovascular risk reduced further. Eighty-four percent had a haemoglobin estimation, and a higher proportion with reduced renal function were anaemic (P<0.001). Testing for proteinuria was less well recorded; negative stick tests were not recorded. Clinical diagnoses of prostatism and bladder outflow problems made these data hard to interpret. CONCLUSIONS: Automated searching of general practice computer records could provide a reliable and valid way of identifying people with stages 3-5 CKD who could benefit from interventions readily available in primary care.

Adult↗
PubMed1999

Computed tomography and pathologic findings in fulminant forms of idiopathic interstitial pneumonia.

This study describes the computed tomography features of various fulminant forms of idiopathic interstitial pneumonia and to clarify the usefulness of computed tomography in such patients. Computed tomography scans in 19 patients with fulminant forms of idiopathic interstitial pneumonia were reviewed. This study included patients with acute interstitial pneumonia (n = 7), an accelerated form of idiopathic pulmonary fibrosis (n = 2), and an acute exacerbation of idiopathic pulmonary fibrosis (n = 10). Pathologic confirmation of the diagnosis was obtained in all patients. Follow-up computed tomography scans were available for eight patients, and postmortem computed tomography scans were available for three patients. All patients had progressive ground-glass attenuation, consolidation, or both. In patients with an acute exacerbation of idiopathic pulmonary fibrosis, subpleural honeycombing was also seen. Follow-up computed tomography showed a change from ground-glass attenuation to consolidation with distortion. Architectural distortion, traction bronchiectasis, and ground-glass opacity were the prominent features in the initial computed tomography scans obtained more than 7 days after the onset of symptoms, and cystic lesions were seen in follow-up computed tomography obtained more than 1 month after the onset. High-resolution computed tomography was more sensitive than the plain radiographs in the early detection of these entities. Computed tomography examination at the onset of the acute symptoms is useful in classifying these fulminant forms of idiopathic interstitial pneumonia.

Acute Disease↗
PubMed2005

The use of computed tomography to assess asthma severity.

PURPOSE OF REVIEW: Chronic inflammation in asthma can also lead to airway remodeling, which contributes to airway narrowing. It may be possible to assess and quantify the extent of airway remodeling in vivo using computed tomography. This review examines recent developments in the evaluation of asthma severity using computed tomography, and the effect of treatment assessed by computed tomography. RECENT FINDINGS: Asthma patients have thicker airways on computed tomography scans than do healthy control individuals, and the degree of thickening is related to the severity of disease, airflow obstruction, and airway reactivity. Recent studies have indicated that patients with severe asthma and irreversible airflow obstruction had longer disease duration, a greater inflammatory process and more airway abnormalities, assessed by high-resolution computed tomography, suggestive of airway remodeling. Other studies have shown that high-resolution computed tomography lung density correlates with airflow limitation and lung volume (but not with lung transfer factor), and also correlates with patient age and severity of asthma. More recently, two publications demonstrated the effect of treatment on airway wall thickness and lung density assessed by computed tomography in patients with asthma. SUMMARY: High-resolution computed tomography is one of the most useful tools for imaging airways and parenchyma. Computed tomography scanning may be useful in determining which patients might benefit from more or less treatment. With additional advances in technology, it is likely that quantitative assessment by computed tomography will ultimately be a valuable tool for the study and treatment of chronic airway diseases.

Asthma↗
PubMed2005

Use of an educational computer program before genetic counseling for breast cancer susceptibility: effects on duration and content of counseling sessions.

PURPOSE: Patients seeking genetic testing for inherited breast cancer risk are typically educated by genetic counselors; however, the growing demand for cancer genetic testing will likely exceed the availability of counselors trained in this area. We compared the effectiveness of counseling alone versus counseling preceded by use of a computer-based decision aid among women referred to genetic counseling for a family or personal history of breast cancer. METHODS: We developed and evaluated an interactive computer program that educates women about breast cancer, heredity, and genetic testing. Between May 2000 and September 2002, women at six study sites were randomized into either: Counselor Group (n = 105), who received standard genetic counseling, or Computer Group (n = 106), who used the interactive computer program before counseling. Clients and counselors both evaluated the effectiveness of counseling sessions, and counselors completed additional measures for the Computer Group. Counselors also recorded the duration of each session. RESULTS: Baseline characteristics did not differ significantly between groups. Participants and counselors both rated the counseling sessions as highly effective, whether or not the sessions were preceded by computer use. Computer use resulted in significantly shorter counseling sessions among women at low risk for carrying BRCA1/2 mutations. In approximately half of the sessions preceded by clients' computer use, counselors indicated that clients' use of the computer program affected the way they used the time, shifting the focus away from basic education toward personal risk and decision-making. CONCLUSION: This study shows that the interactive computer program "Breast Cancer Risk and Genetic Testing" is a valuable adjunct to genetic counseling. Its use before counseling can shorten counseling sessions and allow counselors to focus more on the clients' individual risks and specific psychological concerns. As the demand for counseling services increases, a program such as this can play a valuable role in enhancing counseling efficiency.

Breast Neoplasms↗
PubMed1990

Computer-assisted instructions: a role in teaching human gross anatomy.

Eight computer-assisted instructions were developed concerning selected topics in human gross anatomy. The computer lessons were designed to be very flexible in terms of the selection of material to be presented and make extensive use of colour graphics to explain the anatomy. Voluntary testing with immediate and cumulative feedback is incorporated into the lessons so that the users can evaluate their own progress in mastering the subject material. In an effort to assess the value of the computer lessons, the programs were provided to a volunteer group of 48 first-year medical students from a class of 151 students. At the completion of the gross anatomy course, the student users were requested to complete an anonymous questionnaire regarding their impressions of the value of the computer lessons. In addition, test performance on multiple choice examinations was compared between the users of the computer-assisted instructions and their non-user classmates. The responses in the questionnaires revealed a very positive attitude regarding the value and usefulness of the computer-assisted instructions in learning human gross anatomy. The overall rating of the programs on a scale of 1.0 to 10.0 was 1.8 +/- 1.0 with 1.0 representing 'extremely helpful' and 10.0 being 'of no value'. A comparison of test scores showed no significant difference in test performance between the users of the computer-assisted instructions and the non-users. The results of the study suggest that while the computer lessons provide neither an advantage nor a disadvantage in test performance as evaluated by a multiple choice examination, students perceive the computer-assisted instructions as valuable educational tools in mastering the subject of human gross anatomy. The potential role of the computer-assisted instructions in curriculum development is discussed.

Anatomy↗
PubMed1997

Comparison of eye position versus computer identified microcalcification clusters on mammograms.

The purpose of this study was to compare identifications of microcalcification clusters on mammograms by a computerized detection scheme and by human observers having their eye position recorded. Eighty digitized mammograms (half with a subtle microcalcification cluster) were analyzed by a computerized detection scheme and then were read from laser-printed films by six mammographers while eye position was recorded. The computer had 83% true positives with a false-positive rate of 0.5 per image. The true positives of the radiologists ranged from 78% to 90%, with false-positive rates ranging from 0.03 to 0.20. Locations of true and false positives identified by computer and by the human were compared. All but 5% of the true clusters were identified by either the computer, human, or by both. Here 10% of the clusters were detected by only the computer, and 11% were missed by the computer but detected by at least one radiologist. False positives were of three types: identified by computer only, by the human reader only, or by both. Eye-position data indicated significant differences in dwell time between both true-positive and false-positive locations reported by the radiologist versus the computer detections. A follow-up analysis indicated that microcalcification clusters and false positives were judged to have more identifiable characteristics of true calcifications and were associated with longer gaze durations than those with fewer microcalcification characteristics. In general, the computer was able to detect clusters judged to have few or no features that the radiologists were not able to detect. Comparison of computer versus human identification of microcalcification clusters may be useful for improving computerized detection schemes to serve as clinical aids to mammographers, and for understanding what image features lead to false-positive decisions for both the computer and the human reader.

Breast Diseases↗
PubMed2001

Randomised trial of personalised computer based information for patients with schizophrenia.

OBJECTIVES: To compare use, effect, and cost of personalised computer education with community psychiatric nurse education for patients with schizophrenia. DESIGN: Randomised trial of three interventions. Modelling of costs of alternatives. PARTICIPANTS: 112 patients with schizophrenia in contact with community services; 67 completed the intervention. INTERVENTIONS: Three interventions of five educational sessions: (a) computer intervention combining information from patient's medical record with general information about schizophrenia; (b) sessions with a community psychiatric nurse; (c) "combination" (first and last sessions with nurse and remainder with computer). MAIN OUTCOME MEASURES: Patients' attendance, opinions, change in knowledge, and psychological state; costs of interventions and patients' use of NHS community services; modelling of costs for these three, and alternative, interventions. RESULTS: Rates of completion of intervention did not differ significantly (71% for combination intervention, 61% for computer only, 46% for nurse only). Computer sessions were shorter than sessions with nurse (14 minutes v 60 minutes). More patients given nurse based education thought the information relevant. Of 20 patients in combination group, 13 preferred the sessions with the nurse and seven preferred the computer. There were no significant differences between groups in psychological outcomes. Because of the need to transport patients to the computer for their sessions, there was no difference between interventions in costs, but computer sessions combined with other patient contacts would be substantially cheaper. CONCLUSIONS: The computer based patient education offered no advantage over sessions with a community psychiatric nurse. Investigation of computer use combined with other health service contacts would be worth while.

Adolescent↗
PubMed1992

Computers in healthcare: overview and bibliography.

OBJECTIVE: The objective of this article is to provide an overview of computer technology and an associated bibliography, emphasizing institutional-based healthcare applications and pharmacoinformatics. DATA SOURCES: References were selected from the authors' files and from a computerized search over the last five years on computers in healthcare/medical informatics and in pharmacy. STUDY SELECTION: Articles selected for review and discussion were considered to be important contributions to the respective areas listed in the bibliography and representative of advancements in computer applications in healthcare and pharmacy. DATA SYNTHESIS: The computer has become an important support tool for healthcare professionals. Medical informatics and the discipline related to pharmacy, called pharmacoinformatics, have evolved from the cognitive underpinnings of medicine, pharmacy, and computer science. Recent developments in computer technology have resulted in computers that are fast, increasingly portable, and user friendly. Hospital information systems employ computers in various ways to deal with the vast amount of information used by various departments. Standards for electronic data exchange are being developed to increase the integration potential of these systems. Hospital pharmacists have used computers for drug distribution, financial analysis and inventory control, drug interaction detection, pharmacokinetic dosing, drug information, and drug therapy monitoring. Expert systems are being developed in several areas of drug therapy. Pharmacy educators have developed interactive courseware to help students learn problem-solving skills in the areas of calculations, therapeutics, and drug information. CONCLUSIONS: Pharmacists need to become more involved with applications of technology to pharmacy. Properly implemented, computers can provide more time for pharmacists to use their cognitive skills in the delivery of pharmaceutical care.

Clinical Pharmacy Information Systems↗
PubMed2007

Effectiveness of computer-navigated minimally invasive total hip surgery compared to conventional total hip arthroplasty: design of a randomized controlled trial.

BACKGROUND: Moderate to severe osteoarthrosis is the most common indication for Total Hip Arthroplasty (THA). Minimally Invasive Total Hip Surgery (MIS) and computer-navigated surgery were introduced several years ago. However, the literature lacks well-designed studies that provide evidence of superiority of computer-navigated MIS over a conventional THA technique. Hence, the purpose of this study is to compare (cost)effectiveness of computer-navigated MIS with a conventional technique for THA. It is our hypothesis that computer-navigated MIS will lead to a quicker recovery during the early postoperative period (3 months), and to an outcome at least as good 6 months postoperatively. We also hypothesize that computer-navigated MIS leads to fewer perioperative complications and better prosthesis positioning. Furthermore, cost advantages of computer-navigated MIS over conventional THA technique are expected. METHODS/DESIGN: A cluster randomized controlled trial will be executed. Patients between the ages of 18 and 75 admitted for primary cementless unilateral THA will be included. Patients will be stratified using the Charnley classification. They will be randomly allocated to have computer-navigated MIS or conventional THA technique. Measurements take place preoperatively, perioperatively, and 6 weeks and 3 and 6 months postoperatively. Degree of limping (gait analysis), self-reported functional status and health-related quality of life (questionnaires) will be assessed preoperatively as well as postoperatively. Perioperative complications will be registered. Radiographic evaluation of prosthesis positioning will take place 6 weeks postoperatively. An evaluation of costs within and outside the healthcare sector will focus on differences in costs between computer-navigated MIS and conventional THA technique. DISCUSSION: Based on studies performed so far, few objective data quantifying the risks and benefits of computer-navigated MIS are available. Therefore, this study has been designed to compare (cost) effectiveness of computer-navigated MIS with a conventional technique for THA. The results of this trial will be presented as soon as they become available.

Adolescent↗
PubMed2002

Computer-related anxiety: examining the impact of technology-specific affect on the performance of a computerized neuropsychological assessment measure.

This study was conducted to examine the effect of impairment status and computer-specific anxiety on the performance of a computerized neuropsychological assessment measure. Computer related anxiety was measured using a standardized self-report measure tapping anxiety specific to computers and technology. Outcome on this measure was compared with error scores and response timing variables on a computerized version of the Category Test (CT) in both normal individuals and individuals with neurological, psychiatric, or substance abuse histories. Multivariate analysis results, controlling for psychomotor performance, revealed significant main effects for group status and computer-related anxiety. CT performance was significantly related to the level of computer-related anxiety, in that high anxiety resulted in higher CT error scores and longer response times, and the negative impact of computer-related anxiety on computerized neuropsychological assessment performance was stronger in individuals with impairment histories. Our results suggest that as computer-related anxiety increases, performance on computer administered neuropsychological assessment measures tends to decrease. Key words: computers, anxiety, computer-based task performance, clinical neuropsychology, Category Test

Adolescent↗
PubMed1993

A computer-controlled ventilator weaning system. A clinical trial.

The purpose of this study was to determine if a computer-directed weaning system could wean patients with complex medical problems from mechanical ventilation and appropriately respond to signs of respiratory failure more effectively than traditional physician-directed weaning methods. In a prospective, randomized, controlled study, we tested the system in 15 patients who had required prolonged mechanical ventilation and met predetermined weaning tests. Patients were randomly assigned to one of two groups: (1) automatic, computer-directed weaning or (2) physician-controlled weaning. The computer-directed system decreased or increased the synchronized intermittent mandatory ventilation rate and pressure support (PS) based on predetermined limits of patient respiratory rate (RR) and tidal volume (TV). Pulse oximeter oxygen saturation was monitored, and alarms were triggered by an oxygen saturation of < 90 percent. In the physician control group, weaning progressed with SIMV rate and PS reduction, as judged appropriate by the physician. Nine patients were assigned to the computer group; six patients were assigned to the control group. The average patient age was 64.8 +/- 14.9 years for the computer group, 65.2 +/- 22.7 years for the control group. The average time on mechanical ventilation prior to weaning was 13.4 +/- 7.8 days for the computer group and 14.5 +/- 11.1 days for the control group. Seven of the nine computer group patients weaned within 48 h of the study, with an average time to wean of 18.7 +/- 5.9 h. All seven were breathing spontaneously 48 h after weaning. Two of the six control group patients weaned within 48 h of the study, with an average time of 25.6 +/- 5.6 h. Both patients who weaned were placed back on mechanical ventilation within 30 h. The number of arterial blood gas samples drawn during the study was 1.4 +/- 0.7 for the computer group, 7.2 +/- 4.3 for the control group. The number of minutes per hour outside acceptable limits of RR > 30, RR < 8, or TV < 5 ml/kg was 3.2 +/- 2.8 min for the computer group and 6.6 +/- 4.1 min for the control group. The study suggests that use of the computer-directed weaning system results in fewer arterial blood gas samples, shorter weaning times, and less time spent outside acceptable RR and TV parameters.

Aged↗
PubMed2005

Computed tomography in the assessment of periacetabular osteolysis.

BACKGROUND: Computed tomography recently has been proposed as an accurate method for diagnosing periacetabular osteolytic lesions. Several investigators have attempted to validate the accuracy of this technique, but they employed cadaveric and animal models, which cannot replicate the adaptive changes that occur over time in vivo. This study was performed to determine the accuracy of computed tomography in identifying and measuring periacetabular osteolytic lesions in hemipelves retrieved at autopsies of individuals with a previously well-functioning total hip prosthesis. METHODS: We evaluated nine hemipelves, retrieved at autopsy, that contained a cementless porous-coated acetabular component. The fresh specimens were examined with conventional radiographs and computed tomography and then were embedded and sectioned into 1.5-mm slices for evaluation with slab radiographs. Anteroposterior and iliac oblique plain radiographs as well as axial, coronal, and sagittal computed tomography scans were reviewed to determine the presence and location of any periacetabular osteolytic lesions. These results were then compared with those identified on the slab radiographs. Lesion volume was calculated from computed tomography scans with use of post-processing software. RESULTS: A total of twenty-three periacetabular osteolytic lesions were identified on the slab radiographs of the nine hemipelves. The plain radiographs identified twelve (52%) of the twenty-three lesions, and the computed tomography scans identified twenty (87%) of the twenty-three lesions. Three medial wall perforations were identified on the computed tomography scans but were not detected on the plain radiographs. Computed tomography was accurate in measuring the volume of the osteolytic lesions (r(2) = 0.997) but tended to overestimate the volumes measured on the slab radiographs. Periacetabular osteolytic lesions appeared on the computed tomography scans and slab radiographs as areas devoid of trabecular bone that were delineated by a sclerotic border and communicated with the joint space. CONCLUSIONS: In this autopsy model, computed tomography was an accurate method for detecting the location and measuring the volume of periacetabular osteolytic lesions.

Acetabulum↗